Diabetes Self-Management Blog

I don’t know about you, but I’ve learned — and it’s taken me a long time to learn this — that starting a healthy habit, or turning back in the direction of a healthy habit from which I’ve veered off course, does not mean I must make an immediate, complete shift in order to affect change. Nor does beginning a healthy habit mean I need to berate myself and feel guilty for past transgressions; to do so, I’ve discovered, only serves to bring me to the new (or new again) habit with despondency about what might have been — where I’d be now if only I’d taken up the habit years ago, or if only I’d stayed the course.

The habit in question: diet. More specifically: calorie intake. The catalyst for change: Monday’s visit to my endocrinologist for my quarterly checkup.

I enjoy going to see my doctor. It allows me to review my diabetes self-management through the eyes of an expert. I see where I’m doing well, and I see where I can make improvement. On Monday’s visit to my endo, I found out that my HbA1c was over 7.0% for the first time since I’d brought it down after my Type 1 diagnosis four years ago (it’s currently at 7.1%, which isn’t any cause for concern and which will, I assure you, go down in the next three or four months). No big deal. I expected this post-holidays. I expected this, and if you don’t believe me, see here. My self-management on the whole, how I care for myself, was something my doctor commended me on.

I’m doing just fine.

However, the one area we talked about where I could make a change if I wanted to, was with my weight. The conversation began because I said, “You know, I eat relatively healthy foods…for the most part. And I find that I am able to eat most of what I’d want within reason. So unless I hear from you that my numbers, blood tests, all that stuff, are causing you concern, I’m not going to worry too much about food, not in the way that most people think a person with diabetes ought to worry about food. Not going to limit choices, all of that.”

My doctor agreed with me. My weight didn’t concern him. I work out intensely four to five times a week, manage my glucose well, all of that stuff. If I wanted to lose some weight, if that was something that concerned me, then the doc said I should just pay closer attention to diet. Want to lose weight? Why yes. Yes, I do.

Despite all of my working out — spinning, running, weightlifting — that I’ve been committed to since last July, I still weight roughly the same as I did when I started. Yup, I have that mid- to late-thirties man-middle, and I would be happy to see fifteen pounds disappear. Granted, some of the fat has turned to muscle in the last six months. I know this.

Still. Working out should not be a license to eat what I want whenever I want. I need to eat less. Eat more intelligently. I used to be in that habit. And to do so, if I take baby steps and pay attention to what I wrote in the intro to this week’s blog entry, makes it pretty simple, really.

I need to decrease my daily caloric intake.

For the past four days, I’ve done just that, with the help of the Livestrong My Plate Web site, which also has a great app for my phone. Cutting out a few hundred extra calories here and there throughout the day isn’t so difficult to do. In fact, it’s actually rather easy.

The problems arrive when I try to stay on task and workouts demand carbs. The problems arrive when I need to treat a low blood glucose that doesn’t seem to want to kick back up into the normal range. The problems are that I’m trying to recalculate insulin pump basal rates to accommodate the healthier me. Frustrating coincidence: my insulin needs actually seemed to have dropped precipitously since Monday, and I’m not sure why. Exercise? Infusion set location? I just don’t know.

More about that in future blog entries.

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