The New Year gives you a great chance to clean the slate and start over with fresh energy for managing your diabetes with insulin on a pump or injections. Some people might call this list resolutions, but we prefer other words. These are areas for you to Review and decide whether to Return, Revise or Refresh.
Return - Things you want to go back to—the tried and true aids that you used to do but have fallen away from in the rush of life, especially during the exuberance of the holidays.
- Revise - Things you want to adjust and improve to get better results.
- Refresh - Things you have not done before but may want to add.
- Review the following areas and see whether you need to Return, Revise or Refresh.
Counting carbs is a great way to match the foods you eat with the insulin boluses you take. People often learn how to count carbs but lose their edge over time and slide away from the practice by giving it up totally or allowing guesstimates and miscalculation errors to creep in. This is a good time to Return to counting carbs, especially for the foods and meals you usually eat. You may want to crack a book or open an app to Revise the values you use for your favorite foods. If you now eat some new foods that you never counted the carbs in, get out your handy carb counter book or go on line and search for it to Refresh your list of carb counts. You may also want to Revise your carb factor or insulin to carb ratio to ensure good readings from the improved accuracy of your carb counts.
Exercise and Activity
Forgotten to exercise recently? Or is your exercise now sporadic and catch as catch can? Or have you become sedentary and slowed down in general? You may want to Return to the routine you used to do. To improve, you may want to Revise the routine and lengthen or intensify what you used to do. Walk, run or ride your bike further or at a higher speed. To Refresh, consider adding something totally new such as swimming, doing circuit training at a gym, or wearing an exercise device such as a FitBit to count your steps. An activity device is great for reinforcing goals by helping you keep track of steps taken, calories consumed, or distance moved. What ever you do, set a specific goal of how far to run or how long to walk and how often you exercise or do your activity.
Knowing Your Numbers
Do you know what your A1c, blood pressure and cholesterol are? These values are easily quantifiable and are a good way to track some measureable parts of diabetes and health management. If you don’t know them, it may be time to Return by visiting the doctor and getting the tests done that tell your A1c and cholesterol, or by purchasing a blood pressure cuff and monitoring your numbers. Learn the desired ranges for these tests to let you know how you’re doing. Revise by selecting better values for these goals. Refresh by adding a new number, maybe your average glucose from your meter or your CGM. Check with your doctor for the number or range of numbers to aim for.
Downloading Your Records/Data
To do a major review, download your records and data from your meter, pump and CGM for a quick overview of your patterns. Look for any problem areas, especially lows first before you go to bed, since they can be most immediately dangerous. Also look at highs, especially upon awakening in the morning. If you’ve downloaded before, this is a helpful Return to a good practice. See what you can Revise to avoid a pattern that is occurring. If you are high after meals, consider bolusing earlier, such as 15 to 20 minutes before a meal, to avoid glucose spiking. Refresh by using a bolus calculator in your pump or on a meter to help you select accurate boluses that work.
If this list seems overwhelming, choose one area to work on. Return to this Review periodically, say every month, for a quick look at some ways to improve glucose management. Especially Review this list if you are having difficulty keeping within the A1c and average glucose your doctor recommends or if you are having problems with highs or lows that are affecting your life.
Keep up the good work on managing your diabetes. Review, Revise, Refresh are the key words,