I have an appointment with my endocrinologist this afternoon.

Last week I wrote myself a note to call and postpone this appointment.

I’ve gained about 5 pounds in the last year. I’m thin and that is not the end of the world, but for me this is a big gain. I am now over a threshold number that I haven’t seen in ten or twelve years. My endo is pretty observant and I suspect she is going to notice the pounds. I keep reading research reports that indicate that people who are thin and people who are obese have the worst life expectancy numbers. So I can argue that it is good for me to have gained weight and maybe it is. Or maybe not. Or maybe it doesn’t matter at all. None of that changes the fact that I have gained weight that I am having a hard time losing.

My Dexcom graphs are ugly. I have a 10-year run of A1c’s that I privately take great pride in. But it is rare that I have a blood draw that I don’t think that this is the A1c that will end my streak. We read about hypoglycemia unawareness and hyperglycemia unawareness. Even with Dexcom Studio and Diasend (and previously Carelink), I definitely have A1c unawareness. I don’t have a clue what my report card will reveal. I do know that if I postpone this endo appointment, I can definitely have better results in a week month year.

I have had great success in the last couple of years by reducing the number of carbs that I eat. I strongly believe that diabetes, whether Type 1 or Type 2 is a disease of carb intolerance. I’ve read books like Why We Get Fat by Gary Taubes, Wheat Belly by William Davis, and The Diabetes Solution by Richard Bernstein. These books make sense to me. You need to read these books.

My weight gain is the result of following a low carb diet with plenty of high calorie foods such as cheese and nuts and then eating carbs In addition to that diet. My Dexcom tracings are good during the day. A glass of wine, dinner, and then cravings for nuts and SF Jello with mounds of whipped cream lead to lows at midnight followed by Himalayan spikes at 2:00AM.

But I didn’t cancel the appointment. Avoiding this appointment would be little different than hiding candy bar wrappers in the garbage. Avoiding this appointment would be little different than not testing my blood sugar because I don’t want to see the result.  Avoiding this appointment would be little different than refusing to step on the bathroom scale. Avoiding this appointment would be hiding and in some ways “lying by omission”.

Not getting an A1c today doesn’t change the patterns of my blood sugar for the past few months. Whatever the status of my health is today isn’t going to change by not printing out my Dexcom tracings or Diasend reports. I am an adult and for better or worse, I need to be accountable for my lifestyle and decisions.

Avoiding my doctor is a slap in the face to her education, experience, and value in my life. She has never belittled me or made me feel guilty. She has always supported me and made sure that I have access to the latest medical technologies and the most appropriate medications. She is my doctor in order to help me live as healthy a life as I can with Type 1 diabetes. How can she help me if I don’t go see her and tell her the truth?  Maybe she will have some suggestions to level out my BG at night so that I can have an occasional CGM alarm-free night. Maybe she will say something to help me get back on the right self-care track. I am starting to have more autoimmune/inflammatory issues and maybe she will have some advice about whether I should give a gluten-free diet a try.

So I am going to see my endocrinologist this afternoon and I think I’ll survive it.