Spring has sprung once again, and with the new season I'm working to make my diabetes management more of a priority and bring it out of its winter hibernation, so to speak. Burnout's been an issue these past few months, affecting my mood -- inevitably leading to slacking when it comes to taking care of myself.
This psychological factor is certainly a big part of why I haven't been following Amy's so-called "Golden Rules" of D-management recently (see yesterday's post). As our friend Kerri puts it, there have been many signs of Distractabetes.
After marking my 33rd Diaversary in March, I had an endo appointment that revealed a somewhat alarmingly too-high A1C and a down-to-earth chat about what needs to change.
Apparently, that was the nudge I needed.
In the past couple weeks, I've found myself experiencing a surge of energy regarding managing my diabetes -- from getting back into the routine of regular-timed basal shots and keeping close tabs on my carb counts and meal planning, to actually seeing better blood sugars.
I achieved my first 24-hour "No Hitter" (no extreme highs or lows) in months on a recent Wednesday, which made me happy but also sad, noting how very long it's been since I've had such a good D-day.
And did I mention that for the first time in probably four months, I finally plugged in my Dexcom receiver and downloaded my data to review and analyze trends? Using the online data program Dexcom offers, I was floored to see the numbers -- not surprised, mind you, but just reeling seeing actual proof of how poorly I'd been doing.
My average for the past week was 150, and while a number of higher BG trends were clearly visible, that week was looking pretty great compared to my average for the preceding 90 days, which clocked in at a glaring 268 (!) with pretty much all of my BGs on the higher end of the graph.
YOWZERS! (growled in Shaggy voice from Scooby Doo).
So, aside from the pep talk from my doctor and my rising A1C, what specifically has helped get me back on track these days?
These are my Big Three changes that have brought me back into the fold of better D-management:
- Food and Carb Counting: Simple, yet SO EASY to slack off on this. Not accurately counting the carbs I've consumed and not dosing as I should had created a whole ripple effect that spiked my BGs and caused me to remain on the higher end more often than not. I am now doubling down on more accurate carb counting.
- Regularly Scheduled Basal Dosing: Again, it SHOULD be such a minor task to take my Tresiba basal dose every 24-30 hours, but one I found myself slacking on regularly. It seems like Tresiba's dosing flexibility that I originally loved gave me just enough wiggle room to take it too far -- "give an inch, I'll take it a mile," you might say. As soon as I hunkered down and made sure to track my dosing schedule and stay within that 24-30 window, the basal created a foundation in my system after a few days, and I quickly saw a significant change in my BGs.
- CGM Wearing: Out of sight, out of mind... This has been a theme at many points in my life while experiencing diabetes burnout. But once I inserted a new CGM sensor and finally had that handy display of constant D-Data, this brought my control into focus and helped me get back on track in gauging what works and what still needs to be changed.
In Case You're Curious: This doesn't change my desire to stay on my current combo-regime of Multiple Daily Dosing (MDD) with Afrezza inhaled insulin and also daily injections of Novolog and Tresiba.
I did ponder going back on the insulin pump back in February, in a fit of frustration about higher basal amounts not alleviating the Dawn Phenomenon in the early morning hours. But after some recent consistency, I've tackled that problem and seem to be back on the wagon of better early morning BG levels.
But I am still describing my current regime as a pump vacation that's only temporary (aka #PumpHiatus). Next month on a week-long vacation to Niagara Falls and the countryside of Canada, I may opt to briefly reconnect my insulin pump just for the convenience of less gear to fuss with. But that's TBD.
At some point, I do plan to reconnect to an insulin delivery device -- hopefully, ASAP once a Dexcom-integrated closed loop system like Bigfoot or Beta Bionics' iLET are available. If their timing works out as planned, at least one of these new systems could hit the market in the latter part of 2018, which is not too far off. I'm fine waiting for that next-generation tech, which I certainly believe will be superior to anything available now or in the near-term.
In the meantime, I am happy to be on the upswing with better BGs, at least for the time being. We all need to celebrate small victories, right?
Here's to maintaining my improved D-management week over week, month over month, as I'm able.