Diabetes burnout? laziness?

Mental and Emotional Wellness
1

i go to my gp next week to pick up some test results, one of them is my a1c. i wasnt seeing her for anything diabetic, but she said wed do one anyway.
getting the bloods drawn made me think, inevitably, omg, this a1c is not going to be like the last(5s, mostly) ones (read:all of them, only t1 for 2 years). this i had known for a while, like since october. i knew i was slacking a bit and promised myself to do everything i was supposed to. it never really happened and here i am.
so after the blood draw, i started REALLY thinking about it. i made a list and am alarmed to see it there in writing:

Things im doing
physical activity-a good amount-2 hours cycling, walking, running
testing when i should

those are the good things. these are the other things im doing:
grazing all day because that is what everyone else in the staff room is doing, and because of cycling to work just after lunch, dont want to give bolus, then cycle thirty minutes to work. just one unit and i would need to eat about 75 or eighty carbs to be able to stay on the bike.
bolusing after the fact-again for the above or because im grazing and suddenly realize the amount of carbs ive eaten-mindfulness zero.
not counting carbs-just guessing. all the time.
underbolusing, as i have no idea of what my current i:c ratio is.
smoking now and again. ok, like every day, almost.
keeping zero records, missing trends, again, mindfulness zero.
snacking when i get home in the evening, not having a real meal.

now, i have known that i was being a bit "sloppy" with things, but rea had not truly realized how bad things were. or maybe i was consciously ignoring it. this is bad, looking at it, i know its bad.
people say, change things little by little, but its all so connected, the not knowing i:c ratio, the underbolusing, the grazing. where to start? what would you do first?

and im so not looking forward to the visit with my gp, who people call "la doctora house" cuz of how forward she can be. do i tell her all of this? because really, she cant do anything, i have to do it. i just dont want the doctor to make me feel like im in trouble at the principals office, which has never happened, luckily.

so what would you do first?

2

Hi PW: I went through a period of low motivation, and I actually asked for help here on TuD and got some great answers. So the first thing I would say is to reach out to people, which is what you are doing here. T1D is really day-to-day grueling. For me, it helped to first get my eating under better control. I had gotten sloppy and was eating things with higher carbs. Then I think it is worthwhile to do some reading. Have you read "Think Like a Pancreas?" How about reading Ginger Vieira's "Your Diabetes Science Experiment?" Here is a link to Ginger's website. I hope these suggestions help, and I hope others chime in with their ideas!

3

Try to relax. You haven't even seen your results yet - A1c can be hard to predict so maybe it is better than you think? And if it isn't - no big deal. Just use it as motivation to get back on track. The important thing is to care about your control, and you clearly do. Testing more often is for me the best way to combat unexpected results and figure out what has changed, so maybe try to test on a rigid schedule for a while (i.e. test more than just "when I should").

You've only had diabetes for a couple years, and this is a marathon, not a sprint.

p.s. stop smoking!

4

I strongly second Jag's PS. You can start being more mindful about your diabetes but if you continue to smoke you are increasing all of your health risks and diabetes provides enough more than enough of them by itself.

As a first step, I would suggest that you stop grazing (at least for a while), start counting carbs and using the information to figure out your insulin: carb ratio again. You may well find that it hasn't changed all that much.

As Jag said it is a marathon. Keep making small changes in the right direction; that's all any of us can do.

Maurie

5

I'd like to also say to appreciate yourself for making this list and posting it!

That's a really great first step right there! A list helps you focus. Sharing it acknowledges that you're not perfect (none of us are) so that you can move on from there and do something about it.

And sharing it here means that you're willing to reach out for support.

A great first step!

Best wishes,

marty1492

6

I suspect that just making this list in and of itself, and posting it here, might help you be more aware of some of the things you are doing right and not-so-right, and that awareness alone will probably help you make at least a few small changes.

The thing about making changes is that your willpower is a finite resource. So, if you try to make too many changes at once you won't have enough willpower (even more true if you are also stressed in other life areas at the time) and will be bound to fail at some of them.

So I would pick one or two important ones and focus on working on those. Counting carbs might be a good first step, as just doing that might make you more aware of what you're eating and less prone to grazing. I think that if you are able to pick one or two things and get the ball rolling in the right direction, the other things will being to fall into place on their own, with time.

7

I think it's good that you're thinking about all of this. Great that you're testing and doing so much activity too! I agree that you have no idea what your ac1 is so I wouldn't expect the worst. I thought mine would be higher last time but it wasn't. I think the main things I would do right now is first stop smoking all together, at least have some general idea of your carb intake and start keeping records again maybe on a smart phone which is so much easier. If you're exercising 2 hours per day that is really fantastic. As far as your doctor I guess you have to decide how much you want to share- I don't think I would share with someone who made me feel like I was in the principal's office etc. And I just wonder if I gp will have any ideas/input about how to treat D? Most docs I have encountered other than endos don't seem to have a clue about the actual treatment.

8

I would look at my meter average and figure my A1C will be a shade lower (I meter more when I'm high so my meter skews a bit higher than it needs to I think...YMMV...). If the 5.7 you posted is accurate, then you should be happy and relieved that the force is strong with you. Listen to it! LOL...

I would tell the doc how you are feeling. They may not be able to make you do what you can do but they may be able to at least lay out some options. I agree about keeping records. I don't keep any records but using a pump is a lot easier in that sense as it provides records and your various rates and ratios are all socked away in there, if it doesn't work I can change it. I didn't actually learn about the concept of ratios and basal rates until I got a pump anyway so I have no experiences about food. I don't think you should beat yourself up about snacking, I love snacking. I managed to keep the snacking restrained last evening during the football game but still woke up pretty high, maybe the 9.9% ABV brewski had > 25 carbs? I should look into that although I only have one left so what's the point?

I am usually pretty candid with my docs but, fortunately or mysteriously, I haven't been "in trouble" since 2008 when my A1C went up when I was trying to lose weight. Not diabulemia or anything but it was enough to get me on a pump. I dunno if those are readily available in Spain or not or even if you want one but that will do enough logging to keep the doc off your back and enough that I found therapeutically useful.

9

Hi PW,

Was thinking of you today and wondering how things are going for you?

Wishing you well,

marty