I wonder if your endo’s nutritionist can do Tele health visits? They don’t need to do the hands on exam her doctor does - it’s mainly verbal and visual.
If she’s thinking about changing how she eats you might check out the Mediterranean diet. I’ll describe it as full of nutrients, the fats in it are healthier, and it relies on fresh food (and preparation thereof). But wait until you see how the changes you’re making work, and wait for doctor to give the 
to make other adjustments. Plus test results may give more insight to consider with food choices. I think overall the Mediterranean plan is considered a healthy choice, but always be sure to consider any special needs.
I bet it was scary. Good for her for getting herself juice, and to the nurse’s office when she needed to! I’ve almost passed out in front of a classroom before, and it’s no fun. That sense that you have responsibilities to look out for others when you know you can’t. It’s embarrassing, but worse, because you feel like you’re letting others down. I hope she knows, even as upset as I’m sure she was in the moment, that her kids care about her, her co-workers and administrators care about her, and no one is disappointed or mad — they’re all just worried about her and wanting to help!
And she WILL get the hang of this. Not to say she’ll never have highs or lows again, because she will. (When my daughter was first diagnosed, the endo told me parents would often tell him they wanted to keep their kids between 80-120. He would smile gently at them and say, “I wish your kid didn’t have T1, too.” That’s the target, and we do the best we can, but — I read this on this site a long time ago — keeping your BG in range is like keeping a drafty old house between 68-72, and all you have to do it with is a block of ice and a blowtorch.)
But she’ll get better at managing. And so will you.
@aftrshok Brian, that’s not “OCD”, it’s “CDO”…If you’re going to be organized it needs to be alphabetical! 
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@ANewNormal We are thinking the Dexcom is out of the picture due to her insurance but are still waiting to see what it comes back on her pharmacy insurance. We will use that info and her Endo’s info to decide where to go next. I will relay the insulin pump belt info to her so she can file it for later if needed.
@wadawabbit I will have her ask about the tele visit. We were just talking about the Mediterranean diet last night and how that might be what she needs to be doing. We will wait until we here more from her doc.
@srozelle I told her to never be ashamed that she has diabetes. I can’t imagine how one feels knowing how other people look at diabetics and I can’t say I wouldn’t be ashamed though.
I hear ya on the goal is being in a certain target and if it goes above or below that, that’s ok, it happens. You just keep doing the best you can. Right now her daily average is in the mid 200’s and her time in target has been averaging less than 5% a day.
@Tlholz You are correct sir…LOL
Well in a matter of less than 3 hours she’s had quite the rollercoaster…318 to 55 to 252 now. She said she feels like crap, I can only imagine.
FWIW, we get Dexcom through pharmacy (Omnipod, too!), and pharmacy is almost always a significantly better deal than DME. Fingers crossed that’s an option for you!
@srozelle Out of my own curiosity, are pumps always a DME? I guess what I’m saying is (dependent of how insurance pays) are they always a big out of pocket expense upfront? Does that make sense?
That’s why “Omnipod, too!” got an exclamation point in my post above. Usually, pumps are DME, which usually means a big upfront cost, depending on what kind of deductible you need to meet before insurance kicks in whatever portion they cover based on your plan. And yeah, it can be a LOT of money. One of the really big selling points for Omnipod is that although it’s a pump, it is often available through pharmacy benefits. Which means no deductible, no co-insurance, just whatever copay you have based on how it’s classified in your insurance plan’s formulary. Under some plans, it’s free. No kidding. Compared to thousands of dollars through DME. Same insurance company, two different departments, and sometimes, the right hand doesn’t know what the left is doing.
@srozelle I just totally overlooked that you said “Omnipod, too!”. I’m not thinking real clearly right now.
That’s the insurance business for ya. My dad is a retired doc and I’ve asked him if he would do it all over again and he said probably not due to the regulations and insurance crap. He started his own practice back in the 50’s in a small rural town and people couldn’t pay so they would bring him food or anything they could. I remember as a teenager going down to the clinic he worked at and I could just walk right in and go see him without having to tell someone at a desk who I was. Can’t do that anymore, you have to give blood, DNA test, Credit Card info and sign over your kids. LOL
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“I’ve heard” that pump supplies are covered as pharmacy benefits under some plans. A pump rep can do the legwork of determining your benefits and where the pump and supplies fall.
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For sure, have the reps do it. They want you to use their product, and they know the system. Far better use of their time than yours to figure it all out!
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Wife just got her C-peptide test back.
Results are 0.3 ng/mL (Normal range is 1.1 - 4.4 ng/mL) according to the report.
Not sure what that means though.
Brian @aftrshok , is is best if you wait for her doctor to do the interpretation. Like most lab tests, this value, and what it means for your wife, will need to be read in the context of her conditions. Does she have any other antibodies?, for example.
All my c-Peptide testings have come back with value of <0.01% meaning the lab couldn’t find any. I’d assume, in absence of knowing what else appears in her lab reports, is that she MAY be producing a small amount of insulin. Producing some insulin is not really unusual; the Joslin Medalist study [all having lived with diabetes for at least 50 years] reports that even people with very long-term diabetes can still produce some insulin.
Exactly, he might interpret it totally different based on his training.
Hello, my name is michele but everybody call me Sottiletta 
I honestly deal very well with Diabetes type 1 and I managed to get my sugar level well controlled .
I’m here because few doctors told me to share my experience and what I do because maybe it could be useful.
The first tip I have to suggest is this one: the best medicine is sport. The second keep controlled, the third do your best to be inside the right range of sugar level.
I know that several doctor say to accept value even high but in my opinion is wrong. Your body get used to them and slowly you end up perceiving normal sugar level like an hypo.
The combination Lantus + Humalog is very good but I split Lantus to avoid Hypo during the night.
6 units before sleeping - 8 when I wake up…it works great because you get the best effect during the day and the less during the night. Since I developed this method I had almost 0 Hypo during the night. I would try to be careful about cheese and crackers. The combo is not fantastic and cannot surely become a daily routine. I personally eat only fish, vegetable, fruits, bread, eggs, tofu…
I avoid very complicated meal for a simple reason. If before sleeping you have food that take time to be digested you have big change to wake up with high sugar level. For example the worse ‘mistake’ doctors do in people with Diabetes type 1 is to suggest Pasta. Well…If you check the Humalog curve of actions and Amid curve of assimilation you discover they do not match. It is embarassing and stupid what they say because you get Hypo at the begininng and Hyper after 3 hours.
I notice from your perfect Diary that the amount of insulin is not so much. If I was in you I would try with attention to calibrate the Units to get better Value. When I was 17 they told me I had to accept consequence for my Diabetes type 1. I had read that sport was a big help. The doctor laughed asking me if I wanted to practise sport all my life…I did not answer…but it is what I did…now I’m 47 and I partecipate to 10k competition…and I was on the podium several times…
I say this because we can do well in spite of our issue but we have to pretend the best for us and not feel happy when a doctor say it is ok. I know that at the beginning be inside the right range can be very hard but it is worth it. If you combine a diet with little fat, good protein, vegetable , fruits (not too sweet) and good carbs like brown bread with daily sport routine and you pretend to be in the right range you can do it. I hardly reccomand to split Lantus because doing the math is very evident you get a distribution of Lantus that is less effective during the night and quite high during the day.
Obviously there are surely people that do better than me but my best advice is to keep trying to achieve almost a perfect range of sugar level.
Morning update…Doc called yesterday evening but did really discuss much in the way of changes except for now to change her ICR from 1:12 to 1:15 since she had that big of a drop. He hasn’t looked at the lab results yet. He said he’s been in the hosptial all day with his wife, they are having a baby. So we will give him a pass for now. LOL
Her numbers came down to 74 before supper, she took her bolus to cover her carbs and by bedtime her BG was 345. Nothing like starting the day at 315 and ending at 345 and all over the place in between those during those 16 hours.
She’s staying as strong as she can, even though she dropped the F bomb (she never says that word or anything else for that matter) when she saw the 345.
Here overall BG average yesterday was 214 (surprisingly) when you look at her graph, it’s like the Grand Canyon with Mt. Everest sprinkled thru out.
She did say that she wants to start looking into the Mediterranean diet (hate the word “diet”, lifestyle or eating style sounds better) and get away from the Keto type diet she has done for the last 4 years. Any thoughts on that? She is going to call the nutrionist at her Endo’s office and see if she can meet with them and talk about different diets. I couldn’t eat that type of diet, I’m waaaaaay to picky and don’t like very many veggies.
Hmm. When she had her low yesterday, was that after she gave herself the “right” amount of insulin for her carbs, to the best of her knowledge, based on the ratio she’d been told to use at the time? Or did she give herself one unit too many?
Based on what you had written yesterday, it sounded like she took one unit too many, which would explain the low. It would also contradict the doc’s conclusion that her ratio was too aggressive, and explain the 345 at bedtime (assuming she used the newly-reduced amount of insulin with dinner).
If she DID bolus “correctly” yesterday, then ignore me, with my apologies for the confusion!
Congratulations to you endo on the new addition, even if it does mean he’s a little distracted right now. 
@srozelle She took the right amount of inulin for her carbs to cover her coffee carbs and based on her sliding scale as well. That’s what doesn’t make any sense about the drop. Maybe 1 unit is to much for her carb coverage in her coffee but she can’t take half a unit so it’s either one or none for her coffee. We know the coffee and what she puts in it is raising her sugar so it has to be accounted for but 1:12 or the newly 1:15 just doesn’t work for it.
As far as changing her ratio at supper time, she had already ate before he called to tell her to change the ratio so she was on the old ratio of 1:12
Just as long as he’s not too distracted!!
I too hate the term “Mediterranean diet” - it is really a lifestyle. Hopefully you’ll get more guidance from your doctor soon.
Got it. So there actually ARE 1/2 unit syringes, which might be the solution. We had the same problem: 1 unit was too much, but 0 was not enough. Call the dr’s office and see if someone can order you some 1/2 unit syringes.
Not everyone is familiar with them — I once had to explain to our mail order pharmacy that they did, too, exist, because I was looking at a box on our shelf at that moment. And the nurse at our daughter’s elementary school didn’t know how to read them (it’s the same syringe you’ve got now, just with half-units marked on the left, in addition to full units marked on the right). It wouldn’t have been the end of the world — she’d have gotten half as much as she needed, and as you now know, a high is safer than a low — but still, I’m glad I was there to teach the nurse how to read the syringe. 
But that might be your wife’s ticket.
And if she ever does get on a pump, they can dose in .05 unit increments.
@wadawabbit We hope so too, it’s been a very frustrating (close to) year since she saw the first endo. Nothing but a constant struggle so it’s hard to keep being patient while trying to get the right doses, treatment, etc.
@srozelle We will have to ask about them.