Congrats on “starting again” with your diabetes care. I was much older when diagnosed and can only imagine what it is like to have dealt with this your whole life. I can definitely understand getting burned out and then recommiting yourself. A new pump and a new endo sounds like a good new beginning!
The most important thing I want to say to you is to not compare yourself to others! You know how it is when you look and see all the girls who are “prettier” or “thinner” or have nicer clothes, but you don’t see those who are less so, and you don’t know what those pretty girls feel like on the inside. When I see the term flatline all I can think is that word means dead…lol. Seriously, with diabetes care what I think is this: Sure, if we work harder on our control, our results will show it, and if we neglect our diabetes, that will show up in the numbers too! But beyond all that I really do believe it is “the luck of the draw”. By that I mean there is something nobody has identified whether it is genetic or whatever, that gave some of us fairly easy to control blood sugar and others are always struggling. I believe that because there are many people that post enough on here that you know they are working hard on their diabetes management. But some of them seem to effortlessly stay between 80 and 105 (WTF??) and others roller coaster between 40 and 400 for no discernable reason. Then most of us are somewhere in between. And it’s nobody’s fault. Also, some of us make decisions about the quality of life where we choose other things above perfect blood sugar. For me for example, I’m a vegetarian and a foodie and those things are important to me. I’ve made lots of changes in diet, but I will never eat truly low carb even though I know I’d have better numbers if I did. It’s a choice.
Also, please, please, please don’t feel guilty. Do your best and you have nothing to feel guilty about and it sounds like you are, like you said, giving your diabetes care your all today. If you’ve never had an A1C below 8, then getting below 8 (not someone else’s 6!) is a great goal.
So what practical things can you do? Ok, so you went to bed at 138 and woke up at 2AM and were 58; that’s obviously too much of a drop. If that was a one time thing, I wouldn’t worry about it, if it happens all the time than you are taking too much basal for that time period. Do you have your basal set to different rates for different times? Our needs definitely vary. If you often go too low around 2AM, then you might want to lower your basal for the period around 11PM. Ok, so you “over-treated” and got back up to 318. But you know why it happened so you can change your treatment of lows. For me, as an average sized woman, if I was 58, I would only take 2 glucose tablets to get me back in range. If you use “goodies” for raising lows and you feel super hungry when you are low, then you have trouble controlling your eating. So switch to glucose tabs and take them like medicine. “Two tablets for a low of 58”. Are your I:C ratios correct? There is no such thing as “too much” or “too little” insulin, but only the amount that works for your. If you need more to keep your numbers in target range, then you do. I suggest bolusing 15-20 minutes before eating to let the insulin work. Do you eat a large number of carbs? It can be hard to accurately bolus for large amounts of carbs, and you might also be developing some insulin resistance. Reduce your carbs as much as you can and you will not only use less insulin, but find your dosing more accurate.
Finally, yes, it is emotionally draining to “think about nothing but numbers and carbs”. Give yourself a break. Sure, work on your diabetes, but then let go. If you have a high number, don’t beat up on yourself, but see if there is something you can learn from it and move on. And, please do the things you love OTHER than fretting about diabetes. Go out, have fun, laugh with your husband or your girlfriends, buy something new. Life is meant to be more than just struggle.