OBs and their staff are all probably somewhat familiar with diabetes, but primarily gestational. I felt ever so slightly like a diabetes super star at my OB's office yesterday, with my fancy equipment and good control.
First, while I was giving my health history to the nurse, my Dexcom vibrated in my pocket. I glanced, saw a 68, and wondered if I should wait until the questionnaire was over (68 with a steady line isn't so horrible). But then I thought, wait, she's a nurse, she's not going to be the slightest bit phased if I check my blood sugar. So I said, "Don't mind me, I'm just going to test. My CGM says I'm low." But outside of the diabetes community, I guess "CGM" doesn't mean much.
Nurse: Wait, what told you? You mean you feel it, right?
Me: No, my continuous glucose monitor buzzed. (I placed it on the desk for her to see as I dug for my meter.)
Me: There's a sensor that takes my glucose levels all the time, and it's not as accurate as a meter, but it'll tell me what range I'm in.
Nurse: And what? Did it beep?
Me: It vibrated, but it can beep too.
Nurse: Wow, like a phone!
Me: Yep. At night I can set it to beep, but I keep it quiet during the day. It's GREAT.
Nurse: No kidding!
Me: (Lancing my finger.)
Nurse: Jeez, you do that like it's nothing! I'd probably still be squirming!
Me: You get used to it. It doesn't hurt much. Oh, 64. Not too bad. (Pulling out glucose tabs.)
Nurse: Oh, those are HUGE! I'd just drink pop!
It was kinda fun. And I was amused by the idea of a nurse being scared of a little lancet, when nurses have been jabbing me in the crook of my elbow with bigass needles for months, now!
Then the nurse practitioner (who handled this appointment, though I got to chat with the doctor a couple of times) asked if my endocrinologist had me keeping a log, because they'd like to see my numbers as well. When I showed them to her, she was clearly overwhelmed by the abundance of information. It does, after all, also include all of the food I'm eating. She showed me the chart they use.
Me: I'd be happy to just transfer my numbers onto here for you at the end of they day, if that'd be easier.
NP: That would be great. Does is match what Dr. Kennedy has you doing?
Me: That's the testing schedule I already use.
NP: And then... AM insulin and PM insulin... But you... That's not how you do it.
Me: No, that chart's not set up for a type 1.
NP: No, it's for gestational. They only take insulin once or twice a day. Maybe you could put... Hmmm...
Me: I could just look at my total daily dose for the day on my pump and put that down?
NP: Sure, that's probably as close as it gets. Now, I'm not sure what Dr. Kennedy has told you to do, but what we normally tell our gestationals to aim for is a fasting number below 90 and never anything above 135.
Me: She has me at a fasting below 100, then below 120 two hours after a meal. Do you want me to ask her about the below 90 goal?
NP: No, no, 100 is fine, and I love the 120.
(Later, while she's explaining that they don't induce diabetic mothers early unless there are signs that it's necessary...)
NP: Or if it looks like you're growing 10-pounder already, we might need to start discussing it. But seeing your numbers, you're doing great. Honestly, for as little time as you've had diabetes, I'm very impressed. You take better care of yourself than most of our gestational patients, that's for sure, and she rarely ever puts them through early induction.
So I felt pretty stinkin' good about the pregnancy and about myself as I left. I felt like, yeah, I am doing well! Not only am I not having those unexplained 200+ highs anymore (those were total WTF!), but I've also really gotten my numbers into the ranges my doctors want. At worst, since adjusting my lunch I:C, I've had a 122 after a meal. That's pretty badass!
I am starting to suspect the trademark lows of early pregnancy may be approaching. I had two slight lows like an hour before meals twice yesterday, and an almost-low that I headed off today. If I have another day like that tomorrow, I'll fax my numbers to my endo and see what change she recommends.
Yay! It's about time I started feeling good about this. :)