Hi everybody. Last summer I achieved my lowest A1C since diagnosis (6.5%). I was obviously ecstatic to see such a result. I know it doesn't sound like a big deal to some of you out there with A1Cs around 5 (Kudos!). But me, I have major elf-control issues and I usually feel indignant about having to change m life style and I thought for such a long time that I could eat anything as long as I bolused for it. So that was something I was very much proud of. I restrained myself, went to the gym everyday and my work finally paid off. I felt great. We traveled and I was active all day long. It was the perfect scenario and I didn't want anything to change. And then I started med school and hell broke loose.

First off, my eating habits. I lived on granola bars, cup-in-a-soup and other processed food products. Chocolate and coffee were my daily routine. Whenever I stayed up late to study I would fix myself a pot of coffee and have some biscuits to go with it if I'm hungry. When my reservoir goes empty before my midterm I try to ignore it and tell myself I'm going to do it can wait. I didn't test often because seeing high numbers breaks my heart. Naturally I couldn't keep my regular fitness program and dropped my TKD classes. I walked to school everyday (I live near the hospital) and try to walk at least twice a week and do situps whenever I can. And the stress, of course, only made it worse. The week before my finals I had ketones every morning. Waking up was torturous. Both my diabetes control and grades suffered. One semester later and my A1C is 8. My endo was devastated. The staff just kept shaking their heads in disappointment at my incriminating test results. But they couldn't possibly be as devastated as I was. They hinted at the possibility of taking me off the pump and that finally did it. I'm really willing to do anything it takes. I'm not going back on MDI.
Which is why I'm here.

What I'm asking for is, how do you do it? How did achieve your perfect A1C score? How did you fit your diabetes regimen in your life? How do you keep yourself motivated? Your dos and don'ts? I'm ready to adopt a new attitude because my old I-can-eat-whatever-I-want is not cutting it anymore. Any tips appreciated. Thank you.

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For me, it is all about forgetting the past AND using the numbers as data only. Numbers are not good, numbers are not bad, numbers are ... NUMBERS!

From there, I get to make the choice on what to do, how to do and when to do it ... well, kind of. When I see a 53, there's not much choice on what or when, or even how for that matter. The point is I am in charge of my life, not the numbers, not my doctors, etc, etc. IT'S MY LIFE (see Bon Jovi for more)!

Again, this is for me. For you it may be different, but here is another part of my thinking:

If I don't test (a lot!), change my sites, put a new cartridge in the pump, eat sensibly MOST of the the time, exercise, and all those other things a PWD does, then I GIVE UP CONTROL of ... MY LIFE. Just in case you missed it, IT'S MY LIFE!

Oh and here is a really important point - no one has perfect A1Cs, perfect BG readings, perfect diabetes regimens that fit into their lives, perfect anything. We are ALL struggling in some way to try and achieve the unattainable. You are no exception, so cut yourself some slack.

Start small. If you tested once yesterday, test 2 - 3 times tomorrow, 5 - 6 times the next day. If you ate crazy yesterday, eat a little less crazy today with something sensible added. Gain control a bit at a time, give yourself a high five every time you test regardless of the result, because now you have information on what to do.

One day, today. I know you can do it!

Thank you, Mike,for your kind words. This is exactly what I needed to hear. I used to test at least 5 times a day. Then it became 4 at most. Now I'm going back to testing more often. It's not that hard to slide back to testing when you have fixed meals. I lost my pattern and that wrecked havoc with my control. I underwent a dramatic change the moment I walked out of the clinic. I eat baked wedges, turkey sandwiches and granola bars almost exclusively. So far (almost a week) and my average dropped down to 126 from around 149 a week ago. As for my BG results, I can't promise anything but I'll try. I literally skip around when I see an 86 post-meal.

Hi Asma. Taking your pump away sounds like a punishment to me, which is unacceptable. I had to stop pumping and use MDI because I didn't have enough sites that absorbed well for an infusion; the result was a higher A1C and the nuisance of continual shots. Since I know I should bring down a 130-150 BG, I often take a tiny correction shot, but that is so much easier on a pump. You need to keep your pump, but perhaps use it more effectively.

I hope you can also find ways to have a diet that works better for you, rather than too much relying on granola bars. Difficult I'm sure, but well worth the effort. (In full disclosure, I drink coffee and eat Dove Dark Chocolate.) Best of luck to you!

Not really. The whole staff has been very supportive and I love them. I just wish they wouldn't judge as much. It felt like I let them down when the person I've let down the most is me, really. It's more of a "you're not utilizing your pump well. This is not worth it". Yes, that is exactly what I plan on doing.Actually granola bars aren't so bad. They average aorund 20grams of carbs a pop. Thank you, Trudy.

Mike makes some excellent suggestions. I recommend that you pick up a copy of Chuck Eichten's, The Book of Better. The basic concept is that we can't be perfect but we can make things a little better. Perfect is hard but better is within reach.

Another thing that I have learned is that when I watch my BG numbers (a fingerstick log or my computer records from my CGM), they almost always get better. For me, the act of observing my BG reality makes me want to influence the outcome in the positive direction. Choosing to remain uniformed about my BG reality is a self-defeating habit.

This is a large question that you've raised, one that books can be written about. I suggest that you choose just one or two things that you can do to make things better and just focus on that for a while. Once these things start to improve, that success will energize you take on more. Success does breed success.

Good luck. I trust your life will get better!

Sounds like a promising book. Already marked it as to-read. The thing about keeping a close eye on my BG is, I can't take bad readings in good humour. I know what they mean. But I am testing more often already and I've only had one reading the past week that made me blue so that's progress. Thank you! Knowing that people out there are rooting for me to get better and do believe I can do it helps tremendously with my injured morale ;)

I also have major self-control issues. If I walk away from (insert deliciously indulgent food item here), I think I've done something monumental.

For me, testing (and correcting) more regularly made a difference in my A1C. I've never gotten into the 5s, but my specialist is happy with my numbers so I don't have that as a goal right now.

Thank you for this thread ... I am going to watch it so that I can piggyback on the ideas posted. I could use a little attitude adjustment.

Have a good'un.

All of these suggestions are excellent ones.

Another book to consider is Riva Greenberg's "The ABCs of Loving Yourself With Diabetes." She did a live event here last week that was one of the best attended ever. She is a lovely person, T1, and one of very few writers to focus on the emotional aspects of diabetes rather than the medical stuff.

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