That's ME to a "t." I feel your pain. I wish I had seen your post earlier. I think the best thing you can do is factor the stress into your insulin/carb ratio. Assess your stress as being the equivalent of an extra few units of insulin. I use a pump, and one of my basal settings is actually elevated stress. The worst thing you can allow to happen is to let your blood sugar drop when you're in a stressful situation.
The scenario you described, seeing your doctor, is certainly something I've faced before. My problem is that while the stress may be related to the doctor visit, the resulting danger manifests immediately BEFORE the visit...the GETTING TO the visit.
I have been in a few sugar-related close call car accidents in my lifetime, and the last thing I ever want to do is harm another human being or myself because my sugar dropped out on me. I have learned, to an extent, to put time stress into perspective. If I'm late for something, and I feel my sugar starting to respond, I grab my cran-apple juice (in convenient travel-sized plastic bottles) , breathe, make the appropriate phone call, and .assure myself that it's better to be late than to be behind the wheel of a several-thousand pound weapon and not be in full control.
Every doctor I've ever spoken to about this issue has said the same thing...better to err on the side of caution. And always be prepared. Life is full of stress. If you know your body's reaction is to burn through carbs, you have to stay ahead of it. as much as you can.