Let me bounce this off you

I had an appointment with my endocrinologist this week. When I got there I posted what Karen described on Twitter as one of the best #waitingwithdiabetes pictures we’’ve seen.


I tend to agree. How many of you have a piano in your doctor’s waiting room? Exactly!

Overall the appointment went well. My endocrinologist is a good fit for my needs. My A1c came back at about the same level as my last one and my blood pressure and weight are still good. I am waiting on the rest of the lab work that was ordered after my appointment (two vials and a cup as I described to Kerri ).

The endo asked me if I was still doing the “blogging thing” and I told her about my upcoming trip to San Diego. She reminded me that the DexCom headquarters are there and suggested I should try to see if I could get a tour!

Speaking of DexCom, due to the unfortunate incident from last Friday, I could not bring my DexCom for any reports. She was still able to download my pump – what’s that saying about losing things that aren’t attached?!

Side note: An angel in the online community is sending me their old receiver and will not accept anything in return. Isn’t that amazing?! Delta can’t provide adequate customer service but the diabetes online community can! I love it!

The endocrinologist brings the MiniMed print out back into the exam room. She said that my A1c was in a good range but according to the report she thinks I am bouncing too much from high to low. I adjust my own pump settings usually and I had not felt I was bouncing or I probably would have adjusted the appropriate settings.

We talked about what might be causing the problem – correction factors and carb ratios – and talked about adjusting those settings. I think I seemed hesitant because she said something like, “it’s up to you, you know what you are doing.” It’s been a few days and so far I am not entirely sold either way.

I was thinking about it later though and I think maybe I am not “bouncing” as much as it appears on the report. Because of the DexCom, I really test most often to confirm what it says. “Really, I’m low? That can’t be right.” or “Am I really that high right now?” When I am nicely in range (with a horizontal arrow), I tend not to test.

What if the “bouncing” is just misinterpreting incomplete data?


  • You really have to decide if you are okay with the boucing. If she likes your a1c number, and more importantly, IF YOU LIKE YOUR A1C NUMBER why would you change? If you’re not happy, that would be the only reason to change.

    I like that your endo said your setting are up to you! My settings are all me! When my endo gets her own pump, then she can have her own settings

    I’m a grazer- I eat 3 main meals a day that are relatively small, and then lots of other small things during the day. I think it keeps me flat, but I don’t really know- I’m not using CGMS.

    That’s really exciting that someone helped you with your Dexcom receiver. That was very generous of someone to gift you with the piece that you lost. Very generous!

    My endo doesn’t have a piano- I agree that you win best waiting room. Do they have a piano player?

  • Sara, that makes a lot of sense. You look at a 24 hour graph of insulin and pick 10 random points. If you test before you eat and one hour later, you’d look like a yo yo. If you tested during really static parts of the day, you could look perfect, even if you were having major highs at night or in the mid-afternoon. It’s awesome that your doc looks at the data and says: “You are the judge of whether or not this is working.”

  • Sara,

    I have the same problem with my Navigator logs. While very good, they are my glucose at it’s worst, because I only use my navigator when it is time to adjust pump basal rates. That is one week, 4 or 5 times a year.


  • I’ll bet you’re right. I generally test with a fingerstick to calibrate. And then I test when I’m not sure about the Dexcom, these latter readings are generally off the charts in one way or another.

  • I’m a sociologist & statistician in addition to also having Type 1, so I maybe think about these kinds of issues more than the average PWD. I usually remind my doctor of this when I go in. I test much more when I think I am high or low than if I am not, so tests averages are definitely biased (even though I know there is still room for improvement). One thing you could try would be to test every 2 hours or some sort of regular intervals to try to capture the “in-between” data as well as the pre & post meals, so you’d get a fuller picture- similar to the benefits of basal testing. Admittedly, I’ve thought about doing this myself but have yet to implement it.

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