The solution is pretty clear.
The current one don’t look at the data.
He just wants the Dexcom reports and he wants 0 BG below 80.
So, I set the alarm, knowing that it will reliably go off 20 points above 80.
When I hear an alarm, I check manual BG, get a perfect BG, shut off the phone, and ignore it until I feel like turning it back on again.
Voila. He’s not bothered by pesky data analysis. I’m not bothered by him.
No wasted time or energy. I retire from diabetes.
Why in the world would he say no glucose levels below 80? Sometimes I am glad that I have already had this illness for 60 yrs and have never had to listen to this nonsense.
You do realize the Dexcom transmitter remembers data for up to 3 hours even when turned off? I turn it off because it annoys me sometimes, but the data is still there.
It is more likely to smooth out the numbers more if turned off I noticed. So if you have one or two points low it might not register them. But if you have a few numbers low it will pick it up when you turn it back on. How many it smooths out I’m not sure.
Even a gluco-normal would stumble on this dictate. He’s got the right idea but why the drama? Serious and clinically significant hypoglycemia starts at 54 mg/dL or 3 mmol/L and falling. Putting a lid on that level is what’s really important. He’s sweating the small stuff.
Well, I guess it was the nurse who asked if I had any numbers below 80 this week.
I need some funny, shocking come backs - some good one liners. You guys gotta help me think of some. This is a joke to me now.
I think they boss me because I have a baby face. I need to say something back that really makes them think twice about that. I’m gonna stand up and just throw a chair across the reception room. Then, I’ll say my blood sugar must have drpped below 80. Sorry.
I’ll give 'em something to write about in that medical record.
What if I told him that I think I’m in love with him, and every time I think about scheduling an appointment, I faint. I’ll tell him that I bought some kinda remedy online and since I’ve started taking it my insulin doesn’t work. He can spend the appointment chewing on that.
I’ll tell him that I need a whole bunch of Rx for syringes because my neighbors kept borrowing them and they didn’t always return them promptly.
What do you think they would do if I smoked a cigarette in the exam room and then denied it. What if I lit it up right in front of them? What do you think they would do? Would they tackle me? It might be worth $350 in co-payment to find out.
Just curious, what data is he not looking at? Aren’t the DexCom reports the data? Have you ever asked him why he is so adamant about not being below 80. I wonder if it somehow has something to do with the A1c. If you had an average blood sugar of 80, your hemoglobin A1c would be 4.4% which is well below normal reference range for even non-diabetics. Maybe that’s where he is getting the 80 thing…
"Majoring in the minor’s " comes to mind. My endocrinologist told me they have found complications with an a1c higher than 7, however, most findings advocating a1c s lower than 7 are counterintuitive…its not golf…or the lowest hba1c game is great until everyone starts dying from hypoglycemia unawareness…
I think they don’t care about A1c anymore. I’ve been diabetic for 27 years and have never passed out from low BG - not once. I think its a bad fit for me to have a super risk averse endo because his thoughts get into my head and I start to get scared to do normal things. It affects me. I forget that I have a lifetime of experience doing things. He’s probably ultra nervous because I’m using a system that he is unfamiliar with. I suppose that’s a large part of it.
I’ve honestly been afraid to ski. I’ve been skiing since I was a child with diabetes. I was a ski patrol at an expert level mountain where they don’t even allow most people to ski. I’ve climbed up that mountain with skis on (note: the first time I climbed up a hill in my 20’s, it was a close call, but I’ve done that many, many times since then and I know the drill. I know how to do that with diabetes. That’s also what taught me why diabetics aren’t allowed in the army, lol.) I’ve had to pull people down the mountain, with or without low BG. I’ve had to climb up the hill with skis on, and then pull people down when they were dying. You gotta do that stuff with or without low BG. Its just gotta happen. You just do it.
I skied a baby hill yesterday. My dad told me I was being ridiculous not to. He was right. This was ridiculousness. I don’t like having to prove myself again and again. My resume really speaks for itself. I can’t let these guys make me afraid.
Hi Roger, I have had a non diabetic A1c for almost 20 yrs. I was under 7 for years and during that time I was still getting all kinds of problems with my hands including trigger fingers and dupuytren’s. When I got my A1c numbers down to 4.6 to 5.4 all of those problems just disappeared. I wonder if a lower Alc enables the body to heal.
I was dx in 1959 and I am still very aware of when my glucose levels are falling.
I think the body heals very slowly over time, and activities and exercises help to repair it. An a1c of 4 is 68 mg/DL…for me, a glucose level of 68-97 mg/dl is too low…I usually walk 5-8 miles at work(a surprise because my watch tells me, and the only reason I had the watch was for the xdrip watchface telling me my glucose numbers and how many mg/DL it was changing). I wouldn’t be surprised if you were able to be more active, bringing your hba1c down, and making you feel better… you might think it was the lower a1c, but I suspect it was the increased activity
The fact that you haven’t passed out is excellent, however, I have a type 1 coworker who also never passed out, has problems with his feet, and has had plans to see his doctor next week for 3 years…not saying you are in that category, but the system you are using that he is unfamiliar with is why…my favorite nurse practitioner was not a type 1, however, she wore different pumps and Cgms and knew a lot more about them because she was brave enough to use and understand them. I went snowboarding a couple years ago and was surprised that my glucose was steady one day, then all over the next, but as long as you have the Cgm, I think you’ll be fine. Also I recently showed my endocrinologist xdrip and the miaomiao2 and he was very interested… some are not and I usually switch if they won’t listen
I think it is great that you walk to work and get all of that exercise! Good for you!
I only started riding my exercise bike 10 miles a day most days about 2 yrs ago. In fact I had chronic fatigue syndrome for 5 yrs before that and spent a great deal of time off my feet. Exercise had nothing to do with my hands healing. I am positive it was my non diabetic A1c.
Just wanted to clarify… I don’t walk to work, but when I’m at work, my step counter usually ends at 8 miles…also the goal of an a1c <7 for type 1 diabetics starting in 2015 had a lot to do with all the type 1s dying trying to reach the a1c 5 or 6 goal…keep in mind even with the relaxed goal of the a1c of 7, 30% of type 1s actually are below 7…I just think trying to reach normal levels can be dangerous and counterintuitive…
While A1C and blood glucose targets are needed, the ADA emphasizes that glycemic targets should be individualized with the goal of achieving the best possible control while minimizing the risk of severe hyperglycemia and hypoglycemia (Table 7). Goals should be individualized based on duration of diabetes, age/life expectancy, comorbid conditions, known CVD or advanced microvascular complications, hypoglycemia unawareness, and individual patient considerations. More or less stringent glycemic goals may be appropriate for individual patients. Postprandial glucose may be targeted if A1C goals are not met despite reaching preprandial glucose goals.
I think trying to have the lowest possible or “normal” a1c is majoring in the minors and can be very dangerous for the 70% of type 1 diabetics who have their hba1c >=7. There are no studies proving an a1c<7 creates significantly less complications, which is why the general goal is individualized and focuses more on the 70% who are way over 7…I know when I’m snowboarding, swimming, diving, walking the dogs, etc. If I start at 120 mg/DL I’ll have to eat something or I’ll be at 68 or lower when I’m done…and eventually, by going that low every day you will have a lower a1c and hypoglycemic unawareness… its just not worth dying for a lower than 7 hba1c… you might not agree with the accord study, but that’s not the point. If you start your 10 mile bike ride at 97 mg/DL you’ll most likely end in the 50s…you might be fine at 50mg/DL but many others are waking up with the EMTs and an iv of glucose…just hypoglycemic common sense
Hmmm, why would you think that I am not extremely careful about glucose levels? I have lived with this disease for 61 yrs and have needed help with a low glucose level only a handful of times. I have never been hospitalized for anything related to my diabetes.
You have your opinions and I have mine and that is fine. I may not agree with your assumptions but that is ok.
