Way Off Track...And How to Get Back

WebMD

5 days ago

In June, my diabetes hit a speed bump.
Although my A1c readings had been ticking up over the years, none broke 6.5.
But a month ago, for the first time, my labs sent back a startling report of 7.6, a full point higher than normal.
My first reaction was to panic. After all, I've written enough about complications to know that a higher A1c can lead to any number of physical problems, from injured nerves to heart disease. But even as I thought this, I realized that while it wasn't entirely my fault, the higher reading probably could be traced to several things that might be in my control.
First, though, came my regular six-month endo visit. Reading my chart, he too was surprised but not panicked. Calmly, he backed away from the computer screen and asked me what, if anything, had changed in my diet, my exercise, my stress levels.
And then, together, we talked about my medication plan and adjustments that I might make to lower the next A1c.
Luckily for me (and you), there are many new medication options for people with type 2 diabetes these days, and after outlining the possibilities, he wrote a new prescription.
'Don't panic,' he told me. 'You can do this.'
A few weeks later, the new medication is helping lower my traditionally high morning sugars. But as we all know, controlling type 2 diabetes isn't all about medication. Any number of things play a part.
As I left my doctor's office, I went over my role in the higher A1c. There was a week's trip to Mexico City, where I had most certainly overconsumed tempting flour tortillas. Toss in a few seasonal holidays — Mother's Day, two children's birthdays, and a wedding anniversary complete with carrot cake and cream cheese icing (my favorite). While I didn't down a full slice, there were crumbs and swipes of icing.
Plus, a bit burned out on my usual 60-minute-a-day cardio and/or weight routine, there were days when I slept in, exhausted by my routine.
Sitting behind the steering wheel of my car, I faced the truth: I had taken an extended vacation from my diabetes. Which might be OK for a few weeks or days, but after six months it had translated into a higher A1c.
But as I started the car to head home, I realized I was no longer panicked. After all, what goes up must come down. And while bringing my sugars back into line might take a little work, I felt ready to start.
If you find yourself in a similar spot, here are a few questions to ask yourself:
How is your diet? Have you been consuming more carbs than normal? Are you eating more white flour? Can you add more whole grains and healthy fiber to your meals?
How are your portions? Even if you are selecting the right foods, it's possible to overindulge. Sometimes it helps to weigh and measure foods for a few days to remind you just what a half-cup of Häagen-Dazs looks like.
What kind of exercise have you been getting? Cardio is great, but weightlifting two times a week can reduce your blood glucose more effectively. If you find your sugars creeping up after meals, a stroll can work wonders.
How are you managing stress? Have you considered yoga, meditation, or long dog walks in nature? Can you turn off the news? Or even declare a no-news day or two? Might talking to a therapist ease anxiety?
What have you been drinking? Alcohol can lower your blood sugars, but it can also reduce your inhibitions, making it easier to plunge your hand into that bag of chips.
Do you have enough support? A partner, friend, or family member can help you to weather the daily strain of having a chronic disease.
Are you taking your meds correctly? Did you miss a dose? Do you know the best way to make up for a missed dose?
Are you taking any new meds that might interfere with your diabetes medications?
Are you dehydrated? Not drinking enough water, particularly on hot or heavy exercise days, can increase your blood glucose.
Have you put on a few pounds? New diabetes drugs can help with blood sugar and weight loss. A talk with your doctor may be in order.
Have you been less active than usual? Have work or family duties made it tough to get to the gym? If so, can you find an online exercise program at your fitness level that you might do at home?
These are but a few of the questions you might ask yourself if you find your A1c, like mine, has jumped. The important thing is not to panic (more stress!) but to calmly consider how to slowly shift the needle on your care.