Hi MekaMom -
Your history sounds much like mine, but my time-line is shorter. For several years my Doc sang the "loose a little weight, get some exercise, and quit smoking" song to me and then "tweaked" the meds(Metformin and then Lantus) and my glucose came back into line. I didn't change anything. About 3 years ago, after 5-6 years of ignoring it, I "progressed" to insulin before every meal - that got my attention and I got involved.
Over about 18-months my A1c dropped back to the 5.6-6.1 range and is staying there, I no longer use ANY insulin. I do still take Metformin, and test before every meal and before bed just so I can keep an eye on what is happening.
So, what do you do -
FIRST - My Doc's clinic has a FANTASTIC diabetes education and support team.
. . . YOU need a Doc and more importantly the education and support team
SECOND - I am The Boss. Managing my glucose is my responsibility and as The Boss I call upon any and all resources that I think will help me run this show.
. . . YOU need to look at Glucose Management as your job, 'cause you're The Boss, and tap every resource available. That includes the diabetes education & support team, the records you keep, this and other diabetes-oriented forums, and MOST IMPORTANTLY - don't sweat the small stuff.
You will stub your toe, and that's OK. Remember - you are The Boss - everyone else is just hired help and they will slip-up from time-to-time. When you do, walk into the bathroom, stand in front of the mirror, and talk about what happened with The Boss. THEN - because you learned something, you can "pick yourself up, dust yourself off, and start all over again".
I had to check my glucose before every meal to determine insulin dosage. I gave up trying to test 2-hours after eating 'cause I'm not disciplined enough, and I decided the test before the next meal was good enough. I held my carb.intake to 100-125 grams per day. I didn't worry about calories, fat, or anything else - JUST CARBS.
I changed eating habits as I determined the meals that left me with hi-glucose at the next pre-meal test. I started loosing weight--not because I was "dieting" but because I was reducing my carb.intake. I view that as a GOOD side-effect.
In the course of a year I dropped 40-pounds, which is a good thing except I have to admit it was there to loose. I started walking for about 30-minutes 4-7 days a week, in a treadmill and reading while I walk so I don't get bored. I also quit smoking. I did discover that a shot of bourbon has only 1-gram of carbs in it so I added that to my daily schedule (bourbon on the rocks) with no concern over the calories.
As the year progressed my insulin dosages began to reduce, I guess because my carb.intake was lower, and probably because my system was making better use of the carbs and insulin (injected and body-created) it had to work with.
When my insulin usage dropped to about 3-units of Lantus at night and 2-3 units before meals we decided I could quit using it. My last A1c was 6.1 and I'm wearing the new pants I had to buy because the old ones were too big.` Yup, I WON!
I'd be happy to share some tips on the record-keeping tools I used, if you're interested drop me a note. Most importantly REMEMBER -
1. A wise man once said - "We shall overcome!", and we shall!
2. You ARE The Boss, every body else is just a helper - take full advantage of them!
3. Don't sweat the small stuff, and 99-1/2% of it IS small stuff!