This year, I pledged to make November not just National Diabetes Awareness Month, but MY Diabetes Awareness Month too. As I’ve struggled to get my A1c back down under 7% since the Great Noodle Fest of 2013 (a.k.a. our Southeast Asia Trip), and been hit by one distraction after another (see: Our wedding. See also: My best friend’s wedding. See also: 2 bachelorette parties within two months of each other. See also: tequila. OK. I’m done now). Suffice it to say, a little focus on my diabetes was long over due. Putting this much energy into my d-management was tough, but eye-opening and well worth it too. Below, a list of things I know I significantly improved upon – and intend to try my best to keep up with:
1.) Actually getting up and correcting high blood sugars in the middle of the night. Yes, this means losing a few minutes of sleep and sometimes getting out of the warm blankets and your slumbering partner but it’s so worth it. Night time highs lead to morning highs which often lead to a day on the Glucoaster which is one crappy day. 30 seconds in the middle of the night to get up, test, and correct won’t kill you. And my fear about being too low in the mornings to work out? Unfounded. This only happened once after a night time correction bolus this month and you know what? I just worked out later. NBD.
2. ) You actually have to count the carbs for carb-counting to work. I know, I know, paging Captain Obvious. But the fact was, I had gotten lazy. This was evidenced by my last glucose log book that I took in to my CDE in October. I noticed there was a common bolus number of two units, regardless of what I was eating. Salad? Take two. Cookie? Probably two units, right? Wrong. By paying more attention to carbs, looking up nutrition info when I don’t know it, and actually using a real, live carb-to-insulin ratio, my post-prandials are starting to improve. Except for on Thanksgiving. But come on, who has good blood sugars that day?!
3.) Bolusing after my morning workouts, even if I’m having zero carbs for breakfast. Nine times out of 10, my liver will drive a post-workout BG through the roof if I don’t get a bolus in before eating my usual egg whites with cheese and a side of coffee. Bolusing early for that meal means I don’t end up at 200mg/dL by 10am and feeling like my workout was a waste because I’m now rage-bolusing to get my liver-induced high down. Because we all know how that game ends up.
4.) My technology is only as good as I’m willing to make it. CGMs don’t mean never testing with a finger stick again. And a “smart pump” can only help you if you help it understand what you need. To maximize the abilities of these gadgets, you have to use them the way they were intended, and not rely on them to put certain d-management items on auto pilot. Just because I can push buttons, take a few units, and check my CGM later and fix something doesn’t mean that’s the best way to manage diabetes. Being proactive, thinking ahead with this disease, and thinking through my food and workouts before there’s a problem is how to truly manage well. I’m still the cruise director of this ship, and that means I have to put the time in. But I know for certain it will be worth it!
As I go further in to the holiday season, I know things will be harder for a little while, not easier. There’s going to be more food, alcohol, and great reasons to not work out. But I hope to keep up with these habits I rediscovered during my Diabetes Awareness Month. Because all I want for Christmas this year is an A1c under 7% Come on Santa!