glucose control

Another reason why medicine needs feminism

Because full grown male residents don’t bother to ask a woman if she’s menopausal and make the connection that this is what threw off her otherwise controlled diabetes into DKA. Because estrogen aids in glucose control and protects against rising insulin resistance. 

 And I, as the only female on the team today, asked her, researched this, and defended this theory. With papers. For which I got laughed at repeatedly and told “that’s not a real thing.” Physiology and endocrinology are real things, assholes. We get tested on them. 

 And guess what. The attending, a man with twenty plus years of experience and a great breadth and depth of knowledge of medicine and respect for women, said I was 100% correct. And he straight up told the male residents “duh. It was so obvious. Why did none of you ask her these simple questions? Use your brains!" 

 Moral of the story: Defend your female patients. Don’t discredit them. Educate the ignorant, fight for your patient’s health. Even if it’s with your colleagues. Protect and listen to female patients.

Plans, goals... dreams. A1C Now (maybe later)

I’m pretty focused on glucose control right now and I think I have to be. I have all the tools and discipline to get better results and am ready to put it out there. A little bit of public accountability, if you will.

I’m going to try to get my A1C into the 5s. I’ve never seen a number lower than 6.2 in the past.

I have found the Bayer A1C Now tests to be accurate “at home” measurements. I have done them the same day as my lab work was done and gotten the exact same number.

While I was typing this I was actually running one of the tests to get a baseline… but, 2 of them came up with a QC error. So I’ve wasted 2 tests today, with no numerical results. I wonder what I did wrong? I’ve never gotten an error before and today it’s 2 for 2. I have one left, should I try it once more? Is there something chemically whacky in my blood that is throwing the whole thing off? I’ll call them A1C Maybe Later kits.

Alright, I’ll be flexible… I’ll go with my average glucose number according to my CGMS, which is also prone to error… at times. My 30 day average is 150 mg/dl. And my meter average agrees. It’s been a rough month with infection causing swings all over, mostly up. I think it will be easy to improve on this.

My goal, based on less error prone devices… will be to bring my average BG reading to below 126 mg/dl.  According to my A1C test kit, that’s equivalent to 5.9% Right now, according to my numbers I have something equivalent to a 6.9%. While I was in the hospital for my heart arrhythmia they tested it at 6.8%.That was roughly a month ago.

Okay, I’ll record my progress here around the beginning of every month.

P.S. I have never been able to get my pump to tell me the average BG in the past. I just found out this weekend while looking at the manual (it took me 4 years to go back and read it) that it was just one more button press away. Now I can quickly see my average sensor glucose and meter glucose anytime. So, my monthly averages won’t be a surprise at all, like A1Cs sometimes are…

reuters.com
Coming soon to a workplace near you: 'wellness or else'

NEW YORK (Reuters) - U.S. companies are increasingly penalizing workers who decline to join wellness programs, embracing an element of President Barack Obama’s healthcare law that has raised questions

“For some companies, however, just signing up for a wellness program isn’t enough. They’re linking financial incentives to specific goals such as losing weight, reducing cholesterol, or keeping blood glucose under control. The number of businesses imposing such outcomes-based wellness plans is expected to double this year to 46 percent, the survey found.”

“But there is almost no evidence that workplace wellness programs significantly reduce those costs. That’s why the financial penalties are so important to companies, critics and researchers say. They boost corporate profits by levying fines that outweigh any savings from wellness programs.

”“There seems little question that you can make wellness programs save money with high enough penalties that essentially shift more healthcare costs to workers,” said health policy expert Larry Levitt of the Kaiser Family Foundation.“

”Kevin Covert, deputy general counsel for human resources, acknowledged it was too soon to tell if Honeywell’s wellness and incentive programs reduce medical spending. But it is clear that the company is benefiting financially from the penalties. Slightly more than 10 percent of the company’s U.S. employees, or roughly 5,000, did not participate, resulting in savings of hundreds of thousands of dollars.“

”About 95 percent of large U.S. employers offer workplace wellness programs. The programs cost around $100 to $300 per worker per year, but generally save far less than that in medical costs. A 2013 analysis by the RAND think tank commissioned by Congress found that annual healthcare spending for program participants was $25 to $40 lower than for non-participants over five years.

“Yet at most large companies that impose penalties for not participating in workplace wellness, the amount is $500 or more, according to a 2014 survey by the Kaiser foundation.”

“Lori, for instance, an employee at Pittsburgh-based health insurer Highmark, is paying $4,200 a year more for her family benefits because she declined to answer a health questionnaire or submit to company-run screenings for smoking, blood glucose, cholesterol, and blood pressure. She is concerned about the privacy of the online questionnaire, she said, and resents being told by her employer how to stay healthy.”

But it’s about health.