Episode 14: How to Manage Long-Term Control

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Long-term control for type 1 diabetics is still a somewhat “unexplored” part of life with T1. We’ve only had injectable insulin for 100 years! Many early diagnosed diabetics died young, or died middle aged because the care technology and our understanding of type 1 just wasn’t there.

So how do we take care of ourselves now so that we live as long as Dr. Richard Bernstein has lived? (He’s over 85 and was diagnosed at age 12).

Apologies in advance for the weird audio! There’s some low-level buzzing whenever I talk.

Remember, this isn’t medical advice—this is me talking from 25+ years of experience figuring out what works for me. It’s my hope that you can use my experience to help you learn how to better control your own diabetes.

Something I love saying is that I want you to take what works and leave the rest.

That all being said, there are several important factors to look at when it comes to the metrics of long-term control. These include:

Your A1c
Total daily dose of insulin
Time in-range
Avoiding complications
How often you exercise
And what you eat

Some softer factors include:

Your mindset
Your mental health
And your relationships with yourself, your family, friends, coworkers, and caregivers

Wins & Fails

Colleen’s Fail: After getting a late-night dinner with family on my work trip, my blood sugar went high even though I had a lot of insulin on board and my “Ate Dinner” basal profile active. Just another piece of evidence that I don’t do well when I eat dinner!

Hack of the Week

I’m trying out Brazilian Jiu-Jitsu. To help keep my Dexcom G6 sensor on during grapples, I’m wearing rock tape from Amazon over the sensor and pre-warning my grappling partners about the sensor location.

Diabetes in the News

Artificial pancreas system better controls blood glucose levels than current technology

We reported in episode 7 that Tandem submitted their Control-IQ algorithm to the FDA, which is the final piece of the closed-loop system using the Tandem t:Slim X2 pump and the Dexcom G6 sensor, which doesn’t require calibration.

The trial showed that this artificial pancreas system better controlled blood sugars than the current tech we have on the market.

“The researchers found that users of the artificial pancreas system significantly increased the amount of time with their blood glucose levels in the target range of 70 to 180 mg/dL by an average of 2.6 hours per day since beginning the trial, while the time in range in the [control] group remained unchanged over six months. Artificial pancreas users also showed improvements in time spent with high and low blood glucose, hemoglobin A1c, and other measurements related to diabetes control compared to the [control] group.”

Question for You!

If you’ve had diabetes for a while, what have you found is important for your long-term control? How are you managing your mind and avoiding the complications we’re all warned about?