Joined
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22 Posts
Hey all
I've been a t1 since right around my 14th birthday in ...... 1983. I've certainly seen plenty of ups and downs with control issues usually precipitated due to my own hedonistic tendencies during college and those roaring 20's. However for the past ten years I've consistently obtained A1c < 6 despite having a general laissez faire approach (maybe just second nature at this point) to my disease.
However passing the age 40 I've recently discovered that I am not, in fact, invincible; and have starting seeing my a1c get as high as 8.2. I believe that this is due to several reasons. First I quit smoking two years ago and have seen a significant weight gain. Despite addressing this fact last December (concurrent with a switch to a new primary doctor) and gradually dropping weight at about 2lbs a month, I was using considerably more insulin without great results.
The second major factor that I believe contributed to the rise in bg was my insurance mandated switch from humalog to novolog. Despite being a Lily humulin and humalog user since 1983, my Endo gracefully bowed to the insurance dictates and switched me. And now to the major change in my attitude and maintenance direction.
Despite having a "best of Philadelphia" endo for over 10 years. My relationship with him has always seemed rather perfunctory with only a basic review of recent bloodwork. Granted this may have been due to my long term <6 A1C results or my aforementioned laissez faire approach to maintenance, however with my recent bg increases I sought out more direction and instruction from my endo. To this his response was to take more insulin. when hypos started to increase the response was the opposite and take less insulin.
Given this unsatisfactory direction and in discussion with my new primary (who I've been aggressively seeing quarterly since December 2010) I switched to a new endo Dr in October of this year. To my amazement I've learned more in the past two months than the last 10 years. Some of the new things that I've learned and which seem to have been affecting my control are "morning rebounds", fat effects on carb absorption and better timing or stretching of insulin delivery. I even believe that my consistent low A1Cs may have been the effect of "averaging" of too many hypo events. Oh yes I've become hypo unaware (to a certain extent)
That allllllllll being said (sorry folks, but it was a bit cathartic for me) I am feeling very happy now, due to my new direction and attitude towards maintenance and my disease. My postprandial sugars have been much too high (wow its amazing what more frequent blood testing can tell even those WHO KNOW IT ALL
)and I've switched Two days ago to Apidra with dramatically better results. My fasting bg is still high and we have been tweaking my nighttime Lantus. With more consistent 3am testing I should be able to get this last piece straightened out shortly. Stay tuned for future (I promise much shorter) updates.
Bob
I've been a t1 since right around my 14th birthday in ...... 1983. I've certainly seen plenty of ups and downs with control issues usually precipitated due to my own hedonistic tendencies during college and those roaring 20's. However for the past ten years I've consistently obtained A1c < 6 despite having a general laissez faire approach (maybe just second nature at this point) to my disease.
However passing the age 40 I've recently discovered that I am not, in fact, invincible; and have starting seeing my a1c get as high as 8.2. I believe that this is due to several reasons. First I quit smoking two years ago and have seen a significant weight gain. Despite addressing this fact last December (concurrent with a switch to a new primary doctor) and gradually dropping weight at about 2lbs a month, I was using considerably more insulin without great results.
The second major factor that I believe contributed to the rise in bg was my insurance mandated switch from humalog to novolog. Despite being a Lily humulin and humalog user since 1983, my Endo gracefully bowed to the insurance dictates and switched me. And now to the major change in my attitude and maintenance direction.
Despite having a "best of Philadelphia" endo for over 10 years. My relationship with him has always seemed rather perfunctory with only a basic review of recent bloodwork. Granted this may have been due to my long term <6 A1C results or my aforementioned laissez faire approach to maintenance, however with my recent bg increases I sought out more direction and instruction from my endo. To this his response was to take more insulin. when hypos started to increase the response was the opposite and take less insulin.
Given this unsatisfactory direction and in discussion with my new primary (who I've been aggressively seeing quarterly since December 2010) I switched to a new endo Dr in October of this year. To my amazement I've learned more in the past two months than the last 10 years. Some of the new things that I've learned and which seem to have been affecting my control are "morning rebounds", fat effects on carb absorption and better timing or stretching of insulin delivery. I even believe that my consistent low A1Cs may have been the effect of "averaging" of too many hypo events. Oh yes I've become hypo unaware (to a certain extent)
That allllllllll being said (sorry folks, but it was a bit cathartic for me) I am feeling very happy now, due to my new direction and attitude towards maintenance and my disease. My postprandial sugars have been much too high (wow its amazing what more frequent blood testing can tell even those WHO KNOW IT ALL
)and I've switched Two days ago to Apidra with dramatically better results. My fasting bg is still high and we have been tweaking my nighttime Lantus. With more consistent 3am testing I should be able to get this last piece straightened out shortly. Stay tuned for future (I promise much shorter) updates. Bob
