Heh. You know, last time I posted here, I really did mean to start blogging and contributing more. I guess I just disappeared instead, which seems counter-intuitive. Maybe another try will be successful!

My treatment floundered a little bit upon entering my third year of grappling with Big D (back in November). I'm due for an A1C reading, which I'm dreading just a little, since I'm pretty certain it'll bust back open the 6.0+ barrier that I've been so proud of constantly skirting underneath.

Thing is, I'm not entirely sure what the problem is. Part of it might be that I've been a little lazier with scheduling and carb counting lately, allowing myself to eat whatever I want whenever I want and shooting myself full of Novolog as a last-ditch method of making up for it all. Maybe it's just holiday stress working its way out, though. There is a method to the madness - I don't think there's been a day in the last week when my level hasn't shot up above 230 a few hours after dinner. Maybe a little post-dinner bonus bolus would help things out... I think I'll start experimenting with that tomorrow.

Meantime, I'm fretting over the cost of it all... Kaiser upped my copayment for Lantus threefold with no real explanation (I wonder if stress from that has contributed to the imbalance above - man, how appropriate would that be?). On the plus side, though, a coworker with a type 1 kid informed me that our Kaiser coverage DOES universally include a pump for anyone with diabetes. As confusing as it is that my doctor and endo never mentioned this, I'm pretty stoked! I don't mind the pen too much, but I guess someone like me who gives 7-8 injections per day could benefit from a hard line.

New years resolution: Eat more low-carb meals. We'll see if it takes.

Views: 1

Comment by Kristin on January 19, 2009 at 1:01am
Hi Gabe! I find that my control always comes in waves... you have done *amazingly* well. So you'll get back there! I'm still working for the first A1c under 6.

You sound like a perfect candidate for the pump! If you have full insurance coverage, you might as well seize the day!

In the mean time, do you know if your insurance coverage is better if you were to switch to Levemir (another long acting insulin that many people like) or if you get your insulin in the mail (it might count as medical supply rather than prescription then-- this was true for me ordering testing strips with my last insurance company).

Another idea-- Do you take your Lantus in one dose or two? If you take it in two, you can play with the amounts... for example some people require more basal insulin in the morning and less in the afternoon. The pump is the best for meeting your insulin needs at each time of the day, but splitting your Lantus dose gives you some options in the meantime!

Glad you returned to TuDiabetes!
Comment by elaine peterson on January 19, 2009 at 5:51am
Yes, Gabe....welcome back. I am impressed with your past 6.0 readings. As Kristin says, you know you are able to get there again.

I have been lax myself since Halloween, into Thanksgiving, my daughter being home from school for 2 long breaks, holiday parties, etc. It's time for a lot of us to get back to our routine. Maybe we can start a New Year low carb support group.

I dose multiple times per day with my pen as well and am in the early stages of getting a pump. I don't mind the pen except for the privacy issue when not at home. The pump sounds more exact in basal and/or bolus and timing so it's probably a wise move.

Good luck.
Comment by Lois on January 19, 2009 at 12:29pm
The pump is a blast! I have one and would absolutely DIE if I had to give it up. But, BEWARE OF THE COST of the DME that goes with it to get it covered. Medicare only pays about $50 per month for them so my local provider won't serve me. The other in-network provider wants $300-$400 per month!! OUCH!!!

Good Luck.

Lois La Rose
Milwaukee, WI
Comment by Gabe on January 20, 2009 at 12:28am
Thanks very much for the advice, everyone!

Kristin: From what I'm told, my copay is the same for every "non-generic" prescription, which covers any and all insulin, so switching types unfortunately wouldn't help. Just gotta roll with the punches, I guess! That's a really fantastic idea about splitting the Lantus dose - I'll definitely give it a shot (or two shots, as the case may be).

Elaine: Precision seems like a really big advantage of switching to the pump. As cool as the pen is, those half-unit-off doses can be maddening!

Lois: Yikes, I'll definitely go over every little detail about the pump before I commit to it. Thankfully, Kaiser is usually more generous than most other U.S. providers.
Comment by Lois on January 20, 2009 at 12:49pm
Yea, it's good to have good coverage. I had really good coverage when I worked and I continued that insurance (I was an state of WI employee for 20+ years) and it was supposed to be just as good as the regular employees have. You know ... uniform coverage and all that jazz. Well, along with my Medicare, I have LESS coverage than ever. And I'm paying almost $500 per month for the Anthem Blue Preferred plus the $96 something for Medicare. I might as well drop the secondary and go with something cheaper. Siiiiiiggggghhhhhhhh.

Well, gotta move on. Talk to you soon?

Lois La Rose,
Milwaukee, WI

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