Healthspan/Kaiser in Ohio Need Doc Recomendations T1D

I just moved back to Ohio and my new insurance is Healthspan/Kaiser. I am concerned about the doc I was assigned to because she told me that I needed to be using long acting insulin along with short acting in my inulin pump. (I explained that the pump used Apidra for basal and she said Apidra could never be used as basal, pump or not.) Anyway, I am just looking for the name of any PCP or endo that understands T1D. I am just looking for the basics. RECOMMENDATIONS PLEASE! Thank you.

Check out John Walsh's website (the diabetes mall www.diabetesnet.com) He has some articles on pumping and maybe even getting his book that discusses that rapid acting insulin is used in pumps. Meanwhile (and I should have done this first) I'll look on his website to see if I can find something specific.

so let's see if I did this right
Why Use A Pump? Mon, 11/19/2012 - 11:49 -- Diabetesnet The use of insulin pumps has risen dramatically over the last 30 years to nearly a million people worldwide. The number of satisfied users continues to grow as pump technology and its benefits for control evolve. Enthusiastic pump wearers of all ages propel this growth when they share their experiences with others. They see their pump as a turning point in diabetes care, saying “For the first time in years, I can eat when I want to,” or “I can really control my blood sugars now and I feel better, too.” A Pump Really Helps Those Who: Want better control and more stable readings Need or desire a freer lifestyle Have an A1c over 7% Are very sensitive or very resistant to insulin Use less than 35 units a day Want to give insulin discreetly. Have problems with lows or are hypo unaware and can’t always tell when they are low Keep glucoses high because they fear lows Live alone Want to prevent long-term complications Experience insulin stacking Participate in intensive exercise Want to easily track data for optimal control Forget to take insulin Travel or do shift work Want peace of mind One enthusiastic pumper who started at age 70 says, “My insecurity is gone. My A1c said my control was good on injections, but I couldn’t avoid overnight lows and that created stress day after day. On my pump, I feel positive and really in charge of my body.” An 11 year-old boy was happy to “eat just like my friends if I count my carbs and cover them with boluses” and added “Going on hikes this year at diabetes camp was easy.” Pump benefits include fewer injections, the ability to give insulin easily for spontaneous events, with faster insulin adjustments for changes in eating, exercise, and activity. Unlike injections, a pump uses only a rapid-acting insulin. The large depot of long-acting insulin under the skin that is absorbed differently from day to day as temperature or activity changes is no longer needed. The infusion site stays in place for about three days rather than being injected into different locations with different absorption characteristics several times a day. Insulin stacking from previous boluses can be avoided for more consistent insulin activity. A pump offers convenience, more consistent insulin action from day to day, easier problem solving, easier tracking of insulin use, less hypoglycemia, less risk of hypoglycemia unawareness, and fewer morning highs. A built-in bolus calculator (BC) uses personalized settings to make bolus doses more accurate and glucoses more stable. In the background, important insulin dosing and glucose history gets recorded to solve control issues. An insulin pump may seem complicated, but wearers quickly become advocates when they can finally match their needs with the right amount of insulin at the right time. Powered by AAA, AA, or rechargeable batteries, pumps benefit people of all ages, from infants to those in their 80s and 90s. People on multiple injections who have to eat meals on a rigid schedule, require a snack every night before bed, wake up at 3 a.m. sweating profusely, return to consciousness in an emergency room, face high morning readings that ruin the rest of the day, or want to sleep late on the weekend, find that changing to a pump offers a new confidence and a freer lifestyle. - See more at: http://www.diabetesnet.com/diabetes-technology/insulin-pumps/why-use-a-pump#sthash.BZH8wGn8.dpuf

And if you go to the link, you'll find more of Walsh's info on how pumps work that you can show this Endo(rk)

I’ve been on a pump for 14 years and never heard of using long acting insulin with it. Why use a pump? I can’t help you with a doctor but I would question the one who told you that.

I probably should not have included the information about her telling me that I needed long acting insulin, I was only trying to show why I want another doctor. To be fair, this DOC told me that she was unfamiliar with pumps but I thought that the pump replacing long acting insulin was a no-brainer and it really worried me that she made it through med school but could not figure this out. Anyway, my only reason for posting that was so you understand-I am not looking for a great DOC, just one that knows the basics because this one scares me. I am hoping I made more sense this time. Thanks for the responses and I am hoping someone knows of a Healthspan DOC I can try. Thanks again.

I'm picturing Lantus in a pump. Waiting, waiting ...

I hate to admit my own stupidity but I did this accidentally once (thought it was apidra but it was my backup for pump breakdowns). Anyway, yes waiting while BS jumps into 500s and I kept correcting. The worst part was-12 hours later when U GUESSED IT, UH OH!!!...

My endo told me it didn’t matter if my A1c was 6.3 or 7.0. Didn’t matter if I averaged 150 or 190. This was from my endo. Comments?

I think I would also be looking 4a new endo. Did he say why? Never heard this b4. Healthspan?

I don’t know if he was having a bad day or what. My wife was with me and she couldn’t believe,it either. My PCP said he would be glad to take over my diabetes and that is probably the route I will go for now.

Wow I knew and understood full well that pumps only use rapid acting insulin within a few hours of being diagnosed. Clearly that doctor is not a person who should be advising you on diabetes issues

I think after all these years I know what I need but she started questioning whether I needed scripts (ok new insurance and HMO I was expecting that) but then the last question made me think I am in serious trouble and better find a doc that knows what they r doing. Hoping 2 find 1 soon. :slight_smile:

Agree!

Well, I suppose you could take long acting insulin injections and then just bolus with the pump. One of the advantages of the pump is only dealing with one insulin.

This doc's ignorance of basic pump therapy would be a red flag to me, too.

I used to expect my diabetes doctors to know more than me about all aspects of diabetes. I now realize that living with diabetes for so long provides an education that doctors do not get. I don't expect any dosing, correcting, or insulin adjusting advice from my doctor.

at first,I'd get a doc who can give you the basics, like appropriate prescriptions and get the heck out of your way. You seem smart enough to know what you're doing. Diabetes is largely or mostly self-manageable. Doctors give us the tools, like an auto parts supply store, and we do the work.

And then I'd get an endo who's with it.

Neither do I. At this point, I am just happy when they sign scripts but if they are both ignorant arguing about neccesity of dme and scrpts, I need 2 find another.

MY THOUGHTS EXACTLY!