This week my two oldest kids started school. With the summer coming to an end it’s been a nice change for me to get back into a routine and restart good habits. We’ve been working on regular nighttime and morning routines, and so far, things are going fairly well, but they’re still adjusting to going to bed early and getting up early for school.
As a diabetes care and education specialist I often find myself telling my patients that good diabetes management involves developing good habits as well. As I consider my own diabetes over the years, the times when I’ve had the most success have been when I’ve been on top of things and prepared for anything diabetes has thrown at me. As you read on, I’m sure you’ll agree that this article could probably more effectively be titled, “How not to be like teenage Annette.” I’ve improved a lot over the years, and although my diabetes management isn’t perfect now, and I still don’t always have good habits, I’ve learned a lot. I consider success to be a relatively good A1c, good time in range, diabetes not getting in the way of my activities or the activities of those I love, and not having to put a lot of thought into my management.
You may question if these are lazy or smart, but I choose to believe they’re smart. You can be the judge of that. Some of these suggestions involve a little work up front, but I feel it all pays off in the long run and saves time and stress.
That being said, here are my good diabetes habits:
Set up a blood sugar testing schedule and stick with it. Whether you use a Continuous Glucose Monitor (CGM) or a regular blood glucose meter, check it at regular times so it becomes more out of the ordinary for you to not check than to check. Know how to use the data.
Always have low treatments or glucose tabs with you. I can’t tell you the number of times as a teenager I found myself low without something to treat with. I wish I’d been smart and had snacks on hand, but somehow I was always rummaging through the fridge at night looking for something, anything to treat my lows. Or at swim practice I would have to buy a drink most days to treat my afternoon lows, rather than bringing something to treat with in my backpack. I could’ve saved myself a lot of money and stress by being a little more prepared.
Order your supplies on time; set up an automatic order if possible. Luckily my mom was in charge of this for me for a long time until I was old enough to take it over, so I never ended up without supplies. Granted, my dad always had the same supplies as me, so if I ever forgot to pack some while visiting from college, I’d just raid his supply drawer. Now depending on who I get my supplies through I either have it set up on an automatic reorder (like my insulin) or put it on my calendar and call regularly at the 3-month mark and reorder my supplies. This way I’ve never found myself low on supplies or out all of a sudden.
Test basal rates and settings to verify they’re right. This is one of the habits that require a little more work up front but is worth it in the end. Essentially it comes down to making sure you’re taking the right amounts of insulin at the right time. How often you do this will depend on your situation, but blood sugars will be so much better and easier to manage when settings are right. If you’re not sure how to do this on your own, we’re happy to help! Give us a call.
Always bolus before you eat. This one may seem simple and like a no-brainer but believe it or not I’ve not always been good at this one. Ideally you should bolus 10-15 minutes before eating if your blood sugars not low, but at least before you eat is better than waiting until partway through or not bolusing at all. Timing of the insulin truly is important and can mean the difference of spiking to 180 after a meal vs 300.
Exercise regularly. I find that when I’m regularly getting at least 30 minutes of cardio exercise most days of the week I use much less insulin and feel better overall. When I’m not very consistent with it (more than 2 days in between exercise) I run higher on the non-exercise days and lower on the exercise days and find it frustrating. When I’m consistent with the exercise it’s much easier to maintain blood sugars steady without having to change my insulin settings.
Set reminders for when it’s time to change your infusion set/give your long-acting insulin. Make this a part of your routine and try to do it at the same time of day, if that works for you. As a teenager I would change mine when the insulin ran out, which wasn’t a good idea for more than one reason, but we’ll focus on the consistency of the time of day. I would sometimes have to wake up in the middle of the night with an alarm going off saying that I was completely out of insulin, and sometimes I’d been out for several hours before I’d wake up. Had I been more on top of things I could’ve avoided those high blood sugars that came from being without insulin for so long, and the interrupted sleep.
Get all of your regular tests and blood work. Schedule regular checkups with your Endocrinologist and make sure you’re healthy and aren’t developing any complications. If you do have complications this can help ensure that you’re getting the help you need to manage them.
Wear medical ID and have Glucagon with you. It’s always good to be prepared in case of an emergency.
So there you have it! My good diabetes habits. The more consistent you are with making them part of your routine, the easier life can be.
Annette Valle is a registered nurse and certified diabetes educator who also serves as an English/Spanish medical language interpreter. She has lived with T1D since age 13. Annette has personal experience and is certified to train on all models of insulin pumps, CGMs and hybrid closed loop systems.