I had an appointment with my new endocrinologist
(diabetes doctor) and nurse practitioner this morning. After my in-office blood sugar (169 mg/dl) and
vitals were taken (turns out I’m 5’ 11 3/4”!) and the nurse went through the
standard medical history questions, Carrie, my nurse practitioner, came in and asked
about my diabetes care routine. She then
checked my feet, pulse, and lungs/heartbeat.
After that, she told me about some new medicines
that were on the market that some Type 1 Diabetics use to control their blood
sugar and asked if I’d ever been on an insulin pump. I told her I had, several years ago, and that
I preferred being “unhooked” from a pump with tubing, especially since my old
endocrinologist had told me that being on a pump with my lack of discipline was
dangerous for my health (when Dr. Bussey heard this, he said that was a bunch
of malarkey).
I told her about my desperate need for the Dexcom G4
Platinum Continuous Glucose Monitoring System, and she confirmed that it was a
good system with the highest accuracy available. She looked over my blood sugar numbers from
the past few weeks (which they had downloaded from my glucometer), asked me
some questions about them, and gave me an informational packet about the Dexcom. She then left the room to get Dr. Bussey, the
endo.
When they both returned, Dr. Bussey made some
suggestions for adjusting my insulin doses.
He said since my numbers were still running high that I should increase
my overnight basal insulin by 2 units, adjust my insulin-to-carb ratio (changing
it from 1 unit per 12 grams to 1 unit per 9 grams), and changing my correction
factor from 60 points over 120 to 50 points over 120.
We then discussed my plans for the future regarding
children. I told him we were thinking not
for another year or two down the road, especially since my numbers are so high
and our finances aren't quite where they need to be. Dr. Bussey told me that the best A1c during
pregnancy is about 5 (but 6 or 7 was okay) and that the most precise way to
maintain that much control for a pregnant Type 1 Diabetic would come from being
on an insulin pump – however, it was not required. I’m still undecided on the matter. I know I at least want a Dexcom.
My current A1c is 11% (average blood sugar of 269) –
so I balked a little. A chart on the
wall across from me said that an A1c of 7% equates to an average blood sugar of
154. 6% = 126. The lowest I remember my A1c ever being is
about 9 (212 mg/dl)…5, 6, and 7 all seem so hard (nay, impossible) to
achieve! However, he assured me that
getting my A1c down that low IS possible and they are going to keep me
accountable as I work to get my numbers down, down, down. They told me they wanted me to come back in 2
weeks to go over carb counting (although they are sure I know what to do) and
insulin pump therapy information. I’ll
then come back at the end of August for fasting labs.
Before I left, they had me do some lab work for them
(a quick and painless blood draw). I left
feeling encouraged but also a little daunted.
I know I have a lot of work ahead of me, but I hope that having a team
of people who are committed to seeing me improve my health will give me the
motivation I need to succeed. Obviously
the core determination has to come from my desire to prepare the best I can for
the future. I know that with God’s help,
all things are possible – even the things that seem impossible.
