I had to go to Effingham Il today,

[Ms. Toad]

33. She's been refusing to test -

So her family doctor just kept throwing more meds at her (while her A1C was bouncing around between 10 and 11 for a year). Medicare won't cover CGMs unless you have a history of lows (which she probably had - but we'll never know since she wasn't testing) or are on insulin.

Markers for diabetic ketoacidosis (as a result of unrelated tests - blood glucose around 400, high ketones, and acidic urine (they didn't order a blood test since they weren't looking for it)) sent me into a tizzy. She refused to go to the ER since her doctor wasn't ordering her to go. The doctor who ordered the tests said, "not my problem" and the family doctor didn't know the tests were coming so he didn't bother to respond to her message until Monday (tests were Friday). When he finally looked at the tests he told her to come in immediately . . . 3 days too late.

So NOW she is on long-acting insulin and has a CGM - and is actually learning. The instant feedback is really helping her. She also now has an endocrinologist who all but rolled his eyes at her family doctor's incompetence. Unfortunately, it is a question of when, not if, she'll need not only long-acting but short-acting insulin. Her nephew (25 years younger) is already on an insulin pump. Her grandmother was on the full range of insulin for most of her adult life. Nearly all of her siblings have it. It's a pretty nasty version for something that at least starts out looking like T2. It's a rare day she doesn't hit both above 350 and below 70. (She's had diabetes for at least 30 years, but wasn't diagnosed until about 20 years - so it's not new - but it finally hit the point at which I stepped in and insisted on an endocrinologist.)