Miscommunication about when to test?

Good for YOU!! Firstly that's a crappy endo to tell you not to test after meals. What if you ate a huge pasta dinner and were starting to go high? Or like you said you didn't eat enough and were low. On the weekend I thought I had enough insulin for my food - ends up I was crashing and quick. So I ate something for the low before it got too serious. Wouldn't have known if I hadn't have tested.
So glad you have another Endo. With the new one ask him/her some questions before you start giving them you history. Ask what they would recommend for a T1 in regards to testing. If you like their answer then give them your info, if you don't leave and find another one. It can be tough if you live in a smaller city like I do - we only have one endo. Another is a 4 hour drive away. :( Thank goodness he's good and likes my testing schedule.

So the resident still doesn't fully "get it", but at least you now know the whole story. And since you're "honeymooning big time", that's all the more reason to stay on top of things.

A BG of 90 two hours post-meal would be a dream-come-true for me. But only if it meant I was also 90 three- and four- hours post. Unfortunately, even the most rapid of rapid-acting insulins have some efficacy left after 4 or 5 hours.

I'm looking forward to your update in May (you WILL update us, right?)

Whoops, sorry Shawnmarie, I lost track of your details. Yeah, that does make it more complicated. Whenever people on here talk about ways to "preserve beta cells for longer" I sometimes wonder if that is a great idea because it makes it harder to manage! As for exercising, I think everyone seems to have trouble with that. It's my "good" excuse for not exercising! But hopefully that will get easier with time as well.

Everything you say makes it more and more obvious how wrong that person was to tell you not to test after meals!!

Yeah, that strikes me as a bit odd as well; maybe there's more to the story, such as she is pre-diabetes, has multiple risk factors, etc. I like the idea of a professional who would test and/or wear a pump or CGM to increase their understanding, but testing multiple times a day??

Is she out of pocket or is she stealing the samples she's supposed to be hooking her patients up with? I'd avoided tapping that until recently when the Rx service achieved astonishingly low levels of customer service and my doc hooked me up, which I was pleased with. I hope your doc pays for her stuff...

Sorry, but, LOL, are you kidding me? Give me a freaking break- if we want to test ourselves every hour of the day and we pay for the test strips, then don't be concerned about it. That's what I feel like sayin' to them.

It's pretty funny that the same thing was said to you as was said to me. And I read the responses below that affirm we are all hearing the same thing.

I would also prefer to know what's up before I crash and burn, so to speak- it's almost worse to have HYPOglycemia than it is to have HYPERglycemia.

All babbling aside, thank you. Seriously. I've been feeling like some sort of bad person lately for not wanting to go back to the endo that I've only seen once, since his PA told me I was micromanaging and will "burnout" with the number of tests I do in a day. FYI, I am going to write a letter to them as well- not scathing, not evil, not rude, not with the goal of getting someone fired- but a letter to let that office know that showing compassion and care for their patients instead of berating them for taking care of themselves would really make a big difference.

It's my finger, and I'll puncture it if I want to!

Good for you! They've already proven that A1C is not the biggest determining factor regarding how long you live when you have T1. So it makes sense to monitor the numbers. A1C is not the end all beat all, and I'm sure as heck not relying on it 100%.

In fact, here's an article talking about how having high glucose variability influences your HbA1C.


More so at levels greater than 7, but obviously it's important.

I also thought this article was helpful too while I was looking:


Almost seems appropriate to forward these articles to the people who say we test too much.

OK, sorry. I'm on a roll tonight. I found this too, from the AACE:

3.Q8. When and How Should Glucose Monitoring Be
• R33. A1C should be measured at least twice yearly in all patients with DM and at least 4 times yearly in patients not at target (Grade D; BEL 4).
• R34. SMBG should be performed by all patients using insulin (minimum of twice daily and ideally at least before any injection of insulin) (Grade D; BEL 4). More frequent SMBG after meals or in the middle of the night may be required for insulin-taking patients with frequent hypoglycemia, patients not at A1C targets, or those with symptoms (Grade D; BEL 4). Patients not requiring insulin therapy may benefit from SMBG, especially to provide feedback about the effects of their lifestyle and pharmacologic therapy; testing frequency must be personalized (Grade D; BEL 4). Although still early in its development, continuous glucose monitoring (CGM) can be useful for many patients to improve A1C levels and reduce hypoglycemia (Grade D; BEL 4).

Do you have access to the articles because you are interested in diabetes or because you are a scientist yourself? Just curious? I look at the precis on the pages and am like "interesting..." but haven't ever "bought" access to them.

I don't like "testing frequency must be personalized" as that implies that testing frequency is "fixed" and, of course, determined by a doctor, which is how insurance companies prefer it-- "your doc said you can have _____ test strips" whereas it's my foot on the gas pedal of my pump and I should be testing whenever the heck I want to or need to, unless I am clearly evinced to have some sort of OCD situation and am testing every 5 minutes or something ridiculous?

I think many of us who have been doing this for awhile would disagree with this, "official source" notwithstanding. "More frequent SMBG after meals or in the middle of the night..." are required not only for the reasons they state. Aside from catching lows, it's also very important to catch and correct highs. The longer you spend at high numbers the more likely you will develop complications. Then there are all the times you are low or high and need to re-check to see if your corrections have worked.

I felt like it meant that doctors need to be flexible in their recommendations, and not fit everyone into a box, but I see what you are saying too…

It was free for me, probably because I was at school at the time?? But, I thought they said they were free access anyway. If you want to read them, let me know and I could email them to you pretty easily.

I haven't the foggiest whether or not she pays for the stuff she uses or if it comes out of the office. I didn't really think about that until it was brought up here. Also didn't ask about pre-diabetes or anything like that. I kinda just took it as this was her field of work and an interest of hers so that got her to do the testing on herself. I agree with Shawnmarie, before I found out I was T1 testing my blood glucose wasn't even a background thought in my mind. Then again, I may think differently if I was faced with it everyday at work.

I totally agree... :( I hope the new endo goes better. Unfortunately I don't think I'll be able to find another one until I move in a few years.