Today was the big endo appointment. I haven’t had one since July because my previous one was cancelled and I couldn’t get in until now. This was a big appointment because there have been a lot of changes in my life. The main ones were my diet and being on Apidra full time which means that I am using less insulin. Over the past week, I have talked about the multiple lows that I am getting every single night and during the day, so I have been making a few adjustments to basal rates and carb ratios trying to find the perfect match.
When I began the visit, I explained everything that was going on and then we went straight to the drawing board, literally. I do not see an endo, I see an ARNP and she is awesome. She is well known in the industry and teaches CE courses to diabetes educators, so a lot of our discussions are very scientific and involves studies and data. Back to the drawing board.
She moved over to the white medical paper on the bed, or whatever you call it in a doctor’s office and she drew out the ideal basal graph and we began mapping out my current basal rates. We decided to lower all four of my basal rates, and we made some pretty aggressive changes to them. However, there are no basal rates that increase more than 0.4. The main basal rate that we adjusted was from midnight to 8 a.m. I have been going very low during that time period since my diet began. Here’s an example from last night. I tested my blood sugar at midnight and it was 291. I decided not to take a single unit of insulin to correct because I wanted to see what would happen with just the basal rates and the little bit of insulin on board. I woke up 7 hours later and my bg was 145. That’s a drop of 150 with no correction, pretty damn crazy.
I am starting a new basal test tomorrow so we can get a better idea of where the numbers need to be with the new diet and insulin.
Next up was the carb ratios. I have been eating so unhealthy for so long that my ratios were not accurate because of all the fatty foods that I was eating. Now that I am eating less fat, less wheat, and just overall healthier, my old ratios are sending me low every single time. I have two different carb ratios. One for late night when I eat a snack and another that is for the rest of the day.
We then discussed some “social” items. I have some information that I will be sending out later about some local support groups and pump training groups and some other free nutrition classes.
I did not have any blood work for this appointment and I won’t have blood work done until 3 months to see how well these changes are working, or not working, but let’s not hope that is the case.
Well, those were the highlights of the appointment. I now have my new orders and my new goals, and now it’s time to accomplish them.