I have a few thoughts on my Endo appointment yesterday that I wanted to “talk through”.
I knew going into this appointment that it was not one that would show an improvement since my last appointment in September (I was supposed to go in December but had to go out of town unexpectedly with work, so I was rescheduled to January.) I traveled quite a bit over those last few months- a family trip to Disney World, and many work trips. I have no excuses, and I own the poor choices I made. But all in all, I was not expecting good results. Although, the numbers weren’t “as” bad as I had anticipated. My A1C was up .2 points, and my weight was up 4 lbs, but again, wasn’t AS bad as I’d expected. #perspective. But I do know that I have a lot of room for improvement, and I’m the only one that can do that. I met a new T1 friend recently and she put it in a perfect analogy – it’s like going in to take a test that you know you aren’t going to do well on, but you always leave the test feeling pumped telling yourself you’ll do better next time. That’s exactly how it feels!
But back to the appointment itself ….
I brought my Dexcom reports with me and the word that he used was “erratic”. He’s not wrong. My reports did show a few patterns, though, and we talked about that. One is I am consistently high after dinner. I thought maybe I needed to adjust my bolus formula for dinner. He said not yet -suggested the following: taking my insulin sooner than I currently do (I usually take it as I sit down to eat); or he said he has some patients who eat little to no carbs at dinner and see great results; or he also has patients who don’t eat until their BG is 100 or less (this one is not practical since I’m feeding my family and I can’t very well feed them and sit to wait for a magical BG number before I eat.); or he said I could take a brisk walk after dinner (again, not always practical.) So I’ll start with trying to take my insulin sooner, and eating less carbs. But I am consistently correcting a high bg before dinner, and then my overnight basal is perfect right now, so I wake up with a perfect number almost every morning.
He said there is a newer, more fast absorbing, insulin coming out next month that I may want to try. I asked if it was approved for pump users and he said not yet, so I’ll have to think about that one. I will try these other options first before changing from Humalog, which works well for me.
The other thing we talked about is why is it is so dang difficult for diabetics to lose weight. I can lose inches when I’m consistently working out but I rarely ever see the number on the scale go down. He said his only answer was “insulin”. *sigh* It’s possible, but very difficult.
I also asked him his thoughts on the Libre. He said he’s written 60 scripts for it in the last week. And that it works great so far – but he would not recommend it for someone already on the Dexcom because you lose so many of the bells and whistles (literally) with the Libre.
He also did another ultrasound on my thyroid – I have a large nodule (approx. 2 cm in diameter) that I’ve had for years – had a biopsy on it in 2011 and it still looks about the same. I do appreciate that he keeps a close eye on it, though.
On the way out of the office, I mentioned to the nurse that I’d lost 300 units of Humalog (I will post separately about that mishap) and she said “Oh I can give you a sample bottle of Apidra, it works the same as Humalog.” *sigh*
Thoughts on that one, anyone? I’m thinking it does not work the same but have no experience with Apidra.
Do any of you have any thoughts/feedback/comments on any of the above mentioned rambling thoughts? Thanks in advance!