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.

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Good for you. Maybe she'll infer #3.

Thanks for the update, Shawnmarie!

I was wondering how things were going for you with this issue!

Here's hoping that the answer is #2, and that she gets up to speed on your situation and is useful!

Best wishes

Marty1492

The best diabetes clinics (or any specialty, for that matter) are often teaching institutions. The doctors are excellent, and the others you may deal with are students. They're bound to make some mistakes as they build up experience, it's how they learn. If this is the case, I'd let it slide, knowing that (after your letter) the mistake will stay in her mind forever and she'll never make it again.

The attending assumed T2 without reading your history=unmitigated idiot. If anything, your waxing and waning pancreas means you may want to test more often than most T1!

It's not a pretty picture but you've done a good deed. There is a chance that the fellow will learn something here and be more aware of the variety of diabetic experience and methods of self-care.

Maurie

Glad you expressed your feelings and were (sort of) heard. Yes, it is shocking. I expect (and get) the same comments about how unusual my control is, but that's because I only see a PCP and they have mostly Type 2's. (no offense to the type 2's who are in good control). My answer to that statement would be, "ok, what are you doing to change that fact?" But I, at this point, don't expect much from doctors.

Just one other thought. Even if your ratios become stable (as stable as things ever get for type 1's!), you still want to know if you are high so you can correct. I'm convinced that prompt correcting is the single factor that gave me my last low A1C. More importantly, it means I spend minimal time high to avoid complications. In time, I hope you find a solution to the later lows by tweaking your basal dose (or getting a pump!) Because 90 is a perfect number, and it is most likely the basal that crashes you down a few hours later.

Whoops, sorry Shawnmarie, I lost track of your details. Yeah, that does make it more complicated. Whenever people on here talk about ways to "preserve beta cells for longer" I sometimes wonder if that is a great idea because it makes it harder to manage! As for exercising, I think everyone seems to have trouble with that. It's my "good" excuse for not exercising! But hopefully that will get easier with time as well.

Everything you say makes it more and more obvious how wrong that person was to tell you not to test after meals!!

Wow, I think I would do exactly as you have done if my endo was telling me I tested too much. It's my body and I'm the one that has to deal with this day in and day out so I'll test whenever I feel like it, thank you very much! I'm like you, just starting out on this journey and you're completely right. How are we supposed to know and figure out our I:C ratios if you're not testing often and especially after each meal with a bolus? I'm pretty stable (so far) and I still test 7-10 times a day usually because I want as few surprises as possible and to know how I trend at different times of the day. Luckily I think I have an endo who understands the testing. She doesn't have diabetes but, according to her, is obsessed with her BG levels. She'll test herself multiple times a day and wears CGMs from time to time. At least I know she knows how it is to stick yourself several times a day!

Yeah, that strikes me as a bit odd as well; maybe there's more to the story, such as she is pre-diabetes, has multiple risk factors, etc. I like the idea of a professional who would test and/or wear a pump or CGM to increase their understanding, but testing multiple times a day??

Is she out of pocket or is she stealing the samples she's supposed to be hooking her patients up with? I'd avoided tapping that until recently when the Rx service achieved astonishingly low levels of customer service and my doc hooked me up, which I was pleased with. I hope your doc pays for her stuff...

I haven't the foggiest whether or not she pays for the stuff she uses or if it comes out of the office. I didn't really think about that until it was brought up here. Also didn't ask about pre-diabetes or anything like that. I kinda just took it as this was her field of work and an interest of hers so that got her to do the testing on herself. I agree with Shawnmarie, before I found out I was T1 testing my blood glucose wasn't even a background thought in my mind. Then again, I may think differently if I was faced with it everyday at work.

Good for YOU!! Firstly that's a crappy endo to tell you not to test after meals. What if you ate a huge pasta dinner and were starting to go high? Or like you said you didn't eat enough and were low. On the weekend I thought I had enough insulin for my food - ends up I was crashing and quick. So I ate something for the low before it got too serious. Wouldn't have known if I hadn't have tested.
So glad you have another Endo. With the new one ask him/her some questions before you start giving them you history. Ask what they would recommend for a T1 in regards to testing. If you like their answer then give them your info, if you don't leave and find another one. It can be tough if you live in a smaller city like I do - we only have one endo. Another is a 4 hour drive away. :( Thank goodness he's good and likes my testing schedule.

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