Latest / The Healthy Diabetic / #170: Diabetes Non-Negotiables - Part 1 - A1C

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#170: Diabetes Non-Negotiables - Part 1 - A1C · The Healthy Diabetic

• 0:20
  Speaker 1: Welcome back to the Healthy Diabetic Podcast.
• 0:23
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• 0:28
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• 0:34
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• 0:44
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• 0:52
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• 0:59
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• 1:06
  Speaker 1: You're why I'm doing this.
• 1:08
  Speaker 1: I started this podcast in 2020, during COVID, as something really cool to do, and it's really involved, evolved into something special for me being able to have a platform to talk about diabetes, but also, hopefully, for you guys, being able to get a lot of value out of my thought processes and the thought processes of the guests that I'm bringing on.
• 1:29
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• 1:58
  Speaker 1: Okay, let's dive into this, because I'm really pumped about this episode.
• 2:02
  Speaker 1: If you've been following me for the past I don't know three, four, five months you know that I've been talking a lot about nutrition.
• 2:10
  Speaker 1: You know I've been talking a lot about A1C and I have not made my thought processes and my feelings about this A1C number secret, and we're going to talk a little bit more about this today.
• 2:24
  Speaker 1: I'm sure you're intrigued by the title of this episode.
• 2:28
  Speaker 1: This is a brand new series and I'm going to get started here on the podcast.
• 2:31
  Speaker 1: I'm really pumped for it.
• 2:33
  Speaker 1: I got 20-some different topics all designated around this thought process of diabetes, non-negotiables.
• 2:39
  Speaker 1: What are the non-negotiables and diabetes that I really focus on?
• 2:43
  Speaker 1: I'm really excited to bring these topics to you Today.
• 2:46
  Speaker 1: It's A1C non-negotiable.
• 2:48
  Speaker 1: What does that mean for me, a1c?
• 2:53
  Speaker 1: For me, my non-negotiable with A1C is I do not allow whatever.
• 2:59
  Speaker 1: My A1C number is every three to four months when I get it done.
• 3:02
  Speaker 1: I do not allow that number to define who I am as a diabetic.
• 3:06
  Speaker 1: The reason I say that is because you probably, like me, are someone who, when you were first diagnosed maybe you are first diagnosed you probably have been in a position where you're putting the blame game on yourself.
• 3:20
  Speaker 1: You probably have been in a position where you have been identified or felt compelled about that A1C number.
• 3:32
  Speaker 1: The reality and the truth of the matter is too many people in our community, too many diabetics, stay so hyper-focused on this A1C number that it overwhelms everything else.
• 3:49
  Speaker 1: The A1C, your A1C, that you get every three to four months, all it is is a tool.
• 3:55
  Speaker 1: That is what I look at with this number.
• 3:58
  Speaker 1: It is a tool because it can give me some insight on what has been going on.
• 4:04
  Speaker 1: Here is the example my previous A1C, about six months ago, was 6.1.
• 4:09
  Speaker 1: I have been basically 6.1 for the past year and a half, almost two years.
• 4:14
  Speaker 1: This past one that I got in November was 6.4.
• 4:17
  Speaker 1: Why is that?
• 4:18
  Speaker 1: That is a great question, because when we get these numbers whether it is higher than your previous one, lower than your previous one, the same as your previous one.
• 4:26
  Speaker 1: That number can give you insight and clarity on what could possibly be going on with your blood sugars.
• 4:33
  Speaker 1: For me, that is a a difficult number to take, but I know why that number happened.
• 4:41
  Speaker 1: That number happened because I had two really big sicknesses in that three to four month span GI bugs that knocked me down.
• 4:50
  Speaker 1: So my appetite was jacked up, my exercise routine was jacked up, my food intake was jacked up.
• 4:56
  Speaker 1: So all of these things were happening.
• 4:58
  Speaker 1: Because of these two things that happened, these two sicknesses that happened.
• 5:04
  Speaker 1: Also, I had multiple way more than usual, multiple site problems.
• 5:11
  Speaker 1: Insulin resistance, probably because of the sicknesses.
• 5:15
  Speaker 1: Insulin resistance because of bad sites and when that happens that makes our blood sugars fluctuate and it was on me because I did not proactively change out the sites fast enough.
• 5:32
  Speaker 1: I have a whole protocol, whole series of things I've talked about before, about if I've got fluctuating or sticky sticky blood sugars.
• 5:41
  Speaker 1: I got a whole six to seven step process that I go through.
• 5:46
  Speaker 1: That helps to get past that very quickly, get past those tricky blood sugars or sticky blood sugars very, very quickly.
• 5:55
  Speaker 1: And I wasn't following that because I was sick, because things were going on in my life that happens.
• 6:01
  Speaker 1: So, now that I understand what happened in the past, now I know what needs to change in the future.
• 6:09
  Speaker 1: If I don't ask myself any of these questions, if, from when I went from a 6.1 for almost a year and a half, two years, to a 6.4 when the span of three to four months, if I don't ask myself those questions in that timeframe and try to figure out what happened, then what's to say?
• 6:26
  Speaker 1: The next one isn't going to be the same result, be the result that I don't actually want, because I think that's the other thing that we have to think about here.
• 6:35
  Speaker 1: What is the A1C result that we actually want?
• 6:38
  Speaker 1: And you have to figure that out for yourself, because it can't be what the doctor says, it can't be what I say, it has to be what you feel comfortable at.
• 6:50
  Speaker 1: And if you're killing yourself, getting down to 6.0, 6.2, or even below, if you're killing yourself, and it's a challenge and it's just you can't, you're constantly going low, or you can't figure out how to stay steady in range in a good, healthy, healthy range, because, depending on what your in range is, if that's healthy for you, right and this is why I say this, because I don't agree I will take a stand and live and die by this sword and every person is different.
• 7:22
  Speaker 1: I do not agree with the standard in range variation, not variation, but the standard in range numbers, the low and the high.
• 7:33
  Speaker 1: The standard in range number that the medical system goes by is 80 to 180.
• 7:38
  Speaker 1: Well, I'll tell you what if you're constantly in and that's your in range right.
• 7:43
  Speaker 1: So the other thing that irritates me with this in range and with our A1C is I'll see post all the time.
• 7:49
  Speaker 1: 99% in range okay, that's awesome, great, great for you.
• 7:53
  Speaker 1: 100% in range for seven days, 90% in range for seven days or longer, whatever it is, that's awesome.
• 8:01
  Speaker 1: But what is your in range number?
• 8:02
  Speaker 1: What's your low number?
• 8:03
  Speaker 1: What's your high number?
• 8:04
  Speaker 1: Because I'll tell you what my in range is typically on.
• 8:08
  Speaker 1: On really really good days, where my insulin sensitivity is super heightened, everything's doing really well.
• 8:14
  Speaker 1: My exercise is on point, my eating is on point, my sleep is on point, my hydration is on point, everything is going well.
• 8:20
  Speaker 1: Typically, I'm between 80 and 85% because my low number is 80 and my high number is 150.
• 8:29
  Speaker 1: So if I go to 151, I'm out of range because I want to be really tight.
• 8:34
  Speaker 1: I want to be really tight in my control.
• 8:36
  Speaker 1: I don't want to go to 160, I don't want to go to 170, I don't want to go to 200 plus.
• 8:41
  Speaker 1: I don't want to do that.
• 8:44
  Speaker 1: So that, for me, is how I define what my A1C is and what my in range number is, and you have to figure out what that's going to be for you where you feel the most comfortable.
• 8:52
  Speaker 1: So let's go back into this A1C thought process.
• 8:55
  Speaker 1: So when we think about A1C, you really need to think about what your A1C, what you actually want your A1C to be, and then you work backwards from there of everything else that kind of works within that actual number and saying that I want.
• 9:10
  Speaker 1: I just want to reiterate that that number shouldn't define every single decision that you make.
• 9:17
  Speaker 1: I'm not going to make my decision on my diabetes management just because, oh, this is actually going to impact my A1C.
• 9:25
  Speaker 1: That's great.
• 9:26
  Speaker 1: But again, we're splitting hairs here on how are we going to define and what you actually want to look at with the A1C, it's just an average number, it's all it is, and us being so hyper focused on that number and having every single little decision that we make based off of that number isn't I don't believe that's that sustainable emotionally?
• 9:48
  Speaker 1: I know for me it's not.
• 9:49
  Speaker 1: If I'm hyper focused on that number and every decision I'm making is based off of that number, I'm just.
• 9:54
  Speaker 1: It just drives me crazy and I get too caught up in that number.
• 10:00
  Speaker 1: Now, what I do focus on doing is I'm making decisions based off of what my blood sugar is right now, in this, in this second.
• 10:09
  Speaker 1: That's what I'm making decisions off of.
• 10:12
  Speaker 1: If I'm going to a restaurant and I want to eat a burger and some fries, I'm asking myself two questions.
• 10:17
  Speaker 1: I'm asking myself what is my blood sugar now and how is my blood sugar has been?
• 10:21
  Speaker 1: Have I been insulin resistant?
• 10:23
  Speaker 1: Have I been insulin sensitive?
• 10:25
  Speaker 1: Have my blood sugar has been in range over the past couple days?
• 10:29
  Speaker 1: Because that's going to allow me to say to myself okay, well, my blood sugar have been in range and they've been really good, so I'm going to treat myself.
• 10:38
  Speaker 1: Or my blood sugar hasn't been in range, I've been sick, I've been.
• 10:43
  Speaker 1: What's?
• 10:43
  Speaker 1: Whatever is going on, I'm insulin resistant.
• 10:45
  Speaker 1: I know I am, because my blood sugars are sticky and they're running high or they're fluctuating.
• 10:51
  Speaker 1: I'm going to make a different food choice.
• 10:52
  Speaker 1: That's the way my brain works.
• 10:54
  Speaker 1: You gotta figure out how your brain works, but just these simple thought processes that can ultimately help the A1C, but not allow us, not make us be hyper focused on that A1C, because all the other decisions that you make will ultimately, yes, affect your A1C.
• 11:09
  Speaker 1: So if you're making these really good decisions for yourself, based off of your blood sugar, where it is now, where it has been in the past and what possibly it could be in the future, based off of am I going to practice?
• 11:21
  Speaker 1: Am I going to exercise in the next couple hours?
• 11:25
  Speaker 1: Am I?
• 11:26
  Speaker 1: What type of meal am I eating right now?
• 11:28
  Speaker 1: Is that a little bit higher glycemic meal, because I need some more carbohydrates?
• 11:31
  Speaker 1: We're getting deep into this, but all these things go into your A1C and we're not.
• 11:40
  Speaker 1: We shouldn't be making decisions based off of your A1C number.
• 11:43
  Speaker 1: We should be making decisions based off of how you want to live your life and you should be making decisions based off of what your blood sugar is right this second.
• 11:52
  Speaker 1: Now, those of you who are not on a CGM, that strategy becomes a little bit harder.
• 11:58
  Speaker 1: 100%, 100%.
• 12:00
  Speaker 1: That strategy becomes a little bit harder because now you're literally having to prick all the time, which I think that we should be doing that anyway, if you're not on a CGM, you should be pricking at least six, seven, eight, maybe even 12 times a day, because you should be pricking before you consume food.
• 12:17
  Speaker 1: You should be pricking an hour or so after you consume food, which that's standard, that's what your doctor's going to tell you, but then you also need to be pricking throughout the whole entire day.
• 12:28
  Speaker 1: If you're exercising, you should be pricking yourself and testing your blood sugar before exercise, because you need to know if you need to ramp up your insulin, maybe turn up a tent basil, or you need to know if you need to suspend some insulin if you're on a pump, or if you need to give yourself some type of micro-bolus if you're on MDI or if you don't need to give yourself a micro-bolus.
• 12:53
  Speaker 1: So many things go into this thought process of diabetes management.
• 12:59
  Speaker 1: So many things.
• 13:00
  Speaker 1: The one thing that I have become very successful with my blood sugars is not being hyper-focused on all of those little things, only being hyper-focused on the things that one I have put into my management system and my management plan, but also being hyper-focused on the things that I want to be hyper-focused on.
• 13:21
  Speaker 1: I don't want to be focused on a thousand what is it 100 plus decisions that we make every day.
• 13:27
  Speaker 1: That's going to make anybody crazy.
• 13:29
  Speaker 1: So you take the trends of the decisions that you make right.
• 13:34
  Speaker 1: So, typically, on a daily basis, you probably make somewhere between 12 to 20 different decisions every single day and I'm looking at those decisions, taking those decisions into my thought process and then I'm hyper-focused on those specific decisions.
• 13:56
  Speaker 1: If I make 20 decisions every single day, I might be hyper-focused on 10 to 12 of them, maybe 13 of them, because those decisions are decisions that happen every single day.
• 14:07
  Speaker 1: If it's the same 20 decisions every single day, great, then you need to be hyper-focused on 20 decisions.
• 14:13
  Speaker 1: So the things that are happening in our life with diabetes, those things should be part of our management style in terms of how we think about the day to day.
• 14:27
  Speaker 1: And the other thing that's really helped me rationalize and clarify a lot of that for me is routines and consistency.
• 14:36
  Speaker 1: The more consistent I am with a routine, the better my blood sugars are, because I don't have to think so much.
• 14:44
  Speaker 1: It doesn't become this humongous jigsaw puzzle.
• 14:49
  Speaker 1: Even though I love the jigsaw puzzle, I love figuring out the why, the why something happened.
• 14:54
  Speaker 1: I love that as me being a coach and me being the person I am.
• 14:59
  Speaker 1: I love that.
• 15:00
  Speaker 1: I love the jigsaw puzzle, but it also is daunting.
• 15:03
  Speaker 1: It's a daunting thing to think about the jigsaw puzzle every single freaking day 100%.
• 15:09
  Speaker 1: It is so the easier that we can make that jigsaw puzzle by looking at the trends of the things that happen every single day, the better off your blood sugars will be and, ultimately, the better your A1C will ultimately be.
• 15:22
  Speaker 1: This is going to be a really fun continued conversation on the things that I believe.
• 15:29
  Speaker 1: For me, my diabetes non-negotiable my diabetes non-negotiable with the A1C is.
• 15:36
  Speaker 1: It does not define who I am.
• 15:38
  Speaker 1: It is a tool that I use to figure out past things that are happening, things I need to improve upon, and allows me to take all the information and continue to evolve my management style.
• 15:52
  Speaker 1: That is the only thing that number does.
• 15:54
  Speaker 1: This is how I define what this means to me and this is what this means to me.
• 15:58
  Speaker 1: If you're not defining things for yourself and just listening to what other people are saying in terms of what this other really successful person does or this is what my doctor told me to do you're not being true to who you are in yourself.
• 16:16
  Speaker 1: Really.
• 16:17
  Speaker 1: Think about the words and the things that I'm saying Really.
• 16:21
  Speaker 1: Think about other people that you listen to or watch on social media and what they're saying.
• 16:27
  Speaker 1: Listen to what your doctor says, because the more information that you have, the more questions you can answer and the better you are in a position to be able to figure out what works for you, because that's the ultimate goal.
• 16:40
  Speaker 1: Our only job is Diabetics to figure out what works for us.
• 16:44
  Speaker 1: The crazy thing is that's always different, which I think is insane to me.
• 16:52
  Speaker 1: I talk about that thought process so much and I just truly believe in it that our only job is to figure out what works for us.
• 17:01
  Speaker 1: But that is not an easy task to do because this condition is ever evolving.
• 17:08
  Speaker 1: How you respond to specific foods now is not going to be the same as how you respond to specific foods in five years.
• 17:14
  Speaker 1: It's just not If you're a young female or a young male.
• 17:18
  Speaker 1: That's going starting puberty right now and you've been diagnosed for two or three years.
• 17:23
  Speaker 1: How your body responds to diabetes right now, going through puberty and growing into a young man and a young woman is going to be different than how your diabetes responds or how you respond to diabetes when you're 20, when you're 30, when you're 40, when you have kids.
• 17:42
  Speaker 1: It's so fascinating to me.
• 17:46
  Speaker 1: Anyways, a1c, don't let it define you.
• 17:51
  Speaker 1: It does not define who you are.
• 17:53
  Speaker 1: Ask questions, be curious.
• 17:55
  Speaker 1: I hope this all resonates with you guys.
• 17:58
  Speaker 1: Thank you so much for listening and I will see you guys next time.