Chris Johnson — Health Portal

📊 Key Health Metrics

HbA1c

9.3 %

May 2026 · target <7% · Aug draw done

LDL

114 mg/dL

May 2026 · target <55 (T1D+PAD) · Aug results pending

HDL

51 mg/dL

May 2026 · target >40 ✅

Triglycerides

73 mg/dL

May 2026 · target <150 ✅

TIR (70–180)

22 %

May 2026 · target >70% · improving ↑

TIR (Aug 2–8)

55 %

Aug 2026 · Omnipod 5 started Aug 4 · ↑↑

Avg Glucose

175 mg/dL

Aug 2–8 · was 243 in May ✅ trending

Non-HDL

131 mg/dL

May 2026 · target <100 · Aug pending

eGFR (Kidney)

? mL/min

Baseline needed · 23y T1D + post-contrast CT

hsCRP

? mg/L

Baseline needed · inflammation marker

Magnesium

? mg/dL

Baseline needed · vascular calcification link

BP Target

<130/80 mmHg

T1D + PAD · monitor closely

Time in Range (TIR) ProgressTarget: >70%

May 2026 (pre-Omnipod)

22%

Aug 2–8, 2026 (transition week — 4 days pre-Omnipod included)

55%

✅ Significant improvement. Pure closed-loop window (Aug 4→) is even cleaner. Algorithm still learning.

📡 Active Devices

Omnipod 5

🟢 Active — Started August 4, 2026

Closed-loop insulin delivery system. Automated basal adjustments + bolus calculator.

Key Settings:
Target glucose: 110 mg/dL
Correct above: 120 mg/dL
ICR: 1 unit per 8.6g carbs
Correction factor: 37 mg/dL per unit
Max bolus: 15 units
DIA (duration of insulin action): 3 hours

Pod replacement: Every 3 days

Dexcom G7 CGM

🟢 Active — Paired with Omnipod 5

Continuous Glucose Monitor. Real-time readings every 5 minutes.

Ranges set:
In range: 70–180 mg/dL ✅
High: 181–250 mg/dL
Very high: >250 mg/dL

Sensor replacement: Every 10 days

Data app: Dexcom Clarity (combined G6+G7 history at clarity.dexcom.com)

CGM Pattern (Aug 2–8, standalone Clarity): Nighttime highs 12:40–3:15 AM (6 events) and late afternoon highs 4:30–6:40 PM (6 events). These are exactly the patterns the Omnipod 5 algorithm will progressively correct as it learns your profile. Track week-over-week improvement.

🩻 CT Angiogram — August 10, 2026

Study: CTA Abdominal Aorta with Lower Extremity Runoff
Location: UMI of Torrance · 3640 Lomita Blvd Suite 105, Torrance CA · 310-802-7000
Ordering physician: Dr. Anand Gautam, MD
Formal radiology report: PENDING — request from Dr. Gautam or UMI

Zone	Vessels	Finding	Significance
Aorta / Iliac	Abdominal aorta, common iliacs	Relatively clean — patent lumen, no aneurysm, no gross calcification	Favorable
Thighs (NEW)	Bilateral SFAs (Superficial Femoral Arteries)	Moderate-to-severe circumferential Mönckeberg calcification — bilateral, symmetric ring pattern	New finding
Lower legs (known)	Tibial, peroneal arteries	Severe calcification — consistent with prior Doppler findings	Previously documented

Overall: Multi-level bilateral PAD — thigh (SFA) → lower leg (tibial/peroneal). More extensive than previously documented.

Key unknowns requiring formal radiology report: Degree of actual luminal stenosis at each level (calcification ≠ occlusion — Mönckeberg hardens the wall; atherosclerosis narrows the lumen; both may be present). Specific stenosis %, collateral vessel development, and runoff quality to the feet.

📅 Upcoming Appointments

AUG

17

Dr. Anand Gautam — Vascular Surgery Follow-Up TODAY

575 E. Hardy St, Suite 322, Inglewood CA 90301 · 310-673-6950
Bring CT disc (Torrance CTA Aug 10) + PAD distribution map image. Push for formal radiology report.

AUG

26

Dr. Gordon — UCLA Cardiology DTLA

700 W. 7th St., Suite S270, Los Angeles, CA 90017 · 213-988-8380
Bring: Quest lab results (Aug 7 draw) + Omnipod 5 / Dexcom Clarity CGM data + CT findings summary.

❓ Questions for Upcoming Appointments

Dr. Anand — Vascular Surgery — August 17 (TODAY)

ASK Request the formal radiology report from the August 10 CTA — from UMI of Torrance or Dr. Gautam's office
ASK"Do you use intravascular lithotripsy (IVL / Shockwave) for heavily calcified vessels like mine?"
ASK"Can future procedures use CO₂ angiography instead of iodinated contrast dye to protect my kidneys?"
ASKAspirin allergy clarification — I had a thick/viscous saliva reaction. What antiplatelet strategy instead?
ASKAm I a candidate for the COMPASS trial combination: aspirin + rivaroxaban (Xarelto) 2.5mg? Reduces major adverse limb events in PAD
ASKReferral for Supervised Exercise Therapy (SET) — Class I guideline recommendation for PAD

Dr. Gordon — Cardiology — August 26

ASKCAC (Coronary Artery Calcium) score — has this been done? T1D + PAD = need to image coronary arteries
ASKEchocardiogram — valve function, ejection fraction, diastolic function (Mönckeberg can deposit on valves)
ASKHolter monitor or event recorder — to capture palpitations and assess for arrhythmia / silent ischemia
ASKEECP (Enhanced External Counterpulsation) referral — grows collateral vessels, non-invasive, 35 sessions
ASKSGLT2 inhibitor (empagliflozin/dapagliflozin) — cardiovascular + renal protection, appropriate for my T1D + PAD combination?
ASKACE inhibitor (Ramipril) — HOPE trial data shows CV benefit in PAD even without hypertension; requires eGFR check first
ASKAspirin allergy — what alternative antiplatelet do you recommend?
BRINGQuest lab results (Aug 7 draw) + Dexcom Clarity report (30-day or 90-day) + CT findings summary

💊 Current Medications

⚠️ NO current antiplatelet therapy — Aspirin discontinued summer 2026 after a reaction (thick/viscous saliva). This is a significant gap for a patient with T1D + PAD + cardiovascular risk. Needs physician clarification before any antiplatelet restart. Raise with both Dr. Anand (Aug 17) and Dr. Gordon (Aug 26).

Atorvastatin 80mg

Max-dose statin — LDL lowering / secondary ASCVD prevention

Nightly with dinner

Aspirin — ON HOLD

Reaction summer 2026: thick/viscous saliva. Not a true IgE allergy — needs physician clarification

Do NOT restart without doctor guidance

Under Discussion — To Raise with Physicians

Medication	Purpose	Next Step
Ezetimibe (Zetia) 10mg	Lowers LDL additional 15–20% on top of statin	Raise with cardiologist if Aug LDL >55
PCSK9 inhibitor (Repatha/Praluent/Leqvio)	Lowers LDL additional 50–60%; injectable	Qualifies for prior auth (T1D + PAD); discuss if LDL still >55
Aspirin 81mg + Rivaroxaban 2.5mg BID	COMPASS trial: reduces major adverse limb events in PAD	Raise with vascular surgeon — aspirin reaction needs clarification first
ACE inhibitor (Ramipril)	HOPE trial: reduces CV events in PAD even without hypertension	Raise with cardiologist; eGFR check required first
SGLT2 inhibitor (empagliflozin/dapagliflozin)	CV + renal protection; off-label T1D use	Raise with endocrinologist and cardiologist
Vitamin K2 (MK-7) 100–200mcg/day	Activates Matrix Gla Protein — inhibits vascular calcification (Mönckeberg-specific)	OTC supplement; mechanistically sound; not guideline-backed
Magnesium glycinate 200–400mg/day	Inverse association with vascular calcification; BP + insulin sensitivity	OTC supplement; discuss with physician

👥 Care Team

Specialist	Role	Status
Dr. Gordon UCLA Cardiology DTLA · 213-988-8380 700 W. 7th St, Suite S270, Los Angeles CA 90017	Cardiologist — coronary screening, arrhythmia workup, lipid optimization	Aug 26 appt
Dr. Anand Gautam, MD Vascular Surgery · Inglewood · 310-673-6950 575 E. Hardy St, Suite 322, Inglewood CA 90301	Vascular surgeon — PAD, CTA interpretation, revascularization planning	Aug 17 TODAY
Endocrinologist (T1D-focused)	CGM/insulin optimization, SGLT2 evaluation, A1c management	Not yet engaged — NEEDED
Podiatrist	T1D + PAD foot risk — quarterly minimum, wound surveillance	Not established — NEEDED
Nephrologist	eGFR baseline after 23y T1D + post-contrast CT; pre-ACE inhibitor check	Consider consult

🎯 Lab Targets

Marker	Target	Last Value	Status
LDL (Low-Density Lipoprotein)	<55 mg/dL — AHA/ACC 2018 very high risk (T1D + PAD)	114 mg/dL (May 2026)	🔴 Above target
HDL (High-Density Lipoprotein)	>40 mg/dL	51 mg/dL (May 2026)	✅ OK
Triglycerides	<150 mg/dL	73 mg/dL (May 2026)	✅ OK
HbA1c	Per endocrinologist / track TIR >70%	9.3% (May 2026) — Aug pending	🔴 High (improving)
TIR (Time in Range)	>70% (blood glucose 70–180 mg/dL)	22% May → 55% Aug 2–8	⚠️ Improving ↑↑
eGFR (estimated Glomerular Filtration Rate)	Baseline needed	Not on file	⏳ ORDER ASAP
Blood Pressure	<130/80 mmHg	Monitor	Monitor
TBI (Toe-Brachial Index)	>0.6 normal · <0.25 = critical	Pending (use TBI not ABI — Mönckeberg makes ABI falsely high)	Pending

🦶 Foot Care — Non-Negotiable

T1D (23 years) + PAD = highest-risk foot combination. Peripheral neuropathy means wounds don't hurt. PAD means they don't heal. A small blister can become an amputation. These rules are not optional.

DAILYInspect feet every single day — mirror for sole, between toes. Look for blisters, redness, cuts, or calluses
ALWAYSNever barefoot — not even at home. Slippers count as shoes
WEARDiabetic footwear: extra-depth shoes + custom orthotics
Q3MOPodiatry every 3 months minimum — establish a podiatrist ASAP
URGENTAny wound, blister, redness, or swelling → same-day call to doctor. Zero tolerance.

❤️ Cardiac Connection — Palpitations & PAD

Palpitations and cardiac symptoms are very likely connected to PAD via the same systemic disease process. Four mechanisms to discuss with Dr. Gordon:

1Same systemic disease — atherosclerosis + Mönckeberg process may involve coronary arteries (not yet imaged). A CAC score will answer this.
2Diabetic autonomic neuropathy — after 23 years T1D, autonomic nerves can be damaged. Causes resting tachycardia, loss of heart rate variability, palpitations, and silent ischemia (can't feel angina).
3Mitral annular calcification — Mönckeberg can deposit on heart valves → atrial fibrillation → palpitations. Echocardiogram will assess this.
4Silent myocardial ischemia — coronary disease without chest pain due to neuropathy; may manifest as palpitations. Holter monitor needed.

🩺 Chris Johnson — Health Portal