Dr Ashley Ng

The other week, I finally managed to see my diabetes educator to pick up my new insulin pump. Leaving the appointment, I felt refreshed and really comforted by the conversations we had. I had expected the appointment to just be about setting up my new pump and away I went. We didn’t even touch the pump until the second half of the appointment. Instead, we just…chatted.

She asked how things were going and it gave me the opportunity to pause and breathe. Life had been pretty frantic, often finding myself being in pure survival mode (as you do with two young kids and trying to rebuild your research career). I realised that life had been so busy that my diabetes management had just fallen off the priority list. Ironic, given that I was writing a research proposal for grant on that very topic.

Slowly our conversation meandered to my diabetes and I admitted to her that I had kinda given up on making adjustments because I simply didn’t have the brain space to. I knew where my problem areas were with my sugars. I had been ignoring them because i) they weren’t that bad – I’d just keep correcting my sugars when needed and ii) I just hadn’t had time to think about what needed to be changed – was it my insulin to carb ratio or my basal or just bad carb counting. My educator then suggested we look through some data to see what we could change.

Once I figured out what my bloody Dexcom Clarity password was, I was pretty shocked and upset to see what my current Time in Range was. It was sitting at about 65% when we should be aiming for over 75%. I know during pregnancy I would have been sitting around that 75-80% mark. Clearly once the child is out, all hell breaks loose and my TIR reflects that! Looking at my average daily patterns was eye-opening too. I could see that I was borderline my upper limit most of the day so it was pretty clear that my basal needed to be bumped up. Then I had this sudden realisation that perhaps…in the two years since I’ve given birth…maybe I hadn’t put my insulin rates back from labour/first few weeks post-partum settings, which were essentially halved to account for the energy that giving birth and breastfeeding takes.

Two. Whole. Years.

Mortifying.

So we tweaked a few things (aka most of my basal rates), set up the new pump, made light of the whole everlasting baby brain situation and off I went. What I had appreciated this whole time was that she was letting me drive the conversation. As we made changes to my basal and insulin to carb settings, I was thinking out loud all my options and rationales behind them before deciding on course of action while my educator simply reaffirmed my thinking or probed a few other considerations. It was great to have her expertise (and a proer brain) there.

Just because I work in the diabetes space, doesn’t mean I’m effective at my own diabetes management sometimes. I face the same challenges my peers do. My diabetes gets put on the backburner when life gets too crazy. That’s why it’s so important to have an amazing clinical team who can be your cheerleader and support crew when life gets in the way. For me, I just schedule those follow ups that just become non-negotiables in my calendar.