10 Diabetes Management Tips to Improve Your A1Cby Ginger Vieira Health Writer & Patient Advocate
Trying to get your A1C level to budge can feel incredibly overwhelming. The way you manage your diabetes can become as ingrained as how you brush your teeth and which toppings you prefer on your hamburger. Knowing where to begin and what to do differently is tricky to pinpoint. Here are 10 very specific areas of your day-to-day diabetes management regimen to focus on to help you reach your A1C goals.
Have a good meal plan
Having diabetes shouldn’t keep you from enjoying food, but eating well-balanced meals is essential in the management of your diabetes. A registered dietitian or certified diabetes educator can help you learn what foods to eat, how much to eat, and when to eat based on your characteristics and needs (weight, activity, medicines, and blood glucose targets). If you plan well-balanced meals, your glucose and A1C levels will probably be easier to manage.
Evaluate where your blood sugar is
What is your target blood sugar? If you want to lower your blood sugar, consult with your doctor about your target range. Changing your target blood sugar may requires changes in insulin, medication, nutrition, and activity.
Check-in on your overnight blood sugars
If it’s been a long time since you woke up at 2 a.m. to check your blood sugar, it’s definitely time to make it a priority. Eight hours of daily snooze time contributes to ⅓ of your A1C result. If you’re spending half of every night with a blood sugar over 200 mg/dL, don’t be surprised that your A1C won’t budge. Choose a few days over the course of a couple weeks to wake up and test for a little late night diabetes studying! Ask your doctor how to deal with overnight highs.
Lots and lots of lows?
Frequent low blood sugars for those of us on insulin can sometimes be a sign that you’re not getting enough insulin in your back-ground/basal dose if you’re constantly correcting highs and struggling with a high A1C. Constantly taking extra boluses to correct daily high blood sugars means you’re using rapid-acting insulin boluses to compensate for basal rate insulin that may need to be increased. Consult your doctor about changing your insulin dosage.
Your post-meal blood sugars
If you’re eating 4 to 5 meals a day and your blood sugar is high after most of those meals, that means your blood sugar is high most of the day. Getting enough insulin with each meal is an easy area to fix but it starts with a little insulin-to-carbohydrate testing or if that feels like too much work, talk to your diabetes educator or a dietitian about adjusting your diet. Small changes can equal easy improvements in post-meal blood sugars.
The low-down on intermittent fasting
Fasting is a controversial subject and may be dangerous for some diabetics. However, fasting can potentially improve insulin sensitivity, blood pressure, beta cell function, and oxidative stress. People with advanced diabetes or who are on diabetes medication should not try intermittent fasting without close supervision.
Look closely at your last meal of the day
Are you eating pizza every night and struggling with sky-high blood sugars all night long? The meal you choose before bed can have a huge impact on your A1C. Do you starve yourself all day and binge at night? Do you eat a carton of ice cream every night after trying to be so good all day eating low-calorie salads? Diabetes can have funky impacts on your relationship with food...maybe it’s time to take an honest look at what’s going on.
Good old-fashioned pre-bolusing
When we eat a simple meal (some carbs possibly combined with some fat, some protein), taking your insulin 10 to 15 minutes before you eat can really prevent post-meal blood sugar spikes. But this shouldn’t be applied to trickier meals that digest slowly (pizza, cake, burger and fries), or when you’re at a restaurant and can’t be sure when your meal will be served. It does work well, however, for simple meals you eat often and make for yourself at home.
Stop drinking your carbs
Still drinking cow’s milk with a good 30 grams of carbs in a tall glass? Unsweetened milk alternatives (flax, almond, etc.) gives you that milky taste with less than 5 grams of carbs and plenty of calcium. Drinking orange juice for breakfast ‘cause mama always served it when you were little? Have some water, and eat an actual piece of fruit instead. That $5 coffee drink is dessert with 60+ grams of carbs! Let it be a once-a-month treat, not a daily thing.
Always test your blood sugar in the morning
If you’re struggling with regular blood sugar tests, choose one time of day you can commit to, like first thing in the morning. Starting your day off on the right foot will improve your chances of keeping your blood sugar in range during the rest of the day. If your blood sugar is always high when you wake up, then you know exactly where you need to focus first: what you’re eating before bed or your background/basal insulin dose.