Your HbA1c isn’t, of course, the only way to measure how things are going in terms of diabetes management, but it’s still an important part of it.
Real life with diabetes is much more complicated than simply taking your meds and avoiding cupcakes. Day-to-day diabetes management isn’t a straight line. For example, the amount of insulin you need during the middle of the day will be much different than what you need at 6 a.m.
Carbohydrates, fat, protein, hormones, stress, work schedule, juggling your family’s needs, and constantly trying to fine-tune your insulin and medication doses is an ongoing project.
In this article, we’ll talk about 5 real-life tips to improve your blood sugars and lower your A1c.
Reduce how much food you eat for low blood sugars
If you find yourself regularly eating half a loaf of bread and three brownies every time you’re low, you’ll inevitably also find yourself stuck on the blood sugar roller coast. 50 mg/dL followed by tons of food, up to 300 mg/dL, then a “rage bolus” of insulin, then low again, then more food, then back up to 300 mg/dL.
It’s a blood sugar nightmare. It doesn’t feel good. It easily ruins the day. And did I mention that it doesn’t feel good?
Instead of using “normal” foods to treat lows, head to the grocery store and buy a specific type of fast-acting carbohydrate to treat lows. You also want to choose a source of carb that can be measured carefully, like “5 Skittles” for 10 grams of carbs.
The easiest option is, of course, the trusty glucose tabs, but if you prefer something a little more tasty to treat your lows, many types of candy also work great.
Examples: Raisins, Smarties candies (all dextrose!), jelly beans, Skittles, gummy LifeSavers.
After putting a careful stash of these foods in ideal places — your nightstand, your desk, your car, your purse, your backpack, your child’s diaper bag, and your partner’s car — commit to using these foods as if they are medicine. Eat a reasonable serving to equal 5 to 20 grams of carbs depending on the severity of your low, and then…sit on your hands and wait.
The way you currently treat your low blood sugars is merely a habit. And habits can be changed!
Read more from DiabetesStrong on managing low blood sugars:
- How to Treat a Low Blood Sugar Without Eating Everything in Sight
- Symptoms of Low Blood Sugar
- How to Treat a Low Blood Sugar at Night
- What are Normal Blood Sugar Levels
Check your blood sugar at 2 a.m. (…for a few nights!)
If you frequently wake up with high blood sugars in the morning, that means you’ve spent about ⅓ of the day with high blood sugars. This inevitably leaves its mark on your next A1c.
Whether you’re high in the morning because of “dawn phenomenon” or because of what you ate before bed, frequent morning highs are a sign that it’s time to do a little 2 a.m. studying.
- If you’re going to bed with in-range blood sugar and you wake-up high at 2 a.m., it’s likely you’re not getting enough insulin with your dinner.
- If you’re going to bed with in-range blood sugar and you wake-up at 2 a.m. in range, but wake-up at 6 a.m. high, it’s likely you’re dealing with dawn phenomenon.
Talk to your healthcare team to adjust your insulin doses to address these potential causes of your morning highs!
Read more from DiabetesStrong on high morning blood sugars:
Manage your carbohydrates a little differently…
I don’t blame you if a ketogenic diet doesn’t appeal to you — it can feel very restrictive and isn’t the best fit for everyone. But even with a more flexible approach to carbs, we can make blood sugar management easier by choosing to make some of our meals low-carb while saving the carbs we love most for one or two other meals.
If bread and butter at dinnertime is the most valuable carb for your cravings and taste buds, you can still keep your overall carb-intake low by eating a lower-carb breakfast, lunch, and snack.
Keep in mind that those lower-carb meals shouldn’t necessarily consist of bacon and more bacon. Instead, try to ensure that the majority of your meals are whole-food choices full of real vegetables and high-quality sources of protein — salmon, beef, chicken, tofu, etc.
The overall point is that you can still get the benefits of a reduced carbohydrate diet by organizing the starchier carbohydrates you love into one or two meals of the day, making blood sugar management that much easier during other parts of the day.
Read more from DiabetesStrong on managing carbohydrates:
- No-Carb, Low-Carb, or Moderate Carb: Which is the Best Diabetes Diet?
- 10 Low-Carb Breakfast Ideas
- 10 low-Carb Dinner Recipes
- 10 Easy Low-Carb Desserts
Tighten your “goal-range” for blood sugar levels
If you’re aiming for an A1c below 7 percent, but you don’t consider 180 mg/dL a high blood sugar, you’re likely spending far more time above 154 mg/dL (what 7 percent translates to as a blood sugar level) than you realize.
Take a look at how your goal A1c translates to a blood sugar range, and then correct blood sugars more often that are above that goal range.
It sounds simple, and yet, too often we spend a larger majority of our day than we realize with high blood levels.
Do keep in mind, when correcting highs, how much insulin you still have onboard and active in your system. If you just ate an apple and you didn’t take your insulin for that apple until you finished it, you’ll easily spike high simply because the apple is being digested more quickly than the insulin is working.
When correcting highs that follow meals, try to give at least 2 hours to see if your meal dose brings your blood sugar back into range on its own. If you are consistently high after meals…well, that’s a nice big red flag, isn’t it? It means you likely need more insulin with your meals!
Look for signs that you need more basal insulin
Did you know that even a boost of 1 or 2 units in your total background insulin dose could help bring your blood sugar down significantly?
Here are three signs that your background insulin dose needs a little help in order to help you reach your A1c goals:
- If you feel like you’re constantly sitting at 180 mg/dL, and you feel like you’re doing everything else you can to manage your blood sugars, it may be time for an adjustment in your basal insulin dose(s).
- If you’re experiencing a lot of low blood sugars because you’re constantly correcting high blood sugars, this is actually a very big sign that you need more basal insulin. Constantly compensating for too little basal by taking extra doses of fast-acting insulin isn’t an even trade, and can easily lead to frequent lows.
- If your A1c just won’t budge and you haven’t increased your basal insulin dose(s) in a long time, it’s probably time. And that’s okay! What’s most important is that your blood sugars are in a healthier range.
It can be daunting to increase your basal insulin when you’re struggling with frequent lows, but it can actually prevent future lows by preventing the need for extra corrections! Talk to your healthcare team about making a small adjustment — never more than 3 units at a time — to your basal insulin. After making that first adjustment, give it a few days to see how things go before making another adjustment.
For an even more in-depth guide to A1c (and why you should look at more than just A1c, please read How to Lower Your A1c – The Ultimate Guide
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