Not sure why you think my BG is more stable than yours, if anything I believe it to be the opposite for the reasons I already stated above. Please read them.
I think you are focusing on the wrong issue. Instead of tilting at windmills (trying to change the medical system), it sounds to me like you should focus on improving your control for the few hours you need to interface with your dentist. Your dental staff is asking for a completely reasonable thing - they want you to start with a comfortable BG (100 or above) and keep your BG under control while they are working on you in their chair. They are trying to teach a dental trainee how to do the work needed to maintain your teeth. It is not their job to watch your diabetes and your BG - it is their job to fix your teeth while YOU take care of your diabetes.
Can any of us T1 diabetics keep our BG stable all the time - of course not. I am not suggesting that. But all of us should be able to keep our diabetes in reasonable range for a few hours to allow a medical procedure to take place. If that means letting your BG spend a couple hours slightly above the level that you strive for the rest of the time - then that is what you need to do.
That said, I am VERY surprised that your loop algorithm is not able to keep you above 75mg/DL after a twelve hour fast with no insulin and no food. If it is not, then I have to believe that you need to adjust the parameters controlling your loop algorithm, at least during medical procedures. Just to be clear - do you ever wake up with a BG of 61 after an overnight fast with loop running? If so then I would suggest you need to change your looping parameters.
Why wouldn’t you just tell them your blood sugar is whatever they want it to be, and you’ve done whatever they want you to do (eat whatever)? They won’t know. This seems like a lot of overthinking something that be easily/simply effectively dealt with. You can tell yourself you’re acknowledging that for the vast majority of people, their rules likely make sense, while at the same time you know well enough it doesn’t matter for you, so essentially opt out of it. Done!
ALL my stats vary much more during a medical visit than when at home. Even when I’m not feeling stressed, meeting with a PCP who should know me well after 5 years, and many visits, all it takes is for them to make a remark that indicates their persistent ignorance about diabetes or anything “outside their scope of practice”.
If anyone wonders why some men don’t want to go to doctors, I’d have to put doctors who aren’t interested in anything they didn’t learn years ago near the top of the list. Most men are never allowed to stop learning, and our work is supposed to be easier than theirs is. Continuing medical education seems like something only the youngest doctors and medical assistants are required to pursue.
“The only thing necessary for evil to prevail in the world is for good men to do nothing” Edmund Burke The core meaning of the words “good” and “evil” are right and wrong.
Particularly at a practice with students, NEVER be reluctant to point out when anyone, whether teacher or student, is asking for, telling you something, or doing something that is wrong. Don’t let their white coat and 8+ years in school feigned confidence deter you. Just be tactful about it, be certain that you know what is right, and pick your battles.
Why? Off the top of my head:
Because there are students.
They are students because they are ignorant. Ignorance taught is ignorance indoctrinated. Literally, followers of a doctrine are indoctrinated, taught what to believe, what to do based in those beliefs. Wrong taught and not questioned, becomes wrong practiced.
Agreeing with or accepting something you know is defective perpetuates the defective knowledge by making them believe it more firmly.
Doctors aren’t perfect; they make mistakes. That’s why they carry malpractice insurance. Small mistakes are not usually harmful, but the ones coming from ignorance can cascade.
A doctor’s defective knowledge of truth and fact is going to eventually hurt a patient.
The one hurt could be someone that you, or they, care about.
I Agree you would think that medical specialist would know more about diabetes. Recently I had vascular surgery on my Arm to create a fistula for dialysis in the future. They to seemed not to care when I showed the the Dexcom Glucose value dropping over night until the time of surgery . They blamed me for taking too much in insulin , Tried to explain because with out breakfast And no insulin onboard it would continue to drop. Now the biggie. They asked me what I would do to rise the level.
Even thought your supped to be fasting prior to surgery. They took my suggest of 4oz of cranberry juice. 20 min. Later I was up to a steady 130.
Of course, your correct Terry. I don’t know what is to be done about this.
When I go to the dental school at my university in town, the population they serve tends to be poorer with fewer resources. It’s possible that they don’t see a lot of insulin pump users and you are probably the best managed diabetic that they will meet in their career. I think it’s ok for you to say that to them.
Try to remember that diabetes scares the ■■■■ out of some practitioners. It’s probably good for them to announce that they are in over their heads. I think that’s beneficial information for you to have.
If a medical practitioner is in over their heads, they should say so. You don’t want people proving care that they don’t feel completely competent to provide. It’s ok.
