Diabetes Self-Management Blog

Earlier this week I made my way to the endocrinologist for my four-month checkup. As has become my blogging habit, it is now my duty to share the details of this visit with you. Why? Because I know you really care. Why else? Because apart from visiting my doctor, this has been a slow week for Eric Lagergren, person with diabetes (PWD).

The thing is, going to the doctor is such old hat these days, so maybe the next time around I won’t have anything to tell you about my visit. (Yeah, right.) It used to be that I’d fret over what my HbA1c would be. I’d lay awake cataloging highs over the previous three months, trying to remember if I spent much time with a blood glucose over 200 mg/dl. Then I’d try to think: What questions should I ask the doc? Kathryn and I would collaborate, devise a laundry list of things we thought we needed to know, questions I must ask during my visit. I’d pull out a slip of paper midway through the exam and see what was highest priority based on what the doc and I had already discussed.

I’d also try to find ways to let the doctor know that I was doing all I could to be a wonderful PWD, to be that person who does his best to keep his self-management under control. I don’t know, in my early days with diabetes, I wanted that physician’s pat on the back. We’re so proud of you, Eric! Look at Eric, he should be our poster child for a PWD!

Gross, huh?

This time around, though… Well, to be honest, I didn’t give much thought to the visit. They called with an appointment reminder two days before, and although it was on my calendar, I needed the reminder.

During my visit last April my A1C was 7.0%. That was before my new insulin pump, which I started wearing in late June. I can’t say I made a wholehearted effort to lower my A1C, but when I started the new insulin pump, I set my target blood glucose at 105 instead of 120. I’ve also been checking my blood glucose more with this new pump. Most everything else, though, has been pretty consistent. Exercising about the same amount, eating pretty much the way I always have. It is summer, though, and on the whole I’d say I’m more active. On the whole, I am probably working out longer, which probably does help lower my A1C.

This time my A1C was 6.6%. Yay for me! The doctor told me that lowering it a tenth of a percent when you’re at 7 is a pretty good achievement, so I should feel pretty content with the 6.6%. I do. I’m happy, especially because I wasn’t obsessing about lowering, especially because I didn’t have any severe lows over the previous four months — and we all know that the lower we go with our A1Cs, the more risk we run for going hypoglycemic.

Next week I think we may have our first meeting with our new medical students at the University of Michigan Medical School’s Family Centered Experience program. (Scheduling between us and the students: in process.) If our meeting’s over by the time my blog entry is due, look for news about the smart doctors-to-be we get to have conversations with about my illness for the next two years. I love the FCE program and look forward to writing about it once again.

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Comments
  1. Congrats Eric. Great work and hope health continues good.

    Posted by jim snell |
  2. I went from 7 in February to 6.8 in July and was very proud of myself. My DH, who has been eating sticky buns and gooey desserts and who knows what else for the past three months, was a 6.5! Life is so unfair.

    Posted by Deb |
  3. Congratulations, Eric! When I went on the pump 12 years ago, I didn’t really find much difference in my A1c, BUT a lot fewer highs and lows, because I wasn’t struggling with the !@#$ NPH. This was before Lantus or Levemir came out, and there was no other choice. Now, I have a CGM, and while the numbers are not that accurate, you can see the trends and catch highs and lows before they get severe.

    Wishing you a long, and even more important, HEALTHY life with DM — maybe you’ll live to see a cure, and be ready for it! :-)

    Posted by Natalie Sera |
  4. What is the best way to manage diabetes?

    Posted by Sally Pinkerton |
  5. I have only been on insulin for eight months. The strange thing is, my situation has gotten worse since being put on insulin, it stays over 200 all the time now. It seems the more they raise the units the worse it gets. My last A1c was 8.5. I am getting really concerned because my blood sugar only went over two hundred once in a while before going on insulin. A very dear friend of mine died two years ago of insulin shock. My doctor never says anything, she just shakes her head and says to increase the insulin another 11 units. I believe a big part of my problem is I am a veteran and only have the VA for medical care. Veterans do not get the best of care, and are never told much. I am considering coming off the insulin period because I don’t know what else to do.

    Posted by Don Gibson |
  6. Wow, Don, sorry to hear about that. If I were an endocrinologist, I’d sure try to help you out with an answer, but as such, I’m not about to try to help problem-solve that issue. When you say increase your insulin another 11 units, to you mean overall, throughout the day? (Are you injecting insulin? Are you Type 2? How are those extra 11 units administered?)

    It seems to me that keeping your blood glucose under 200, well under 200, is what’s important. I mean, yeah, insulin is great, but probably not for everyone in every situation.

    Good luck in figuring out that glucose management, insulin or no. Keep us posted on how it goes.

    Thanks,
    Eric

    Posted by Eric |
  7. Fist off, I am not Doctor but my impression is as follows ( and your Doctor is responsible for your saftey and cure):

    Constantly increasing insulin on a type 2 insulin resistant person does not seem best answer.

    Drop diet to 1200 calories, also get scan of liver, kidneys, gut , hormone activity to see what is out of whack.

    Get more exercise - walking, gyms etc. For me 1 to 2 miles walking crucial.

    Changes you make can take 8 weeks to 6 months to see benefit. Getting BG down is fastest.

    Get on low glycemic diet and ensure your liver is not sugaring you up. Watch out for grains, pasta, rice etc and carefully respect serving size.

    As indicated, I am not Doctor and anything you do for your health and safety needs review and concurrence of your Doctor.

    As indicated , I am only sharing my side. Some insulin may well be needed due to ageing and organ degen.

    good luck and good health.

    Posted by jim snell |
  8. U am woly jealous of your A1x numbers. I havent;s seen those numbers since the 1st year of T1 diabetes.
    Now, If I can keep by BG’s under 200 & my A1c’s around 9, ots’s a banner day for me.

    Posted by miss kitty 3 |
  9. Read Dr Richard Bernstein’s book …Type 2 Diabetes, ….My numbers are terrific now, …and could be even better if I did exactly as he said.
    Try 6 carbs, …breakfast
    12 for lunch, …and 12 for dinner.
    You need less insulin, …you will not be having huge swings. Less insulin, …less carbs, ….less mistakes. ….Try not to eat inbetween meals, …at least 5 hours between meals. Don’t eat after
    7 if you want your blood sugars low in the morning.
    Dana Carpander ….is a wonderful low carb cook with books on amazon, ….
    Bernstein runs a clinic and is known throughout the world. Some say he requires more than people are able to do, …but he is 79 years old and a Type 1 himself, …with NORMAL a1c of 4.6. I went from a 7.0 to a 5.6 almost immediately. If I followed his plan exactly, …I know I could lower it more without a doubt. It is not hard, but you must be determined. Atkins had similar ideas in his diet plans

    Posted by Karen Okamoto |

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