Rewind back to February 2015, it wasn’t a healthy time for me. My Diabetes was out of control, I felt unhealthy and my latest HBA1C result showed my average blood glucose levels (based over an 8-12 week period) were an unacceptable 10%, the equivalent to an average blood sugar level of 13.3mmol/l or 240mg/dL.
Fast forward to April 2016, by making some essential lifestyle changes, I’d successfully managed to reduce my HBA1C to 7%, the equivalent to 8.5mmol/l or 154mg/dL. Although the recommended HBA1C for Type 1 Diabetics is 6.5%, I felt proud of my efforts and it showed I had the dedication required to be eligible to try Insulin Pump Therapy, which will hopefully enable me to reduce it further again.
I wanted to share with you the steps I took over the last year to gain better control. Now, I’m not saying it’s going to be easy because it’s far from that… but gotta be worth a try right?
- Join some Diabetes Support Groups on Social Media. I’ll let you in on a ‘not so secret’ secret… I am a self-confessed Facebook addict! After finally realising that I needed to seriously change my lifestyle, the first thing I did was scour Facebook for anything Diabetes related. I hadn’t realised how many support groups there were on there! I joined anything that sounded relevant, and quickly worked out which were my favourites and which weren’t. My top 3 would be Type 1’s Rant Moan & Share Stories, The Insulin Gang and
Moms With T1 Diabetes. Pop over to say hi, you’ll be welcomed with open arms! These groups have been a huge supply of information for me. It was these groups that brought my attention to my next point…
- Carb counting is a big must if you want to eat as normally as you possibly can! Call me naive, stupid or even pure reckless, but I didn’t know a thing about Carbs or Carb Counting. I was injecting set doses per meal, but what I wasn’t aware of was that by eating whatever I wanted to, over-eating, I just wasn’t getting enough insulin, and this was the main contributing factor for my high sugar levels. Through my Facebook Support Groups, and a little help from good old Google, I taught myself how to carb count.
- I started regularly testing my blood glucose levels. I’m ashamed to admit this, but I’d eventually stopped testing my blood sugars at all. I made my numbers up before each appointment or use the pathetic excuse that I’d “left my book at home”. I didn’t even own a book! Id gotten lazy, plus I wanted to be normal, testing my sugar levels was not a part of normal life! Also, testing my sugar levels and seeing them so high made me feel guilty. By not testing, I had nothing to feel guilty about! After my disastrous results that February, I decided to start testing. It took a while to get into the habit, but as I was now carb counting, I needed to know exactly what my sugar levels were. After a few weeks, it just became a part of my daily routine. I am now slightly OCD about testing and I’ve worked out that I test, on average, approximately 12 times a day! The recommended amount is 4-6 times a day, but I can’t imagine testing so little nowadays!
- I attended a Carb Counting Course… Aka DAFNE (Dose Adjustment For Normal Living) or DAFYDD (Dose Adjustment For Your Daily Diet) to name but a few. I’d been invited by my DSN (Diabetes Specialist Nurse) to attend several times in the past but there has always been a reason (or excuse?) not to attend… I couldn’t take time off work, or I was busy on those particular dates. If I’m honest, these ‘excuses’ could easily have been rearranged, but I was in total denial of my condition and I suppose the thought of attending a ‘back to basics’ course, made me feel like I’d failed. In actual fact, I failed myself by not attending! Last year, I was once again invited to attend, and although I’d already taught myself, this time I agreed! My biggest regret in life is leaving it this late to attend one! I learned so much! What carbohydrates actually are, which foods contain them, how to use food labels to calculate them & the tools that are available if you need to guesstimate carb content. My DSN re-calculated my insulin:carb ratio and found that I was actually using too much insulin! If you only decide to use one of my pointers to make an improvement in your own Diabetes care, attending a Carb Counting course is the one you should follow!
- If you are able to, invest in a CGM. A Continuous Glucose Monitor helps to identify trends in your blood sugars. I decided to invest in the Freestyle Libre Flash Glucose Monitoring System, which is very similar to a CGM, in that it helps to identify trends in sugar levels, as long as it is scanned at least once every 8 hours, but it is much more affordable, which encouraged me to make the purchase. I was finally able to see what was going on in my sleep. I’d wake up high so would increase my insulin by just 1 unit, and then I’d wake up low! Right now, I have the option to wake up at 3am every morning to either correct a high or to prevent an impending low. The Freestyle Libre actually convinced me that an insulin pump would be the best option for me. Before this, I absolutely would never have even considered it! There is a downside to CGM’s though, which I’ve already made a brief reference to- the cost. They are not currently available on prescription via the NHS in the UK. The Freestyle Libre is the cheapest alternative on the market, costing approximately £50 for the meter plus £50 per sensor. Each sensor lasts 14 days. Unfortunately, I couldn’t sustain the cost of £100 per month, so my encounter with CGM’s have been rather short lived. Which brings me to my second disadvantage. CGM’s measure glucose levels in tissue fluid instead of the blood, which can cause results to be slightly behind actual sugar levels. I couldn’t justify paying £100 a month for results that are slightly time inaccurate, although I would reconsider if I needed to re-check my overall trends. In my case, the jury is still out on CGM use, but if you’d like more info, you can visit the Freestyle Libre website here.
- Try and limit your carbs. Ok, so this may not be for everyone, I appreciate everyone has individual dietary needs/preferences and I would recommend discussing it further with your Consultant & Dietician beforehand if you have any concerns. It most certainly is not as simple as it sounds, but I personally decided to start cutting down on my carb intake. I stopped buying bread (I was a massive toast addict!) and stocked up on eggs, meat, fish & fresh green veg. I cut down on unhealthy savoury snacks & ready meals. I’m not 100% strict, I wont deny myself a treat if I want one, but I’ve drummed it into myself that moderation is the key.
- Try NOT to over treat a hypo. Another difficult point to follow. A Diabetic having a hypo is like Pacman charging around the kitchen! You just want to empty the entire contents of your fridge into your mouth! All self control goes out the window when a hypo kicks in! Over treating a hypo will send your sugar levels sliding to the other end of the scale & causing high blood sugars. I try my hardest to stick to the general rule of 15g of fast acting glucose followed by 20g of slow release to keep sugar levels steady and stop them crashing back down, but granted, it’s not always easy.
- Write everything down! Struggling to work out where you’re going wrong? Keep a diary for a few days! Record your food intake, blood glucose results, insulin doses, exercise, emotions, anything you deem necessary! Try to identify anything that causes your blood sugars to rise… Me personally? Exercise & warm weather raises mine… And eating eggs!! Huh? I know, right!
So there you have it! The 8 essential steps I took to help improve my Diabetes control & lower my HBA1C! To further improve my control, my next step is to try Insulin Pump Therapy, which I’m pretty confident is the way forward for me! Please note, I am by no means a Doctor, so please consult your Team before you make any changes to your treatment plan, as what works for me may not work for everyone!
But if you do decide to follow any of my pointers, remember to take baby steps! I didn’t charge right in to do it all at once, that would have totally overwhelmed & confused me, and I would have failed at the first hurdle! Be reasonable in your expectations. I changed my habits little by little. Every day is a new day… If you had a terrible time yesterday, start afresh today, forgive yourself, let go of yesterday and just move on! Try not to see any number as bad… It’s just a number! Good luck!
Click here to read about my Diabetes Diagnosis and my difficult journey in accepting and living with the condition.