Expect changes. Expect to use experience.
2 simple statements but it isn’t that easy to navigate life with diabetes. Keep these in mind though as you move ahead in life because everything changes, and we can’t expect that diabetes will be any different. All the work you put in today will help in the days ahead as you adjust to the change life is expected to bring.
One good thing to expect is that in life with diabetes there are 3 things that do stay the same in terms of impact. The 3 main pillars of management – medication, activity, and food, can be used to adjust to the other variables life throws at you. They will always play an important role in your blood glucose management.
Expect change to happen and consider each of these 3 things as it occurs:
? Have you fine-tuned your medication, especially insulin, when something seems to be off?
As we grow and change through all of life’s stages, expect that the doses of insulin will need adjustment as well. Variables in life can bring about momentary changes (exercise, food choices, illness) in need, or long-term changes in need (menopause, weight gain/loss, muscle gain, schedule change, growth). When your current strategies are not working, go back to the foundation of management, basal and bolus doses of insulin, and evaluate if this needs adjustment. Also, consider what the variable might be that has caused the shift. Is it long-term or short-term?
? Have you evaluated how activity impacts Blood Glucose levels?
Has something changed in your activity level? Is there more or less than normal or has the type of activity changed (running vs Pilates)? While you might have one type of exercise figured out, the adjustment for a new type, intensity or duration will take some adjustment. Expect to make changes to what you know. Also consider if the change is more permanent. A change in job or lifestyle may include more or less activity on a daily basis, so this might also need to be built into your daily plan for overall medication use.
? Do you know what the fueling plan you follow does to your blood glucose?
If you are eating the same as usual but something is off with your post-meal glucose levels, consider going back to that first pillar, medication/insulin dose. If you have all around changed the content of your meals – more protein and lower carb, more fat and lower carb, all carb, lower Glycemic, etc. – this will likely mean an adjustment in your dosing strategy to keep things contained. Learning to navigate changes around food takes time especially when it is very different from what you had figured out before. Give yourself time to keep some notes and analyze data and create a foundation to this new fueling plan.
Using experience can help tremendously when something changes too. Expect that what you have seen happen in the past will happen again and use the tools from what you have learned to adjust in a similar way. While it may not be exactly the same (exercise before or after this time, illness in the picture, etc.) you do learn from experiences and if you do something enough (take a run every Sunday morning at the same time, or have soccer after school at the same time) then it gives you a good visual for what to adjust based on what worked or didn’t work out the last time.
Expect that what you are doing now will need adjustment as life changes. It would be wonderful to figure it out and then have it all stay the same forever. There wouldn’t be so much frustration.
If you sense a change has happened or have enough foresight to see things will change (job change, schedule change, etc.) plan to go to the pillars of management first and see if one of these things is a good place to start. When change happens, it can be easier to navigate if you narrow the playing field to things you can address and use experience to guide you to adjustments that will make a difference.
Thankfully today we have good technology and tools to use for analysis as well. We also have teams like Integrated Diabetes Services to help you navigate these changes. Let us know if you need help adjusting to all the changes life can bring!!
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