Is it wrong to think your educator is nuts

Last week I meet with my second Diabetes Educator and really had no problem till she went over my Blood Sugars. OK one 43, maybe one or 2 high 50s, three in the 60s a hand full of 75 to 85 but mostly in the 100-135 range. She told me I was running to low. Of course I’m thinking wait I am catching my lows and only went over 180 like three times. From what I have read to me it looked like my numbers fell into a decent normal range, but she insisted I had to be feeling shaky if I when I was in the 90-80 range even though I told her I start to feel it around 70-75. She was sure that since I went into the hospital at 500 that I should feel low anytime I was under the 120 range.

oh most of the lower numbers 70-80 range have been overnight at work, when I am pushing 1000+ LBS cans of freight at work I also test at least 2 times at work and have a snack half way through my shift to make sure I stay in a safe range. If I even feel low I do extra test and wont drive any equipment if below 85 at work.

Yup. She’s crazy. Those numbers are perfectly normal.

While it is true that when we spend extended time really high, our body ends up getting used to those numbers as if they were normal, and thus it makes normal numbers seem like they are low, this does not make those numbers to be lows. 80s and 90s are ideal target range numbers and every Diabetic should be lucky to have them. lol

Honestly, I hate Diabetes Educators, Nutritionists, Dietitians, and any of those useless professions… (yes, yes, how offensive, woe is me.)

I have learned MORE from access to information, the internet, forums, and actual Diabetics, than so called professionals who don’t live with this, and don’t have to worry about the consequences.

I was talking about the 80s, and 90s, which he was questioning her on… not the actual, real lows.

LOL I know I’ve seen various ranges online but 70-80 seems to be the standard for low.

Even 70 is normal.

No but she was saying being in the 80-90 range is to low, Below 80 seems to be when I start feeling slightly off. Most of the Lows have been from morning or afternoon chaos(feeding kids, getting ready for school, getting kids ready to leave for the sitter, People delaying cause they fail to realize when I say I need to eat soon that I need to eat soon).

IMHO the medical field as a whole seem to be reciting the “party line” when they stress over occasional lows. If one wanted to be cynical you could say they are afraid of malpractice. A bit less cynical is the view that lows actually can be an immediate medical crisis, while highs are risks for complications in the long term. And who ever said our medical field is not overly focused on medical crises (costs plus the whole principal of fire fighting rather than looking at prevention and long term big pictures). I agree with DWQ that there is no need for concern over 70 and I only treat under 60. As for the comment about “feeling low at 120 when you’ve been high so long” that is correct but I don’t recall how long ago you were diagnosed and that feeling disappears as you get used to more normal numbers. Also, as DWQ said, it isn’t low (and a need for concern) just because you feel that way, but only if its actually hypo numbers.

I don’t know what period of time she was looking at but a handful of actual lows to me is to be expected as are a handful of highs. I strive to catch and treat both and only get concerned when I see a pattern and then I wiggle my doses accordingly.

I agree as usual with DWQ formerly known as Lizmari. Your numbers are good. And you will learn with time that you do in fact know better than your diabetic educator. I find it offensive that you told her you felt low at 70 and she insisted you must be feeling low at 90. I don’t care for people who try to inform me how I feel when I state differently. I’m an educator (not a diabetic educator) and I know that part of teaching is listening. I ask my students a lot what is their personal experience as related to the subject matter to make it relevant. Your diabetic educator doesn’t sound like she listens too well.

She also insisted I needed straight long hours of sleep, something that with being third shift with small children and going to school doesn’t happen. I get 8 hours a day but in 3-4 stints.

I agree she is nuts also, so if you are wrong, so am I! I agree with Lizmari that 80s & 90s are ideal target numbers. Everyone flipped out because I put 85 plus or minute 10 points as the target in my pump. Like Zoe said, I also hate when someone proceeds to tell me how I feel. I had a doctor do that to me last year and that was the last time I saw that doctor.

The red flag for me, is she is insisting on telling you how YOU feel at certain levels. I am guessing that she is worried you might become low more frequently. If she can’t understand you and you don’t feel comfortable with her, switch to someone else if you are able too. It’s easy to break from her now and find someone who will advocate for you and support you. I have learned that the HARD way. Trust your instinct.

Not nuts but overly cautious with the lows and overly generous with the “normal” range. Looks to my like you’ve got pretty good average numbers. A 43 and some high 50s and three 60s over what period of time? In a month, maybe something to pay closer attention to. Over three months, not, IMHO.

My experience is that CDEs and many health professionals like to give a large margin of error, which is why they say 80-140 is okay for a diabetic. They totally freak at lows, which to my doctor is anything under 60. Her focus ( and my CDE’s, too) is to eliminate lows before worrying about highs, because lows are life threatening.

But don’t let your CDE tell you when you should start feeling a ‘low’. If i’ve been high for awhile, I’ll feel low when I’m in the 80s. That’s not low. When I’ve been in a good range for awhile, I might not feel a low until I’m in the 50s. Your one time high of 500 is not going to govern when you feel a low for the rest of your life - it’s all context, baby.

Keep on keeping on.

Terry

Right on, Zoe. Well said.

LewisJ1474, it sounds like you’re in command of your situation and your Diabetes Educator sounds very arbitrary. Are you carrying some of those glucose tablets to tide you over when you DO start to feel low? One of my Type-1 friends, who goes hypo often, carries a small squeeze-able tube of cake icing sold at the grocery. Works quickly for her.

I think it sounds like you are doing extremely well. If you are hanging in the 100-135 range you’re great. and I honestly wouldn’t be too worried about the 75-85 range either. There a couple of schools of thoughts on this – but I really don’t get concerned unless I start to drop under 70. Moreover, you are so new to regulating yourself having been recently diagnosed so I think this is downright remarkable. I went through 2 educators before finding the one I have now who I love. She is the first one that really that really seemed on the ball. The others often left me scratching my head. When you get a good one, you’ll know it. But to answer your question – no it’s not wrong and in fact she sure sounds nuts to me.

Uninterrupted sleep is the most rejuvenating, but you can only do what you can do. I always say I have so much respect for all of you who integrate diabetes management into your busy lives, because retired and living alone I find it takes up a lot of my time. All it takes is a long phonecall with a friend and I find I’ve missed a testing time!

A month but my first month. My family members tend to be very brittle. Most of the lows seems to come from over working or stress

Well, I’m no real fan of what is taught by CDE’s but let me just suggest that it is always good to be a little cautious when it comes to hypos. You were only diagnosed at the end of august. Many newly diagnosed T1s will be given fixed doses, monitored on a very close basis and any reading below 100 is considered too low. It is more typical to consider a newly diagnosed in their first couple months to be doing great if they can just say they were "mostly under 200 mg/dl."



Now, that being said, I do think that in the long term, you want to go for tight control. But for some, a 43 could be an ambulance trip. You are still learning all the ropes, the greatest fear that your CDE has is that you will have a bad hypo. I do thank that CDEs are often nuts, particularly with diet, but in this case, it may be prudent to try to target a control that avoids potentially harsh lows as you gain more expertise in tightly managing your blood sugar.



ps. You must understand, you are doing far better than most newly diagnosed T1s.

Glucose tabs for real lows. Keep honey roasted nuts for when I know I’m getting low but not hypo. Cliff bars and cashews for if I know lunch is going to be missed, 50 carbs http://www.clifbar.com/food/products_clif_bar/

I wouldn’t call her nuts. But, you are the one who is trying to control your diabetes so you get to decide what parameters work for you.



My pump trainer is a very sweet and helpful lady who, so far, has gone out of her way to make sure I have everything I need. Still, the first thing I did after she programmed my pump was to change all of her conservative settings to more aggressive settings. When she did her follow-up, she wasn’t happy that I changed anything but she shrugged it off and we moved on. She still left some extra supplies for me, still told me to call her if I needed anything, and still seemed like a very sweet and helpful lady.

Well said.