Type 1 diabetics do not make insulin. The specific portion of the pancreas that makes insulin has been destroyed. They need insulin to survive. The bourdon of this therapy can take hours a day to appropriately manage. They are constantly checking fingerstick glucose, calculating an appropriate dose, then injecting the bolus insulin.
The struggle is to maintain a smooth blood sugar, avoiding highs and especially going low.
Insulin pumps have come a long way since their introduction. We are specifically trained in several insulin delivery systems and work closely with manufacturers and medical equipment suppliers to ensure the most appropriate treatment at the most affordable price.
The most recent device to relieve stress in the patient is the Continuous Glucose Monitor (CGM). We adopted these devices very early and have been very active in using the personal and professional versions of them. The not only allow the patient to monitor their own glucose but also may allow a parent or partner to remotely view their status.
New technology now allows insulin pumps to communicate with the CGM and will suspend insulin if it is trending low. It will increase insulin if it is trending high. We call it cruise control and have been involved in this technology since it was first developed.

Type 2 Diabetes is the most misunderstood disease and usually undertreated.  There are eight core defects in a Type 2 that cause hyperglycemia.  These defects absolutely need addressed in order to appropriately treat their diabetes.  The idea that one medicine, such as metformin, can manage this disease is absurd.  In fact, the ADOPT trial proved monotherapy does not work.

The defects are addressed with different classes of medicines.  Aggressive management and close follow up ensure rapid improvement in glucose management.  Multiple trials prove improvement in glucose control improves “Metabolic Memory”.  The Lancet published the average time to follow up for an endocrinologist is 4-1/2 months.  Our average follow up is 2 weeks, until we get appropriate control of our patients’ glucose.

When initiating a regimen, we titrate medications as needed and rely on the use of sample medications until we reach reasonable goals.  The medications are then sent to the pharmacy.  We do prior authorizations and will help with patient assistance if needed to ensure our patients are receiving the best therapy at the most reasonable price.

We work with women during their pregnancies to ensure appropriate glucose control.  High glucose during pregnancy can lead to high birth weight of the child.  It can even cause low blood sugar in the child after birth.

While any pregnancy complication is concerning, there’s good news. Expectant mothers can help control gestational diabetes by eating healthy foods, exercising and, if necessary, taking medication. Controlling blood sugar can keep you and your baby healthy and prevent a difficult delivery.

In women with gestational diabetes, blood sugar usually returns to normal soon after delivery. But if you’ve had gestational diabetes, you have a higher risk of getting type 2 diabetes. You’ll need to be tested for changes in blood sugar more often.

Many medications cannot be used with diabetic mothers.  We utilize the latest technology including insulin delivery devices and continuous glucose monitors to achieve the best results.