Going from Good to Great Diabetes Management

Posted by alexis on Wed, 05/14/2014 - 08:44 in

OmniPod-Insulin-PumpWhen my husband and I were traveling throughout Asia with diabetes, I didn’t deny myself any part of the experience – including all the delicious food available over there. Noodle and rice dishes abounded, and I tried them all. During our three-month adventure I was on multiple daily injections. Throw in multiple time zones, bizarre exercise patterns (mostly based on walking and biking around ancient ruins for hours on end) and you can understand why my blood sugar control wasn’t the best during my time over there.

When I returned, I had to face the music. My A1C had crept up to 8%. For someone who keeps her A1C under 7% (and usually under 6.5%) this was a bit of a blow. I knew all the reasons it was up there (they mostly involved Pad Thai and ongoing, imperfect basal adjustments with injections), but it was still a crummy feeling. I vowed to get my number down by my next visit.

And I did. In fact by my next doctor’s visit, I had lowered that number all the way to 7.3%. When we got back from Asia I immediately went back on my Omnipod insulin pump, allowing me greater control and flexibility with my insulin dosing. I settled into a regular exercise routine and I stopped having pho (a Vietnamese noodle soup) for two meals a day.

These changes alone slashed my number by 0.7% in a scant three months. I was so stoked and really feeling like I was on the right path. I thought for sure my next number would go down by the same amount and I’d be sitting pretty in the sixes in no time!

But then I got my results in October. And I had barely budged. There it was, a 7.2% staring me in the face. My doctor even wrote next to the number: “Holding steady. But let’s fine tune to get under 7!” Holding steady? Yuck. Holding steady was the last thing I was looking for in my diabetes management – I wanted another dramatic drop! Without even putting in any big effort! But that’s when I realized that 7.2% is exactly where the going gets tough.

The real work with diabetes isn’t in the macro changes. Going back to my insulin pump and a major shift in my diet were sweeping changes that made a big, immediate impact. But going from good diabetes management to great diabetes management – and getting my A1C under 7% – that is what takes real work. Getting there is all in the details and it’s exhausting.

Getting to great diabetes management means bolusing a half unit when you’re 163 mg/dL at bedtime. It means bothering to bolus a half unit for anything, actually. It means when the CGM blares at 2:00 AM, you actually have to get out of bed, finger-stick confirm it and fix the problem. It means remembering to bolus right after your workout to avoid a blood glucose spike an hour later. It means remembering to bolus 15 minutes before that carby meal. It means telling your friends at happy hour that you don’t want to share the chips and salsa appetizer, but can we please get the carb-less chicken skewers instead? It’s all these little changes that can add up to a big drop in A1C. But these are the hardest parts of diabetes management, because it’s about being conscious of each decision, each hour, each day.

Going from good to great diabetes management is so challenging. But I also know it’s going to be so worth it when I finally get that number down in the sixes. Because the real bravery in having diabetes isn’t about how many good days or bad days you have. It’s about finding the strength to get up the next day and try harder.

NOTE:  Information posted on Podder Talk is not intended to be taken as medical advice. Always consult with your healthcare provider for questions and guidance on managing any health-related issues.