10 Diabetes Management Tips to Improve Your A1C
Ginger Vieira | April 4, 2018
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 manage-ment regimen to focus on to help you reach your A1C goals.
Choose when to eat your favorite carbohydrates
When do you crave carbs the most? If eating low-carb all day isn’t a good fit for you, choose one or two times of day where you’ll eat carbs, and let the other meals be intentionally very low-carb. You might prefer a little something sweet every night or maybe you love bread in a sandwich for lunch. Give yourself permission to eat carbs when you want them most, eat low-carb at other meals, and benefit from fewer carbs overall.
Change your idea of what an “OK” blood sugar is
When you see 150 mg/dL on your meter, do you usually think of this as an “OK” blood sugar? If your blood sugar is frequently around 150 mg/dL, you can expect an A1C of at least 7.0 percent. If you want it lower, your standards for an “OK” blood sugar need to be lower, too. Getting a new average blood sugar requires changes in insulin, meds, nutrition, and activity. You can’t do what you’ve always done if you want different results.
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!
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 simply needs to be increased.
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 about a simple slight increase in your dose with every meal. Small changes can equal easy improvements in post-meal blood sugars.
You might love basic “intermittent fasting”
Fasting between bedtime and the next day’s lunch is one of the easiest ways to ensure that your blood sugars will be steady and in range for a huge chunk of the day, reducing the amount of energy you need to spend trying to manage diabetes around food! It’s also proven to increase insulin sensitivity, increase energy, and help you lose weight.
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.