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RE: [IP] Re: basals and boluses/Relationship with one's doctor

I think the ultimate responsibility of controlling glucose lies in the
diabetic's hands. I like my relationship with my endocrinologist because he
gave me certain parameters to follow and it was agreed that if I needed help
I would holler. If you haven't already purchased Pumping Insulin by Walsh, I
would suggest you do so and the link is on the IP website. Most of the
information you need to run good sugars is contained in this book. I would
tell your doctor what is going on and ask his advice concerning a CDE as,
like everything else, there are good ones and not-so-good ones. Why not just
tell this trusted physician you think you could improve some with a little
extra help....I'm sure it would please him immensely.


-----Original Message-----
From: email @ redacted
[mailto:email @ redacted]On Behalf Of Laura Gulley
Sent: Thursday, November 27, 2003 9:54 AM
To: email @ redacted
Subject: [IP] Re: basals and boluses/Relationship with one's doctor

Here's a long one... I have had the same endo since college and that was
almost 20 years ago. I've always liked him because he has given me the
space and the respect to figure out everything on my own, and I also think
he's a fine human being who cares about me and who I look forward to
seeing. He's one of the best-established endos in the state and though
nearing retirement continues to be up to date as far as I can see and is
still very active in teaching and professional leadership. And he's
continuing to learn more about pumps and put more patients on them all the
time. So I'm lucky and I know it. But since we've known each other for a
long time, we've developed some habits, as human relationships always do.
When I see him he glances at my decent averages and my decent A1C and my
24-years-no-complications status and normal bloodwork and very active life
and says "Whatever you're doing, it's working" and never pushes me to try
harder to even things out or examines the fine points of my logbooks, which
don't even exist :), having had record-keeping issues from way back. And I
contribute to this situation by telling him I'm doing great, not
complaining about my daily lows and my constantly changing basal rates and
postprandial highs and drops, pretending to have everything under control,
just like I do with everyone else (complaining being uncool). He has lots
of older Type II patients with serious complications, and I think I'm sort
of a nice break for him, and I like him so much that I kind of want to
please him, and if I wrote down every BG for a week it would not be a
pretty sight! I'm starting to realize from Pam's post here, and many others
on this fantastic list, that some endos actually help you manage the
details of your diabetes care. Wow! And a CDE is a creature I've never once
met. So you guys are spurring me on to look around for some detailed
support. Asking for help when you need it, what a concept. Thanks for
letting me think out loud. Anyone want to share details of what their
endo/CDE does at the office visit?

Laura G.
who is ordering a little scale for weighing rice and bread!! thanks folks

At 07:56 PM 11/26/2003 -0800, you wrote:
>I too was doing what you were doing, using higher basals to cover part of
>meals. Same thing as you - it was a problem if I skipped a meal, exercised,
>etc., plus my post meal blood sugars would be really high and then drop
>later. I
>always thought I was brittle. Last summer I changed to a great new endo,
>and the
>first thing she did was significantly lower my basals and increase my bolus
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