Miscommunication about when to test?
I saw the Endo a couple weeks ago and I've been confused ever since. I'm honeymooning and my pancreas is covering my basal, so I only bolus. My I:C ratio is all over the map and I'm never certain when my pancreas might decide to dump some extra insulin, so I generally test my BG before meals and two hours after, primarily to make sure I'm not trending downward too quickly. Also, if I don't bolus in the evening, it's because I'm going to exercise, but I'll still test because I can crash during a workout even without bolusing. The Endo is a resident with a fellowship and she has to have the attending come in at the end of the appointment to okay everything. The attending told me I test too much. She said once in the morning and maybe after dinner is fine. I was too shocked to really say anything at the time, but as I continue to do my "excessive" testing, I'm wondering whether she misunderstood my situation. Perhaps she thought I was a T2 not on insulin? Does it seem right that an Endo would tell someone on insulin that they should not be testing after every meal for which they bolus? My understanding was that testing was pretty much standard operating procedure. How else am I going to keep track of my I:C and also make sure I don't go hypo? I intend to take this up at my next appointment, but that's not for three months.
I also test my fasting every morning because I know that will be the first sign that my honeymoon is ending.
Replies to This Discussion
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Permalink Reply by palomino on -
I am just newly diagnosed but that sounds very odd to me as well... I'm interested to see what other people have to say.
Maybe the endo was just confused...
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Permalink Reply by still_young_at_heart on -
The attending gave you very bad advice but if she didn't reduce your scrip for strips she didn't do any harm. Testing before every meal and two hours post is good standard procedure for the reasons you mentioned. Personally, I wouldn't raise the issue with the attending but would simply ignore her advice unless she complains about your overtesting after reviewing your logs.
Good luck!!
Maurie
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Permalink Reply by Johanna Burton on -
I test more often than that and I'm a T2 and not on insulin.
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Permalink Reply by Shawnmarie on -
Information is power for all T1s and T2s. We should get kudos for testing like we do!
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Permalink Reply by Scott E on -
There's nothing wrong with telling this person that she's wrong. If she's coming in with the wrong info (thinking you're a T2 without insulin) she should appreciate the correction. If she's arrogant, or thinks you're arrogant, she'll complain to the doctor who will set her straight.
It's your body and your health, and ultimately the person responsible is you. Don't be afraid to speak up.
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Permalink Reply by Shawnmarie on
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My test strip prescription (from a different doc and for 10/day) is good for quite a few more months, so that's one reason I wasn't immediately concerned. I think in the heat of the moment I felt a little like a child who was told they were doing something wrong and I couldn't really form a response. It was upon reflection that I started thinking she might be confused about the facts. I initially thought I'd try to follow the advice, but I don't think it makes sense and I'm continuing to test as I was before.
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Permalink Reply by acidrock23 on -
I agree that it's very unnatural to tell doctors to buzz off. On several occasions, they get *very* snippy when you do. I think that it's important to stick to our guns though.
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Permalink Reply by T1Forever on -
I found a new endo and basically told him I needed him to update my scrips and try to assist in dire situations. He understood. We treat ourselves and the endo community is beginning to get an idea--we are basically better at determining our needs. but cannot precribe meds. I truly believe we are our own docs.
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Permalink Reply by Shawnmarie on
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Yes, yes, yes!
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Permalink Reply by Shawnmarie on
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I realize I have a difficult time with authority figures when I have to stand up for myself. I can stand up for other people quite well, but when it comes to me, it somehow becomes a different story.
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Permalink Reply by Zoe on -
What an idiot! You are absolutely that testing before and after meals, as well as other times when your blood sugar might be out of range, waking, before bed and before driving all are important for a Type 1. I personally don't think it's any excuse at all if she thought you were a T2 not insulin. Why would she be giving treatment advice to someone without knowing their diagnosis let alone their individual situation? Testing is very important for any Type 1, and even more so when you are honeymooning and have variable numbers and still learning about how certain food, doses, ratios, etc affect your blood sugar.
Do not let the ignorance of much of the medical profession confuse or throw you. You sound like you are learning well and coming to trust your instincts. Keep up the good work. If you haven't gotten a book like Using Insulin by John Walsh, please do so. As you say you will not be seeing this provider for three months (which also seems odd for someone so new to insulin! Do they have you seeing a CDE, e-mailing your numbers, anything?? Personally, I shouldn't be surprised. Like most of us, you will learn that the vast majority of your D management which is 24/7 happens with you, with support from books like I mentioned and the wonderful people of TuD. As you learn and progress in your treatment, you might have questions for your providers, but what good is it if it's only every 3 months. I personally only use my doctor to write scripts and when I have a question I come on here or look in my books and get useful and meaningful information in moments. Hang in there!
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