A question at a Diabetes themed table quiz “What is the end goal in diabetes management?” gave me pause for thought. Why is it that I do all that I do? How do I know if I’m doing it right or even well?
Last January, the Clare Type 2 Diabetes Support group kicked off 2018 with a diabetes themed table quiz. It was really good fun but then again I made up the questions and knew all the answers. Always a bonus!
Sidenote: When I was in school my friends use to say I should be a teacher because I was good at ordering people around :-S Anyone who has attended Thriveabetes will not be surprised at this. So who put me in charge of a diabetes themed table quiz?
Answer: I put myself in charge. (eyeroll) What am I like?!?
On the night, there were a couple of questions that were a bit of a challenge for us and it made me realise that sometimes we forget to talk about the basics of diabetes. One question, in particular that gave me pause for thought was:
“What is the best way to avoid developing complications of diabetes?”
People listed all the things that are recommended you do if you have diabetes, such as: eat healthy, exercise, etc. But there wasn’t a single mention of glucose/sugar levels and I have to admit I struggled to answer this one in a short sentence.
The answer I had “researched” was:
“Studies* have shown that if blood sugars are kept to as close to normal as possible, you can reduce if not avoid the complications of diabetes.”
The answer might have been a short sentence but the achieving glucose levels as close to normal, well. Not. So. Much! Then I asked myself, "is trying to keep glucose levels as close to normal as possible my overall diabetes End Goal?" Is it the “why” I do all the things I do to manage my diabetes?
Should I have a goal?
If I don’t have a diabetes goal, then when will I know when I’ve achieved it or do I just not think about it because I’m never going to achieve it anyway :-( So rather than be “goalless”, I decided I would define what my big goal was and the steps I take to get there and I will save it for a day when I’m struggling and may need it to give me a lift.
What my goal is not!
Is my goal to get my HbA1c under 53 mmols/mol or 7%, but my HbA1c? No, not really. While I do consider trying make that my goal it isn’t something that I think about every day. Plus, it’s not really a good indicator of how well I’m doing overall. There are many faces of a 7% A1c - please read this article from DiaTribe.org for more information on this.
Photo credit DiaTribe.org - https://diatribe.org/BeyondA1c
My Diabetes Goals
1. Staying alive - I mean that’s a given. I really don’t have to try to do this because I roll out of bed every morning.
2. Not die - this is a little bit tougher because of insulin which ironically keeps me alive.
3. Keep blood sugars as close to non diabetes as possible. Within reason. And don’t obsess every single number that is not.
How to reach my goal
- Check glucose at least 7 times per day or use the information from my CGM. use those numbers to help in decision making.
- Count all the carbohydrates, as much as is possible because it’s one of the variables I can make less variable.
- Fine tune insulin to carb ratios when they need it.
- Make some time to review all the information I collect daily. One bad glucose day does not make me a failure and if one bad day turns into three or more days, I will put some time aside and try to figure out where the issue is.
- Stick plastic and metal devices to my body and walk around like a cyborg so I have more information to make more informed guesstimates on insulin dosing.
- Try to eat healthy as much as possible and get moving. However, I will remember that Enzo’s Fish and Chips is sometimes required. Or beer! Or chocolate. Or cake.
Done! Now for the “why”
Why I Want to Keep my Blood Glucose Levels in Range:
Because I feel good when all of the above come together.
It reduces my odds of developing any more complications of diabetes as much as possible. Doesn't make the odds zero but lower is better.
I might be able to stay as health as I can for as long as I can.
My diabetes end goal might be to try to keep those numbers as close to a reasonable range as possible, but I will not think about that End Goal every day. What I will think about every day is all the things that I do every day to manage my diabetes and why I do all of those things..
Sometimes I forget why I do all of those things and sometimes because I forget why I’m doing them I forget to do them. So reminding myself “Why” is something I need to do for myself to keep it going. Maybe this is my diabetes end goal too?