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    • 9 hours, 45 minutes ago
      KarenM6 likes your comment at
      In the past 12 months, have you experienced nausea and/or vomiting as a symptom of high blood glucose levels?
      "It's a forever learning curve" - so very true
    • 9 hours, 52 minutes ago
      KarenM6 likes your comment at
      For pump users: In the past 3 months, have you had issues with insulin delivery due to a bent cannula or occlusion?
      I hesitate to bring this up but I am quite sure this happens more than people realize. I use a tubed pump and small amounts of total daily insulin and have checked the tubing for YEARS for bubbles. YES, they are difficult to "notice" unless you have a good light behind the clear tubing because the insulin is also colorless. I detach and check the tubing in the morning and before bedtime if not before the evening meal...I'm talking about significant bubbles----8-10-or12 inches in length can appear and you would NOT notice them unless you were looking. I wonder how many people wonder why their blood sugar is occasionally high and it's being caused by a significant bubble...NO, not the champagne sized version that's often mentioned to "ignore." The pump company I deal with tried to get me to switch to injections instead but I am an EXPERT with the bubble situation. Also, comments over the years that I am probably not filling the reservoir correctly, etc....just plain silly. I am NOT new at this...LOL!!!
    • 10 hours, 17 minutes ago
      KarenM6 likes your comment at
      In the past 12 months, have you experienced nausea and/or vomiting as a symptom of high blood glucose levels?
      I said yes to nausea, occurred with a bad pump site insertion and rising BG over the next 4 hours. I picked it up early w CGM notification and realizing that it was very unusual for me to have rising BG at that time of the day (morning) when on Control IQ pump. The severity was delayed because I had given a breakfast meal bolus via the prior site before the change, so BG was rising after 3 hours, and I knew something was not right. I think this is an important clue for pumpers- when I see people get in trouble w bad sites or insertion failures, the thought process usually is- I just put a new site in, it must be ok- or maybe it does not occur to people that the pump site could have failed--when it should be- did the insertion fail? ----If in doubt, pull it out!----- I pulled the site and could see the cannula was bent, so I know what happened and injected w a syringe, put a new site in, and was better in a 3-4 hours.
    • 14 hours, 54 minutes ago
      Janis Senungetuk likes your comment at
      In the past 12 months, have you experienced nausea and/or vomiting as a symptom of high blood glucose levels?
      I said yes to nausea, occurred with a bad pump site insertion and rising BG over the next 4 hours. I picked it up early w CGM notification and realizing that it was very unusual for me to have rising BG at that time of the day (morning) when on Control IQ pump. The severity was delayed because I had given a breakfast meal bolus via the prior site before the change, so BG was rising after 3 hours, and I knew something was not right. I think this is an important clue for pumpers- when I see people get in trouble w bad sites or insertion failures, the thought process usually is- I just put a new site in, it must be ok- or maybe it does not occur to people that the pump site could have failed--when it should be- did the insertion fail? ----If in doubt, pull it out!----- I pulled the site and could see the cannula was bent, so I know what happened and injected w a syringe, put a new site in, and was better in a 3-4 hours.
    • 14 hours, 54 minutes ago
      Richard Wiener likes your comment at
      In the past 12 months, have you experienced nausea and/or vomiting as a symptom of high blood glucose levels?
      I said yes to nausea, occurred with a bad pump site insertion and rising BG over the next 4 hours. I picked it up early w CGM notification and realizing that it was very unusual for me to have rising BG at that time of the day (morning) when on Control IQ pump. The severity was delayed because I had given a breakfast meal bolus via the prior site before the change, so BG was rising after 3 hours, and I knew something was not right. I think this is an important clue for pumpers- when I see people get in trouble w bad sites or insertion failures, the thought process usually is- I just put a new site in, it must be ok- or maybe it does not occur to people that the pump site could have failed--when it should be- did the insertion fail? ----If in doubt, pull it out!----- I pulled the site and could see the cannula was bent, so I know what happened and injected w a syringe, put a new site in, and was better in a 3-4 hours.
    • 15 hours, 14 minutes ago
      Ahh Life likes your comment at
      In the past 12 months, have you experienced nausea and/or vomiting as a symptom of high blood glucose levels?
      I began playing Pickleball last year in March. When the temperatures started to rise the extra effort my body was experiencing because of the heat got my body hormones out of balance and I began experiencing nausea, higher heart rates and feeling very uncomfortable. I soon realized that I cannot play when is too hot or I’ll end up with ketones. Any new activity when on. Insulin requires adjustments. It’s a forever learning curve. Adding to the heat, last year I was having some absorption problems by the overuse of my abdomen. I have now move the infusion sites to my upper front side and it’s working much better.
    • 15 hours, 14 minutes ago
      Kristine Warmecke likes your comment at
      In the past 12 months, have you experienced nausea and/or vomiting as a symptom of high blood glucose levels?
      I said yes to nausea, occurred with a bad pump site insertion and rising BG over the next 4 hours. I picked it up early w CGM notification and realizing that it was very unusual for me to have rising BG at that time of the day (morning) when on Control IQ pump. The severity was delayed because I had given a breakfast meal bolus via the prior site before the change, so BG was rising after 3 hours, and I knew something was not right. I think this is an important clue for pumpers- when I see people get in trouble w bad sites or insertion failures, the thought process usually is- I just put a new site in, it must be ok- or maybe it does not occur to people that the pump site could have failed--when it should be- did the insertion fail? ----If in doubt, pull it out!----- I pulled the site and could see the cannula was bent, so I know what happened and injected w a syringe, put a new site in, and was better in a 3-4 hours.
    • 15 hours, 15 minutes ago
      Ahh Life likes your comment at
      In the past 12 months, have you experienced nausea and/or vomiting as a symptom of high blood glucose levels?
      I answered no, but I do experience nausea and/or vomiting, usually on a daily basis, but this is because I have gastroparesis. I have rarely been able to eat breakfast over the last 20+ years as I end up vomiting it all back up ... try explaining that to ward staff in hospital(s). ;-)
    • 15 hours, 34 minutes ago
      Becky Hertz likes your comment at
      In the past 12 months, have you experienced nausea and/or vomiting as a symptom of high blood glucose levels?
      I said yes to nausea, occurred with a bad pump site insertion and rising BG over the next 4 hours. I picked it up early w CGM notification and realizing that it was very unusual for me to have rising BG at that time of the day (morning) when on Control IQ pump. The severity was delayed because I had given a breakfast meal bolus via the prior site before the change, so BG was rising after 3 hours, and I knew something was not right. I think this is an important clue for pumpers- when I see people get in trouble w bad sites or insertion failures, the thought process usually is- I just put a new site in, it must be ok- or maybe it does not occur to people that the pump site could have failed--when it should be- did the insertion fail? ----If in doubt, pull it out!----- I pulled the site and could see the cannula was bent, so I know what happened and injected w a syringe, put a new site in, and was better in a 3-4 hours.
    • 1 day, 8 hours ago
      Wanacure likes your comment at
      Have you developed lipohypertrophy due to repeated injections/infusions of insulin? Lipohypertrophy is a term to describe hardened lumps of body fat just under the skin that resulted from repeated insulin injections/infusion sites. If so, share how you’ve handled lipohypertrophy in the comments!
      After 62 years I have skin issues everywhere. I am an avid at rotating every time I change my infusion set. When I was on multiple daily injections, up to 9 per day, I had massive skin hardening. Since on the pump it’s not nearly as bad that’s been 33 years. I take very little insulin my daily basal comes out to 9 units over 24 hours I eat two meals that I count carbs for and try to keep at a minimum of 30-40 per day. Everything is going well. Rotation is key
    • 1 day, 8 hours ago
      Wanacure likes your comment at
      Have you developed lipohypertrophy due to repeated injections/infusions of insulin? Lipohypertrophy is a term to describe hardened lumps of body fat just under the skin that resulted from repeated insulin injections/infusion sites. If so, share how you’ve handled lipohypertrophy in the comments!
      I use a pump and have had issues with insulin absorbtion. It seems I have a lot of them on the side I primarily use for infusion sets. I recently switched to the other side of my abdomen and dropped more than one point on my a1c.
    • 1 day, 9 hours ago
      Wanacure likes your comment at
      Does your T1D healthcare provider suggest new medications or devices that they think would be beneficial to your T1D management during your appointments?
      When I first started with my current Endo we would discuss the released and upcoming products and I would tell her about the 'off-market' applications and devices, we both learned from each other. But she was so good with helping me transition to the Dexcom and then the Tandem after Animas was pulled from the Market. She followed my Dex and even finer tuned my Basals and early this year I got an "unbeleivable" 5.4 A1c and we are both extremely happy!
    • 1 day, 9 hours ago
      Wanacure likes your comment at
      Does your T1D healthcare provider suggest new medications or devices that they think would be beneficial to your T1D management during your appointments?
      Yes. But then I self-selected when choosing an endocrinology clinic that pursues cutting-edge advances 40 years ago. Cutting-edge is a phrase that is also often called bleeding-edge because it is often experimental, hit or miss on results, and very expensive. I am convinced the “bleeding” refers to $$$.
    • 1 day, 9 hours ago
      Wanacure likes your comment at
      Does your T1D healthcare provider suggest new medications or devices that they think would be beneficial to your T1D management during your appointments?
      not anymore, and I am happy about it! Most of the time they were recommending things that had been recently pitched to them by a pharmaceutical salesperson or a durable medical supplier. The doctors would give patients the "free samples" and it was often not the best fit, then after the "free" supply ran out, the prices were exorbitant. Maybe it still happens, but I haven't seen it for a while.
    • 1 day, 9 hours ago
      Wanacure likes your comment at
      If you have never used an insulin pump with automated insulin delivery (also known as a hybrid closed-loop pump), what are some of the reasons you’re reluctant, or obstacles you’ve encountered? Please select all that apply.
      The need for better CGM accuracy is a big consideration for me. Also my control is pretty good right now (a1c in the low 6 range). Although I am tempted by the sleep and exercise modes which would be very helpful since I’m getting back in to exercise. So…I keep sitting on the fence…
    • 1 day, 9 hours ago
      Wanacure likes your comment at
      If you have never used an insulin pump with automated insulin delivery (also known as a hybrid closed-loop pump), what are some of the reasons you’re reluctant, or obstacles you’ve encountered? Please select all that apply.
      I don’t want to change from the Omnipod Dash to Omnipod 5 because the minimum target blood glucose is level is higher than where I like to keep it. My A1C is currently 5.0.
    • 1 day, 9 hours ago
      Wanacure likes your comment at
      If you have never used an insulin pump with automated insulin delivery (also known as a hybrid closed-loop pump), what are some of the reasons you’re reluctant, or obstacles you’ve encountered? Please select all that apply.
      For the last 5 years, the highest HbA1C I've had was 5.3. For the last 3 years the high, low, & average have been 5.2, 4.7, & 4.9. I'm not willing to go to an AID that sets a target of 6 to 7.
    • 1 day, 9 hours ago
      Wanacure likes your comment at
      If you have never used an insulin pump with automated insulin delivery (also known as a hybrid closed-loop pump), what are some of the reasons you’re reluctant, or obstacles you’ve encountered? Please select all that apply.
      I do MDI. For the last 7 years my A1C has averaged around 4.8. I have no reason to believe that a closed loop automated system could do that well.
    • 1 day, 9 hours ago
      Wanacure likes your comment at
      If you have never used an insulin pump with automated insulin delivery (also known as a hybrid closed-loop pump), what are some of the reasons you’re reluctant, or obstacles you’ve encountered? Please select all that apply.
      There are many reasons, as well as "something else." My arthritic fingers do not serve me well with a cell phone. I have trouble putting the needle covers back on to my insulin pen needles. If I had to take care of all the fine muscle issues associated with setting a pump up, I would probably require assistance. I am also not drawn to the issues I hear about tissue damage at the infusion sites, or knowing whether everything is seated properly and the insulin is actually flowing. Finally, I just have some kind of negative karma with electronics. I have worked as a lab biochemist. Somehow, I find the weaknesses of every machine in the lab. (the ideal industrial beta-tester) Having said that, what I hear about the numbers achieved with the tandem CIQ gives me pause to consider.
    • 1 day, 9 hours ago
      Wanacure likes your comment at
      If you have never used an insulin pump with automated insulin delivery (also known as a hybrid closed-loop pump), what are some of the reasons you’re reluctant, or obstacles you’ve encountered? Please select all that apply.
      Like others, the "closed loop" runs me too high - even the target bg is too high for me. I use the TandemX2 with BIQ integrated wqith my Dexcom G6. I also appreciate - and use - the temp basal function often. I would lose that with CIQ. L:ike Nilla Eckstrom (I think?) I like to be between 80-90, with maybe up to 120 after I eat.
    • 1 day, 9 hours ago
      Wanacure likes your comment at
      If you have never used an insulin pump with automated insulin delivery (also known as a hybrid closed-loop pump), what are some of the reasons you’re reluctant, or obstacles you’ve encountered? Please select all that apply.
      The constant refilling and site changes...doesn't seem worth it.
    • 1 day, 9 hours ago
      Wanacure likes your comment at
      If you have never used an insulin pump with automated insulin delivery (also known as a hybrid closed-loop pump), what are some of the reasons you’re reluctant, or obstacles you’ve encountered? Please select all that apply.
      Luddites just may be the most comfortable people on earth. 🙃 
    • 1 day, 10 hours ago
      Antsy likes your comment at
      For pump users: In the past 3 months, have you had issues with insulin delivery due to a bent cannula or occlusion?
      Holy cow! 8 to 10” bubbles? There is definitely something wrong if that is happening to you. I occasionally get 1/4” inch 10” is excessive. Have you gone in and shown your pump instructor how you’re doing it so that they can help you figure out the problem?
    • 1 day, 10 hours ago
      Wanacure likes your comment at
      Aside from the first year after your diagnosis, have you seen a registered dietitian for help managing nutrition and T1D?
      When I was put on insulin, the first dietitian I payed to see said I could eat whatever I wanted as long as I followed the set number of macros (carbs, protein, fats). The stupid diet had my blood sugars all over the map. She didn't care/listen when I told her milk, bread/pasta made me feel really sick. She said because I was on insulin I need to eat a high carb, low protein and low fat diet. What bad advice! Thankfully, I came to my senses and starting reading the experiences of other T1D's who were following the The Bernstein diet.
    • 1 day, 10 hours ago
      Wanacure likes your comment at
      Aside from the first year after your diagnosis, have you seen a registered dietitian for help managing nutrition and T1D?
      Saw one, recently out of school, when I was first diagnosed ten years ago. She insisted I needed 150 grams of carbs per day minimum and handed me a sheet with meal plans. She explained that I needed those carbs to keep my brain functioning properly. GEEZ. I can only hope she's learned a thing or two since then.
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    Before making changes to your insulin management, do you check with your healthcare provider?

    Home > LC Polls > Before making changes to your insulin management, do you check with your healthcare provider?
    Previous

    How comfortable do you feel giving injections, testing blood sugars and/or changing infusion/sensor sites in front of strangers (ex: at a restaurant, airport, on public transportation, etc.)?

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    In your experience, what are the biggest barriers to accessing diabetes-related medical care? Select all that apply.

    Sarah Howard

    Sarah Howard (nee Tackett) has dedicated her career to supporting the T1D community ever since she was diagnosed with T1D while in college in May 2013. Since then, she has worked for various diabetes organizations, focusing on research, advocacy, and community-building efforts for people with T1D and their loved ones. Sarah is currently the Senior Marketing Manager at T1D Exchange. Sarah and her husband live in NYC with their cat Gracie. In her spare time, she enjoys doing comedy, taking dance classes, visiting art museums, and exploring different neighborhoods in NYC.

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    22 Comments

    1. Ahh Life

      I pull the pin on the grenade I hold. I pull the strap on the parachute I use. I buckle the seat belt on the cars I drive. Why shouldn’t I put the changes in insulin doses? It’s my body. It’s my life. The experts and professionals have been advising me for 70 years. Sometimes their wisdom rubs off, even on us slow learners. ( ͡°👅 ͡°) ( ͠° ͟ʖ ͡°) ( ͡°👅 ͡°)

      2 years ago Log in to Reply
    2. Molly Jones

      I see my endo my often now and wait to discuss changes with her. I used to make these changes on my own more often.

      2 years ago Log in to Reply
    3. Grey Gray

      Self management… real time decisions… Too many variables to wait for a doctors opinion… sometimes I tell him about it. My body. My pump. If it weren’t for needing scripts I would probably never see the doctor.

      2 years ago Log in to Reply
    4. Janis Senungetuk

      Sometimes, depends on how drastic a change. I’ve only been using the Control IQ app for 5 months, so right now I hesitate to make any big changes without first asking my CDE what she thinks. Before starting with Tandem last June I often altered basil rates on my Animas Vibe on my own.

      2 years ago Log in to Reply
    5. Michelle Tepley

      Never.

      2 years ago Log in to Reply
    6. Patricia Dalrymple

      Agree with everyone: sometimes I do and sometimes I don’t consult with them. This really annoys me: they ask for my pump, make a change based on my numbers, hand it back to me with no comment. That pump is part of me. They wouldn’t touch me without telling me what they were going to do. Don’t grab at my pump. Tell me what you are doing and why. Sometimes they change things and I change them back. Funny part about that is they never seem to notice.

      2 years ago Log in to Reply
    7. HMW

      I make adjustments to my insulin to carb ratios as needed. Sometimes my endocrinologist makes suggestions when I see her. I let her tell me how to adjust my insulin sensitivity factor if needed.

      2 years ago Log in to Reply
    8. Amy Nance

      All on my own, my life and my body. If I contacted my diabetes specialist with every change I make, she would have time for her own life.

      2 years ago Log in to Reply
    9. Gene Maggard

      I do all the changes myself. I meet with my endo four times a year (apparently required by Medicare), and he and I discuss my TIR, my A1C, and he always asks me if I’ve made any changes in my basal and bolus settings. He sometimes makes suggestions based on my answers, but otherwise leaves it to me to make my own decisions.

      2 years ago Log in to Reply
    10. Chip Brookes

      In the legal profession there is a saying: “A person who represents himself has a fool for a client”. Treating diabetes yourself is analogous to the above. I regularly submit my data to my Endo so that he can make changes necessary.

      2 years ago Log in to Reply
    11. connie ker

      It depends on what the changes are before checking or not checking with your Drs. If you want to change insulins, or pumps, or size of syringes or medications – you need a script written by your health care provider. If it is a simple correction, you can do that without making an inquiry. Live and learn but controlling diabetes is a team effort for sure. I always see my Dr. with questions written down before the apt.

      2 years ago Log in to Reply
    12. Patty Harris

      I’ve only just started adjusting my basal rates up and down as they just don’t seem right since my stomach is emptying slower than it use it. I NEVER take insulin before a meal anymore as it seems to result in very low blood glucose up to an hour after eating. My endo just doesn’t seem to understand why.

      2 years ago Log in to Reply
    13. Britni Steingard

      Depends on the severity of the change. Changing my doses by 10-20%? I’ll do that on my own. Switching from MDI to pump or vice versa? I check with my doctor first.

      2 years ago Log in to Reply
    14. Jose Almodovar

      My Endo and I are on very good terms. Yes, I can make changes to my Basal rates without conferring but there are limits we have agreed upon.

      2 years ago Log in to Reply
    15. Becky Hertz

      I make small changes based on guidelines I’ve been given from my endo. I live with this 24/7 so should have some idea of what to do.

      2 years ago Log in to Reply
    16. Pat Reynolds

      I spend a _lot_ of my life in diabetes management. I have a PhD, so I know research … And the time involved … So I know that my doctor has both the skills and time to do the leading edge research (or at least follow it) which requires a knowledge and access to.paywalled resources that I don’t have. So I use him for that. The diabetes community is great for real.life experience of new tech, particular situations, etc.

      2 years ago Log in to Reply
    17. Stang777

      From day one of having this I have made my own adjustments as I have had to. If I had not made the changes on my own from the beginning is there is no way I would still be here as they started me off on way too much insulin and never had me call them with my levels or anything else. I learned to figure out what I need and just tell the doc at my appointment how much insulin I need the script written for. I have done well with it so only need to see my doc once a year to get scripts. I have gone in once or twice a year between visits for an A1c test but otherwise, only need the doc to write the scripts, which is all my appointments with them is for. In order to have good control, changes need to be made at the time the shots are being done, not continuing to do what doesn’t work well until one can have an appointment with a doc who is just guessing at how much one should do and setting a set amount to be done with no consideration for all the other factors that can go into making the determination of how much insulin one needs at various times due to various factors that are present at the time. In my opinion, when it come to diabetes management, docs are only needed for writing scripts.

      2 years ago Log in to Reply
    18. Sasha Wooldridge

      Just like many others have mentioned, I only use my doctor for prescriptions, authorizations, and tests. I had a good endo that would look at my information and discuss my BGs just to see if I needed any guidance, but he retired last year. Still on the hunt for a new endo that will write the prescriptions I need rather than what they decide I need.

      2 years ago Log in to Reply
    19. Daniel Bestvater

      I make all of my own insulin type and adjustments decisions. Things change day to day so it is important to be able to quickly adapt with basal and bolus changes for optimum control.

      2 years ago Log in to Reply
    20. Sherolyn Newell

      I only make changes occasionally and only after a couple of days of the same unexpected results. For instance, if the regular bolus leaves me high or low for a couple days in a row, I will adjust. Usually, I might have one bad day, but the next I go back to normal with no adjustments.

      2 years ago Log in to Reply
    21. Cheryl Seibert

      I usually don’t mess with basal patterns unless I review it with my endo. However, he is very open to my self-management. I will tweak carb ratios and frequently use the extended bolus for tighter control. Much of the spikes result from miscounting carbs and/or hidden carbs in home-prepared foods (I take care of an elderly relative and her food served is often made at home or by others). It can be a guessing game! LOL!

      2 years ago Log in to Reply
    22. Carlene Vaitones

      I do inform my doctor when I make a change, with a data sheet of BGs and notes to explain why I made a small change. I would consider it irresponsible to wait for a doctor to make a “hit or miss, trial and error” suggestion instead of taking care of myself.

      2 years ago Log in to Reply

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