As someone who is currently diagnosed with both an insulin production and insulin resistance condition (i.e., LADA), I have needed to rewire my approach to living toward making glucose management a full-time background process in my life. Wearing my CGM, I am regularly checking where my glucose is, and responding to these levels with a variety of tactics that guide my levels into safe zones for as long as possible (as detailed in the Taking Control of Your Insulin Disorder section).
As a Type A Diabetic with both insulin resistance and insulin production issues, I am currently committed to keeping an average glucose level between 80-115 mg/dl (which generally gets me to about a 5.4% A1c – slightly below the level of incurring high risk of most complications) without any prescription medications, and without any daily injections (thanks to Afrezza).
One of the terms I hear from medical professionals is “standard of care.” As far as I can tell, while there certainly a ton of patterns that can be broadly established around how people in general process carbohydrates, protein, fat, and insulin, each individual is indeed a snowflake when it comes to diabetes management. What works well for me might not work as well for someone else, for a host of reasons. Heck, what worked well for me two years ago doesn’t work as well for me as I write this – and I’m the same person!
Still, some may be asking “how do you consistently maintain non-diabetic levels of glucose?” Or, as I like to put it, “How can you, too, become a gluco-normal despite having an insulin disorder?” This is where being a Type A Diabetic really shows its metal.
How I Maintain a Healthy Glucose Equilibrium
- To combat my dawn phenomenon, which used to have me waking up to glucose levels of 130+ mg/dl, I discovered a supplement called Restful Sleep that seems to keep my liver sleeping along with the rest of my body at night. I now wake up between 95-115 instead (but that 115 occurs just as I wake up, so I’m hanging out at around 100 all night).
- To mitigate my “morning highs” (which is the combination of a “shower spike,” a “caffeine spike,” and even a “feet-on-the-floor spike” each morning) where I surge up to between 130-150 mg/dl, I jump on a treadmill for a brisk walk for 1 mile (10 degree incline; 3.8 mph rate). This will usually bring me right back down to between 100-120 mg/dl. When it doesn’t, I will do a quick 4-unit inhale of Afrezza.
- I consume a low-carb diet (soon you’ll be able to visit LowCarbLifeHacker.com where I outline my truly enjoyable diet): Usually no more than 6 net carbs per meal, and snacks that are 4 or less net carbs. Low-carb snacks and meals will only raise my glucose between 5-25 mg/dl.
- NOTE: As you’ll learn in the future sister-site LowCarbLifeHacker.com, this low-carb diet is barely a compromise. Thanks much to the super-popular keto movement, low-carb innovation is at an all-time high. Would you believe that I can eat low-carb versions of pizza, pad thai, ice cream and candy bars without impacting my glucose levels?
- If my glucose levels are hanging out around 120-130 (due to the small amount of carbs consumed, or even protein) any time during the day, I’ll either jump on the treadmill again, go for a walk outside, sip on an ounce of scotch, have a small glass of wine, or inhale another 4 or 8-unit Afrezza. Any one of these activities from the Type A Diabetic Glucose Control Panel will take me down about 20-40 mg/dl.
- By the time I go to bed, I have exercised twice, and am usually at or around 90-100 mg/dl, and thanks to my Enzymatic Therapy Fatigued to Fantastic! Revitalizing Sleep Formula supplement (note: despite how it might look, I am not being paid to promote this supplement), I usually stay in that arena the entire night.
The key to my Type A Diabetic strategy, however, is to immediately mitigate glucose levels above 120 at all times. I’ve gotten on the treadmill at midnight when I’ve accidentally overcarbed late at night, and I’ve briefly left parties to do a brisk walk around the block for 20 minutes if I happened to have eaten too many carb-y things at said party. Now that I have started using Afrezza more regularly, I can use that instead of a brisk walk if the timing isn’t good.
To many, this way of living might sound exhausting. Nearly every pre-diabetic and type 2 diabetic that I know seems to want to keep their insulin resistance disorder as distant from their daily lives as possible. Sure, they will prick their fingers once in a while and “keep tabs” on carb intake, but they mostly want to live a life that is not impacted by an insulin disorder. They want to be “normal.” I get it. I was in this mode as well when I was first diagnosed. I was appalled by the idea that I was a victim of a disease that was going to force me to change my life for it. This seemed wrong to me. And, in all honesty, depressing.
How I Shifted from Victimization to Empowerment
So how did I get from being depressed and victimized to being a Type A Diabetic? By realizing a few things in my pursuit of understanding what it meant to have my first “chronic” disease:
- Virtually everyone has to deal with something. For me, it’s now glucose management. For others, it might be depression, or cancer, or a debilitating autoimmune disease, Alzheimer’s, or simply chronic anxiety that makes people miserable no matter how many carbs they’re “allowed” to eat. So, I’m definitely not alone. I just have “my” thing to deal with.
- With a CGM like the Freestyle Libre, the entire food/drink management situation changes from “being told” what I could no longer eat to self-actualization. With a CGM, I get to see real-time results of how my body responds to what I consume. As a result, I now understand that if I eat a bunch of carbs, my glucose spikes to dangerous levels (as if I have a carbohydrate allergy). This is not my doctor telling me what I ate was “wrong” or “bad” or that “I cheated”…this is my body telling me that it is not responding well to what I just consumed, which honestly is so much different. My body isn’t scolding me, or making me feel guilty…my body is just like “Here’s what’s up, bud. Do what you wish with the information I’m providing you.” My CGM results are not judging me…my CGM is just telling me what’s happening. And I get to decide how I want to deal with the information I’m being provided. I’m in complete control. When your body is telling you what’s happening, you tend to empathize with it because, y’know, you’re kind of in this thing together. You realize that that piece of cake just set you back a bit and, if you keep up that kind of thing, indulgences like that will likely lead to glucose toxicity complications sooner rather than never. The result: that piece of cake might just be worth the risk, or it may not. It’s my choice. I’m in control based on my own personal risk profile.
- With a CGM, you will quickly learn (within a week!) that you can put a ton of stuff in your mouth that is not a death sentence (well, at least not one caused by glucose toxicity!). With my new low-carb diet, I’m eating far more meats and cheeses than I ever could on my regular calorie/fat-counting diet that I had been on for decades. And on this new low-carb diet, I’m truly never hungry, and snacks are now whatever cheese or meat I like. Not too shabby. And that’s not even including all the new, innovative low-carb snacks that are out there. The variety, taste, and number of calories I can now consume without gaining weight is frankly amazing.
- When friends and I went out to dinner in the past, I’d usually order a salad or something “light” (because when on my normal diet, I’d only be looking at calories and fat). Now when we go out, I am now more inclined to order a nice juicy steak with a side of broccoli (with cheese sauce – and even a blue-cheese wedge salad if I want!). Meals like this are like the opposite of dieting for me. Eating meat, cheese, and fatty foods is like an indulgence. And while it might appear to be a cholesterol death-trap, it may not be, and it’s certainly good for my glucose equilibrium! Point being – I was able to convert my prior calorie/fat-limited diet into a carb-limiting diet, and found out that the new diet is actually, on the whole, more fun [learn more about how to hack your diet at my (future) sister site: LowCarbLifeHacker.com].
- Thanks to the CGM, I’ve learned an important lesson – this is not about what I can’t consume. This is about how things impact my body. It’s just a completely different frame. If everyone in the world were required to install a sensor that reported blood health on a regular basis, I bet a lot of people without any disease would change their eating habits because they’d see real-time data about how it’s negatively impacting their health and body.
- As I engaged deeply in my learning journey about “diabetes” and how to mitigate long-term complications, I was suddenly in a world of medicine and diseases that I had never been immersed in before. Having just turned 50 years old, I have been fortunate enough to not have to think much about my own mortality. Suddenly, everything I was researching was about how to ensure diabetes wasn’t the cause of my mortality. And, as this sunk in, I came to the realization that everyone (my doctors, researchers, me) was trying hard to let something else lead to my death! In other words, this was basically an exercise in finding the longest path to death. Grim? Perhaps, but analytically, this is precisely what is happening. Even if I completely mitigate my insulin disorder, something else will eventually get me. This shifted my thinking from “managing my diabetes” to “living the best and longest life I can” – which included taking other issues like cholesterol levels and blood pressure just as seriously as my glucose levels. After all, there are complications for each one of these issues – it’s not just diabetes.
- Finally, all of this led me to a philosophy of life reckoning: Given my belief that we all get one shot at life, on my deathbed, do I want to see my life as being more of a consumer or more of a contributor? I ask this because, like many, I really enjoy consuming! I used to be a craft beer aficionado. I love sampling local cuisine when traveling the country and the world. Many of my most enjoyable vacations included surfing craft breweries with my fiance. Now, I am questioning this approach to life (yes, because I’m kind of forced to, but….). Perhaps if I shift my focus from “I am what I consume” to “I am what I produce,” I’ll live a more fulfilling and purposeful life as a result. Trust me, I’m not fully there yet (but I am making progress – have you seen my Type A Diabetic Manifesto?). In theory, this philosophy could be a situation where diabetes “saves” me from a life of consumption to a life where I produce things that are durable, help others, and be proud of when eventually staring death in the eye.