In knowing and talking to many friends and acquaintances with T1 (thanks to T1 camp and a small hometown), and to several endocrinologists, I have found that one’s experience with insulin and meds can be drastically dependent upon one’s endocrinologist- translation, if you like and get along with your endo, you’ll generally seek and take their advice when having struggles with blood sugars, injection sites, strategy to lower A1C, etc. I was lucky to get along with the only endocrinologist within a 6-hour radius who treated my brother (who also has T1) and I through our youth.
Transitioning to a bigger city on the east coast for college, I needed a new doctor, who I initially (and naively) assumed would simply serve as a ‘script provider (i.e. would write a prescription every year to get me insulin). As school was busy, I often didn’t maintain 3-month checkups, and if I ever got into a jam with the prescriptions running out or expiring, I would make a fast appointment with a physicians assistant, who generally could see me within a week (versus a month or two wait to see the MD). And while this worked, it probably wasn’t the best strategy – through other medical issues, I have found that building a relationship with your endocrinologist is important. But, sometimes this can be difficult. I saw two endocrinologists while in Baltimore: one I got along with very well, for he viewed treatment for diabetes in a similar manner as I did: that you treat in a way that is livable, although often not perfect. The other doctor was much more stringent and rigid in how I should be controlling my disease, the frequency with which I should be testing, and how I should be treating highs and lows. I was in decent control (my A1C at that time was around a 7.2) had a hard time imagining drastically changing my daily life to fit her proposed treatment schedule just to lower that number by .3- we fundamentally did not get along, which became obvious and awkward during my visit. Through this experience, I found that sometimes the better medical advice comes from the less intuitive resource, so I went back to the lesser known hospital that housed the endocrinologist who not only understood the way I treated my diabetes, but also who gave me advice and tips that enabled me to live better with my disease (my next A1C with him was a 6.7)! And based on his view of enabling his patients to live as fully as possible while also controlling their T1, he not only supported my decision to pursue 9 months in Kenya, but he encouraged me to go forward with confidence! This support became very important when I discussed my plans with my family, as their first question was about if it was possible for me to move for 9 months to a non-western, low-income country—and I was able to answer truthfully that it was, and that my doctor supported the decision! So my advice for you is to find an endocrinologist who you click with, and who you will approach when you need advice and guidance, both for the science behind the medicine, and for how to implement the science while living the life you want to live!!
Tip: If moving, ask around about new possible doctors. Start with your current doc, maybe they will be willing to advise you from afar, but also have a colleague in your new city who can help you out! If you are starting college, try asking the school’s medical office. Reach out to your local ADA office! Google docs and see if there are any reviews. If you become part of a T1 group, or know/meet any other T1s in your new town or city, ask for their opinion! The more information you have, the better you can choose. And, if you have a meeting with a doctor, and absolutely cannot get along with them/don’t respect their opinion, then try another! You shouldn’t pay for advice you know you won’t follow. So find an MD who’s advice you can take, and who will give you tips that you will be able to implement in your daily life to live as fully and be as healthy as possible!