Problem Coping

I wonder if anyone out there has some ideas/thoughts? I was diagnosed about 2.5 years ago as Type 1. I guess LADA, because my pancreas still makes enough insulin that I am “getting by” without exogenous insulin. My A1c is about 6.6 and hasn’t changed since diagnosis - so I consider myself lucky as it could be much worse, of course. I am a masters athlete (sprinting), at the same time, I am officially retired as a research scientist, but still get non-salary support from my institution - like office space. I really want to keep up my research, but my productivity has dropped so much that I am probably going to lose my non-salary support. My productivity has dropped because (i) I have been trying to keep BG below 140-150 mg/dL. This has required 4-5 meals a day, and needs each meal to be restricted to less than 20g carbs. (My weight is 114 lb, or about 52 kg). So meal, meal preparation take a significant amount of time. (ii) I spend waaay too much time looking at diabetes things on line (like tudiabetes forum :smirk: ) and (iii) I do not want to give up sprint training. partly because it keeps my BG lower - estimate 10-15 mg/dL very roughly). I think I am about to try basal insulin which may save time – not sure as hard training causes BG ~ 250 then a steep descent to < 70 mg/dL.
I think I need someone to tell me I’m being too silly about BG control… – well, about (i), (ii), and (iii).
Anyway, I would like to somehow control my life with diabetes, as well as (perhaps), give my boss some idea of what it’s like to live the way I do. Any references for the latter, without seeming like a complaining idiot!?

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As a septuagenarian whose hardest exercise is working in the yard, I’m not the best person to give advice here. Perhaps someone will be along who has more experience with training while on injected insulin. But if maintaining adequate diabetic control without exogenous insulin is getting in the way of your “life,” I’d sure explore the possibility of a small dose of basal with your doctor. And try to trim your meal preparation time by either selecting easier things or making enough for several meals at once.

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Thanks, Uff_Da, I have an appointment with endo coming up in 2 weeks. I will try some insulin. I try to keep meals simple. Keep lots of salad things in fridge! I’m vegetarian, so try to get protein from fermented dairy (Greek yogurt, kefir, hard cheeses + whatever is in greens; also nuts and seeds. That’s pretty much my whole diet – occasionally make seed bread, etc. I’m lucky my hubby likes greens too!
I wish I’d done insulin 2 years ago, before I got in this job mess. Maybe some other forum member will learn from my mistakes.
I’m septuagenarian too! And you can get lots of exercise from gardening! Good to do some warm-ups first – shoulder shrugs, arm circling.
Your reply has motivated me to change. Thank you SO much.

Agree with @Uff_Da, a little insulin can go a long way to keeping your control and giving you the breathing room to do the other things you want to.
Grazing is a good food strategy if you can make it work.
It seems like you might be using a cgm, but if you’re not that would be my other recommendation.
If you’re accustomed to research, you’ve got this!

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With an A1c of 6.6 you have an average blood glucose of 143 mg/dl. This means you are insulin deficient and you need exogenous insulin - though most likely only basal insulin for the time being. I really recommend to make the switch to exogenous insulin as soon as possible. This way you take some burden of producing insulin all the time from the beta cells and this will help you to preserve more beta cells. The more beta cells you can manage to preserve the more easy it will be to control your blood glucose in the future.

Right now you are really fighting a war you can not win. Remember an average of 100 mgdl increases the risk of makrovascular complications (blood vessels). An average of 126 mgdl will increase your risk for microvascular complications (eyes, kidneys). If you protest now please remember: if the life expectancy of humans would be 200 years then all of them would develop diabetes related complications at the end of their lifetime. Glucose is a highly effective fuel but can be dangerous if these healthy limits in the blood glucose are not maintained - even for healthy people. An average of 140 mgdl - which is clearly an indicator for diabetes - causes glucose toxicity: the beta cells have to produce insulin all the time and this burden will damage the beta cells until most of them are killed. An average of 160 mgdl will force the kidneys to filter excessive glucose from the blood stream and this will be very stressful for the kidneys.

So please give your body the insulin it needs. It will be much easier to integrate diabetes into your life with having insulin and management knowledge at hand. This way you take the control back and it will not control you. If you experience first hand that you can manage and control T1 then coping will be much easier for you.

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Thankyou Uff_da truenorth and Holger. I wish I’d posted to you when first diagnosed. I think I was relying too much on CGM rather than A1c. I calibrated a lot at first (now 2-3 times per day). CGM gives A1c estimate as about 5.8, compared with direct haemoglobin measurement of 6.6%. Part of the reason for this is actual BG spikes higher and more rapidly than CGM after meals (and after workouts). And CGM nearly always shows BG declining while asleep, being 10-15 too low by morning fasting BG calibration. Kinda misleading! Not that I didn’t know; maybe I was wishful thinking, or felt secure that my doc says I was doing OK… Oh well…
In a week I hope I’ll be on insulin! Many thanks to y’all. I’ll add a comment to this thread when I have results!