January 8, 2015

Why I Do Not Like the ADA

Each year I become more discouraged reading the new (supposedly) guidelines. So few changes are done that it should be only referred to as the (year) ADA Guides. Some areas actually use the term individual or individualized for treatment of diabetes, but when talking about us older adults it seems they have established three one-size-fits-all categories and like certified diabetes educators want to put square pegs in round holes.

I dislike saying this, but the ADA does not understand people. They would put me in the middle category and I would not like having an A1c that high. I will continue to stay below 7.0% and keep working to stay below 6.5%. Yes, this is less than 8.0%, but the diabetes clinic keeps insisting that I let the A1c rise above 7.0% and with this, I am not going back there. Thank goodness, I have the VA to test my A1c twice a year. I have attempted to get another doctor, but when the new doctor wants to convert me to Afrezza and mainly oral medications – no, thank you. I like the regimen that I am currently using and find that I have fewer problems when I concentrate on doing it correctly.

Yes, I am like many other people and I do make mistakes, some are doozies, but I do learn from them. I occasionally repeat the same mistakes, but normally this is when I am attempting to prove something to myself and the results were not what I expected. Do I sometimes wonder if I am having cognitive issues, all the time, but since I am still learning, I have to discount many of the mistakes as being cognitive issues.

As I age, I know my body is changing and I must adjust how I handle my medications and discuss some issues with my doctor. Occasionally we disagree, but after following his directions for a couple of experiments, we were in agreement. Since I have fired a couple of doctors, my primary care doctor, and my VA doctors are in agreement with me more often than not.

The number of hypoglycemic episodes has definitely decreased and for that I am happy, as I have not had one for more than nine months. Yes, some would disagree when I have readings of 67, 68, and 69 mg/dl, but to me these are not as long as I remain above 65 mg/dl. This is a minor excursion and not something that makes me stress. Most of these occur during the afternoon with one in the AM.

When I adjust my Lantus to avoid these, then I end up with readings above 180 mg/dl in the afternoon. Days that I move around more than normal, my blood glucose levels drop into the upper 60s to lower 70s. Then there are fasting blood glucose readings in the 110 to 130 range and are often difficult to understand the reason for this. These things seem to happen for days on end and then I can go for days with excellent readings. I have determined that when I have the above average blood glucose readings, I tend to sleep for longer periods of time and when the blood glucose readings are all below 130 mg/dl, then with eight hours of sleep I am feeling just fine.

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