Before I tell you about where I am now and bestow upon you any tips or tricks, we kind of need to visit where I've been. After all, as a OnTrack Diabetes reader you are here for advice on how to manage the diabetes beast so you need to know what you're reading comes from someone who has been here and not only collected the t-shirt, but also worn it in style too, right?
Well, four years ago I was a little less OK with diabetes than I am now. My HbA1c was 9.6% (81 mmol/mol in new money,,,), I was blood-testing 10-15 times a day, eating a 'delicious' yet wildly under-nourishing diet more junk food than anything else, and my diabetes management could be summed up nicely as 'chaotic', at best. Mainly because despite my best efforts and 22 years of experience, the stowaway named D that had been cramping my style for so many years was having a big 'ol party in my body. A party that I didn't seem to be consulted about, let alone invited too.
If A + B + C + D = 6.6, I just couldn't figure out what A, B, C and D were.
Through a series of well-timed hospital appointments, asking the right questions and seeking for a LOT of advice from online resources, I managed to secure the agreement of my clinic that I might benefit from an insulin pump. With and A1C of 9.6% (I'm all about the 'old money') and full engagment with my clinic, I was one of those who teetered over the threshold for insulin pump funding, which is how it works out here in England; we don't have insurance, so only certain people will be supported by the National Health Service for funding. I was one of them.
A year on and with an HbA1c of 7.6% now, things were now much better. I felt more in control, understood my insulin needs in much greater detail and could even predict my waking blood sugar range. Most of the time, anyway.
A = insulin pump.
By two years in I was an avid low-GI convert, understanding for the first time way food interacts with insulin, and understanding that sometimes no matter how well-meaning the attempt, our by all accounts sluggish 'fast-acting' insulins will never be able to match the foods I would perhaps like to eat. Understanding that made everying a little easier.
B = diet.
Now able to use an insulin pump in my sleep and understanding my body's reaction to a range of foods much better, I was able to contemplate exercise beyond the occasional walk. My once littered-with-hypos exercise routine now became more challenging and thanks to a Sports and Exercise weekend run by Animas and one of the UK's leading exercise gurus, I found my overall success at all things D vastly improved with the introduction of more intense and regular gym sessions.
C = exercise
Having had the chance to try CGM for a short but delightful time I could spend hours pining over images of CGM on the internet, secretly envying anyone lucky enough to have one, praying that the cosmic costs of the system would lower 300% overnight so I might be able to afford it. I wasted many hours wishing, then wishing some more. But in March this year I cracked: I bought myself a Dexcom G4. Within days I was smoothing out bumps and delighting as I 'flatlined' - even after meals, lovely carby meals. It felt like for the first time I was truly driving with Sat Nav, rather than a dog-eared holey map with chunks missing, leaving me hazarding guesses and stabbing in the dark. I never looked back.
D = CGM
And so there it is; my journey so far. Through many winding turns, sometimes feeling more like 180s and donuts than gentle meandering corners, I found my way here. An HbA1c of 6.6% finally in the bank and at last with an invitation to the party. My solution. My diabetes algebra that finally added up.
Insulin pump + Diet + Exercise + CGM = HbA1c of 6.6%