Wednesday, December 5, 2007

Endo Appointment and the Crazy A1c

Yesterday I had my check-up with my endo. I got all my prescriptions straightened out. That's a plus. I also got some good news about my CGMS. They are going to have to re-submit the letter as it did not have the correct codes, but the nurse in charge of the whole CGMS thing said that she's had another patient in the office with the same insurance that I have and he was approved. This gives me hope. Hope for a lower A1c.

Lately I haven't been being as diligent as I should be with my blood sugars. I've been testing regularly, but not being so careful what I eat and when. Because of this my blood sugars have been running a little bit on the crazy side. My 3 month average, according to all my meter downloads, is 136. This is higher than I would have like. I've also been having fewer lows, which for me means higher blood sugars overall.

I went into my doctors office toting a stack of graphics and print-outs from my pump and meter software, a list of all the vitamins and medicines I take, a list of the prescriptions that I needed him to write for me, and a list of questions that I wanted to ask him. Call me the good diabetic. :)

The last time I was in the office, my endo had not written me a lab order to get my A1c done. And to be honest with you, I had forgotten about it (bad diabetic!). Maybe it was my subconscious not wanting to know what my A1c actually was...

When I sat down with my doctor we looked over my blood sugars and made some major changes to my pump settings. We changed almost all of my basals, 2 of my carb/insulin ratios, and we also changed the active insulin time from 6 hours to 5 hours. This was after looking over the last 4 weeks of graphics and discussing the trends. He sees stuff I never can.

I also asked him some questions about Dr. Bernstein and what he thought about low carbs and no carb diets. He, of course, did not agree and spouted off something from the ADA that says we need at least 160 grams of carbs per day. I am not sure that I agree with that. I would much rather keep my carbs per day under 100. Although I have trouble doing it most of the time.

I also asked him about the vitamins I have been taking. He told me he wanted me to take more Vitamin D. So that's next on my list of stuff to buy.

Before I left the did an in office A1c. It was one of the home-type tests, I think. When it came back it was 5.6. That is CRAZY! I know there is no way that my A1c is 5.6. Not when my average of blood sugars is 136. It doesn't add up. If I believed it was correct, I would have jumped up and down and screamed for joy. I just don't think it was. So basically I am pretending like that A1c never happened and I made sure to get an order for lab work for my next appointment.

Honestly, I don't know what the deal is. I just know that my doctor called me "motivated," which I took as a complement. I figure that I have a right to be obsessive compulsive about my diabetes care. I want to live a long and healthy life. I want to still be alive when there is a CURE!


Donna said...

Hi Cara,
Good luck with the insurance & the CGMS. I hope that all works out for you.

My endo has been doing an A1c when they do the rest of my blood tests in his office. Then he knows my result right then & there. It's really nice to not have to wait.

Hey, maybe all the pump changes your endo made will make a positive difference. I honestly try to understand all my charts & graphs, but I just don't get it all. But my endo looks at them, does some calculations in his head & makes some changes - and he's usually right. I guess that's why he gets paid the big bucks! LOL! Hopefully, yours will be right, too.

BetterCell said...

Hi Cara.......
Being involved on a daily basis in exercise and kinetic movement, I want to say a few words about exercise and carbohydrate intake.
Basically, the more active you are and the more involved you are in anaerobic/or and aerobic exercise, the more carbohydrate
the body needs for energy production and maintenance.
However if you are a "sedentary type of person" then less carbohydrates are needed or desirable for the body. It is a ratio that is NOT FIXED but dependent on energy expenditure and Life Style on a 24/7 basis.
Even in having T1DM, the same philosophy applies. There is no "one size fits all" in relation to carbohydrate intake. In general however, in having T1DM there would be better glucose numbers if less carbs were taken, especially if you are not "actively involved in exercise."

As far as "Cure" for T1DM is concerned, get on Line Cara.
This Line is and has been getting longer and longer rather than shorter. I have been waiting for the "Magic Cure," since I was six.
The only cure that exists is for that other Disease called IRD(aka type 2 Diabetes) because it is totally preventable regardless of all the "political correctness talk" regarding it is concerned.
Most people do not want to take responsibility for their own Bodies.