As I mentioned in a previous blog, we found out my blood sugars were high in December, and I am officially now considered diabetic. Today I had my first appointment with my diabetes doctor, aka endocrinologist.
First off, I think I'm really going to like him. He has his wonky moments, I noticed, but he really knows his stuff. He spent over an hour with me at my appointment. He explained things so well and took his time and never, ever gave me the impression he was just trying to move on to the next patient. It was really nice.
As I said before, CFRD is its own type of diabetes. It has aspects of Type 1 and aspects of Type 2, so it's a bit more complicated to treat.
The biggest question—and anxiety—I had going into this was: will I need insulin or not? Everything on the CF website said the only way to treat this is with insulin. He echoed those same sentiments today, but luckily there is a bit of "phasing in" to this. Right now, he was encouraged to see my fasting level where it was. It's not on the high end, and tells him that most likely a small dose of long-acting insulin should work for me right now. There are two types of insulin: rapid- and long-acting. The rapid/fast stuff is what people use right around the time they eat. It involves counting carbs and math and figuring out how much you need so your blood sugars will land in their target area and not be too low. Long-acting is a once-a-day thing, and it does just that: it lasts a long time in your system at a consistent, smooth level.
Obviously, knowing nothing about what might be used, I was dreading hearing I would need (rapid) insulin at every meal. I'm so glad I don't need to do that right now. At some point in the future, I most likely will. He explained that our pancreas are always producing insulin, but due to the nature of CF, my pancreas will produce less insulin over time. So eventually, yes, I will probably add in the rapid insulin. But for now, and hopefully for many years, the long-acting stuff should do the trick.
So that's what I mean by "phasing in"... in future I will have to count carbs and deal with more insulin, but for now I can start out with less; kind of ease into diabetes care.
There is a chance the insulin will not work, though. He has had a few patients that can't tolerate insulin because it keeps their blood sugar at a constantly too-low level, so that is something I'll have to watch out for. If that happens then we'll try something else. For most people, this works, and I'm hopeful it will.
Not like I'm dying to stick myself, but I actually wanted to get a glucose meter, because I like data and knowing what's going on. Ahead of time, I checked our insurance drug formulary to see which meters were covered and I picked one out I liked. It seems that diabetes testing has greatly improved in the past few years, so thank goodness for that. There are many meters now that require so much less of a sample of blood to test, which means a smaller finger stick, which means less pain in my fingers. I am so thankful for that, because I must admit I was a tad worried what this might do for my crocheting hobby; wondering if it might make it more unpleasant and then I wouldn't want to do it as much. Plus, the meter I chose has an app and will Bluetooth my results to my phone. Considering all of the stuff I have to keep track of and remember these days, this sounds like a good convenience to have.
They happened to have the meter I wanted on hand, so they gave me one (yay freebies from drug reps!) I've already taken two readings so far today, and they are so small and light that maybe my finger aches for 30ish minutes after, but like if I press on my fingertips right now, I don't feel a thing. Hopefully that stays that way.
So for now, he wants me to test my blood sugars 4 times a day, basically. For two of my meals, he wants me to test before and then two hours after. That will give us a good picture of what's going on and we can have data for my follow-up in two months. And I'll start my Tresiba insulin once I pick it up tomorrow from the pharmacy. Tresiba ready!! (Darn that company for having so many commercials on TV with such a dumb, catchy jingle!)
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