Yesterday I went to my diabetic clinic for the first time in over a year. I wasn’t nervous, but I was definitely prepared for the speech I thought I’d get about my HbA1c (average blood glucose.) I was certain it had risen since the last time I visited. Last year I was the most lax I’d ever been about my diabetes in a long time. I didn’t stop taking care of myself or giving myself insulin. However, I didn’t note down every single number, I didn’t check 10+ times a day and I didn’t stress over highs and lows. At this visit, I was told that my average blood glucose was the best it’s ever been. My HbA1c was 6.5% with no frequent low blood sugars. A non-diabetic would average from 4.0 to 5.6%. Before, at my peak micromanaging state my A1C was around 8.0%. This just proved to me that being obsessive and over-thinking really doesn’t help at all. These are the five simple things I did last year that I truly believe contributed to this lower A1C.
Ripping Off the FreeStyle Libre
One of the best decisions I’ve ever made was to free myself of the FreeStyle libre. You can click here for a more in depth video explaining why. Yes, it was handy. When I had a low blood sugar in public, I wouldn’t have to be the weirdo who’s aggressively squeezing blood out of their finger on the side of the street. To check your blood sugar all you have to do is hold your phone against the little pod on the back of your arm and it would display the number on your screen. Too easy. I was literally going to town on glucose checks, scanning my arm every hour. I wasn’t getting correct readings because I was checking too frequently. So, I was acting on a false number (taking insulin or treating a “low”), when I didn’t need to. I actually felt a burden lift off my shoulders when I dramatically ripped it off and threw it on the floor one day. I have good enough control to not need to know my numbers every minute of the day. I know some people will disagree with this and can appreciate all the convenience that a CGM (continuous glucose monitor) provides. I however, have no chill and am better off without it.
Created a Routine of Insulin
This is the little trick I implemented that helped me see an improvement of sugar levels straight away. Ever have those times in the evening or morning when your blood sugar spikes for no reason? I discovered that for me, these spikes were because of a lack of background insulin in my system. I take two shots of background insulin a day, one in the morning and one before bed. I noted down the time of day the spikes were happening and began a background insulin routine based on these times. Every day without fail I take one shot in the morning at 8am and one in the evening at 9pm so I have a constant bit of insulin in me. I stick to this routine even when I’m out. I set two alarms so I don’t forget.
Started Being Active
In Boston, it was very rare for a day to go by that didn’t involve 10,000 steps or more. (You can check this on Apple Health). I walked to work, walked around the city on my days off, went to the gym around 3 times a week and threw in a run here and there too. I can’t express how much this helped. I’m not going to lie, being back home I struggle to get to 5,000 steps a day. I’m currently job hunting and am quite stranded in my little village with no car. I’ve noticed my sugars are slightly higher throughout the day just because of the sheer lack of activity and places to go. No offence to Galway. As soon as I move up to Dublin I’ll get back into an active routine and join a gym within walking distance. For now I’m going for runs (as slow and as painful as they are after that holiday break) and taking my dog for aimless walks around country lanes just to get those steps in. You can click here for a few of my top exercise motivation tips!
I heard about people changing their pump sites all the time but didn’t really think this related to those on injections. What I discovered this year, is that injection sites need to be regularly swapped around also. During December last year I had an absolute nightmare with my sugars. They were constantly high and then I would have random, severe lows throughout the day. They came from nowhere and hit so hard I wouldn’t be able to see. I wondered what people must've thought while they passed me as l stood like a zombie at the side of the road, in freezing conditions, intensely shoving skittles into my mouth for breakfast. Probably nothing, it was America. Anyways, the reason behind this situation was because my insulin wasn’t being absorbed properly and was releasing all at once at random times of the day. Long story short, I changed the area where I was injecting my long acting insulin and the problem solved. Now, every time I change the long-acting insulin vial I change the injection site. I change my rapid acting insulin location every time I inject.
I am now a stone heavier than when I left for America. This was to be expected considering the cinemas over there have melted butter dispensers and gluten-free donuts are a thing. Although I’m back in a country with food portions that now seem drastically unsatisfying, I’m making a conscious effort to keep the weight I’ve put on. I’m doing this by having a healthy balance of carbs, fats and protein in each of my meals. Two years ago I went through a phase of cutting out carbs. I didn’t do this to lose weight, I did it because I thought it would be beneficial to my sugar levels. In short, it was destructive. I was a cranky, living skeleton with no energy. When I was faced with carbs, I didn’t know how much insulin to take with them. Also, my body took longer to digest the carbs leading to sugar spikes hours after I had eaten. Now, at a healthier weight for me, I can now freely eat the carbs I want without the worry of splitting insulin doses or guessing the amount to take. You can click here for my favourite, every-day, healthy carbs.
So there you have it. These are the five changes I made this year that I believe helped me to lower my HbA1c. If you have any go-to tips for improving blood sugar control that you'd like to share, please let me know. I hope you enjoyed this post!