Recommitting

[EeyoreButterfly]

Confession Time: I have not been good about counting carbs or realy doing anything that I need to. I did pretty much eliminate soda from my diet except for once in a blue moon (I need to fix that.) But I have hard time with pastas, etc. A lot of it is I eat out too much. I also have not been exercising like I should. I have started to really work hard to change all that.

I joined a gym with a discount available from my school district, and have been working with a personal trainer. I also got this gizmo called a Bodybugg and it helps to log my calorie output for the day via a sensor. I then record food online and it can tell me now much of a deficit there is as well as show my a breakdown of where those calories are coming from. I'm hoping it will help me to be honest.

I haven't been testing like I should either and I am trying to get back into the habit. To be honest, one thing I have found discouraging is that the doctors seem to ignore my highs and lows since my a1c looks good. I thought I might finally get some validation from the OGTT as my meter put my 2 hour over 200, but on their test it was 197. Even though my 1 hour was over 200 and diagnostic criteria generally says any random reading over 200 is diabetes, they are still classifying me as pre-D. That 3 point difference is causing me a lot of problems.

I feel like pre's just don't get taken seriously a lot of the times. I want to test after meals because that is where I have problems, but I can't get the doctor to agree to more than 100 strips a month. Even after I told them that I have multiple lows a week. They told me I need to only test once a day, but I don't see how anybody can have good control if they do that. On the advice of you all I started testing after meals, and it is only through doing so I realized that something was not right. If I only tested fastings, I would never know that my postprandials are so out of whack and I would be off in la la land thinking everything is okay. I don't want to do that.

I know how Rob feels sometimes. It's easy to say why should I care if nobody will support me? Particularly the doctors. But I'm determined not to fall into that trap anymore. I know that it will take awhile to break old habits, but I'm hoping that I can get this thing under control and start putting my words into action.

[foxl]

Well, welcome back to it, and best wishes for recommitting!

It is not just the pre- s who backslide -- I think all of us do. Eating out however .... need to quit that. Easier on the BUDGET, too! I have convinced my husband that we must raise the kids to not expect restaurant meals, once to twice per week ... it is costly and not healthy. Not to mention, his unemployment is about to run out ... :mad:

[jenb]

Jesse - I'm sorry you're having such difficulty. This really can get you down.

Your self-developed test regimen makes the most sense for people who really want to gain control. I encourage you to buy strips outside your insurance company's allowance even if it's expensive. Your long-range health is worth it.

Try to stay positive and let us know how you're doing.

Jen

[EeyoreButterfly]

I'm really frustrated right now. I went to the diabetes educators and they were mystified why I am still called prediabetic. They agreed that I should test after meals since that is when I have my problems. They told me to advocate and ask the doctor why I am still called prediabetic despite my meetin the criteria to be diagnosed with full blown Type 2. It's not that I want type 2, but I am do not believe I should be properly called prediabetic, and I think doctors (and insurance) take you more seriosuly with the proper lable.

Anyway, I was at my doctor's this week for an unrelated issue and brought up what they said. I was told testing more than once a day is unnecessary. Even after I told her what the diabetes educators said, she told me there's no point to it. I tried to tell her I change what I eat based on the readings, but the endo told her it was unnecessary. I like this doctor for everything else, but this just blows me away. My insurance is willing to pay for it, so I dont' understand what the problem is. It's frustrating. People always ***** about us fat lazy Type 2's who don't comply or do anything to treat, but when we try to really do something we are blown off.

[Subby]

Everything screams "new doctor" to me. Can you afford to stick with one who won't take you seriously with D, because they are good for other things? You don't need good for other things, with this issue. You need good with diabetes.

[Granny Shanny]

And when diabetes is taken seriously and controlled, SO many other things fall into place!

[ShottleBop]

Print out this report from the Mayo Clinic and take it to your doctor: Mayo Clinic Report on SMBG (http://www.mayoclinicproceedings.com/content/82/2/229.full). Your doctor may be thinking of studies that have reported that SMBG doesn't improve matters--but, according to this, the people in those studies were averaging only one or two tests a day--there is real value in SMBG if it is used properly to assist a patient in making decisions and taking appropriate action: To take full advantage of the benefits of SMBG, patients must collect data at appropriate times during the day, recognize readings that are outside their target range, and take action to improve their glycemic control. This is most easily accomplished by having patients compile a periodic glucose profile by taking a series of blood glucose measurements throughout the day, capturing information from the fasting, postprandial, and postabsorptive (or late postprandial) periods. Conversely, by staggering SMBG measurements at different times on different days, patients can generate an accurate portrait of day-to-day glycemic excursions while avoiding the need to test many times in a single day. Regardless of the testing regimen, patients should be encouraged to collect data on glucose levels relative to meals. Studies that have used meal-based SMBG testing have demonstrated improvements in HbA1c.51,52 The ability to download memory meters with a date and time stamp greatly facilitates this process. Some meters have event markers for meal times, insulin doses, exercise, and hypoglycemia, substantially adding to the power of the analysis.

Pattern Recognition

Regardless of the monitoring regimen, a key to effective use of SMBG in clinical practice is “pattern management,” a systematic approach to recognizing the glycemic patterns within SMBG data and then taking action based on those results. This approach consists of several key steps53: (1) establish both premeal and postmeal blood glucose targets; (2) gather data on blood glucose levels, carbohydrate in-take, insulin dose (when applicable), activity levels, schedule, and physical and emotional stress; (3) analyze data to determine whether any patterns emerge; (4) assess any influencing factors; (5) take action; and (6) regularly monitor blood glucose levels to evaluate the impact of actions taken. By using the data gathered during a specified period, the clinician and patient can review patterns of glycemic excursions and then make adjustments to meals, activities, and medications to better control glucose levels, minimize glycemic excursions, and limit hypoglycemia.

[EeyoreButterfly]

I honeslty don't know that that would help, because their attitude is my a1c looks good and I am "only" a prediabetic, so anything more than once a day is overkill.

[yannah]

I would procede as though I am T2. I do not even beleive in prediabetes.

Living the diabetes way is healthy! fun! full of exploration! wonderment! fellowship! friends!

really, thats just what I would do, so a new committment is a really good thing. congrats on a great desicion.

[EeyoreButterfly]

You guys rock! You gave me the kick in the pants that I needed. I have this thing where I want to please people. I like the personality of my PCP, and I don't like thinking bad about her, but this is one my main issues and I don't feel I have the support I need, mostly because she is listening to the endo that I don't care for.

I am going to see a new PCP. I am going to the one affiliated with the hospital where my mother got her medical training. It is a world class hospital, and I am hoping for a better outcome there. Especially if I tell them what the diabetes educators said.

[davef]

Jessi,

I glad to see you are recomitting, when it comes down to it, we are the ones responsible for our diabetes management. If you believe you should be consider as T2 then why start by changing your type here on the forums. To be honest I have often wondered why you were classed as pre-D, with the BG levels you have mentioned in the past you do sound more T2 than pre-d. That said, you should deal with your classification as you need to. I think consulting another PCP is a good idea, we do need people who will work with us to be part of our care team.

Best of luck!

[EeyoreButterfly]

Thanks Dave! I made the appointment with the new PCP for next Friday. This is through Saint Luke's hospital system. My mother received her medical training through them and highly recommends them. I have not heard one bad thing about them, so I'm keeping my fingers crossed.

[foxl]

Thanks Dave! I made the appointment with the new PCP for next Friday. This is through Saint Luke's hospital system. My mother received her medical training through them and highly recommends them. I have not heard one bad thing about them, so I'm keeping my fingers crossed.

Who? Who? I use St Luke's too! PM me if you prefer ... It is a good hospital, my family and I have all been very well-treated as inpts and love my PCP ... but my Endo there is "strictly clinical" in her approach ...

[EeyoreButterfly]

It's at Saint Luke's East in Lee's Summit. I would have to look up the name of the PCP. There were a lot available, and since I know nothing about any of them, I told them it didn't matter who it was, but I did prefer a woman.