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Recently Diagnosed And I Have Tonnes Of Questions!!
A DiabetesTeam Member asked a question 💭

I am curious, for those of you who can remember; how long did it take your PCP to get your glucose under control and what is considered an optimal range for you?
It seems my doctor (and his nurse who is the one managing my care) cannot seem to get this right. And my sticks are all over the place. 🙄

posted February 22, 2021
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A DiabetesTeam Member

TBH, I didn't wait for them. I did my own research and figured it out myself. I've known for 30+ years my diabetes was coming, so I had time to prepare.

For me...
Carbs (100-125 per day)
Water (roughly 100 oz per day)
Exercise (1+ hours per day)
Sleep (7+ hours)
Stress (control it as much as possible)

Don't let anything become a craving, that leads to binges.

Keep a food journal (or get an app that lets you make notes as needed) to help track trends. This can be foods that spike blood sugars (or level them out), trends in bs numbers (mornings, exercising, illnesses, etc), exercise times and routines, illnesses, meds, anything out of the ordinary.

Learn what spikes your blood sugars (outside temps, hormone fluctuations, hot showers, stress, etc). Controlling these helps control the diabetes.

Do research. Keep journals to track your collected knowledge. Don't be afraid to take it to the doctor's office with you. Foods and superfoods, medications, exercises, blood sugar vs A1C, dawn phenomenon, glycemic index vs glycemic load, what causes blood sugar (and A1C) fluctuations, how perimenopause affects diabetic women, and research anything you run across that you don't understand. Try to stick to reputable websites. (Several universities publish their diabetes research.)

Beyond that information overload... I'm concerned that they're adjusting your meds so often. Why are they doing this? Depending what you're on, it's probably a steroid. Those do better on an even keel, not being fluctuated from one visit to the next.

You are your own best advocate now. Don't be afraid to offend your doctor (or the nurse) by refusing to cooperate and requiring an explanation for the changes they're making. Especially when they are not in your best interest (like constantly changing your meds).

They may be the medical personnel, but this is your life and your body. They deal in generalities. You deal in specifics keyed to your knowledge of you. If you are hesitant to cooperate, listen to yourself and hesitate.

posted March 10, 2021 (edited)
A DiabetesTeam Member

My Doc had almost no input on getting my diabetes under control. Primary Care/Family Doc's are not diabetes experts nor should they be - they need to know "a little" about many things. In most western countries they "treat" using a set of published "guidelines".

It's really just a giant "flowchart" (see a very simplified one below). They try the "first step" and if it doesn't work or not well enough they move on to the next level.

As for "my treatment plan" I did it myself, with the assistance of a dietitian in 3 months. But to be fair, I had been testing for almost 20 years "waiting for the diagnosis" due to massive family history so mine was caught "as soon as I crossed the line".

If I had of made some changes earlier I probably could have delayed onset for a good number of years but made the decision to "live normal" while I could "knowing" what restrictions would be in place after diagnosis. That was a calculated choice.

My Doc was looking for an A1C of 6.5 or less. I was diagnosed with an A1C of 6.9 and had it down to 5.7 ninety days later. It has been 5.4 or 5.5 (wobbles a bit) ever since.

My fasting target range (FBS) is 4.0-6.0 (72 - 108) and my 2 hour post meal (PPG) target range is 5.0 - 8.0 (90 - 144) but I shoot for "no higher than" 7.7 (about 140) because above that level you start doing "cumulative damage" to your blood vessels.

I achieve my numbers through "never an excuse, strict diet control" with calories limited to 2000/day and no more than 130 "net" carbs a day. I was fortunate that I caught my diabetes before I needed meds. But whether you initially require meds or not what goes into your mouth is "completely and totally" within your control and can have a dramatic effect on your treatment and control no matter how advanced/progressed your diabetes is.

The only decision most of us have to make is "how much we are willing to do for ourselves" to gain control or how much we will abdicate that responsibility to someone prescribing drugs.

posted February 22, 2021
A DiabetesTeam Member

For me, i did a alot of research and taught myself what worked. I would test and then eat...then test after an hour then 2 hours to identify what effected me and for how long. Takes time, patience and being consistent. I have never been to an endocrinologist for my diabetes. I found, for me, carbs are way worse than sugar. I can eat carbs and it takes hours to cone back down. Sugar is a quick spike and then a rush back down. Ask a lot of questions and do some reading.

posted February 22, 2021
A DiabetesTeam Member

Sorry, here is the treatment chart.
In the "real chart" there is a ton more detail and considerations but it doesn't post well - too large

posted February 22, 2021 (edited)
A DiabetesTeam Member

Diabetes sucks! I was diagnosed about ten years ago, but I never really took it seriously and continued to eat like always. BTW, I am not overweight. The years went by and my A1C has crept up and am now seeing an endocrinologist who started me on once a week Trulicity injections two months ago. He told me it is genetic and progresses with age. UGH. I can’t change either one of those two factors. So now I really try to avoid most carbs and all sweets. Not at all easy but necessary if I want to have well-controlled diabetes.

posted February 22, 2021

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