Back on the OT…
As someone diagnosed back in the dark ages, 1983, there was a long (far too long) period for me when I did have to scrupulously avoid scheduling meetings that interfered with my eating exactly on time. Also known as the good old mixed-R/NPH routine. Not only were the peaks relatively unpredictable day to day, but there could be abrupt drops when the effect curves overlapped. For me, this was absolutely a work requirement, because when that mealtime drop kicked in it could get severe in a big hurry and those R/NPH hypos were nastier than any I’ve experienced since. Which was effectively a form of behavioral conditioning I still experience to some extent. I did not screw around with mealtimes on that stuff and I decidedly did regard this as a necessary accommodation in my work environments. Fortunately that was never an issue with my employers, who I kept informed about the issue. And if I went back on R/N (God forbid!), I’d have to make it a condition again.
But that’s part of what makes this whole discussion so strange to me. After 20 years on what I half-jokingly (but only half!) refer to as the Eat Now Or Die regimen, getting moved to basal-bolus MDI was like being let out of prison. And in fact, my strongest memory of that transition, now 16 years ago, is workplace related: it was a specific day, the first week on the new regimen, and I decided just as an experiment, to see what would happen if I didn’t eat right at noon. I was sitting at my desk, watching the clock tick past 12, 12:30, 1pm and beyond, and it felt like those old cartoons where Coyote runs off a cliff but he’s still hanging in the air, spinning his legs, only for me the gravity wasn’t kicking in. The fear of those midday lows was so drilled into me after twenty years that the moment was practically miraculous. I had to close the door to my office because it literally brought me to tears. That was ten years before going on a pump, which I know some people experience as a liberation from MDI, but for me it’s an incremental improvement compared to the feeling of freedom when I finally got off R/N.
I realize this is all just my very subjective take on things, but I guess the point is that it disturbs me that with a pump–let alone MDI–you seem to feel as straightjacketed by your medication as a lot of us did back when. It’s not that it’s a bad idea to be regular–I generally keep to a pretty regular schedule myself, partly because of my old conditioning, but partly just because it keeps things simple, and for a similar mix of reasons I too choose to eat low carb. The less insulin you take, the easier it is to deal with. But it’s a choice for me now. I can’t stress enough that there’s a huge difference between doing it because it’s convenient and being forced into it by absolute necessity. I have to wonder if your endo team are maybe steeped in those older ideas (and that would not be all that unusual) if that’s how they’re conveying it to you. Because it saddens me to think you’re not really getting the benefit of these newer treatments, unnecessarily locking yourself into the straightjacket they were designed to liberate us from.