He’s a role model; although not “playing a role”, he is a living model for bests in T1D behaviors – as are so many others like all of you here.
1 Like
I think achieving a TIR over 80% is excellent. Your 58-year run with diabetes while keeping good health is an outstanding achievement. Taming glucose variability is a tough project but well worth the effort. Lower glucose variability in me produces a calming effect that improves my quality of life.
I fully agree with your philosophy to enjoy the many exquisite moments present to us throughout the day. I’m finding my evening walks in the park with my dog contains many of those scenes. Diabetes is not everything!
Yeah, it would be nice if insurance companies recognized our efforts to keep a lid on hyperglycemia but I don’t think I’ll ever witness that fantasy.
Thank you for your thoughtful comment, @Arfiezy!
I resent when this happens as our brief encounters four times per year just can’t communicate the level of effort we put in to steer our diabetes ship with defective steering. I appreciate your comment, Steve. Your wife picked a winner!
2 Likes
I am greatly encouraged by this conversation. After almost 50 years of T1D I’ve found myself struggling more than usual to manage my blood sugar levels. I’ve had two severe hypos in the last 12 months. Both times I was <30 when ( thanks to my husband) the paramedics arrived. ( This had NEVER happened before) My endo is married to a T1D so his approach is “ you have a much better idea than I do what to do” “ now what prescriptions do you want me to fill?” This has worked for awhile but I feel like I need more help at this point. It seems like all of my basal rates are off so I will focus on tweaking those first. I have felt frightened and discouraged since the hypo incident but I always feel so hopeful to read the comments here. Thank you!!
4 Likes
Best Defense against hypos is a CGM.
#1 reason I got the Dexcom.
Dexcom also brought down my A1C by 2%!! (Although that brought its own set of problems, it seems; that’s a topic for another day)
2 Likes
@Suzan1, I’m happy that you find this discussion useful. Peer support is a potent factor in starting and sustaining better health habits.
Do you use a CGM? If not, I highly encourage you to at least try one on an experimental basis. It will give you feedback unique to your metabolism. Intelligently using that CGM feedback can lead you to better glucose management.
If you do use a CGM, I encourage you to target lowering glucose variability as a goal. Glucose variability is measured by Standard Deviation (SD) and Coefficient of Variation (CV). A reduction of glucose variability will help you to reduce exposure to both hyper and hypoglycemia. In addition, it can, from my experience, enhance your quality of life and fuel your motivation to sustain better health habits.
Severe hypos are scary for everyone and can undermine your confidence to effectively continue good practices. A CGM with hypo alarms can directly address this vulnerability. @MBW’s comment above certainly aligns with my experience.
Good luck and let us know how how you are doing from time to time.
3 Likes
I do use a CGM now and it has given me great results. I was testing 10-12 times a day and never knew what direction I was headed. CGMs are game-changers for sure. My A1C always stayed around 7.6 and the last two have been 6.5 ( a personal best!) The only problem I’ve had is that the alarm does not wake me up.
I meet with my endo this week so I will talk to him about my new goal of lowering glucose variability. Thank you for the suggestion!
1 Like
Congrats on your CGM success! I remember a similar 1% drop in my A1c when I started on a CGM. It is a powerful tool.
Overnight lows are the worst. Any ideas about how you might enhance the CGM alarm’s ability to wake you? Are you using the CGM receiver or a smart-phone?
I use the CGM receiver and place it on the nightstand right by me so I can hear it. Sometimes I do hear it, but not always. Lately I’ve been setting a loud alarm to do a 3am check. I’m also paying more attention to my evening numbers and reviewing the day’s activities. Both times I went dangerously low I had been doing several hours of yard work during the day. I appreciate any other suggestions??
1 Like
Try placing the receiver into a glass. The sound from the alarm when it is amplified by the glass should wake the dead.
2 Likes
What a good idea @Firenza! So far it always wakes me up. But I will have to remember that!
@Suzan1 Do a basal check. You want your levels not to fall too low under normal activities. Our needs unfortunately can change at different times. It’s really the best place to start before you make any other changes. Working on your SD level will be hard if your basal is off.
The SD is best controlled by not having huge changes in blood sugar levels. I found that setting a tighter range on my cgm helps gives me alerts before I go out of range. Make changes to the alerts in small changes at first until you get used to it. I slowly tightened up my ranges. Setting my low at 80 allows me to keep an eye on what my levels are doing, versus the 65 that I actually don’t want to go below. Same with the high level, I can get on my exercise bike to stall a rise in Bg levels.
I either ask in advance or make clear early (before any HbA1C conversation) that my criteria is TIR. No problems for three endos I’ve had over the past two years. Next comments will be A1C is out of date, followed by I need to find a different endo (plenty in my area), if pushed.
1 Like
I wonder how my endocrinologist would react if I told him that the A1c number is irrelevant in my case since I wear a CGM. If I refused that finger-prick test at my office visit, there would have been no tension between me and my doctor. I can’t see any disadvantage to taking that position. That’s an interesting idea, @William7.
Great idea! Will give it a try!
Thank you for this link…very helpful. It has been a real challenge to get my basal rates correct. That is one of my first priorities and Im getting closer. They have changed quite a bit in the last couple of years. And that is a great idea to set my alerts for quicker corrections!! Duh…! just discovered the “ hop on the exercise bike” to stall a rise trick. I had no idea how much exercise REALLY affected me until I had a CGM to track it. I appreciate the input so much!
1 Like
I usually humor the endo on HbA1C. I’ve actually come with an inconsequential benefit; a drastic change in HbA1C might indicate some shift or change in BG meter readings used to calibrate CGM — or a bad HbA1C test.
2 Likes
I use the Freestylelibre2 and thak goodness for the alarms. I have gone as low as 37 and been completely unaware and asymtomatic. Only problem I have, is that it takes my BGs a long time to come back up so I find myself having eating to much especially before bed and then going high.