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August 28th, 2008
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I thought carefully about what I would wear today, and reconsidered several times. I applied my makeup with an eye toward the wow factor. I wasn't trying to show off, I just feel incredibly good today and wanted to reflect that outwardly.

Truthfully, I couldn't wait to get to my appointment with my endo. Truthfully, I've been waiting for this for some time. Truthfully, if I were still on Byetta I think I would have dreaded this day. Truthfully, with a solid month or so of excellent blood sugars thanks to Novolog and a fairly decent walking schedule, I was proud to report to my endo about how well I believe I'm doing.

We chatted about the normal things, and he caught me off guard with a few questions, like how many carbs per meal I aim for. I'm sort of a creature of habit, so when I find something that works I run with it. So counting carbs is not something I do daily mainly because I know that the baked chicken breast, scoop of stuffing and salad I've had countless times equals roughly 3 units of Novolog.

He of course wanted to know if I thought Byetta is something I might want to try again in the future. Yes, I was willing to give it another shot, I said, but deep down I don't really think it's going to work for me. He seemed to disclose more about the drug now that I've tried it. Truthfully, he told me, you likely won't have the kind of control on Byetta that you seem to be having with Novolog. Well then, I thought, case closed.

The thing that really caught me off guard, though, was this:

"I don't think we should change anything because it all seems to be working," Dr. C said.

"I agree," I said with a ginormous smile.

"So if we continue down this path of multiple daily injections that would make you a candidate for a pump," he said.

Surely he must be kidding, I thought. "But I don't have the kind of resistance that requires a pump," I said. "I mean, I can have 15 or 30 grams of carbs sometimes and not need any insulin."

"You don't have to on a pump either," he said.

"Bbbutt...really? So...you mean...like in a couple of years or something, right?" I stammered.

"No, really we can discuss it at any time," he said, frankly.

"Oh. Huh. Well I'm pretty happy with what's going on now, so I think I'll stick with it," I said.

He was close to not sending me for an A1C, but when I reminded him that I've been off Byetta for at least a month we both agreed that blood work was in order. After taking a picture of the nurse sticking my arm for the Diabetes 365 project on Flickr, I'm now sitting at my desk waiting rather impatiently for an email from Dr. C. I want to say that I'll be happy with anything under 9 (my last A1C), but since we're being truthful, I'd like it to at least be in the low 8s.



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I thibnk Michelle really has things under control, but I would definitely think about what the doctor has to say.
I am a newly diagnosed type 2 diabetic. I am in kidney failure and have a serious problem with my liver now also. In two more weeks I visit my cadiologist to see how much damage to my heart has been done. I had been seeing an internist for a severe hypertension problem and when I couldn't get her to listen to how bad I was feeling, I went to another doctor. He listened and ordered a lot of tests and I am now under control with my blood sugars. He has me taking Glipizide and Byetta and I have been doing pretty well for the past month. I have been able to gradually increase my daily exercise and am contolling my blood sugars. The funny thing is that my blood pressure has really come down now. I have 5 children and 8 granchildren and am deeply grateful for the doctor who listened. I know we will have adjustments to make over the months to come, but feel like everything is worth it. I cook for a daughter who is wheat, gluten and fructose intolerant so it has been no problem for me to make little adjustments for myself. Holiday cooking hasn't been a problem either because we have other diabetics in the family. I encourage everyone to take the bull by the horns and jump in there. You will really feel the difference in no time.


Questions for yourself to answer to yourself. My main concern is that you are happy with a 9 A1c, when most recommend at least below 7. With a pump it is likely you could be between 6 and 7 and could also be with multi injections. Also, what are you goals for you blood glucose before and after meals? I recommend to my patients 80 to 140 all day long which is the recommendation of the Endo association I believe. With some individual changes on occasion. With the pump you can be as close to the "normal numbers" as ever possible probably, therefore to have less complication.


Bobbie, I WASN'T happy with my A1C of 9, but that one was from June. What wasn't included in this post, but is included in numerous other posts I've made that you can read in my archive, is that I struggled with very high numbers on Byetta for close to two months. For approximately one month prior to my last appointment with my endo, I had started taking injections of Novolog in addition to the Lantus and Metformin I already take. So the A1C result I was hoping to be under 9 was going to be a reflection of the crap control I had on Byetta AND the much better control I am having on Novolog. I haven't written about this yet, but I suppose I should; my A1C last week was 7.9. So while it's not perfect, it's a vast improvement from what I had in June. So many things have changed in my life since June. That's what I was hoping to show up in my A1C, and I knew it was unrealistic to expect to be under 7 at this point based on what I went through with Byetta and when I had implemented my exercise routine. I know that many people experience better control on a pump, and I would consider it at some point, but I want to give MDI a shot for longer than a month before I make that decision.


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Michelle Kowalski
Michelle Kowalski, a writer, editor and photography hobbiest living in Phoenix, has had type 2 diabetes since February 2005. In January 2008, as part of her quest to start on an insulin pump, Michelle learned that she actually has type 1 diabetes. (Read More)

Latest Posts: Full Disclosure? | Finding Flexibility | Dear Halls

George Simmons
George Simmons is a father and husband living with type 1 diabetes. A self proclaimed "born again diabetic," George began blogging as a way to meet other people living with diabetes and learn more about managing his disease. (Read More)

Latest Posts: Raging Against the Machine | It Will Probably Win | The Stress of Stress

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