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As people with diabetes, we are tasked by our medical teams with conducting our lives in a manner such as to minimize or mitigate the destructive effects of our medical condition. A lot of press is given to the concepts of "patient compliance" and "patient adherence" -- enough to raise the blood pressures of many of us past the levels covered by our antihypertensive, renal-protective pharmaceuticals. The idea of being "a diabetic in control" (or "out of control") has also been known to raise the hackles of a number of the T1s among us, whose blood glucose levels vary with the tempo and dynamic (but none of the grace) of a Mahler symphony.

Like the four movements of a symphony, or the members of a string quartet, the cornerstones of diabetes self-care are:

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It's my time...to plan phase 2 of my healthcare team.

I'm a girl. A 21-year-old girl. A girl who has spent the last year listening to friend's talk about engagements, attending weddings of high school pals, and buying baby shower gifts for my already-coupled friends. Sometimes it feels like everywhere I turn, someone else is getting engaged or married or growing their family.

All that means that my mind is constantly confronted with the fact that potential coupledom and familyhood is in my future. That means I spend a lot of time thinking about this future, with these couples and families of my imagination. My mind trails in daydreams to consider the kind of guy I want to marry, getting pregnant, and growing old together.

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I'm staring at my logbook right now. I have no idea what to do. My averages are still above 200, although my baseline numbers are generally running between 160 and 180. Yet I'm still seeing numbers like 302, 264, or 270 crop up.

I raised my Lantus to 33 units last night and I woke up at 96 when I'd gone to bed at 224. I'm hopeful that 33 units might be the golden number with all this. If I could get my basal numbers to drop back into a normal range (I'm looking for under 150 at the moment), then my post-meal numbers wouldn't be spiking so high. Plus I could keep working on the post-meal numbers more extensively if those basal numbers dropped.

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Several people have told me lately how A1c results aren't all that important. I agree that A1c's aren't the ONLY lab test or number that diabetics need to be concerned over in their diabetes management. But it's also ingrained into me that A1c's are a very important number in diabetes control.

For about ten years, I went to a doctor who was directly involved in the DCCT trial. I researched the DCCT for a science fair project in 7th grade. I've seen the results. I've heard the stories. A1c results are valued by most endocrinologists in this field. Obviously, there is something to this.

For me, my A1c is one of the telling factors about my control. It's the guiding light at the end of the tunnel. There is an ultimate goal in my mind regarding my diabetes and regarding that number. It's important to me. I'd rather have a lower A1c than risk running at a higher result and increase my chances of diabetic complications.

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In the past month, I've really gotten off track with my life. School and work seemed to be picking up, so I set a few things on the back burner (not to mention that I had a flare up with my other health conditions). The things that got pushed to the back were really major pieces of my diabetes management.

For one, I stopped working out in the way that I had been leading up to mid-March. Before Spring Break, I was working out at least twice a week (jogging 1.5-3 miles on the treadmill). But after Spring Break, life got in the way so I didn't make the time to add those workouts back into my schedule. I made all sorts of excuses: I was too tired, I wanted to go out with friends, I hadn't watched TV in forever, I had to study. Sadly, I think I've worked out a total of three or four times in the past month...that's just really disappointing.

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It's the end of my logging week again, so I'm sitting down to examine the logbook that I hold so dearly close to my diabetes management's heart. The time that I set apart for this goes something like this. First, I update the logbook with my most recent numbers, Lantus doses, and any important comments including new prescriptions, strange food choices, or exercise. Next, I tally daily averages as well as averages for time of day. After that, I analyze those averages compared to the last weeks averages and look for any resounding patterns that might need changing.

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