I’m so glad to hear your therapist visit went well, and I hope the same is true for your new endo. Keep working on letting go and doing your best with what you can control. Looking guard to hearing from you about your new doctor and anything you have to share. Take care (I’m sure you are).
Hello everyone, little life update, I have not made it to my new endocrine yet, an appointment is a next week (was able to move it up). So, I am still stuck with the old one. Last night was the first time I have ever had a low below 50 and so I took the normal steps to correct it. It took me over an hour of following the 15 and 15 plan (15 quick carbs and 15 minutes) to get up. The insulin I took was my long-acting and I took Humalog for a snack (dosing for only half the carbs like I usually would) so, unless I made a stupid mistake, I don’t know what happened. Anyway, finally came up and went super high, but I digress. I called my doctor’s office this morning to check-in and ask for help with what would have been better in that situation and they did the usual looking over my sugars and recommended I drop my long-acting dose, but did not answer my questions about what I should have done better with the low. I know we don’t really do any medical advising on here and I will be talking with the new doctor about it next week, but if anyone has had a similar experience with not being able to bring it back up what would you have done to not shoot up way after. I will mention that there were times yesterday where I had come back up almost into range and so I ate a long-term snack, but then I checked again to make sure I was up further in range and I went back down. So I had to take more fast-acting carbs and then repeat. This was right before bed and I do not want lows overnight!! So I definitely ended up eating a lot of carbs so I figured I would end up being high. Has that ever happened to anyone else?
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If it is any consultation Danielle @fieldiez you did what I would have done. Especially at bedtime with the final snack lasting carbs. Easier to sleep.
It is common for me to need more carbs to got my BG to begin going up when I’m down to 55.
Fixing a low can be tricky. Especially if there are things that are continuing to push your sugar level down. Insulin still in your system, your metabolism still coming down from exercising in the last few hours, etc.
It takes a while for your sugar to come back up no matter what you do, and it’s very easy to overcorrect, especially when you give it some time and find you’re still shaky. But my medical team always told me it’s better to be too high than too low. A low sugar is an imminent danger and could cause brain damage. A high sugar has more long-term effects that can be reversed with better control. (I mean, a super high sugar can put you in a temporary coma, too, but if you’re just correcting for a low, that’s not likely.)
The best thing to do when you’re below 50 is to drink some juice or soda. Simple sugar suspended in liquid with nothing to slow the digestion. Give that 15 minutes or so, and you should feel better. Then you can follow that up with some more complex carbs and/or protein to keep your sugar up. If you’re still digesting dinner, a light snack may be all you need.
You can do a correction bolus later if needed, but don’t do that until you’re sure your sugar is above your low threshold and not likely to come back down. How much insulin you take is a function of what you’ve got in your system now (both insulin and digesting food), how active you’ve been (like I said, exercise can affect your sugar level even several hours later), what you’ll be doing, and your personal experience with how your particular body tends to work. Make an educated guess, and fix it later. But err on the side of too high, especially before bedtime. Whether you want to bolus at all is something to consider. You’ve got long-acting insulin already doing the job. In a sense, taking more of the fast-acting stuff is just correcting for having eaten more carbs than you needed to fix the low.
It can be tempting to over-correct for lows even when you’re trying to follow the 15/15 plan - when it takes so long to see your numbers rise or start feeling like you’re coming back to normal you might easy more just to be sure. You said this was your first time going that low - kudos to you for staying calm and managing the situation. Perhaps you were more active during the day and it caught up with you. Until you get guidance from your doctor, get at bedtime I would do as before and correct afterwards if necessary. As @WearsHats said, juice or soda tend to bring you up quickly (a doctor told me that liquids work faster than solids) but you’ll need to follow up with something that sticks with you.
Wishing you the best for your coming appointment - you’re new doctor should be pleased to hear your thoughtful questions.
Thanks, Dennis. I am glad. I tend to air on the side of caution before bed as if I don’t I end up low in the mornings. But hopefully, the suggested change in my medication (from my doctor’s office) will help me manage that better. It was the first time for me, so I don’t know why it wouldn’t come up, but as many of us discuss, every day is different and changes in anything can affect. Thanks a lot!!
Thanks, @WearsHats I tried juice in the beginning, but I ended up with smarties. I kind of forgot about soda being a good option. I will definitely remember that for next time. I probably could have bolused, but I was worried about going to bed after bolusing. It was an all-around unusual experience for me and I am pretty sure I didn’t take the wrong insulin, it makes me feel a little stupid to not know what it was that caused it. I suppose that my dinner insulin might not have faded off yet and then I had a snack that may not have affected my morning sugar at all. Note: I only take half or less of what I normally would for carbs before bed. So maybe I should have just had the snack and skipped the half count of insulin. I guess like everything in diabetes, this is just something to learn from. Thanks for all of your advice!!
@Wadawabbit Thanks for the advice as always, it was definitely my first time being that low and if I am honest, I was pretty freaked out. It usually doesn’t take me too much to come up from a low, so I was just really freaked out and a little panicky that it wasn’t coming back up. I always manage to stay calm and tell myself I can freak out later, it is time to do something about the low, I guess. No one in my family has it, but I am fortunate that they are supportive and they stayed up with me till almost midnight to make sure I was okay. Though I usually just do everything on my own, my family is always good at making sure I feel safe with where my blood sugars are. I am hopeful for this doctor’s visit as well. I am a little worried. As per the original post, my last doctor has me really freaked out and so I am pretty nervous and worried I will have a major breakdown. This new endo does video visits though, so maybe this will make me feel a little safer as I will be in my own space.
I don’t know if it helps but try thinking of it this way: while that last visit was your first one on your own, you probably had others that went well. I know personally how one negative experience can make you (me) forget the many prior successes. So before your appointment write down questions you have and things you want to you about; review your records - they may not be perfect (if they were we wouldn’t have diabetes) and give yourself credit for the corrections you made and for staying calm in the situation; give yourself some praise for the things you do to take care of yourself. Then take a deep breath and let the new doctor know you had a bad experience with your previous one and are hoping for a better experience this time around. If you’re still seeing a counselor they may have some suggestions for you as well. I hope this doctor turns rings around for you but most of all I hope you regain the confidence you had before that encounter.
Thanks, I have definitely been writing down some questions to ask. I am hopeful and I always try to be open when I meet new doctors (or anyone for that matter) My mom is going to be with me this time as well. My counselor has been helping me with like mindset, but she also says it doesn’t just happen overnight. Most people’s brains jump to the negative even when there are so many more positives. I have been working on trying to see the positive more. I am hopeful for this person, the doctor I was supposed to see had her baby, so I am seeing someone else this time and maybe for a while. He claims to be a partner in his patient’s health and he wants to work as a team to find a plan together. This is what I want in an endo, so I am hopeful that he will be the kind of doctor I want to work with. I am hopeful. Thanks, Dorie!!
Dannielle @fieldiez , I trust that you are looking forward to a positive experience with this “new doctor” next week. Keep in mind that each doctor will have a personal approach - some are direct and others coddle. My strong preference is a doctor who will lay out facts before me and challenge me to improve my own physical wellbeing.
Let me give an example. One of my first tasks a couple of decades ago when I move from Boston to Florida was to assemble my healthcare team. Upon recommendation, I selected an Internist who had a good reputation in the community - still see him regularly. After his complete examination of me, my medical history, we recognized my need for a good endocrinologist and he gave me names of two were know to be the “best in Florida”. I looked up what I could find on each of those doctors and couldn’t make up my mins, sooo …
I asked my daughter [a medical professional] and she asked around among her colleagues. She reported that both endos are outstanding, but the one I’ll call “B” had superior credentials but a less than pleasing “bed-side manner”. I began seeing “B” who immediately removed all disillusion from my mind that I was doing good with my diabetes. That approach, I liked and took up his challenge - now I’m really thankful for what he did for me.
@Dennis Thanks for your reply and perspective. I don’t mind people that are straightforward, but I also want someone who knows how to speak to their younger patients (being 18) and walk them through options. I suppose that that is just the type of doctor that I have always had growing up, even in my adult PCP. I already know I am not perfect, so I have no problem with a doctor who challenges me, but I expect my doctor to help me make a plan for my care (even if it is just a change to my carb ratio once in a while.) I suppose that means I am looking for a doctor somewhere between direct and coddling. Maybe that is too much to ask, but again, I have had many doctors (not just in endocrinology) who are personable, understanding, and straightforward. They work with me to help improve myself and not just tell me I am not doing well enough.
I am not saying that for many people “B” wouldn’t have been great, but for me, I probably would have chosen whichever one had a better bedside manner If I did see “B” and they did not feel I was doing well, I would have no problem seeing them if they at least made suggestions and explained why I should change something because my last endo did not. I even asked if she could recommend some changes and she just kind of ignored my question. I am not trying to make her seem like a bad person, she is very nice, I just didn’t like her approach to medicine.
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@fieldiez I am the exact person who would resort to foul language and anger in the presence of doctor B. In the very beginning of my starting over after 2 decades of self neglect, I would have walked out and not return. I needed a person. I needed someone who could assist me bending diabetes around my life and not asking me to bend my life around diabetes. I found one and he was perfect. No judgement. My first A1c after my dark period was 9%. He said, “I’m glad it wasn’t 11%”. We celebrated my first under 7%. I had his email, eventually his cell number. This gave me confidence at a time that a drill sergeant would have driven me back to the woods.
My relationship with my current Endo is complicated. I can tell you it is working. I can tell you I have confidence now and don’t need the extra care I did around 1999.
Turns out @Joe, I stuck with Doctor B and found him extremely helpful. One of his very positive mannerisms, rather than directly knocking me down was to tell me that I can do better and that I’m smart enough. Then he would give a few suggestions for my implementation. Turns out, every change had to be my choice.
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I love this thread, because it’s such a nice illustration of how what works for one person isn’t necessarily the right thing for someone else. Thank goodness we can choose what works for us!
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There’s a wide range of physician bedside manners to pair with our individual needs and preferences. In shopping for a physician - whatever specialty - chances are won’t find a perfect match but at least someone we can work with. On the other hand, if we find them so unbearable we can’t work with them - keep shopping.
I hope this one works out for you @fieldiez!
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@joe I feel like there are many different approaches to motivation and it sounds like the doctor you found had more of a positive motivation stance. I like positive motivation, I guess. Maybe it is just the type of person I am or that I am young, but I cannot stand up to doctors. I am a pretty passive person in the sense that I feel like I would just sit there and take whatever they say. People I know said they would just fight back, but I feel like most teenagers actually don’t know how to do that to an “authority figure” like their doctors. In my personal opinion, I think that the doctor that was no judgment would be awesome and helpful, it still sounds like he was still able to get you to a place you wanted to be with an approach that worked for you. Thanks for your input!!
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@Dennis I would definitely be open to working with a doctor like that. You know I am still generally new to this (4 years in June), so I am definitely not doing everything right. I know that. I just need a doctor to work with me, not against me. It sounds like Doctor B had a good approach for you. I like the last line, because that is pretty much how diabetes is. Every change is up to us to make and implement and stick with. Our doctors help, but it is pretty much up to each individual.
As a teen I was very passive - if I did try to speak up a bit I wasn’t what you would call a commanding presence. Some people are naturally assertive, and some learn it over time. You’ve already asserted yourself in a way by deciding not to put up with a doctor who treated you so disrespectfully; as well as each time you ask questions and request clarification. You’ll find your voice as time goes on.
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Hey everyone. Just letting you know that my visit went really well!! I feel a little refreshed and a little better. He didn’t really look at my numbers because it was a new patient visit. He asked about what my app said my time in range was and was happy with that. I am going to try the Dexcom G6. I was actually really happy with one thing he said he did. He said he actually wore a Dexcom for a few days to see how it felt so that he could be honest with patients. He is not diabetic, but I like that he tried it out to be able to experience it a little bit. Thanks for your help everyone. I like this thread and all of the different experience levels and perspectives. Such a great community of people!
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