Frustrated that you can’t get your A1C under 7.0 even though others are able to? Managing type 1 or type 2 diabetes isn’t a straight line. There’s no easy list of “1, 2, 3″ that you can do every day that will ever make diabetes management easy … but there are certain habits you can develop in your life that will have a huge impact on your blood sugar levels and your ability to reach your A1C goals.
Here are just a few habits of people with diabetes who successfully maintain A1Cs under 7.0 percent.
1. They count their carbohydrates.
It’s very possible that your doctor told you take _x_ amount of insulin every time you eat, but they never taught you the importance of counting your carbohydrates. Rapid-acting insulin (Humalog, Novolog) is supposed to be taken based on the number of carbohydrates you’re going to consume. If you use rapid insulin, you should have an “insulin to carbohydrate ratio” that determines how much insulin you should take based on what you’re eating.
For example, a typical carb ratio for someone with type 1 might be 1:15, meaning they need 1 unit of insulin for every 15 grams of carbohydrates they eat. People with type 2 diabetes are generally more insulin resistant, so a common ratio might be 1:5, meaning they need 1 unit of insulin for every 5 grams of carbohydrate.
Your body is often more resistant to insulin during different parts of the day or month. Some people with diabetes, after much experience, have learned to use different insulin-to-carb ratios at different times. And many women use different ratios at different stages during the menstrual cycle.
One of the most common questions people have is whether they should be dosing insulin for net carbohydrates (total carbs minus fiber) or total carbohydrates (fiber included).
The answer is different for everyone. You can only learn what’s right for you by testing your blood sugar repeatedly.
2. They check their blood sugar way more than 4 times a day.
Doctors often recommend checking your blood sugar 4 times a day … perhaps because that’s all that the insurance companies want to pay for, or perhaps because they don’t think you’re capable of doing it more than that. The reality is that your blood sugar is changing constantly. And you won’t know when you’re high every day if you only check your blood sugar before you eat and before you go to bed. Instead, checking your blood sugar the moment you wake up, before every meal, 1-2 hours after every meal, before bed, and around any exercise will give you the information you need to know if you’re getting enough or too much insulin at different times of the day! Ask your doctor to increase your prescription so you can get more test strips!
Better yet, get a continuous glucose monitor! With these incredible devices, you can check your blood sugar dozens of times a day, and it’s almost effortless. More and more insurers are paying for CGMs for people with type 2 diabetes, even for patients that do not use insulin.
3. They look at the numbers and make changes!
If you’re checking your blood sugar every morning, and you’re seeing a 200 mg/dL on your meter, that means you may be spending nearly 8 hours minimum every day with blood sugars that will never lead to an A1C below 7.0. If you want to get in the 6s range, then you need to figure out why your blood sugar is high during the night and what you need to do about it. You’ll look at what you’re eating before bed, your insulin and medication doses, etc. to figure out why you’re so high in the morning and what you need to do to get closer to 100 mg/dL.
Look at your numbers and take action.
4. They eat mostly real, whole food.
Whether or not you choose to go low-carb or vegan or paleo isn’t necessarily going to make or break your A1C. What does matter is that what you’re eating is mostly whole, real food choices. That means that 80 to 90 percent of your day is real food — not processed stuff in packages.
If you’re eating well for most of the day, it leaves a little room for a less-than-healthy snack. But if you’re still telling yourself that it’s okay to hit up McDonald’s every morning for breakfast because you just “don’t have time” to make something healthy, then don’t be surprised if your blood sugars aren’t exactly cooperating. Ditch the excuses and start exploring real, whole food! Stopping at McDonald’s actually takes way more time than spreading almond butter on an apple, making a protein shake with unsweetened almond milk, or even just eating a handful of nuts on your way out the door.
Remember, there are unhealthy versions of every diet. French fries and Pepsi are vegan. Pizza and cannolis are Mediterranean foods. Choosing the good stuff will really help your blood sugar conrol.
5. They exercise.
There’s no arguing: exercise helps reduce blood sugar levels in the moment but it also helps reduce blood levels overall. The more you exercise, the less work your body (and YOU) has to do (even the day after you exercise) to keep your blood sugar in a healthy range.
The easiest exercise for the greatest impact? Walking! Get walking. Walking is awesome for burning fat. It doesn’t increase your appetite like running. You can walk before taking any fast-acting insulin to prevent major drops in your blood sugar. And it’s easy on your bones. Get walking. Get moving. Find a type of exercise you like and embrace it because it’s going to help your diabetes goals exponentially.
6. They believe they can.
Do you tell yourself that you “suck” at managing diabetes? What you tell yourself is what you’re going to believe. You will keep yourself stuck in that place for as long as you keep telling yourself that’s who you are. The people who achieve A1C percentages below 7.0 are often encouraging themselves instead of discouraging themselves. They give themselves pats on the back for good choices and successful moments, and they don’t knock themselves down for making mistakes.
If you’re stuck in a habit of putting yourself down, spend a week writing down every negative thought you have about your diabetes management and take a look at them. Those thoughts are with you all day long. Then, make a list of the person you want to be when it comes to your diabetes management and the kinds of thoughts that person has bubbling in their head all day long.
7. They never stop learning.
There are two options you have throughout your entire life with diabetes: Constantly seek out new information about your diabetes and health in general … or decide that you just want to keep doing exactly what you’re doing. The group that chooses the second option is going to get what they keep getting if they don’t seek out more diabetes and health knowledge.
The first group is the kind of person who sees a high blood sugar after their run and relentlessly tries to figure out why it’s happening and what they can do to prevent it from happening again. They see a problem. They study it. They look for answers and solutions. They fix it.
The other secret to learning is to “take what is useful and leave the rest.” If you read about an approach to nutrition that doesn’t really sound like a good fit for you, just take the parts you like and keep on studying nutrition until you develop an approach that feels right for you. The point is: Never stop learning, and give yourself the opportunity to constantly evolve!