Yo, kinkypremed, seen some posts on here hating for seeking advice for your girlfriend. Keep up the good work my man! Nothing, trust me, nothing is sexier and shows more love than doing research for our significant others. Oftentimes, as a Type 1 myself, we are hesitant or simply unaware of a lot things we could do to get better glucose levels.
That being said, I’d definitely start injecting some 10-15 minutes before eating, but don’t take longer! The insulin could start kicking in before her food comes into play in her system.
Also, really (like really) revise your carb counting. Oftentimes we think we got it, but it’s super normal to be conservative. That being said though, our bodies always react differently every day. What worked one day, will probably not work the same the next. If she’s been having resistant glucose levels try accounting for a few extra carbs even though she wont be eating them. Example: if she’s gonna eat 70 g of carbs, she should give herself a dose as if she was gonna eat 80. This could limit her spikes and help her smooth out that “bump” after eating.
If she’s using the Dexcom, I’d recommend you guys read Sugar Surfing, great book you can order on Amazon about how to use your CGM more efficiently.
Sugar Surfing: How to Manage Type 1 Diabetes in a Modern World https://www.amazon.com/dp/0996253904/ref=cm_sw_r_cp_api_i_uhCHCbN92M16V
Good luck!
If you haven’t already, I would make an investment in yourself to purchase the standard diabetes books, and a continuous glucose monitor. My personal opinion is that the sugar surfing book is the most easily implemented that being said a lot of people really like Dr. Bernstein‘s diabetes solution and think like a pancreas I’m going to include the hyperlinks at this point I recommend reading all of them and consulting with your positions because of your kidney function.
My other recommendation is to treat this like a full-time job for a couple months and document everything what you eat when you eat it how much you eat it what you take how you feel then look for patterns.
When I sent my initial pre-employment records in, it took about a month and a half from the time I sent them to the time I got cleared. That includes additional information that I had to send in at the request of the RFS. I imagine that since you are already "in the system" and are needed for staffing, they would probably look at your case more urgently. Hopefully you get something back from them soon. Maybe you could have your OS check with them to make sure they've received your documents and check on the status of your clearance.
It's really hard to know what would cause a delay because part of it depends on who is reviewing your file. If you've sent them exactly everything they've requested, they could still come back and request additional information for a number of reasons. That's exactly what they did to me for my ATC medical and I've also had it done for my pilot medical as well in the past. Keep in mind, the person reviewing your medical probably does not have a lot of experience with diabetes and therefore is sort of limited in their knowledge of the disease as compared to your endocrinologist. I'm on an insulin pump and when I sent in my initial paperwork, it included blood sugar logs that were downloaded from the insulin pump that were presented in a way that showed blood sugar, carbs ingested, suggested insulin dose, and the actual insulin dose given. These are standard graphs and charts that any endocrinologist would be familiar with. The RFS that reviewed my initial file misinterpreted these charts and essentially thought I was having blood sugars in the 20's and 30's -- they were looking at the carbohydrates and not the blood sugars. That resulted in me having to go back to my doctor to have them provide clarification to the FAA. They wouldn't let me just simply explain to the RFS how to read the chart correctly (Yes, it was frustrating). I say that to say, you never really know what they're going to come back with on the first go, just cross your fingers and hope they have what they need to get you cleared. But also, don't stress about it. I would think it would be very unlikely they would outright deny your request for special consideration. They may ask for additional information, but I do believe they want to help you get back to the operation.
A few general pieces of advice:
I try and schedule my doctor's appointments off-step with the months in which my reports are due. For example, if my reports are due in March, June, September, and December, I try and schedule my doctor's appointments for February, May, August, and November. You can comply with the requirement to see an endocrinologist every 3 months without having the appointment in the same month that your reports are due. That gives you a little more latitude to plan your appointments on a day that works for you and gives you some additional time if you need to reschedule one.
There are so many people with endocrine problems in this Country and there aren't always a lot of endocrinologists, depending on where you live. I recommend scheduling your doctor's appointments 6 months out. I always have 2 scheduled, the one coming up and then another one 3 months after. It can be hard to find an appointment 3 months out.
I highly recommend a continuous glucose monitor (CGM) with this job and especially for newly-diagnosed diabetics. There are several different brands out there. I personally use and recommend Dexcom. I use a CGM+phone+watch combination. When I'm on position, I can just glance at my watch and see what my blood sugar is and where it's going. My watch will also vibrate if it goes below 100 and I haven't noticed it. The most dangerous time for a Type 1 diabetic is during periods of sleep (usually overnight). This is the time where your blood sugar could get very low and you not realize it because you're sleeping. I have my CGM set to alarm if my blood sugars gets below 80 at night so that it wakes me up. Having a CGM is in my opinion the best, most modern way to manage diabetes now. Check out Dr. Stephen Ponder's book Sugar Surfing.
There are many tools out there now that are great for managing Type 1 diabetes. Tandem Diabetes has an insulin pump that works with a Dexcom CGM that partially automates insulin delivery, reducing or sometimes preventing your blood sugar from getting low and reducing the amount of time your blood sugar is high. It's a great combination that makes managing diabetes easier.
Hope this helps and hope you get back to the operation soon! Hang in there.