I got a new endocrine M.D. On the last visit she requested weekly pump downloads. This is the first since the diagnosis 12 years ago. I had docs who did not showed any interest in pump data, bu this is the other extreme.
Please share your experience.
My endo only checks my pump info when I come in every 3 months. She only downloads the last 2 weeks of info off the pump to review. When I first started going to her she had me come in every month for a while.
Anytime I feel like I have a issue. The data is online and they can look at it anytime I upload my pump every Monday morning. I see my Endo every 6 months but when I first started pumping it was 1 month then 3 months for a couple of years .
Thank you for the input.
I was not sure If I am not cooperative enough frowning upon this request.
I think it should be reviewed
- on the visit
- if problems, needs for setting adjustments etc
my endo downloads my pump with me at every three month visit. as far as tweeking is concerned, i use my best judgement and if all else fails i call him on the phone. he is amazing and will call you right bk even if it is a holiday or 3 in the morning. i am very very lucky. i have been with him for 25 years and highly recommend him to all my D friends.if you know anyone in the NYC area, i'd be glad to hook you up!
I think the new thing these days seems to be that the Endo will see you every 3 months but you keep in touch more frequently with the Diabetes Educator in that office to go over any blood sugar/insulin tweaking that needs to be done.
I upload my pump data before any phone or in-person appointments I have with my diabetes educator and am thankful that someone cares enough to want to study the data to find any trends they see that they can help fix.
Based on how your control is, the appointments with the diabetes educator can be every few weeks/1x a month, etc. It may be more frequent if they feel the need to monitor you more closely.
My endo has never asked for a download.
Wow! R U happy with the care you are receiving?
I had to change provider 2 years ago 2/2 move. The new provider attempted to monitor my T1 on pump with A1C. ...I changed provider.
I know about one T1 with A1C of 7.1 but if you look at actual blood glucose levels, he has every day extremes like 30-300'. In case like this A1C has not much value as a prognostic factor.
My endo does request print outs when I come in for a visit, and she has access to my account (Carelink via MM). She has used this access when I've had issues between appointments, mostly to troubleshoot basal rates. She also reviews my basal rates between appointments and helps me figure out if there are any issues with those. I mostly don't need her assistance, but like to have someone else look over things in case there is something I miss. Honestly, I would feel like I was getting NOTHING from an endo who didn't request and look at this information.
I sort of think that an offer to check weekly is an improvement over what we usually get. With weekly, I would think it would greatly enhance the chances of having the doc know what's going on. If it's a new doc, perhaps she wants to get to know you and your diabetes, how you approach it, do you make lots of changes on your own, etc., etc. My doc gets the upload before visits and we discuss it. Similarly,
I'm not 100% sure who on her staff is a "nurse" and who's a CDE and if the "nurse" who does email is, in fact, a CDE or a regular nurse (maybe a better nurse than a CDE? I don't actually know anything about nurse "rank" at all...). I could ask but I'm not a big question asker. The one time I had an issue, by the time they got back to me with their recommendation for a change, I was like "oh, I did that yesterday..." I could care less about the big brother implications of sharing diabetes data. It would be unintelligible to just about anybody but you guys.
I would find that a very positive thing if I were having a problem and had asked for some assistance in figuring it out. For routine maintenance, I'd find it absurd. But then I don't have an endo. (or want one - though like anything, that could change at some point)
Thanks for sharing your view. I was not sure if I am unreasonable looking at this idea as annoying and absurd.
I think weekly is helpful if there is a problem, issue needs attention etc. But for maintenance T1 takes already a big part of my time: checking, testing, etc.
A lot of my complaints about doctors/ medical providers are that they make conclusions (e.g. "your BG is too ______") without a really close engagement with the stream of numbers we're all swimming in. If a doc can look at some numbers and come up with a good suggestion, I would be all for it. I'm also horrible at reporting data though so I do a lot of fudging, over and under bolusing, using basal adjustments to cover things, etc. I dunno if everybody does this or not but it would be almost impossible for me to log it as, when I start thinking about it, I start thinking about fiddling with stuff, making little adjustments, etc. I could see it would be very hard for a doc to keep up?
Endo likes a copy of the past month or two glucose meter logs, last month of pump logs and past 2 months of CGMS data.. CGMS optional.. thats how he rolls
I'm also horrible at reporting data though so I do a lot of fudging, over and under bolusing, using basal adjustments to cover things, etc. I dunno if everybody does this or not but it would be almost impossible for me to log it as, when I start thinking about it, I start thinking about fiddling with stuff, making little adjustments, etc. I could see it would be very hard for a doc to keep up? : You and I are SO alike, acid. same here. My endo takes whatever data I give him. I usually supply him with the pump data for the last 4 weeks at every three months appointment; more often if the CDE asks for it, but that has not happened in a couple of years. This year with the stress of all the travel, back and forth to Ga when my father was dying, and the up and down emotions being mirrored in my bloood glucoses, I did not download as often. Needdless to say I had elevated blood glucoses for two A1c periods this year. However, My endo was understandng and said it was to be expected. For the past couple of months,I have dowloaded more often for my own perusal to make changes, and it has helped. Neither the CDE, nor the endo has not asked to see it and it is just as well. Things seem to be moving towards a more "ok" flatter-line level. I can take care of my generally hypo excursions 'til I get this basal/exercise mess straightened out...
God bless,
Brunetta
My endo occasionally downloads pump, maybe 1/year. Sometimes asks questions. Almost always download BG meter, loves to circle the lows !. But we don't really discuss detailed, day to day (hour by hour)logs or adjustments that I do, just general update on how things are going, and if there are any specific things I want to discuss.
I was on the pump for many years before going to my current endo, and I usually don't consult with them for changes. But I think for those new to pump, or seeking help from their endo/health care team, it's a great thing to do. But there can also be a tendency to focus more on the numbers, and less on the PERSON. Each person is different and needs to find what works best for them.
For those with Minimed, some doctors can use a different version of software, not Carelink, which provides additional reports. One time my endo printed out a 'compliance' report, showing how often certain things were done, such as rewind/prime.
I think it's important to remember who we're accumulating data for! I hate the word compliance!
Especially about rewinding the pump, you rewind it when it runs out? Although I was suprised to read about people using the "prime" function to bolus insulin without getting it "on board" which I had never thought of.
I agree that there's sort of a patronizing element to it. On the other hand, I think that my doctors are smart and, if they had better data, they could probably kick my numbers up (or down?) another notch. I'm not really engaged with my doctors, as they look at the numbers for things to talk about like "what's up with this [string of odd numbers...]" to which I can just sort of brush them off "oh, the CGM was off" or "I exercised more that day" or whatever. I'd maybe ask the doc what they were looking for but, the way it works out, you talk to the receptionist to make the appointment and they will likely be either clueless or sworn to secrecy about the doctor's plans or simply say "I'm just the receptionist...you have to ask the doctor." I'd interpret a doctor's desire for more data positively unless there was a problem with their interpretation of it. I don't usually go to doctors unless I like them, even specialists.