Wait - Isn't That Backwards
Gaining control by raising the blood sugar bar.
By Scott Johnson
September 2007 — Like many of us with diabetes, I try my best to keep lowering my A1C. The closer I can get my blood sugars to normal, the lower my A1C will be. When I lower my A1C, I am reducing my risk of complications. Sounds like a good thing to work towards, right?
I agree with this one hundred percent, but that's easier said than done. It is deceiving just how hard it is to pull off blood sugars that are close to normal. In fact, it is impossible to do so after meals. I just don't work the same as someone who has a working pancreas.
I find it very hard to control my urges to snack when my blood sugar is too high. It sometimes feels like cruel and unusual punishment! It is a little easier to explain my urges to eat when my blood sugar is low. My body is experiencing an emergency and my body is trying to get me to eat by any means necessary.
I have a terrible time staying rational when I experience a low blood sugar. It's downright impossible to control my "hand-to-mouth" reflexes when my blood sugar is too low. I almost always eat way too much, and end up taking more insulin to balance the extra food. Even then it is hard to figure out exactly how much extra I ate. I end up guessing more than knowing, and usually struggle with a rebound high or another low a few hours later.
With one of these low blood sugars I end up piling on TONS of extra calories. After I regain my composure, I get frustrated because many times I will have worked very hard to keep my calorie balance under control for that day.
I use an insulin pump to deliver my insulin. I have programmed the pump with a handful of settings, and I use those settings to recommend insulin doses for meals and correction boluses. In order for my pump to recommend a correction bolus, it uses a programmed target blood sugar, a correction factor, and my current blood sugar. It crunches all those numbers and comes up with a recommendation for an insulin dose (or a recommendation against additional insulin).
I have spent a long time with my target blood sugar set at 100 mg/dl. A target closer to 80 mg/dl would be more like a non-diabetic blood sugar, but it doesn't leave much room for error. 100 mg/dl is a pretty acceptable target for many people.
With that in mind, I recently raised the target blood sugar programmed into my pump up to 120 mg/dl.
Wait a second – isn't that the opposite of what I am supposed to do? Aren't I supposed to be working for closer to normal levels?
That is exactly what I'm doing.
By raising my target blood sugar just a little bit, I am trying to avoid more of those low blood sugars. They are a major trouble spot for me, mostly because I can't seem to keep my wits when I'm low. I end up eating too much then I deal with a rebound high and extra calories. If I can run a steady blood sugar, even if it is closer to 120 mg/dl than 100 mg/dl, and avoid some of those low blood sugars, I think it will be better than the roller coaster that can happen when bouncing up and down.
Only time and my next A1C and the bathroom scale will tell!
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dLife's Viewpoints columnists are not all medical experts, but everyday people living with diabetes and sharing their personal experiences, most often at a set point in time. While their method of diabetes management may work for them, everyone is different. Please consult with your diabetes care team before acting on anything you read here to find out what will work best for you.
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