New endo

I got a referral to a new endocrinologist because I moved across the city. It's kind of crazy, but this is only the third endocrinologist I've had in 21 years of diabetes! Maybe he will be able to help me make sense of things ... The endo I originally got referred to (on the recommendation of Nel here on TuDiabetes) was not taking new patients, so I got referred to another one. I have to call today and make an appointment.

Hopefully he can help me get my numbers where I want them. I am looking so forward to having a fresh perspective! My numbers drive me crazy. The fact that I have to change my pump settings SOOOO drastically sometimes drives me crazy. I keep my schedule/food/activity nearly identical and still have such drastic changes.

I was using a ratio of 1:12 and ISF of 2.4 and a basal rate of about 22u a week ago and still having lows almost daily. Then I started going crazy high constantly like no numbers below 11-12 and spikes to 15-19 after meals and even waking up in the morning at 16-18 ... So I put everything up until I am now taking a ratio of 1:8, ISF 1.6, basal of 29u, still having problems with highs if I eat anything with carbohydrates ...

Then yesterday after dinner I was suddenly 2.8 (with 2.5u IOB!), so treated that and so on, went to bed with a blood sugar of 7.6. Woke up at 3:00 (had set alarm, knowing "The Drop" was probably starting) and was 13.5! Don't know if it was a rebound or what, don't think I over-treated ... Corrected that, this morning I was 7.6, bolused for breakfast. Now after breakfast I am 2.6! Looks like I'll start cutting back drastically later today ...

My old endo seemed to have no idea what to do with me. He could never give me any advice other than just keep doing what I'm doing. He seemed satisfied if I could keep 50% of my readings in range and said my A1c for the past 1.5 years of 7.3-7.6 was perfect for me. Maybe he wasn't really satisfied, he just didn't know what else to do, but it made me feel like going to see him was pointless. I would like someone who is actually interested in getting into problem solving and helping me make the few days I sometimes get where I can actually stay between 4-10 last a majority of the time instead of just a few random days here and there.

Also, I got an A1c done again as part of the bloodwork the new endo wanted, even though I'd just gotten an A1c done a month ago. A month ago it was 7.5%, and now it's 7.3%. I know it may not even be a real drop, but it still made me happy.

Hi Jen, i hope you like your new endo, it sounds like you could use some fresh ideas sometimes that helps. i know you have said before how much your hormones play into things. jacob recently switched endos and we couldnt be happier she is the wisest, kindest doctor i have ever met, obviously compassion is really important to me, esp when dealing with pediatrics! in any case your aic's made me go hmmmmm obviously i do not have diabetes my son does... and dont take this the wrong way but i hope having an aic go down .2 points is not the happiest thing for you or what motivates you the most with your daily diabetes management struggle. we all want that number to the the best it can, but dont be to focused on the numbers. i hope you find balance, and peace, and the best endo team you can! best of luck! amy

My A1C went down .2 and I was like "w00t". Not an end in itself but a step in the right direction? I'm always happy about a move in the right direction for me. It sounds like crazy inconsistency you are dealing with and I haven't run into that, although the last 6 months or so I've been fighting DP a lot. I hope the new doc can help make some positive change, maybe figure out some different patterns or something?

I wouldn’t want anyone to think that my A1c is the most happy thing for me. Diabetes doesn’t play a very big role in my overall happiness, actually, unless blood sugar fluctuations are making me cranky (and I do notice I post most of my rants when my blood sugars are all off-kilter …). And, of course, occasionally wondering about complications, which is why any decrease in A1c makes me happy. If my A1c goes down another 0.2% then it will be 7.1%, and it hasn’t been that low in years! I am really hoping this new endocrinologist has some new insights or strategies that might help me get more consistent control.

Every single test pretty much I'm looking to "beat it", with a good number or, if it's not good, to do a good job fixing it. I know you do that too but even a small progress in an improved direction would make me think I'd keep thinking about it the sme way and just do more. Sort of the "buying insulin in the parking lot at the Grateful Dead concert" paradigm? Which is, unfortunately, dangerous as, sooner or later, I run into the 2.8, etc. numbers.

Jen you are in STl right? Who is your new Endo if i could ask?

Jen, do these sudden changes in insulin needs and sensitivities have anything to do with your "monthlies"? I know that when my red geraniums still bloomed, I had a lowering of insulin senstivity right before it started, then normal levelss returned after it was over a ,5-7 days later.
Was just watching dr. Oz today. It was about perimenooausal women who had hormone fluctuating induced rages and what they felt to be out of control emotions and were perplexed at what to do about it. He said that it was all due to the bodies hormone levels waffling at this time; affecting the brains ability to handle normally small stressors. a It was also said that this is common in younger women,though not to the same degree (irritation instead of rsge );who have experienced premenstral syndrome as well. Maybe your prickly emotions are due to the hormones shifts, which also causes higher blood sugars??The female gynecologist on Dr. Oz noted that low-level birth control could help in such cases. I did not take bc pills for long, the kids thry had been prescribed for me then tended to push up my sugars, a LOT more than the hormones changes. I was on MDI aand did not want to fiddle with the somewhat variable control I had . I did someadjustments the days before, just slightly lowering the sensitivity and carb ratios . I was on MDI, and I think I left the once a day lantus as is for that time of month.. I knew not to expect perfect numbers during that time.. I also had some enodmetriosis , so it was not a fun first few days at all. But I struggled through when I was younger. Perimenopause was a bear, One of the advantages of being older is that I no longer have to deal with all that!!. If you do not already have one, get a female gyno, perhaps one who can work with your new endo. and do not stress. Everything will work out, Jen

God bless,

Ps. Are you teaching now? How is the new school year going?