I don’t have a coach referral for you, but I can relate. I’ve been diabetic for 18 years, pumper for 8. My A1c was in the 8s and 9s throughout college and in the years after until I met my husband and had the support and incentive I guess I needed to gain control. Last year, I finally saw 7s. This year has been all about 6s for me!
Some things you might try are diet, insulin, or testing related (big shocker, right?), but I have lowered my A1c using several different ideas I learned here on TuD, so it’s my job to pass them on.
- Carefully controlling 1- and 2-hour post-prandials by, first of all, actually testing post-meal at 1 and 2 hours, and primarily by bolusing my insulin longer before meals. 20-30 minutes. It’s mainly these after-meal numbers that get our A1cs up.
- Changing my diet. You say you eat well (and who’s to say you don’t), but smaller meals have done wonders for me. I have been doing Weight Watchers and I firmly believe that the dietary changes have helped level me out some since I started it 8 months ago. My portions are different, my calories and carbs are lower, and my insulin needs have changed. Maybe some kind of organized program could kick-start your metabolism? Also, these programs might be an easy form of life coaching to get your mind centered.
- Standard deviation. I had always focused on the range of my numbers. Now I look at the standard deviation instead. Your pump or your logging software probably offer that statistic. It tells you the extent of your range but also how often you fall close to the mean. I just started on a CGM a month ago, but I think it will help me monitor this more accurately and avoid spikes.
- I haven’t tried it, but many type 1s are swearing by Dr. Bernstein’s book (The Diabetes Solution). He’s a low carb advocate who knows his stuff, apparently.
- Pumping Insulin by John Walsh. I thought I knew everything about my pump…but wow, this book. It’s everything they say it is. It’s a fine-tuner’s dream.
- See if there’s a Joslin’s in the area? I haven’t been, but I hear great things.
- My endo asked me what finally flipped the switch for me this year. I told her that (though hard to admit), I finally had to understand that I didn’t know as much as I thought I did about type 1. I really thought I knew everything - I mean, I’ve lived this long and am still here, right? But I have learned more in the last six months about diabetes from listening to people here and from learning how to ask the right questions than I have in 18+ years inside this diabetic body!
In any case, good luck. I’ve made it down to 6.1. I wish you the best of success.