Paul – Welcome to the TuD forum! Congrats on a willing curiosity about your glucose control. I have a few questions that might permit me and others to give you more appropriate answers.
I see that you’ve had a stroke. Arteriovenous malformation (cause of brain bleed stroke) is new to me so I’m don’t know what blood-sugar effects, if any, it may cause. Are you (or your doctors) aware of any metabolic effects of AVM? I experienced an ischemic stroke three years ago, so I suspect some overlap with your cognitive symptoms. Is one side of your body more affected than the other?
Can you describe a typical day of eating? Food has an incredible effect of blood glucose. If you can, describe the amounts and timing.
Do you exercise? How often and what duration?
Can you afford to use a continuous glucose monitor (CGM)? Awareness of glucose fluctuations and trends is key to unravelling your unique metabolism. Even wearing a glucose sensor for 30 days every 90 days will teach you a lot about what you eat, the effects of sleep, and how your exercise affects your BGs.
If I was faced with your circumstance, I would narrow my variety of meals to just a few so that I could learn how these foods affect my BGs. You don’t have to live this way forever but limiting the variable for a few weeks or a month can teach you a lot.
If you don’t already, I would try to keep a consistent bedtime each day. Setting an alarm for bedtime can create a good sleep habit!
Try to make regular any stress-relieving practices you use. Meditation, singing, playing an instrument, breathing exercises, or praying are some skills to hone good BGs.
I’ve used a pump for almost 50 years, so my preference is clear. I use an algorithm that lives on my phone to tweak an ever-evolving insulin profile. Some people prefer not to live with that level of control. I understand. My personality fits well with pump therapy. I find that, ironically, once the finite list of levers is mastered, it makes life simpler as it mellows metabolic mayhem. (Controlling glucose variability is just as important, maybe more, as A1c and average glucose.
By the way, I believe that writing is big therapy for the brain and I encourage you to continue!