Monday, March 26, 2007

Trends and changes

Since starting a new endo late last year, I've come across a concern: she seems very apt to make changes to my basal rates after a single day's worth of tests. Her key communication method is fax - she expects this weekly, at the minimal. I've also grown up using the rule of thumb that you take a look at three days worth of results at least before making changes, to make sure you're seeing an accurate trend in the results. In mentioning this to my endo, her response was that with a pump, the changes are "instantaneous" - there's no need to wait. I'm not sure I agree with that; For example, one night may entail a inadequate carb counting or dosing for food, or a different routine of exercise. You can't see what's really happening with that basal by looking at just one day's results. This train of thought seems to be an almost old-school mentality merging with a contemporary push for pump therapy - someone who doesn't understand exactly. Maybe I'm off. She's a highly-recommended and commended endo, and has much creditentials, but I'm wary of this advice. So, I'm taking the suggested changes cautiously and watching my results carefully before making specific changes. Better safe than sorry.

1 comment:

Wendy Morgan said...

I am with you. Changes after one day of readings seems totaly ridiculous. I also agree with the three days as a guide. Even when I was using the Freestyle Navigator CGM I waited three days to see what made sense.

We are weighing averages. If we see a "trend" to go high after a meal we make changes, one high after lunch does not necessarily *require* an adjustment. You might consider trying to work with the diabetes educator directly (may be more reasonable/realistic) or just do what you feel is right, whihc it sound like you are. Fax when you feel like it and make the changes if they make sense to YOU. You know your body better than anyone and you know when something doesn't sound right. Trust your instinct and use the Dr. for guidance.

My .02 cents.