Last week I had a new endocrinologist appointment that went pretty well. She referred me to a Certified Diabetes Educator (CDE) and I went to see her yesterday. I hadn’t been to a CDE in years. I actually think it must have been at least 15 years ago so I was nervous about what to expect. I had mentioned to my endocrinologist that my husband and I were trying to get pregnant within the next year so the documentation from the doctor to the CDE said “Type 1 Diabetic and pregnancy.”
The majority of the appointment focused on nutrition. This is actually a part of my health that I feel pretty knowledgeable and if I’m not doing things right, I do know what I need to do. However, I didn’t want to be rude and come off too know-it-all-y so I listened to her and was open to learning something new. She did give me a recommendation on a new food to try to get over my pesky 100 point hike after breakfast so I am going to give it a try out tomorrow. I didn’t really learn a whole lot but at the end of the appointment I asked her about recommendations on CGMs and insulin pumps. I have always stuck with Minimed so I was curious what else was out there. She gave me a ton of information and in that sense the appointment was very helpful.
I left the appointment slightly disappointed that we only really focused on nutrition (what about T1Ds and pregnancy?) but then she called me today after going over my Carelink reports (I had printed out one month worth of data!) and she suggested some changes. After the phone call, I had a much better feeling about my visit. I’m not going to lie, I’m a little weary of changes that have been suggested to me in the past, most have just been to increase my basal rate, but I liked her suggestions. She still wants me to increase my basal rate but not as drastically as others have wanted me to in the past.
I have had bad experiences with endocrinologists in the past so I didn’t have high expectations going into either my recent endocrinologist appointment nor my CDE appointment. However, I felt both appointments exceeded my expectations and I liked both the doctor and the CDE. While I did like them and the experiences were better than in the past, I still don’t know what added value they really provide. I think it really all comes down to how well I manage my diabetes on my own. I did basal testing on my own and now I feel that I have great basal rates. Sure they could still use some tweaking but overall they are much better than they ever have been in my entire life. My numbers aren’t perfect, as evidenced by my 7.3 A1C (grrr) but to get my A1C down, I really need to take the steps to pay attention to trends like how exercise affects my blood sugar or how certain foods to treat a low affect my blood sugar. A doctor can analyze my data all day long but every single day different things affect my blood sugar. Things that aren’t necessarily written down on my records like if it’s that time of the month or if I was overly stressed. I need to take care to record and understand how certain things affect me and make changes accordingly. One thing I did realize is how much of an impact the Diabetes Online Community (DOC) has made on my diabetes control. I know so much more about diabetes in the 7+ months I have been involved in the DOC than any doctor or CDE has ever taught me (well I guess the exception being when I first got diagnosed). My CDE did give me some great tips and changes to make and while they were small changes, I can use those changes and see if they make any differences and continue to keep track and pay attention and hopefully I will get my A1C lower and not get burnout by all the attention to diabetes which will hopefully lead to a baby in the future and if not a baby at least a healthier Kelley :).