The Joslin Aftermath.
Our appointment at Joslin this past Friday was a much better one. Hard work is paying off, and even with Barcelona smack-dab in the middle of my August, my numbers were much, much better. And that made me grin.
Chris and I met with a certified diabetes educator at Joslin and while reviewing my spreadsheets (hat tip to Kevin, who is currently my diabetes hero), she noticed that my morning blood sugars were a little elevated.
"Mornings are good, but you have a trend of the last few weeks at around 120 mg/dl. For pre-pregnancy, we want you 100 mg/dl or under." But then she grinned. "But not too under that."
My basal rates right now are higher in the morning from 6:30 am to about 11 am, with an extra kick between 6:30 and 8:00 am. The CDE suggested that I just extend the "kick" and keep my morning basal elevated through the 11 am marker. But I didn't agree entirely.
"I'm afraid I'll go low. I don't think I need that much insulin at 6:00 am."
"Well these elevations are a trend, so it could be a good idea."
(Note: It's so, so, so weird to think of 120 as "elevated." I know this is the mindset I need for pregnancy preparation, but it's still disconcerting to look at a blood sugar of 120 and think, "F. I need to correct that." /Note)
So I changed my basal rate reflect her suggestions.
And spent the next three mornings waking up low. The Dexcom was freaking out around 6 am every morning, blaring its alarm. And when I'd test, I'd see 50 mg/dl almost like clockwork. Glucose tabs were part of my morning routine before I brushed my teeth - not okay with me. So I made a different basal tweak a bit later in the morning to help lower that 120 mg/dl - and to help stave off the lows.
This whole boring story (stop snoring and wake up - I promise this post has a point) is to illustrate the fact that even though certified diabetes educators have a pile of education, experience, and compassion, they are only part of our diabetes management team. The endocrinologist, the CDE, the nutritionist ... the list goes on and on and they're all so helpful, but it all comes back to US. We get what - fifteen minutes of their time every few months? Diabetes is our disease every day, and even though we touch base with our doctors every few months and have their guidance, we manage this disease on our own. We aren't just diabetic at the doctor's office. We know our bodies best and we are our own best caregivers.
Joslin kicks arse. That's without question. And when Chris and I are ready to be parents, they'll take great care of us and our baby. But The Sparlings kick quite a bit of arse, too. And I have full confidence that we're going to be able to conquer these blood sugar issues and get things more and more in line.