Diabetes Viewpoints

My Biggest Diabetes Mistake

By Melissa Conrad Stöppler, M.D.

Overall, I think I’m doing a good job taking care of myself- taking my medications as scheduled, getting regular exercise, and watching what I eat. My HbA1c levels always seem to stay within my target range, so I tend to pat myself on the back and tell myself I’m doing all I need to do.

But I know I am still not doing all I should.

My glucometer has become a dust-catching, shoved-to-the-corner-of-the-counter reminder of the fact that I hardly ever remember to measure my blood sugar levels when I should. Maybe it’s due to the fact that like my HbA1c levels, my glucose levels are all pretty predictable. After living with diabetes for almost a decade, I know when my weak times are, when my blood sugar is most vulnerable to spikes, and when my values will be in the normal range. And while I’m making excuses, I can mention that I have a spouse, three children, a job, and countless after-school and extracurricular responsibilities with my children, so even the few minutes it takes to do a measurement can seem like an unnecessary kink in our schedule.

When I was first diagnosed with diabetes, I measured my glucose levels all the time. I was panicked and needed to be reassured that I wasn’t reaching dangerous levels, and I also needed to learn what happened to my levels after eating certain foods and at certain times of day. Now, as I mentioned, I have a pretty good idea of how different foods and times of day affect my blood sugar, and I guess I have become complacent. Still, I need to be more mindful of the fluctuations in my blood glucose levels and need to take both random postprandial measurements several times a week as well as daily profiles every week or two in order to understand what’s going on with my diabetes and whether my medication dosages are adequate. In short, I have to find a way to make glucose checks more a part of my regular routine.

Researchers have actually studied the factors that can influence compliance with medical treatments or measures such as remembering to check glucose levels. They have found that forming a clear and detailed plan, in advance, of when these measures will be carried out is beneficial in ensuring that they are accomplished. Using glucose monitoring as an example, then, one should formulate a specific plan or intention to test either at specific times during the day or at times that are related to an event such as eating dinner, making breakfast, or going to bed.

For me, since I need to check my two-hour postprandial glucose levels, I may need to set the kitchen timer when I sit down to a meal. Or I need to plan to check my levels every morning upon awakening for the coming week. Since the strength of, and commitment to, any health intervention plan has been correlated with its success, writing down my proposed glucose check times in advance for the coming week might also be helpful.

Writing this column, and acknowledging that I need to do better, is therefore part of my plan to make more frequent glucose checks.

Read more of Melissa's columns here.