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    • 41 minutes ago
      Daniel Bestvater likes your comment at
      When you change your insulin pump site, do you tend to notice a spike in your blood glucose levels afterward?
      There are certain areas on my body where the insulin is more effective than others.
    • 10 hours, 14 minutes ago
      Lee Tincher likes your comment at
      When you change your insulin pump site, do you tend to notice a spike in your blood glucose levels afterward?
      I oftentimes give myself a little insulin for when I go unplugged while changing pods, depending on what my current sensor reading is.
    • 10 hours, 14 minutes ago
      Lee Tincher likes your comment at
      When you change your insulin pump site, do you tend to notice a spike in your blood glucose levels afterward?
      Always, until I began to increase the "cannula fill" amount. I found I need a good bit more than the (1.3u) to "prime the site" to have the next blood sugars be in goal. Just remember "every body is different". Darn than OmniPod does not let you change that amount, have to use "fake carbs". Something to consider.....
    • 10 hours, 15 minutes ago
      KarenM6 likes your comment at
      How well do you understand the details of your health insurance coverage?
      They change all the time. Generally not in a direction to improve my health, but to increase the money in their wallet.
    • 10 hours, 15 minutes ago
      Lee Tincher likes your comment at
      When you change your insulin pump site, do you tend to notice a spike in your blood glucose levels afterward?
      Sometimes, which makes sense to me. It seems like it takes a while til the new insulin is absorbed.
    • 14 hours, 30 minutes ago
      KSannie likes your comment at
      When you change your insulin pump site, do you tend to notice a spike in your blood glucose levels afterward?
      **cannula
    • 20 hours, 48 minutes ago
      Kathleen Juzenas likes your comment at
      If you use a continuous glucose monitor (CGM), where do you prefer to view your CGM readings?
      I find a using the T-Connect app I have the main features needed, CMG, bolus, battery level and remaining insulin.
    • 1 day ago
      TEH likes your comment at
      When you change your insulin pump site, do you tend to notice a spike in your blood glucose levels afterward?
      Sometimes, which makes sense to me. It seems like it takes a while til the new insulin is absorbed.
    • 1 day ago
      atr likes your comment at
      When you change your insulin pump site, do you tend to notice a spike in your blood glucose levels afterward?
      Usually the opposite. Fresh insulin sometimes sends me low.
    • 1 day, 1 hour ago
      Lawrence S. likes your comment at
      If you use a continuous glucose monitor (CGM), where do you prefer to view your CGM readings?
      Mostly pump because I want to quickly see insulin on board. Tandem on IPhone when holding my great-niece while she sleeps since getting my pump out of my pocket always wakes her ☺️. Dexcom app if not in need of insulin.
    • 1 day, 1 hour ago
      Lawrence S. likes your comment at
      If you use a continuous glucose monitor (CGM), where do you prefer to view your CGM readings?
      usually the pump; sometimes my phone.
    • 1 day, 1 hour ago
      Lawrence S. likes your comment at
      If you use a continuous glucose monitor (CGM), where do you prefer to view your CGM readings?
      My pump (Tandem X2). Since I have to carry a work phone close to 247, I don't want to deal with two phones (device overload!). As I go about my day, looking at my pump meets my needs, I can decide to bolus etc - and edit the bolus. For more in depth data review and analysis, I use the TConnect.
    • 1 day, 1 hour ago
      Lawrence S. likes your comment at
      If you use a continuous glucose monitor (CGM), where do you prefer to view your CGM readings?
      I read it from my pump.
    • 1 day, 1 hour ago
      Lawrence S. likes your comment at
      If you use a continuous glucose monitor (CGM), where do you prefer to view your CGM readings?
      On my insulin pump
    • 1 day, 1 hour ago
      Lawrence S. likes your comment at
      If you use a continuous glucose monitor (CGM), where do you prefer to view your CGM readings?
      My pump. Keep it simple.
    • 1 day, 1 hour ago
      Lawrence S. likes your comment at
      How well do you understand the details of your health insurance coverage?
      How much of this is intentionally misleading? My mail order prescription service says that can’t possibly know the cost of a medication until after it’s been shipped, which is too late to cancel or return, of course, and makes it impossible to comparison shop.
    • 1 day, 1 hour ago
      Lawrence S. likes your comment at
      How well do you understand the details of your health insurance coverage?
      I have an MA in writing and lit, but gobbledegook is gobbledegook. The fancy term is obscurantism.
    • 1 day, 1 hour ago
      Lawrence S. likes your comment at
      How well do you understand the details of your health insurance coverage?
      They change all the time. Generally not in a direction to improve my health, but to increase the money in their wallet.
    • 1 day, 1 hour ago
      Lawrence S. likes your comment at
      When you change your insulin pump site, do you tend to notice a spike in your blood glucose levels afterward?
      Usually the opposite. Fresh insulin sometimes sends me low.
    • 1 day, 22 hours ago
      Sarah Berry likes your comment at
      If you use a continuous glucose monitor (CGM), where do you prefer to view your CGM readings?
      My pump
    • 1 day, 23 hours ago
      Marty likes your comment at
      If you use a continuous glucose monitor (CGM), where do you prefer to view your CGM readings?
      One nice thing about a watch for readings is that, while it is normally redundant, you can be separated from your phone. For example, when you are in water.
    • 1 day, 23 hours ago
      Marty likes your comment at
      If you use a continuous glucose monitor (CGM), where do you prefer to view your CGM readings?
      I use both as you can’t do everything you want in one or the other
    • 2 days ago
      Kathy Hanavan likes your comment at
      If you use a continuous glucose monitor (CGM), where do you prefer to view your CGM readings?
      I selected “other” because my preference (smart watch, mobile phone, or pump screen) depends on circumstances. Watch for a quick and discrete view; pump if I’m preparing for a profile or activity adjustment or bolus, mobile phone if just a food bolus.
    • 2 days ago
      John Barbuto likes your comment at
      If you use a continuous glucose monitor (CGM), where do you prefer to view your CGM readings?
      I use both as you can’t do everything you want in one or the other
    • 2 days, 1 hour ago
      Gerald Oefelein likes your comment at
      If you use a continuous glucose monitor (CGM), where do you prefer to view your CGM readings?
      I use both as you can’t do everything you want in one or the other
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    Does proximity to your T1D health care provider impact where you choose to live?

    Home > LC Polls > Does proximity to your T1D health care provider impact where you choose to live?
    Previous

    CGM users: When you have a sensor that does not last for its full approved session duration, on average, how many days early does your sensor fail or fall off?

    Next

    If you use an insulin pump or CGM, has anyone ever mistaken your device(s) for any of the following? Select all that apply!

    Sarah Howard

    Sarah Howard has worked in the diabetes research field 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.

    Related Stories

    " At T1D Exchange, we’re proud to announce our Medical and Research Advisory Team — an accomplished group of leaders in endocrinology, research, and quality improvement. Together, they are redefining what’s possible in type 1 diabetes (T1D) care through rigorous data analysis, innovative research approaches, and real-world implementation. Their collective expertise is central to our mission of improving outcomes for all people living with T1D.  “We’re excited to be working with our advisors given their deep expertise across a broad range of areas in T1D,” said Dave Walton, CEO of T1D Exchange. “Their involvement magnifies our reach, knowledge, and impact. These advisors are shaping the future of diabetes care — driving innovation across research, clinical practice, and quality improvement.”    Meet the Medical & Research Advisory Team  The T1D Exchange Medical and Research Advisory Team brings together four leading endocrinologists, each offering a unique perspective and shared commitment to advancing T1D care:    Jenise Wong, MD, PhD Pediatric endocrinologist at UCSF Benioff Children’s Hospital and Professor of Pediatrics in the Division of Endocrinology at the University of California, San Francisco Focus areas: Diabetes technology adoption and usability; health equity and access to care and technology; community-based and peer-support interventions; culturally responsive care          Jennifer Sherr, MD, PhD Pediatric endocrinologist at Yale Medicine and Professor of Pediatrics in the Division of Endocrinology at Yale School of Medicine in New Haven, Connecticut Focus areas: Clinical trials in diabetes technology (CGM and AID systems), disease-modifying treatments and immunotherapies, and emerging technologies and medications, including continuous ketone monitoring and nasal glucagon     Viral Shah, MD Adult endocrinologist at Indiana University Health and Professor of Medicine in the Division of Endocrinology and Metabolism at Indiana University School of Medicine in Indianapolis, Indiana Focus areas: Diabetes technology and adjunctive therapy trials; translational and data-driven research; T1D complications and bone health         Nestoras Mathioudakis, MD, MHS Adult endocrinologist at Johns Hopkins Medicine and Associate Professor of Medicine at Johns Hopkins University School of Medicine in Baltimore, Maryland Focus areas: AI-driven clinical support tools; EMR-based data analytics for clinical decision making; data-driven quality improvement; health equity in T1D care        This accomplished team’s expertise spans adult and pediatric endocrinology, research, and quality improvement affiliated with leading institutions nationwide. Collectively, they have authored over 500 diabetes publications and secured research funding from organizations such as the National Institutes of Health, Helmsley Charitable Trust, the American Diabetes Association, and Breakthrough T1D — while remaining actively engaged in both clinical care and research.  “These individuals represent an impressive body of work while remaining deeply involved in the day-to-day realities of diabetes care,” said Walton. Their expertise covers the full spectrum of T1D care — from AI and predictive analytics to complication prevention, automated insulin delivery, continuous glucose and ketone monitoring, GLP-1 treatments, health equity, mental health, autoantibody screening, and disease prevention.    Turning insight into impact  The team’s work goes beyond research, focusing on translating insights into real-world practice. By leveraging data to scale best practices, the goal is to drive meaningful, measurable change across clinics and communities.  “Our advisors will help to extend our impact — whether through QI strategy, research innovation, funding opportunities, or new data-driven solutions,” said Walton. “We want to take what’s working at individual centers and spread that as broadly as possible.”   He added, “As a Collaborative, we’re also focused on advanced population health strategies such as exploring predictive data models to identify risks earlier and intervene before complications even begin to happen.”    The power of the T1D Exchange Quality Improvement Collaborative  Central to this work is the T1D Exchange Quality Improvement Collaborative (T1DX-QI) — a nationwide network of clinics working together to improve care through shared data, benchmarking, and evidence-based practices.  “I’m thrilled to serve as a Medical Advisor for T1D Exchange, because I’ve seen firsthand the impact this network can have on patient care,” said Dr. Nestoras Mathioudakis. “T1D Exchange is the premier organization for quality improvement in type 1 diabetes, with unparalleled assets like a large EHR database and robust patient registry.”  He added that he is excited to apply his expertise in EHR research and big data analytics to generate real-world evidence across diagnosis, management, and outcomes.  Dr. Viral Shah echoed that perspective, reflecting on T1DX-QI's evolution: “I have been involved with T1D Exchange since its early days and have had the privilege of witnessing how it has transformed the quality of diabetes care across the United States. I’m delighted to return as a Medical Advisor.”  He emphasized the importance of accelerating impact. “I look forward to working closely with the team to accelerate the evidence generation and to help translate these insights to improve patient care.”   Dr. Jenise Wong highlighted the visible impact of T1DX-QI on the delivery of care. "I’m truly honored and grateful to be working with T1D Exchange as a Medical Advisor. T1DX-QI is a remarkable resource for centers that are using continuous process improvement to improve the quality of care for people living with diabetes.”  “Diabetes centers working with T1DX –QI have done amazing work using QI methodology to make care accessible and equitable for all people with diabetes,” she said. “It’s inspiring to be a part of a collaborative in which centers have been creative and thoughtful with initiatives to address individual and systemic challenges to care, improving clinical outcomes as well as the patient experience."  Looking ahead, Dr. Sherr highlighted the opportunity to build on the existing strong foundation. “I’m very excited to be working as a Medical Advisor for T1D Exchange,” she said. “It’s a privilege to help shape what comes next for a group that’s already doing such impactful work.”  “Sharing what’s happening in clinical practice, benchmarking across centers, and understanding outcomes is how we figure out what’s working, what’s not, and where we go next,” she said.      The future of T1D care   With this team’s vision and expertise, T1D Exchange is positioned to accelerate progress in T1D care — bridging research and real-world practice to drive meaningful, measurable impact.  Together, we look forward to advancing innovation and improving outcomes for everyone affected by type 1 diabetes.   "

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    30 Comments

    1. mbulzomi@optonline.net

      With Medicare Part “B” covering all my DEX and Tandem stuff, including Insulin. Along with my Federal Blue Cross Blue Shield, secondary Insurance. All’s well for me, nothing out of pocket.

      4 years ago Log in to Reply
    2. Pat Martin

      Since going on MEDICARE – I am told I must see my provider every 90 days or no supplies will be dispensed from my DME provider. I have been going to a provider that lives 5 hours from me & I have been seeing this provider since the early 1990’s..
      I may need to change now as since retired my income has changed anad i am unsure if I can afford
      the gas to make the 5 hour trip. I have moved several times since starting to see this excellent provider(s). The state that my provider lives in requires that he/she be licensed in the state where they provide telehealth. They are not licensed in the state where I reside. It would not be cost effective for them to obtain this license at this time. So I may be looking for a new provider in the near future with the cost of gas & inflation! Sad!

      4 years ago Log in to Reply
    3. pru barry

      I guess it’s age and diabetes going in tandem that led me to live in a city. I love being out in the country, but the time has come to be closer to providers and the drug store. Tomorrow is the 82nd birthday, and 68th anniversary since being diagnosed. Time sneaks up when you’re having fun!

      9
      4 years ago Log in to Reply
      1. AnitaS

        Happy birthday!

        4 years ago Log in to Reply
    4. Louise Robinson

      Sadly, it did not when we relocated from New England to Florida nearly 20 years ago. I had excellent access to board certified endocrinologists when I lived in New England. They were affiliated with University hospitals and located within a 30-minute drive. We relocated to a more rural county about 90 minutes north of Tampa. There are NO board -certified endos in my county. In general, unless I wish to travel over 1 hour (to either Tampa or Gainsville), I feel that the quality of health-care here is not up to the level I enjoyed up north….and, as we age, access to quality health-care becomes even more critical.

      4 years ago Log in to Reply
    5. Ernie Richmann

      I live near Cleveland Ohio. This area has world class medical services along with wonderful parks, sports, cultural events, and more not to mention we have the worlds largest fresh water reserve- the Great Lakes.

      4 years ago Log in to Reply
    6. Dennis Dacey

      OTHER: I do insist on finding the best medical providers, including people who know diabetes, but that didn’t prevent me from leaving the world’s leading diabetes professionals [decades at Joslin Clinic in Boston] and move 1,700 miles away. After moving, I did seek out and find good medical care including two who understand T1D.

      If I make any future move of residence, diabetes specific medical care will not be a primary deterrent as long as there is a relatively closeby facility with a physician who is open and able to listen.

      1
      4 years ago Log in to Reply
    7. Sue Herflicker

      I thought I hit no and when I hit the submit button I saw yes! I do not worry about the proximity of my health care provider. I will travel as far as I need to for good medical care.

      4 years ago Log in to Reply
    8. Linda Zottoli

      I know that I considered it 50 years ago, more specifically public transportation access, when I was moving while pregnant. And now, no longer driving and considering moving closer to one of my children, available health care is certainly a consideration.

      4 years ago Log in to Reply
    9. Lawrence S.

      I said “other”. When I was young, and working, “no”. I used to drive 10 hours, round trip to see my Endocrinologist at Joslin in Syracuse, NY. I’m sure there were other Endo’s closer to me. I chose where to live based upon where my employment was located.
      Since retirement, we moved to a warmer climate, and living near access to an Endocrinologist was an important part of where we chose to live.

      4 years ago Log in to Reply
    10. megwood805@yahoo.com

      I travel 75 miles each way to continue care since he moved. Absolutely worth it!

      4 years ago Log in to Reply
    11. TEH

      We had chosen a location that had 2 medium sized medical complex 30 miles a way, where my Endo’s office is located. UVA is 90 minutes away….

      4 years ago Log in to Reply
    12. Hieromonk Alexis

      Usually that was not a problem, since I have lived mostly in urban areas with plenty of endocrinologists. But I did live for 12 years in a rural area where the nearest sizable town was an hour away, and it had only one endocrinologist for that county and a few surrounding ones. Boy, was he ever busy! That town, Redding CA, with its population of around 100,000, could certainly use another endocrinologist.

      4 years ago Log in to Reply
    13. Sue Martin

      Definitely. We have been considering moving to a different state. I live in the Seattle area and have had world-class care through the University of Washington Medical center. Proximity to health care is very high on the list of criteria. I have other health issues, kidney transplant, and a meningioma in the brain, which was benign; so a high-class health complex is important where we move next.

      4
      4 years ago Log in to Reply
    14. Natalie Daley

      I’m willing to drive 170 every 3-4 months. When he retires, this may be a different story.

      4 years ago Log in to Reply
    15. Janis Senungetuk

      Yes, it certainly does now, it didn’t as much when I was younger. Transportation to/from medical appointments has become a major consideration now that I’m no longer driving and the pandemic eliminated the volunteer transportation assistance organization I had previously used. Even living in this urban environment with a relativity large number of physicians it’s still difficult to get consistent knowledgeable care on a timely basis. It requires making appointment far in advance and then being able to keep them.

      4 years ago Log in to Reply
    16. Chris Albright

      I live in a small city about 65 miles north of Austin Tx. The town I live in does not have an endo so I prefer to just go to the endo that I used when living in the Austin area. If I could find a good endo closer to me, I would consider switching (i.e., $5.00 / gal gas……)

      1
      4 years ago Log in to Reply
    17. Beckett Nelson

      I chose “other” because I changed endos after relocating. I haven’t stayed in a location because of an endo

      4 years ago Log in to Reply
    18. Molly Jones

      Most definitely. I have a multitude of health concerns one of which causes me not to drive and that need specialists, not GPs. We live in a city with many hospitals less than twenty minutes away that I can use buses for whose transportation keep improving.

      1
      4 years ago Log in to Reply
    19. Amanda Barras

      No! We live where the work and good schools are for our son. I will commute to an Endo as necessary since I only see mine 1x a year.

      4 years ago Log in to Reply
    20. Lori Lehnen

      Interesting question. I recently switched from a local endo to one in NYC, about an 8 hour drive or short flight away.
      When I was first diagnosed, I used the endo assigned to me at the hospital. They were good, but not a good fit for me. When a bad snowstorm forced me to use telehealth, it got me thinking… why am I using an okay doctor when telehealth works for most appointments and my insurance covers any doctor in the state. So, I found an endo that is perfect for me. I’ve been incredibly pleased with my teleheath appointments with her and her staff is amazing. Although she’s not requiring it, I’m having my first face-to-face visit with her in July, followed by a long NYC weekend. Finally, T1D is an excuse to do something fun!
      p. s. My local primary care doctor approved that this set up is medically sound before I transitioned to the new endo.

      4 years ago Log in to Reply
    21. Jillmarie61

      No it doesn’t. My Endo is an hour and a half away. BUT, it does have an impact on how close to a hospital I am, in case of an emergency.

      4 years ago Log in to Reply
    22. Marcia Pulleyblank

      I would say yes in principle, but I does take me at least 90 minutes in order to get to see him. I can however communicate via phone or email if necessary.

      4 years ago Log in to Reply
    23. Drina Nicole Jewell

      It does and it doesn’t. I moved to a huge area with tons of endo’s and couldn’t find one I could tolerate. So I drive 6 hours round trip to see my Endo once a year and the rest are video or phone call appts. 💯 Worth it.

      4 years ago Log in to Reply
    24. Ahh Life

      I’ve lived in areas where the closest endocrinologist was a 140-mile drive to Reno, Nevada with few towns, people or even cacti in between. Easy-peezie in the good ol’ days.

      Then as the ravages of age take their toll – diminished eyesight, diminished public transport, diminished cognitive abilities – and guess what? Proximity matters.

      So now, the answer becomes, Yes. Talis est via mundi. ╭ (o ㅇ‿ o#)ᕗ

      4 years ago Log in to Reply
    25. PamK

      While I have not let this affect where I live, I do miss my old doctors. It is very difficult to find new doctors in my current area that “measure up.”

      4 years ago Log in to Reply
    26. Steven Gill

      From what I’m reading I’ve only seen one “good” endocrinologist in 24 years, and the lone knowledgeable primary physician died during first year of diabetic care. I’ve seen 5 specialists, the only one I’d consider efficient was during those medical trials when my diagnosed mysteriously changed from TYPE 2 to TYPE 1.

      These two stressed never let anyone dictate my diet, meds, exercise, or life because they don’t work my hours, cook my meals, nor live my life. I had two specialists before those medical trials, two afterwards; but at least the last got me to consider the pump with a CGM.

      I now see a GP 5 minutes from my home for convenience, altho he offered to send me to the local hospital to see a specialist (his first visit said he doesn’t see TYPE 1 patients because of their needs, until we talked and he saw my a1C, he agrees to all my requests including my last to add metformin to my care). I’ve since found the end~ that refused my request to start insulin 21 years ago saying I was too old to be a TYPE 1, with instructions to lose more weight (already 20 lbs underweight) is considered a top board certified endocrinologist. I follow the instructions of those two doctors and read everything on diabetes: now listen to various podcasts and blogs on TYPE 1. Thanks to the internet I visit boards from the ADA, I read literature and periodicals, and news releases. With UAB and the Babtist Health system Birmingham I’d considered a top tiered medical community but results vary, sometime I feel better educated than those educated.

      4 years ago Log in to Reply
    27. Lyn McQuaid

      I’ve had the same endo for 30 years and he has changed practices more times than I can remember but has always stayed in the same general vicinity.

      4 years ago Log in to Reply
    28. Wanacure

      Just the opposite. I choose the facility closed to me, but actually now there are three different providers within the same 20’ walking distance.

      4 years ago Log in to Reply
    29. Cheryl Seibert

      40 years ago, yes it did. But now, with Telehealth and CGM/Pump data available via websites, proximity is not a requirement. I am blessed that the community I moved to after college had one of the best endos in the state.

      4 years ago Log in to Reply

    Does proximity to your T1D health care provider impact where you choose to live? Cancel reply

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