22 Comments
Before making changes to your insulin management, do you check with your healthcare provider?
You must be logged in to post a comment.
© 2023 T1D Exchange. All Rights Reserved.
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 ͡°) ( ͡°👅 ͡°)
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.
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.
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.
Never.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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!
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.