I'm a retired advanced practice nurse who did most if not all of the diabetes education for the clinics where I worked before my retirement. I loved workin with my diabetic patients and even the non-compliant ones were a challenge for me and I loved getting that HA1C down. Even when the ADA said a HA1C of 7 was "good" I wanted my patients to do better and was always striving to get them to meet the goals we set.
The most challenging patient I ever had was a young man who was slightly "slow" and who had the highest HA1C I had ever seen, well above 14!!!! In six months--yes, six! His HA1C was down to 6! That is SIX! He was so faithful in following my teaching and never wavering that he accomplished what I thought was impossible. Yea for him, and yea for me!
My late husband was diagnosed with type II and he was another challenge for my motivational skills---because I never considered that I was anything but the Coach, and in fact, I used to tell my patients, "taking care of Diabetes is a do-it-yourself-care-plan, because the patient must be the one who does it and considers food, exercise and medication to all be "treatments" and the professional medical practitioner is simply the coach, teaching the team the rules. If you dont' know the rules you can't get on the field and play a good game, but the coach can't get out on the field and play the game. You are responsible for playing the game and treating your diabetes. The goal and reward is that you get to keep your eyesight, your legs and your heart working well!"
After my husband died suddenly in an aircraft crash here at our farm and airport six and a half years ago and I retired, I started gaining weight..."oh, it's only a pound or two, no big deal." That went on until recently I was feeling pretty bum and on a trip to my internist had her check my HA1C (I have a family history of Type II DM) and sure enough, it was "a tad high." My blood pressure, for years steady at a nice low 90/64 or there abouts, was starting to go up and my feet had begun to swell, so I knew "it was time" to get out of denial and get serious about takin care of myself and my health. To quit being the ultimate hypocrit and to get to work, taking care of myself.
I started checking my blood sugar four times a day for the first month. Yes, I know that isn't necessary to do it that frequently, but just to get a general ball-park-figure of what is going on, I did what I had advised my newly diagnosed patients to do. Plus, I wrote down every bite I ate and the time I ate it and saw how the blood glucose levels rose and fell accordingn to my intake and timing.
Instead of my usually poor timing of meals, I started eating three actual meals per day, with small snacks between meals and before bed. I measured every bite that went into my mouth, and literally became obscessive compulsive about the measurements. I also tracked my blood pressure as well.
I did daily weights and measured the circumfrence of my ankles and calves and checked for "pitting edema" (swelling that you can push on and leave a dent in the flesh after you remove your finger). I also set an exercise schedule and started to move my exercise up slowly from sedentary to more active, using my body and my blood sugars as a guide.
Within three months I had lost 21 pounds and my blood sugar had normalized and my blood pressure as well, and I only had to use the occasional lasix tablet when my sodium had been too high in order to control the edema (swelling) in my feet and legs.
Learning to cook again almost from scratch, since most foods that are processed or canned have added sodium in it, I had to plan ahead and shop more in order to cook a meal with lower sodium. I also learned to look for more frozen vegetables and fresh produce than processed foods. Unfortunately, I also learned that many low calorie items are also loaded with sodium and breads as well, so in addition to the decrease in calories in foods, I was having to eliminate or sharply curtail several of my favorite foods---low calorie salad dressings and cheeses are loaded with sodium. I also found that there was no room for cheating with the sodium, I could have an extra hundred or two of calories on a special day, but not increase the sodium without the edema going "waaaay up! "
Spices and herbs are wonderful substitutes for the high sodium that I had become addicted to from my youth. Sausage and ham, cheese and jerky, cornedbeef, hot dogs and bologna were all "no nos" now. After a while of decreasing the sodium content though, my tastebuds became accustomed to the lower sodium and more sensitive to the salt that was naturally in food.
Potassium Chloried in place of sodium chloride is acceptable to most diets in moderation. The key to just about anything, including diets is moderation. Not feeling deprived. I'm learning to be moderate in my habits and to get out on the field and play the game for myself now. Learning to quit being a hypocrit, and practicing what I preach to the best of my ability---and quit whining about it as well! Diabetes isn't the end of the world, but it will take control of my life if I don't take control of myself and take care of my health!