What do I do now?

I have been diabetic for 12 years, pumping for 11 of them. My worst A1C was 14 at dx and my best was 7.0. For years it has hovered between 7 and 8. In the last year it has been bad. 8+. I know a lot of this has been stress related. I am trying to get things back in control but it seems like it has all fallen apart.

Doctors don’t seem to care too much beyond pontificating. I know this sucks for me short term and long term. I don’t know what to do anymore. I eat well, I try to work out, and I am not a diarexic or anything. In fact I am chasing highs so much I am gaining weight at an annoying rate. I keep correcting but sometimes it seems like the insulin doesn’t work.

I was wondering if anyone knows of a diabetic life coach? or diabetic personal trainer in Manhattan, NYC area. I am sick of dealing with people who have read the books but haven’t lived the life.
Any help would be greatly appreciated.

I can’t give you the name of a life coach or trainer, but I can relate to how you are feeling 100% I’m in the same boat! If you want to vent or talk or whatever I’m here!!

Are you also taking Metformin? From what you’ve said, it sounds like you may have some insulin resistance issues.

Hope you get things going in the right direction soon!

No to Metformin. I am type 1. Is it possible to have insulin resistance with type 1? My pump sites last abt 2 days.

I am sorry you aren’t getting anywhere with your physician. There is a group for the East coast members of TuDiabetes you might want to join them and see who is in your area. If you were in CA or MO I could recommend someone. I wish you the best of luck and don’t give up. Keep knocking an the right physician, life coach or CDE will answer.

Cherise

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.

  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. 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.
  6. See if there’s a Joslin’s in the area? I haven’t been, but I hear great things.
  7. 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.

Hey Yes, it’s possible to become insulin resistant if you are type 1. I’ve read that insulin resistant type 1’s take metformin.

I don’t know of any trainers/coaches but I wanted to ask if you’ve ever seen a CDE (usually a nurse practitioner) instead of or in addition to your endo? They seem to have a liittle more time to go over the little things with you. I didn’t see a doctor for years after diagnosis and when I finally got insurance I only went to my primary care doctor. 4 years ago I finally made an appointment with an endo. After that initial appointment the endo sent me to the NP/CDE who I’ve seen ever since. I have her e-mail address and cell phone number so I can always write or call if I’m having problems and need an answer soon. I know every one will be different but CDEs really do seem to be more accessible than doctors a lot of the time.

I have seen some good improvements with my A1C since I’ve started using a CGM. I’m using the Dexcom now and it has been a great tool. Just today I was thinking how difficult all of this diabetes stuff is. I’ve been type 1 for 38 years and it never gets any easier. But the tools we have are improving. Good luck. I find my other diabetic friends to be inspiring. None of us are anywhere near perfect. I’m here to support you too.
I’m looking forward to starting a yoga class in January. Have you tried it? Nice stress reducer.

Hi Stacy,
I am in the same boat as you. I feel like I’m always under a lot of stress and can never get my blood sugar stablized. I have also gained quite a bit of weight chasing my highs, too. That just makes me more mad/stressed/frustrated with everything. I have always wondered if they have diabetes life coaches, too. I truely think that there is not enough focus on the overall well-being of people living with diabetes. It’s all numbers, numbers, numbers. And truely, we are so much more than a number!!!
Funny you say you feel like your insulin isn’t working. Lately I have too. I have been on the pump for 8 years and have done OK but the past year has been awful. I don’t know if it’s due to my metabolism slowing (i’m in my 30’s) or what?! I think the comments about insulin resistance and Metformin are very interesting.
I wish you luck and if you find out anything, please let me know. Thanks!!! Julie

I am insulin resistant and i am type one. Ive tried the metformin and it did nothing for me. i have the same problems with the sugars thing, I have hear that the metformin can help. nothing seems to make anything any easier on me that is for sure. it is a challenge.

If you don’t mind hauling yourself out to Queens, my endo is out there and he has a very good team that might be able to help. I only had one session with the CDE, but she was diabetic herself (I don’t recall if she’s T1 or T2), and the nutritionist seemed pretty good. Then again, I decided to ignore her anyway, since eating that many carbs would not have been so good for me! Send me a message if you’d like their info.