Reaching an Optimal HbA1c

We live in a results-oriented world, and for people with diabetes, the HbA1c test is the standard for determining how well we are managing the disease. For readers who are not familiar with the A1c test, you can think of it as a 4 month blood glucose average. People without diabetes normally have an A1c between 4.6% and 5.6%. The American Diabetes Association recommends that people with diabetes maintain A1c levels of less than 7.0% in order to stave off any long term complications. However, I strive to keep mine lower than 6.5% because I believe that the closer it is to normal, the better!

Santa delivered my latest A1c results on December 24 (a day early). My results? 5.8%. To say the least, I was overjoyed! This result was down half a percent from my previous A1c of 6.3%, which was also a very solid result. After twelve years with diabetes, I know that I am proficient at controlling the disease. This does not mean that every day is perfect (because it's not), but it does mean that I have more good days than bad. More important, I know that I am blessed to have access all of the resources that people with diabetes need to effectively manage disease. This includes an insulin pump, continuous glucose monitor, blood glucose meter and test strips, and an awesome endocrinologist!

We all have our own methods for managing our diabetes. After all, everyone's diabetes is a little bit different. I thought I would share a few that I use that have proven successful for me over the years.

Disclaimer: I am not yet a medical professional and this is not considered to be medical advice. These are merely methods that I employ that you may find useful. Always check with a doctor before making any changes.

1. Check Glucose Levels Early and Often. Many diabetes groups and organizations recommend that people with diabetes check their glucose levels 5 times / day. I do not believe that 5 times / day is nearly enough. In fact, I usually check mine 3 times before noon! The ability to instantly and accurately know our blood glucose levels is what separates us from people who had diabetes between 1920 and 1980. Information is power, and the more you know about what is happening in your body, the better able you will be to make proper management decisions. I check my levels a minimum of 8 times / day.
2. Don't Eat If Your Levels are High. Even if it is time for a meal or snack, I do not eat if my levels are higher than 140 mg/dl. I bolus, drink water, wait an hour, and check again. Like everyone, I have those mornings where my glucose levels are high when I wake up. Instead of eating and spiking them even further, I make my adjustments and wait. Depending on how much time I have, I may go for an early morning walk, which brings me to my next point...
3. Get Physical. I do a minimum of 35 minutes of exercise everyday. My new passion is cycling, but I do lots of things to stay active: walking/running, playing tennis, yard work, push-ups & sit-ups, etc. I use exercise as medicine. If my blood glucose levels are high (>150 mg/dl) two and half hours after a meal, I look at that as a great excuse to go for a 2 or 3-mile run/walk around the neighborhood. Why  give extra insulin when I could, instead, get the same result with a little exercise? Moreover, exercise is good for the cardiovascular system and reduces stress. Find something physical that you love and do it everyday!
4. Know What's Going into Your Body. I measure all of the food I prepare so that I know exactly how many carbs I'm consuming. I don't like surprises and try to leave as little room for error as possible. Yes, you can "eyeball" the carbs, but it's too easy to be off by 15 or 20 grams. Being off can leave you with high glucose levels for a longer period of time, which leads to a higher HbA1c. You can purchase a nice food scale for about $50 at Bed, Bath, and Beyond. I have used a scale for about two years, and it has been a game changer. I even take it with me when I travel places!

I hope that you find these methods helpful! What methods do you use?