i was diagnosed 2 year ago. my A1c has been 5.6, 5.7, and now 5.3. my secrets are....
1) the Omnipod pump
2) don't snack
3) bolus for any carbs you eat. snacking just one chip at a time counts up!
4) know what you're eating.
5) check your blood sugar 2 hours after a meal you guessed the carbs on.
Excellent advice, Emily Joy. I would add 3 more:
8) Test some more.
If you don't know what your BG is doing and correct for it, you have no hope of controlling the disease. I test 4-5 times per day on average - 2 hours after EVERY meal, like clockwork. After doing that for about 6 months, I got pretty good at carb counting. Anyone can do it, it just takes time and diligence to test religiously and monitor what you eat.
I have been in the 5s and 6s now for a year and a half. I agree with Emily and Eric! Especially Eric! Testing 10-14 times a day became a new norm for me before my cgms took some of the pressure off.
I spent my first 10 years w/ type 1 w/ A1cs over 10.0%. Then another 8 years or so over 8.0%. My highest was 15.4% three years into type 1. So these tips did WONDERS for me!
I will also add:
9) Stop bolusing/injecting with or after meals. Do it before.
10, 15, 20 minutes - whatever starts giving you the results you want at 1 hour post-meal. Learn how to time the insulin peak with your post meal spike by taking insulin earlier before meals. If your post-meal numbers are the highest in your day (and for most of us, they are), then you have to curb those spikes to bring your average down.
It is an old wive's tale that we need carbs at all. I have been on a no carb diet for a couple weeks now after reading Gary Taube's book "Why we get fat". I won't go into it here, but it is NOT a diet book, but a layman's version of a research book he wrote. He pulls together research from the 1700s to current times and explains why this is the best way for us to eat. I eat no carbs and am fine and my BGs numbers are in the 80s and 90s. I am on the Animus pump and I keep lowering my basal rates as well...check this book out. It is worth reading. I've lost 9 pounds in two weeks.
Something else to keep in mind when talking about low HbA1c is that there is a point of diminishing returns. In order to maintain a sub-6% value, you necessarily have to accept increased risk of hypoglycemia. The risk goes up as the average BG goes down. Since we all know how dangerous low BG can be, I don't have to tell you that there is a point of BG control where it doesn't make sense to go any "tighter" or lower; the risks of hypoglycemia become greater than the risks of long-term complications from BG levels.
I'm not just pulling this stuff out of my arse; talk to an informed endo (or just Google) and they'll tell you about the recent studies that indicate extreme BG control is actually harmful.
I'm just pointing this out to remind us all that goals should be realistic and we should not focus obsessively on a "magic number" HbA1c.
I have just recently had this very conversation with my Endo. I've been on a pump for 9 months and each A1c every three months since has been below 5.8%. She isn't happy about it either. The only reason it's that low is because of lows. She says that the longer I stay in really tight control in the 70 and 80 range, I lose the reserve insulin I naturally have on board to respond to lows when I need it, not a good deal. Plus, when I go low from 70-80, it doesn't take much to be dangerous. It's really strange for me to have someone talk to me about over treating my diabetes. Go figure, lol
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