Printing out the info

I have an appt on Monday with my dr at Joslin. I am hoping to provide enough info to convince him I need to go on the pump! He wants me to do 4 shots a day for 6-8 months which if I do that, 1) it will stress me out again like it did last time 2) I work during the lunch shift and we only get a 15 mins of a break so no real time for a lunch and my shifts are the only ones I can do for what I do. 3) I actually have the time NOW to get started on the pump especially the 4 to 5 hour first class as that can be done on a day off. 4) if I dont get the pump now, if I get a perm job, I wont be able to take each week off for the required appts especially the 5 hour class.

So I want to know which graphs should I print that they would want to see? Thanks guys!

Thanks susannah. After seeing my graphs and what not, I am totally roller coasting. I am all over the place and it just shows that no matter how much they up my humalog 75/25, it will bottom me out somewhere. I am not sure why they think humalog/lantus route will work again.

I prefer to print them at home vs on one of their computers where possibly everyone can see.

Show your doctor the roller coaster and also show him the pie charts that show what percentage of the time you spend high and/or low. Those should be the major factors for going on the pump I’d think.

Before pumping I think it is wise to be able to follow a basal/bolus program and know all about carb counting to determine your dosages before meals and snacks. That should give you much more stable control, and get you off the roller coaster. Several years ago I used Humalog 75/25 and that put me on the roller coaster too. Separate insulins in separate vials for basal/bolus control, along with carb counting, should improve your control very much.

If you still have problems then you will at least know the basics that everyone should know before starting to use a pump. Then you could start pumping more successfully and with greater ease.

Richard, you are right in that she needs to know the basics to get the most out of the pump, but she was getting stressed out from all the shots. I don’t think it is good to force her into doing that when a pump would make that part of it easier for her.

I agree Kelly, but I have seen several pumpers start pumping before they knew basal/bolus and carb counting. It was so overwhelming having to learn everything at once, that they became very frustrated and went back to shots. I call those people “pumper dumpers” since they dumped their pumps to go back to injections.

I do agree with you there Richard. I know that pumping works much better when you understand the importance of carb counting and getting basals set right. I also know that it can be overwhelming with all the stuff you have to learn. My concern with Amy is that her problem is the shots, not the stuff that she has to do. I knew someone else that had a phobia about needles and skipped alot of shots so ran high all the time. She does much better on the pump.

Ive been Carb counting since day one…I know what to eat a smaller amount of and what to have once in a while…my main concern is my numbers aren’t coming down and 4 shots a day was too much…plus I work a job where I have a 15 min break…not enough time to check levels, wait to be able to eat, then correct if needed! Plus if I get a perm job I can’t take 1 day a week off for 6 weeks…I’m able to do that now. So if I have to correct, 43 of those meal times can turn into 6 which will turn into 7 shots a day…my insurance only allows 1 box of pen needles a month. So 4 shots a day turns into 120 pen needles and more if needed. My insurance covers the pump and supplies at 100% whereas now they only cover 1 box of pen needles, 1 box of insulin, and 100 test strips a month. And this is across the board with Commonwealth care.

I saw my Endo for the first time this week. I printed every chart.
She was not impressed, did not understand it at all. Gave me a log book and asked me to log my BG.
But I am very new at this, and I only had 11 days of Data on the charts. So maybe that was why.

She also asked me to do 5 units of of Novolog before each meal besides the 50 Levemir at bed time.

But last night before dinner I was at 65, and the 5 units took me down to 50, and it took 45 minutes before the dinner took me back up.

My point is that charts will only help if your doctor is familiar with them.

And if they are familiar, they usually have the software to download the data and analyze it anyway.

I don’t know what your charts looked like but you Endo sound very old school. The fixed insulin dosages are fairly old. Most people adjust there insulin based on current BG and Carbs.

It sounds to me like you can manage this yourself far better than a Dr that wants you to write BG values in a log. Does she realize that you have up to 288 readings every 24 hours? You’re going to need a really big log sheet and that’s simply a waste of time. There’s simply too much data to analyse trying to look at a list of numbers.

I agree with Seth that your doctor is old school. You should be taking insulin on the amount of carbs that you are eating and what your BS is. I am guessing you are fairly new at this since you are just now starting to take Novolog. Does she have plans to get you going on carb counting?

I have no idea what she has planned Kelly.

She told me to “Record your sugar before each meal and at bedtime”, “see a nutritionist”, see me in 3 weeks.

But all I know is that two weeks of using Dexcom, has thought me so much about what each food does to me. For the first time I am reading every lable of every food I buy, and consider how many grams of Carb I am taking.

Before when I was doing it with strips, I never got the full picture.

I have used it only for two weeks, but it has become my best friend. It is the most amazing thing that has happened to me in the last few years.

I never waited enough after eating to get a BG, so I never understood that my body takes about an hour to react to the carb. I never really saw my real high. Now with Dexcom I get the full picture. I am learning every day how each food reacts in my body.

I just love this device. I think it will change my life.

I have a list of the foods I buy and the portion and the amt of carbs. right now I am at 356 and staying steady. And I ate 55 grams of carbs at lunch (I am set to eat between 45-60 grams each meal).

I have read quite a few books on pumping, basal/bolus info, etc. I already know a certain amount of carbs=number of units to take vs a fix dose. I have lots of time on my hands to do lots of research, etc.

The Dex has provided TONS of info that just tells me I just need to change something.

356?!?!? is that your BG reading after 55g Carbs?

I have no idea if he is. I know we can download our data there but not sure what he knows. I just know that the pump is the way to go.

after eating a lunch and heading out to do a few errands that needed to be taken care of.

Forgot you were doing 75/25. When I started I was on the nasty 70/30 the old “eating to cover your insulin” instead of taking insulin to cover what you eat. Hope you can get on a pump and try to level things out.

me too! I so want this pump…I have the days I can go in for the training which at joslin the first one is 5 hours long then you have 5 follow ups. If I get a perm job, forget about that. plus I worry my A1C will jump up and I’ll have to wait longer. I want to do it now…I want freedom, I want better control, I want to better take care of my diabetes. The CGM is helping a lot otherwise I would never of know when I am high or even low.

Wow a 5 hour appointment and 5 follow ups! The Pod was one 1.5 appointment and 1 follow up (I am a quick learner though)