What I love abt my endo is that she works with whatever is real for me. She’ll say, “OK, I see that you were up till 3am several days last week; do you think we should try a different basal on those days?” She’ll notice things I may not. Definitely a partner. Our first 10 mins. are always spent talking about my life (work, marriage, vacation, family, etc.) THEN we talk blood sugar. She treats the whole patient.

I believe this is a disease of self-management. I know way more about it, living with it every day, that my endocrinologist does — another reason that seeing him, or any endo, is useless for me. I will be a doctor in 2 years myself so I’m more current on the latest published articles and research than most docs with busy practices. I also value my privacy. I would never, ever allow my meter to leave my hands to be downloaded and “analyzed,” for example. But again I have a different perspective because I have been in the medical field for so long.

As for my background insulin, I am pretty insulin-sensitive so I don’t do much Lantus — and that could definitely be contributing to the post-prandial highs. I am going to try to sync my exercise with mealtime so I can burn off some of the sugar after dinner — but again, I’m always in class or at clinic so I tend to exercise whenever it’s most convenient for me on that particular day.

Despite your whole grains (I’m assuming this includes whole grain breads and not just oats, right? like bulghar wheat, bran, chick peas, etc.), I still think that whole grain carbs shouldn’t cause a delayed spike (not to mention your fruits).

So now I’m wondering if you have enough background insulin. In other words, if your post-prandial spikes are not being caused by a delayed food spike, but rather that you don’t have a good sustained background insulin (like Lantus) to manage your non-eating times. Have you tried a fast through a mealtime as a way to check your background insulin? And another thought – are you eating a lot of peanut butter, avocados, olive oil, or other slow fats that might be slowing down your carb absorption?

Lastly: fire your endo. Really. I once got my health plan to refer me off the plan when I wasn’t getting what I needed. You deserve to be working with someone you can learn from, who can be your partner in managing your health. Put the word out on the db blogs saying what town/city you’re in and ask for recommendations. There’s no reason you should put up with a r-ship with an endo who is not helping, esp. in your first years of learning to manage diabetes. (don’t get me started!

Basically I’m eating lots of carbs but they are fiber-rich “slow” carbs. My endocrinologist (who has yet to tell me a single thing I don’t already know) suggested I “eat dinner earlier.” Not very useful advice, and doesn’t really explain the late spike. I don’t pump, I inject, so it means lots and lots of post-prandial checking and corrections — you know the drill … *sigh*

Using the Navigator, my A1cs have gone from 8.3+ to about 6.7. If I could get a fast acting insulin, I think with no other changes it would be almost 1 point lower.

Here’s hoping!
Scott

I am not sure if it’s because I eat whole grains that digest very slowly; I haven’t been able to figure it out. But if I eat dinner at 7 PM and go to bed at 10 PM with a sugar of 109, I will wake up at 6 AM with a sugar above 180. ??? And it’s not the dawn effect, as best I can tell.

Here’s something I’m curious about — apparently there is a type 1 diabetes vaccine being developed: Diamyd. I read a bit about it today, and the idea of a vaccine is quite exciting. As a future medical provider I hope to God it works, but as a type 1 diabetic I will be kicking myself for being too late to get it.

But I’d love to have something that works to bring down really high sugars faster. If my sugar’s up over 250, it can take a couple hours to bring it down. If an additive could do that, I’d be all for it.