I have had Type 1 Diabetes for 14 years, and throughout that span of time I have had one primary struggle - Fear of Low Blood Sugar. This fear has diminished my level of control. I tend to bolus less than I should, and I overeat when my bgs are low. Consequently, my HBA1Cs tend to be in the high 7s or even low 8s (twice in a row! = very discouraging).
Two months ago, something inside me snapped. I became really frustrated with my lack of control. I cannot allow my fear to create unnecessary complications. I began bolusing more for the food I eat and testing more often. The next time I got my blood work done, I was told that my HBA1C had dropped from 8.0 to 7.5. My ultimate goal is to get my HBA1C to 6.5 or lower.
My next appointment is in February, so I'm writing this as a form of accountability. I want to stay focused on the goal, and make the increased bolusing and testing permanent habits.
If anyone has tips or advice, I'm open to them. I'm finding that even though I have been a diabetic for a long time, I certainly have a lot more to learn about living with and managing my Diabetes.
Your hesitance to experience low bg's is valid ~~ you haven't done anything wrong ;-)
Do you work with I:Carb ratios and correction factors? Do you use a pump? Nothing is a perfect solution but if you don't mind testing more often, that's half the battle.
Have a great evening ~ I am sure you will reach your goal !
I agree with Boston about the validity of your hesitation. I would say take things one at a time. Try bolusing for more carbs first, try establishing the correct amount of carbs you need to cover a low, etc. I always find putting pen to paper, or plugging numbers into a simple excel spreadsheet provides a world of clarity and I can make adjustments one at a time.
Good luck! Looking forward to hearing about your successes!
Have you read "Using Insulin" by John Walsh? I found it was the key I was looking for. By the time I read it, I was more than 30 years into this. But it got me motivated to carb count, figure my I:C ratio and my ISF. The most valuable thing you can do is test frequently. Knowledge is power. Testing is a decision point: am I higher than I should be? Am I lower than I should be? Am I just right? Minor adjustments can be less disruptive.
Since you are concerned with hypoglycemia, I would suggest you get some glucose tabs. My biggest issue was over-treating my lows. Using the 15 g/15 minutes method helps you to not over treat and the glucose tabs are pretty fast acting and you can quantify them. Tighter control does bring with it the greater possibility of having a low. Since you've avoided them so carefully, you still have a great sensitivity to them and though the symptoms seems dreadful at the time, the brain does funny things when it's low on glucose, fast acting carb can really help. You just have to talk yourself off the ledge. You may want to open the fridge and just dive right in because you suddenly feel soooo hungry, but chew on the 4 glucose tabs and wait for 15 minutes.
When you add the good self-care habits, do it one at a time. Start with testing frequently. It is easy and it is the most immediately rewarding action. I found that doing the 1 or 2 changes at a time to be very useful in keeping me motivated. The successes will build on each other. Good luck.
It's really complicated being a major organ (the pancreas)!
First, really celebrate that 7.5. That's an excellent drop. If you can drop it .5, you can (and will) drop another .5.
For me, learning not to overtreat lows has been a big help with tightening control. Not that I do it perfectly every time (I should fire myself as my pancreas!), but any improvement counts.
I think it's important to think of control in realistic terms and to take small but meaningful steps to achieve--and even more important, maintain--new A1C targets. If you change too many things at once, you won't be able to discern which variables are working for you, which are working against you.
Best wishes. Accountability is a good thing. As is having lots of friends in the Diabetes Online Community. Including friends who have had A1Cs in the 10s, 9s, 8s, 7s, and 6s (and have lived to tell the tales and fight another day)!
