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URL:   http://www.diabetesselfmanagement.com/blog/eric-lagergren/learning-to-love-a-slightly-higher-hba1c-part-2-of-2/print/

Learning to Love a Slightly Higher HbA1c (Part 2 of 2)

Eric Lagergren

August 19, 2010

Last week in part 1 of this two-part blog entry, I told you that over the summer I’ve adopted an attitude where I’ve taught myself to not worry so much and let my blood glucose numbers run slightly higher. Not too much higher, but a bit. This week I’ll tell you why.

Would you believe me if I said the reason I’m letting my HbA1c go up is that I just don’t care anymore? Or said I’ve decided I’m going to enjoy life and stop keeping close watch on my diabetes? What if I said life’s too short to spend time worrying about all those blood glucose checks, all those boluses, and all of the other (too many) things I have to do for this stupid illness?

Of course you wouldn’t believe me.

Get this, though: the genesis of my attitude shift is related to that “I don’t care any more” attitude.

After a spring in which I spent months recovering from thyroid cancer surgery and dealing with the lethargy of hypothyroidism, in which I didn’t gain weight but felt sluggish and out of shape, I wanted to return to exercise (not just walking, but cardio and weightlifting kind of exercise). Getting back to feeling like me wasn’t something I’d achieve only through pharmaceuticals. So when June arrived and I found myself feeling better than I’d felt in half a year, I decided to get back to the gym.

The problem with returning to the gym? Since my diagnosis with Type 1 diabetes, my exercise and gym time has been intermittent at best. Two or three months here, two or three there, and then bam, I’d get off track. It never failed. I’d miss a day or two, then a week or two, and then all of a sudden I hadn’t gone in months.

I thought about why, and I realized I was worrying too much about each visit to the gym, about each time I’d exercise. I worried because of diabetes.

My concerns, valid though they may have been, took up too much space in my brain. My concerns caused me anxiety on the mornings of the days I’d go work out; they’d follow me all day; they’d be there during my late-afternoon workout; they’d continue to nag that night.

For example:

What do I need to remember to take in my gym bag in case I go low? What sport drink should I pack? Do I have a pre-gym snack? Have I packed it? Crap, have I set the temporary rate on my insulin pump low enough so that I don’t go low? It’s too late now, so I might as well not go because what if I go hypoglycemic? Should I work out without my insulin pump attached or keep it on? How much sports drink should I sip during my workout, because I don’t want to go low? Is the way I feel because I’m having a hypoglycemic episode or because I’m simply tired and I’m having a good, hard workout (a hard workout feels good!)? I need to be careful I don’t have a low in my sleep so I need to be extra vigilant before bed to ensure my blood glucose is OK. Is my blood glucose OK? That’s a good number, but am I trending down? What about the second low, which happens to people within 24 hours after a workout?

These (and many, many more) thoughts quickly made going to the gym a burden. All too soon I’d use these (valid) diabetes concerns as an excuse to avoid the gym altogether.

Yet I never really thought, until just this year, “Hey, Eric, let your average glucose run a bit higher and see what happens.”

So I did. I made a contract with my psyche to let new thinking happen, to tell myself that, yes, I may be making a tradeoff in my HbA1c, but the long-term damage is negligible, and the present-time benefits wonderful.

What this shift in thinking has done is allowed me to shove aside a large portion of the gym worry and anxiety that I used to carry. Granted, I still carry carbs to the gym, I still prep for going to the gym as someone with diabetes. But am I a stickler about my blood glucose during the workout (I try to stay between 150 and 200 mg/dl when working out)? Nope. When it’s slightly higher to begin with (for me, at least), I find I don’t dip into those 70s, 80s, and 90s during the workouts, or after!

I’ve really enjoyed the last two months at the gym. I look forward to the days I work out. Maybe I could have learned to love exercise again without my self-inflicted A1C attitude adjustment. Every now and then, however, a mental crutch, some scaffolding around the weaker parts of my attitude, really helps get me headed the way I want to go.

I’m pretty certain my current practice regarding my blood glucose will result in a higher HbA1c reading when I visit my doctor at the end of September. But you know what? I don’t really care anymore.



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