Windsparrow it sounds like getting staff on board with new diets is really hard.

In terms of blood sugar - nothing today was deadly. Even my low of 58 is "concerning". No real long term danger until you hit low 50 or 40s (40s there is a risk of brain damage - not huge risk but significant.) 58 and sixties mainly is a case of temporary impairment of judgement plus extreme irritability. I ended up in 85 which is really a good bedtime number. I am cutting the 24 hour insulin dose again. All this constant adusting of insulin dose is a result of cutting the amount of food I eat. I gradually titerated down from 36 to 16, and finally stopped getting occasional number in the sixties. The problem is that now that I've lost a signifcant amount of weight, the same insulin does that worked fine with the amount of food I'm eating is now too high. I guess less body weight means the insulin does is more concentrated. So I'm not at the point yet where I have to cut food again to keep losing weight. I think that will come if I manage to lose another 15 pounds or so. But I definitely need to cut the insulin dose in order not to increase the food from the amount that has caused weight loss so far.

Typo, you are very right, it is a bit of a PITA to get everyone on the same page. I'm extremely enthusiastic about the chance to shovel more veggies onto people's plates, and I'm willing to follow the orders of medical professionals, but there are aspects of it that even I am not sold on.

I can see you are having an interesting challenge in getting your insulin dosage calculated for your true need. It makes sense to me that as you lose weight, you need less insulin. Sugar is fuel, insulin moves that fuel around in your body. Smaller vehicle, less fuel required to run it; smaller vehicle, smaller fuel lines. Of course, that may be oversimplifying it to the point of inaccuracy.

Windsparrow your analogy is a good model which will yield the right decisions in terms of adjusting my insulin. As long as the model produces answers that let you do the job right, it does not matter whether it is true or not. Maybe you can tell I've spent a lot of time around engineers.

It's not uncommon for insulin to be dosed by weight. There's also fixed-dose insulin (i.e., no matter what your weight, it's always the same dose), but for patients who are more sensitive to it, weight-based dosing isn't unusual. Frankly, I'd be concerned if your doctor isn't dosing it by weight, given that you've lost weight and that you're having such a hard time regulating on the fixed dose.

Also health-related (though more incompetent admin staff-related):

I called the pharmacy to refill my BP meds because I have 2 or 3 pills left, and they told me the doctor's office won't refill it until I come in for a check-up. Now, as it turns out, their policy (or maybe it's a new law? the receptionist was a little unclear about that) is that they can't refill ANY medication if you haven't seen one of the doctors/NPs in the past year, and apparently I haven't been in since February 2014.

I don't object to a yearly check-up, but I do think if they have a new policy that patients need a yearly check-up to get refills, it's incumbent on THEM to let the patients know BEFORE their meds run out. If I didn't know that policy existed, how would I know to call them for an appointment? They have the shittiest admin staff/policies and the best doctors. So weird.

t edit Wait. This is weird. I was refilling 2 Rxs -- one for my BP and one for my IBS. The pharmacy said I could pick up my IBS meds tomorrow. So clearly what the receptionist said about them not refilling ANY prescriptions if you haven't had a checkup in a year is not true, or else the pharmacy wouldn't refill my IBS meds. That's weird.

They have the shittiest admin staff/policies and the best doctors. So weird.

I think this must be a common thing, because it's the same for my family doctor's office. Can't say enough good things about our doctor, but it's a constant battle to get admins to schedule appointments, refill prescriptions, etc. and I don't think I've ever seen the same receptionist twice. The nursing staff is somewhere in the middle of the two extremes—the head nurse is capable but snippy, others are sweet but don't wow with competence, and then one is a longtime family friend who's been doing it since before I was born and can draw blood without any needle sting or leaving a mark.

I am damned lucky; the staff at my GP's office are pretty great. And I LIKE my doctor.

I even edited her husband's sci-fi novel MS.

I just ran into that 'prescription runs out' with my EYEGLASSES. Which, since my old glasses (and prescription) were four years old, and I'm in That Age range, made reluctant sense even though I really didn't want to pay out the $91.

I still have to go back and get my pupils dilated, which I skipped that day.

Such a Monday. Hit snooze one too many times, attitude from Mac including insinuating that I was making up things and lying to him, me throwing a f-bomb at him, no time for dunkin coffee, rain over the weekend means very little work at work today which = grumpy boss (March rains have put us way way off our numbers), new rules for POs mean I need to now do double the number of POs for the same number of invoices (no explanation as to why the old set-ups are all of a sudden an issue), I'M ALREADY HANGRY AND IT'S ONLY 11, and I have run errands at lunch which means interaction with people.

I still have to go back and get my pupils dilated, which I skipped that day.

My optometrist has a machine that can do whatever it is they do with dilated pupils, only without having to dilate them. They charge an extra $25 for it, but when I was working that was totally worth it, because I could go back to work and stare at text and code for the rest of the day.