How to get better control?

I'm 35, been T1 for 30 years. I have some pounds to lose and I need tighter control. No real complications at this point, but I am worried that they are right around the corner. I have a wife and 2 little girls that I want to keep happy for many years to come.

Eating

  • I tend to overeat at meals. Some of it is not keeping tabs on the portions, another part is taking seconds of foods.
  • I'm not really a sucler for sweets, but I do give into the fried, fatty foods.
  • I snack too much. At bed time, I tend to eat things like microwave popcorn, crackers with PB, SEVERAL slices of cheese...
  • When eating food that does not have nutritional values clearly stated...I don't do a good job accurately identifying the carbs and therefore don't bolus correctly.
  • Insulin reactions - when I become hypo, I tend to get really hungry and overtreat and then the yo-yo process begins with my BG going up and down...

Exercise

  • With a busy job, a wife and 2 kids, my schedule is extremly hectic. I need to find a way to get more exercise but I'm not sure how to fit it in to my day.

Diabetes tracking & Maintenance

  • I tend to test multiple times a day, but I don't do a good job of looking at trends and analysis. In less technical days, I tested but would not write down the readings. Now, I test but never upload or really keep tabs. I treat each blood reading acutely versus anlyzing and treating based on long term trending.
  • Sometimes I don't test my blodd and guess-timate how much insulin I need from my pump and bolus based off of "experience"

I just wanted to share this and see if folks have suggesstions. i doubt that I am alone here. I suspect that there are others that have some of these issues.

I also would like to find some more T1 resources for adults. It seems every time I look for a valuable Diabetes resources, it relates much more to T2. I'd really like to find some resources commited to adults with T1.

 

 

Brett....it sounds like you were describing me!!  I am the exact same way and have a hard time with all of the things you said!  I am looking forward to what people have to suggest.

Brett, Angela count me and we are now 3. Brett your description is fabulous, it is hard, your situation is similar to mine, rather than a long term program I focus on the day to day, test by test correction. Let me share my thoughts with you.

By this point you have probably realized that we are no different than the "normal" people, they also need to eat less, eat healthy, workout, sleep and take care of themselves, it sounds like us too, the only part is that their pancreas works well and ours doesn't thus we have to either give ourselves a shot or do the pump (i myself use the needle but I am looking into feeback from pump users but that is a different conversation) so recognizing that that is the only different factor that takes us to the general picture. The support from your immediate familiy is critical and think about this, what would you do if today the doctor said that you have 3 months to live unless you start eating less, eating healthy and doing workout, you for sure will do it and so do I, trouble is that we feel comfortable with what we are doing now and we haven't had any negative effects so far....

My best recommendation is take baby steps, you don't have to be at the gym doing one hour every single day... forget it, if you don't like the gym don't do it, find something you, and someone else that you feel good with likes, could be tennis, squash, walk, swim etc, the point is make it fun, if you do it by yourself you will end up dropping it in less than two weeks, support is basic, even for healthy normal people. if you can find something that you can do with your family is a win win situation, but if not then find someone else.

It is very important that we all keep a record of how we are doing, information is power and we might no see the benefit of it right now but down the road it can prove to be a real asset, keep your numbers handy, I have just recently seen a Bayer meter in the form of a USB stick, you test several times and then you plug it into your computer and the info gets loaded automatically into the computer, that is what I need and I will get it for sure, so things are becoming easier and easier to manage our diabetes it is just a matter of taking action, again, baby steps and not let your guard down.

Hope that helps!
Carlos

I am thrilled that I am not alone in this and quite frankly, just by typing out the issues, I have done 2 things...1) Help identify the pain points that I need to correct and 2) got some unintended therapeutic relief simply by mapping these issue out in front of me.

I have been on the pump for about 18 months now and find that it versus the shots, creates some different issues. I can tell you with the pump, it gives you much more granular control. But of course, garbage in, garbage out. If you say you had 15g CH but it was really 45g, then you'll end up with high BG. But the pump should enable me to get much tighter control bc it really does emulate the human pancreas much better than the shots.

As for the reports and trending software, I have the glucose monitor that talks to my Medtronic pump. And then there is a USB key that is used to upload all of the info to CareLink. It's pretty slick, but I need to actually use it!

One thing that I do now is, if you can say this, embrace my diabetes. I have no issues testing myself in public, answering questions from people or flat out declining a sugar laden piece of food and telling the person that I am type 1. I have found that people have many misconceptions and the conversation usually invokes a lot of sincer questions. the result is that i have educated at least one more person on our disease.

No doubt baby steps are the way to go. I am hoping this groupthis forum will serve as a nice support group for folks to share what has worked for them and what issues they have faced. I really think it's beneficial to fight these things in numbers versus trying to do it all alone.

I'd like to hear from folks how they've been able to successfully manage their BG reading and what softwaretechniques they have used. I also want to know how regimented your diet is and what type of healthy snacks people have used to satisfy cravings. I know personally that I some times eat when I watch TV at night and I'm not really even hungry!

 

So I hope lots of suggestions come ina nd I hope people find some comfort in the fact that their problems are not unique!

[quote user="Brett C. Williams"]

Eating

  • I tend to overeat at meals. Some of it is not keeping tabs on the portions, another part is taking seconds of foods.
  • I'm not really a sucler for sweets, but I do give into the fried, fatty foods.
  • I snack too much. At bed time, I tend to eat things like microwave popcorn, crackers with PB, SEVERAL slices of cheese...
  • When eating food that does not have nutritional values clearly stated...I don't do a good job accurately identifying the carbs and therefore don't bolus correctly.
  • Insulin reactions - when I become hypo, I tend to get really hungry and overtreat and then the yo-yo process begins with my BG going up and down...
[/quote]

The problem with food is that our attachment to it isn't really physical - it's in our heads. We no longer trust our bodies and the signals it sends us. Our body tells us when we are hungry and when we are full. But over the years, we have reprogrammed ourselves into thinking we're hungry when we're bored, we're hungry when we're stressed or emotional, we're hungry 5 minutes after we finish a meal. We've also learned to ignore our own satiety. We don't want those second helpings, but it tastes so damn good I'm going to eat it anyway! We all do this - myself included. It goes back to retraining our head to listen to our stomach. In this one instance, our stomach really is smarter than our brain :o)

There are tricks you can use to try to stop yourself from over eating. Use smaller plates and bowls. When you fill these up, it looks like a lot of food, but you are getting smaller portions because you are using a smaller plate. 9" plates are recommended (if you measure, your plates are probably 11", maybe larger). Try pre-portioning snack foods into plastic baggies. When you are hungry, grab a baggie. When the food is gone, it's too much of a pain in the ass to measure out more. Also, when you feel hungry try drinking something. Water is a good choice, but other calorie-free beverages can help too. Often times, we don't recognize our own thirst and misread it as hunger. Distraction also helps. Feeling hungry but it's close to dinner or snack time? Get away from the kitchen or the vending machines or wherever food is. Go for a walk, play with your kids, read a book, pop in a movie - distract yourself. In addition, don't let yourself get too hungry! When we go too long without food, we feel famished and then overindulge. Try to eat 6 times throughout the day - 3 small meals, 3 small snacks. This keeps your tummy full and you won't feel the need to eat a lot. By eating more often, you also don't have to wait very long before the next meal/snack time. Every couple hours you are introducing food into your body, so it no longer becomes an obsession. Every time we eat, our metabolism speeds up to digest the food. Eating constantly and consistently throughout the day keeps our metabolism at a slightly higher rate of speed.

[quote user="Brett C. Williams"]

Exercise

  • With a busy job, a wife and 2 kids, my schedule is extremly hectic. I need to find a way to get more exercise but I'm not sure how to fit it in to my day.
[/quote]

There are also simple things you can do to incorporate more exercise into your day. Park at the farthest end of the parking lot. Take the stairs instead of the elevator, or walk up the escalator instead of just standing there. If you live close to the grocery store, try walking there once a week. Ride a bike or walk instead of driving to close destinations. When you are watching TV, take a loop around the house during commercials or do jumping jacks, sit-ups, push-ups, or some other physical activity. Kids love to play outside! Go outside and play with them on the weekends. Chase them around the yard, teach them how to play soccer or football or ultimate frisbee, engage them in a game of tag or capture the flag. It's a good way to spend time with them while also getting exercise for everyone.

[quote user="Brett C. Williams"]

Diabetes tracking & Maintenance

  • I tend to test multiple times a day, but I don't do a good job of looking at trends and analysis. In less technical days, I tested but would not write down the readings. Now, I test but never upload or really keep tabs. I treat each blood reading acutely versus anlyzing and treating based on long term trending.
  • Sometimes I don't test my blodd and guess-timate how much insulin I need from my pump and bolus based off of "experience"

[/quote]

This one lies within you. You have the tools, but you are choosing not to use them. Can you set reminders for yourself to download your meter once a week? Put a sticky note on your computer to remind yourself to look at your blood sugars and make changes once a month? Put an alarm on your phone to remind yourself to check your blood sugar? This one is the toughest and one a lot of diabetics struggle with. I find it easier now that all I have to do is plug my meter in and stare at the screen, but it's still a pain in the ass to do it.

All of us are busy people, but we are never too busy to take care of ourselves. A blood test takes less than a minute. Carbohydrate counting just takes a quick glance at a nutrition label. Downloading and analyzing blood sugars can be done in 10 minutes. We make time for our families, so incorporate healthy lifestyles into everyone's routine. Your entire family can go for a walk, or play at a park. If your girls are involved in sports, while they practice you and your wife can participate in some kind of activity you enjoy - walking, biking, swimming, etc. It doesn't just have to be you - it can be a family affair :o)

Good for you, Brett! It takes a lot of courage to state everything that you have just stated.

I also hate record keeping! Ahhh! I hate it the most. Food logs, Blood sugar logs, exercise logs, disguisting.  I have a pump as well and the blood sugar meter that talks to it, I also got a cgms last fall. Have you considered a cgms? My point is that it basically records everything for you and the cgms is really good for trending. You upload to carelink and whola! there is it. I love this. I don't write anything down. As for food log, I like to use livestrong.com, it's database links up with the Calorie King. You still have to record your food, but you can do it all electronically, which I find is better. They also have apps for iPhone and blackberry's so you can log on the go. It's also great, because you can look up a food while you are out to eat if you have a hand held device. Then, all records can be exported to an excel file and emailed to your healthcare provider.

As for exercise, I find that playing organized sports is much more fun for me than going to the gym. So I sign myself up for beach volleyball or softball or plan biking outings with friends. Also, I like yoga. It's not cardio, but it really works your muscles and reduces stress. I feel that if I sign up for something, then I have to go. Also, walking is huge. If you take a walk after dinner each night with your family I bet you will see improvement in blood sugar and curb those night snacks. Oh- night snacks are a difficult thing for me, I love to have them, but if I do, I end up high in the morning.  Recently I have been drinking tea with half and half at night. You still get some fat, to keep you full and make it tasty, but no sugar. Just a thought.

As for eating, I found that getting my husband on board really helped. I mean, you need your people on your team. So if you are going to change eating habits, I would do it with the whole family. So you don't have to make the hard choice all by yourself. My husband loves pizza and was always trying to have pizza for dinner, and I was always saying no. Once I got him to realize just how bad it was for me, he totally understood and now only eats pizza at work for lunch. When he cooks, he incorporates low carb, lots of veggies and protein. It's nice not to have to make a choice at home.

This is the most important! Take one step at a time. Don't try to do everything at once. This is often a fail point for me. I want results fast and I try to do everything at once, but it gets overwhelming. Be patient with yourself. Good Luck!

Hello Brett,

My name is Marlon,  I've been a T1 for 19 years & I had a hard time keeping track of writing my numbers down & exercising. One thing that has help me is having a smartphone i use a app called on track. OnTrack is an application to help diabetics manage their diabetes by tracking various items such as glucose, exercise, food, medication, blood pressure (BP), pulse and weight. click the link below to see a screenshot of it. I hope this will help.

http://www.androidfreeware.net/download-ontrack-diabetes.html

Hey Brett,

Also I use a cgms & that really helps because it shows my trends in realtime & it will give alerts if your blood glucose levels are to high or low so you can act sooner to gain better & tighter control.

Marlon

I use the CGM myself, and having never been in perfect control, I was amazed at the change from 9.6% to 7.6% in three months, just from using the CGM.  I was even less active than I usually am (I typically bike a mile to and from work every day, except for the past 2.5 months) and still, it dropped that much!  I still swing wildly, but less so than before, I like to think.

My suggestions are simple but require you to change.  Using a pump won't change your snacking habits but it will allow the convenience of taking extra to cover the carbs - making the weight gain worse.

This is my strategy.

  • I don't snack on carbs.  Ever.  I eat small serving of nuts, celery sticks etc.  No carbs.
  • I count carbs.  If the box/package says that one serving is 40g of carb, I eat one serving and no more.
  • I eat at regular intervals.  For me, that is breakfast, lunch, dinner.
  • Before I eat out, I research the nutritional information of the menu and make low-carb choices.  I don't cheat.  I would only be cheating myself and my health.
  • I quit eating sweets - unless I have a low.  They have no nutritional value anyway.
  • The only emotional connection I have to food is that whatever goes into my mouth must be the best.  If I am going to eat a sandwich, it better be made with the best ingredients since I don't allow myself to overeat.

This is a tough way to live but ... if I want the outcome (my A1C is 6 or lower) then that is what MUST be done.

Knowing the data won't make a difference if the behavior does not change.  Knowing that I need to exercise and buying a gym membership won't make me healthy.  Doing the exercise will - and I don't need a monitor to do exercise.

It's great that your husband is willing to change HIS eating habits for you.  I don't inflict my disease on my family.  My kids can eat ice cream and cake and pizza.  At the end of the day I am the one responsible for what does in my mouth.  No one else.