A1C swings

It was a long time ago now (2012) that I found the #doc and started my blog here. Back then, I felt alone in my diabetes journey, and I am so happy that I have met so many wonderful people as a result of this condition, and learned so much about life with diabetes on a variety of topics – management, mental health, pregnancy – you name it. 

When it comes to diabetes management, it is a very individual thing. People have different targets and goals, but if there is one thing we can probably all agree on is that celebrating our improvements no matter how large or small is a good thing. So that is what I am doing today!

A little over a year ago, I learned that my A1C was at my personal highest since diagnosis – 8.6%. Yesterday, I learned that I had achieved my personal lowest – 5.7%! And that is a huge accomplishment for me!

To be honest, I never thought it was possible for me to achieve an A1C under 6%. I had a few A1Cs in the 6s throughout my 9-or-so years with diabetes, but I often had lows in the 40s when I achieved those (e.g. 6.2%). Alternately, I have had A1Cs in the high 6s as well, but to be quite honest, I was still globally high (mid-high 100s) a lot of the time, even if I managed to avoid more extreme highs.

What changed between today and 15 months ago for me? Lots of things. I will attempt to summarize as I hope maybe this can help others trying to lower their A1C. 

1.       I stopped drinking alcohol. Well, it’s not like I will never have a drink, but I am no longer choosing to consume 2 or more beers or vodkas on semi-regular (ok, regular) occasions, such as when out with friends or on Friday or Saturday nights. Why does this matter for me? Well, with alcohol’s known bg-lowering effects, I always tend to over-compensate with un-bolused food later in the evening, staying high over-night (in efforts of avoiding lows), and as a result, greatly affecting my overall time in range. 

2.       I reduced the amount of carbs that I eat. I talked about the benefits this provided me in a very long post a few months back. I still am able to indulge, but having more refined carb choices in my diet (such as bagels or ice-cream) for me requires portion control as well as being very patient with pre-bolusing. As an example, I buy those almost child-size ice-cream cups (about 12g of carbs). I add nuts and berries and it’s an awesome treat. Bagels have always been my weakness but are merciless to my blood sugar. I have found that bagel thins (about 20-25g carbs) provide a nice bg-friendly alternative and satisfy about 80% of my bagel cravings.

3.       I do not eat when I am high – I pre-bolus with whatever correction and watch the CGM to see myself at or under 120 before eating. 

4.       ^The CGM = lifesaver. It is quite an investment, but reasonable with my current health insurance, and has allowed me to feel safe in the double digits overnight, be more comfortable with dosing more accurately and pre-bolusing when necessary, and has also allowed me to catch and correct rises very quickly.

5.       Being more consistent with exercise. My exercise really just consists of walking, hiking, and cleaning. I find that if I am doing about an hour (but at least 40 minutes) 4-5 days a week, I get much more consistent results. 

That’s really most of it. Pretty simple, but as we all know consistency can be difficult when it comes to diabetes management. So I am pretty proud of myself for sticking with it! A short three months ago my A1C was 7.3%. That’s just to say that drastic changes can take place very quickly in the same individual – I am so happy that I was able to achieve such as drastic improvement in such a short time on multiple daily injections, and while not feeling like diabetes completely took over my life. I really never thought I would be able to join the 5s club – but here I am! What is most important to me, is the stability. I have not had lows under 55, and I can count on 1 hand my highs over 200 – and that’s the biggest achievement of all.