This is the part where I usually start fucking things up.
I’ve lowered my A1C before. A quarter, a half, even a full percent. Now I’ve jumped one and a half percent and all I can think is: “How long will it last?” Because I’ve seen my A1C go down. And I’ve also seen it go up. And down. And then up. And then down.
My A1C rarely stays put and it rarely stays moving in one direction.
I get my A1C done. It’s above where I want it to be. I spend the next three months diligently counting carbs (possibly even lowering my carb count), testing more often, correcting more aggressively, exercising more often, and in general just being a totally bad-ass diabetic. Okay, well I am always a bad-ass diabetic, but this time I’m extra bad-ass. And then I get my A1C. And it’s awesome (eh, awesome-ish). So I think, great, I have it figured out. We’re all good here. Then the days, and the weeks, and the months go on and I start maybe being a little more careless with the carb counting or bolusing early, but I think, well, my A1C was such-and-such, so this one little (::cough::) indiscretion isn’t going to be the end of the world, right? Until I finally make my way back to my endo, get my A1C done, discover it’s crawled back up to where it was six months ago.
And so it goes.
It just pisses me off because I feel like good control is a recipe for diabetes burnout, but if I relax for even a millisecond everything goes to hell anyway.
I need to find a happy medium between being completely obsessive and completely lackadaisical.
My next endo appointment is on December 29th (Merry Christmas to me!), and my main goal for my next A1C is to keep it exactly the same. Well, within reason. Mid-sixes. To do that, I’m trying to focus on a few things:
1) Download my Dexcom receiver and review my graphs every time I change my sensor. I don’t do this enough. I need to do this more, and if I do it every time I change my sensor, that should be somewhere between every 7 to 14 days.
2) Change my goal BG to 90 mg/dl instead of 100 mg/dl. I saw someone recommend this a few months ago and from what I’ve seen in the last two weeks since I did it, it’s pretty helpful. By having just a tiny bit more insulin going in, I think it helps account for any discrepancies in carb counting or in absorption.
3) Not be afraid to make tweaks to my pump settings. I have a bad habit of thinking things will just “fix itself.” Sometimes it does, sometimes it doesn’t. If a pattern emerges, I should fix it, even if I might need to change it back later. It takes less than a minute to change a pump setting. I should be more proactive.
4) Have regular appointments with my CDE. Sometimes patterns don’t always make themselves known to me, or sometimes I don’t realize that by fixing something, I’ve caused another problem somewhere else. After all, our days are cyclical. What you do at one time of day can impact another part of the day. I have an appointment with Jenny for Monday, and I’m hopeful to keep up monthly appointments with her.
Do you have any tips for making sure you don’t start slipping back into old habits?