Diabetes: All In on the Challenge

 

It’s been a while since I wrote anything about the challenges that come with being diagnosed with Type 2 Diabetes. In part, I haven’t written about it because I seem to have landed on some sort of plateau where my numbers, specifically my A1c, are good but not good enough. Unfortunately, I seem to be stuck on this plateau with no movement either good or bad and that can be frustrating.

At least the doctor was happy with my most recent test results, but I wasn’t because I once again missed my goals. And that’s where self-doubt began to set in. Am I missing my goals because they are unrealistic or impossible? Are my prayers for healing off the mark? Was I being delusional back when I told the doctor that I expect God to do something amazing? After quite a bit of self-examination, I find that the answer to all these questions is a resounding “No!”.

My problem is not unrealistic expectations nor are my prayers misplaced. What is unrealistic is thinking that I could half-heartedly do the things I know I need to do and expect the results that I want. I need to be all in with my diet and exercise, or else I’ll remain stuck on this plateau. The good thing is that I’m blessed since my body still makes insulin. So, if I dive in with both feet, I have a shot at achieving the goals that I have set for myself. I must change in order to make that happen.

I have about five and a half months before my next doctor’s appointment, and I know what I want to see as far as results when that time comes. To get there I must be all in when it comes to my current health challenge. It’s time to stop kidding and to stop my halfhearted approach. The Bible tells me that I have a God who heals and that I can do all things through Christ who strengthens me. These are the promises He has given me. Now I must live like I want to hold on to what He has offered.

The Battle Between My Ears

The end of 2024 is fast approaching which means it is time to update my ten year plan. This also means setting goals for 2025: goals that will help me take a step or two forward along my chosen path. I don’t really make New Year’s resolutions, although I guess in a way some of my goals fit the bill. But whether I call them goals or resolutions, I face the same problem that I hear others talking about year after year as we all take on new challenges without giving in by Quitters Day, something I only recently learned was a thing. (In 2025 it occurs on January 10th.)

Setting goals is a relatively new thing for me. I think I made my first serious attempt at creating a ten year plan at the end of 2017. It sounds funny to admit that I never set any real goals for the first fifty years of my life but before then I simply did what others said was best for me. I suspect this was a direct result of growing up as a codependent, where my mom’s alcoholism too often derailed my attempts at achieving something in life. Codependency meant giving up trying to succeed back when I was a teen, becoming convinced that setting goals would only remind me that I was a failure. (I didn’t understand it back then but a lot of that came from the toxic language that was the norm in my home, especially on the days that the bottle was in control.) By letting others direct my path, I could blame them when I failed even though that really did not help me feel any better about the results.

By 2017 I was ready to set real goals but I was not ready to achieve those goals. All too often I lost the battle between my ears. This battle came in the form of an internal voice which generally focused on my fears and my own perceived limitations. As a Christian, I often encouraged others to believe that God would bless them and that they could do all things through Christ who strengthens them (Philippians 4:13). At the same time I often talked myself out of living with that kind of faith, allowing that voice to have too much control even as I recognized that it was an echo of my life before I became a Christian. As a result I fell short when it came to achieving my goals and in moving forward in life according to the will of God.

This internal, codependent, and negative voice talked me out of doing the things that I said I wanted to do, while talking me into wasting time with things that often derailed my progress. Fortunately I’ve learned to argue with this voice, talking myself into doing the things that I know will help me achieve my goals. I’ve found that for me the, “...all things in Christ…,” begins with being able to win the battle between my own ears. God has freed me from bondage to that voice and He has also empowered me to move forward where I once held myself back. Now I am free of the excuses and of blaming others and I am ready to follow God’s perfect will for my life.

With this change in my own thinking I am prepared to update my ten year plan and to set my goals for 2025. Up until now my track record has not been great but as I win my own internal battle I expect that the results in 2025 will be something to brag about by this time next year.

Diabetes: A Journey, Not A Battle

It’s been a while since I posted anything about having diabetes. As you can tell from the title of this post, I’ve changed my point of view. No longer do I see myself in a battle against something. Instead I see myself as on a journey and Diabetes is a traveling companion sent to teach me a few things along the way. No, that does not mean I’ve walked away from my goal which is to start seeing health numbers that look, “normal.” But now I’ve taken advice from another Christian who taught about how a much more serious illness was in fact working to disciple him in his walk as a Christian.

Before I mention where I am on my journey I want to mention that the American Diabetes Association released its, “Standards of Care in Diabetes - 2025,” which includes, “Consideration of continuous glucose monitor (CGM) use for adults with type 2 diabetes on glucose-lowering agents other than insulin.” This reminded me of my post, “Continuous Glucose Monitors Are Game Changers,” where I wrote about how, “...living with diabetes and not having a CGM was living with one hand tied behind my back.” I believe a CGM should become a part of the standard of care for most, if not all diabetics, so it was good to see the American Diabetes Association recommend this in their standards.

With the help of my CGM my last blood test was very good. My fasting glucose reading was a 98 with an A1c of 6.5. That’s still in the diabetic range but only by 0.1. My goal for my next check is to get my A1c below 6.3 which would be the equivalent of being in a prediabetic stage. In the meantime, my companion on this journey has helped teach me that I can do all things through Christ who strengthens me (Philippians 4:13). I’ve also learned the importance of getting enough protein in my diet and how small changes in my daily habits can pay off with huge rewards.

I’m looking forward to 2025 and to a blood test where every measure is in the green. As I approach that goal, my journey and my learning continue with thanksgiving to God.

Who’s In Your Inner Circle? Who Should be Out?

Over my five and a half decades of life I’ve had the misfortune of being in some toxic relationships. It started within my own family where one of my parents was an alcoholic, trapping me in a codependent relationship. Fortunately, in Christ I have been healed of the injuries that resulted from that relationship. But there have been others who wanted to pour toxins into my life. Some I could easily move far away from my inner circle. One in particular was a coworker who regularly tried to sell me on a very negative view of life. God eventually moved that person out to arms length where they could no longer make me a captive audience for their pontifications. As with this coworker, there are people who need to be held at a distance. Sometimes they sneak into our inner circle and we need to be honest and intentional about moving them back out.

In the Bible Samson allowed someone into his inner circle who never should have been there. He found Delilah to be attractive and seemed to enjoy her company. But at some point she became a negative influence as she worked on behalf of her people in order to try to betray Samson. In Judges 16:15-17 the Bible tells us that she pestered him to the point where “... his soul was vexed to death,...” (Judges 16:16 NKJV). Eventually he gave in to her pressure tactics, telling her the secret to his strength. As a result he lost his hair, his strength and the presence of the Lord in his life (Judges 17:20). In the end, because Samson kept Delilah in his inner circle he wound up paying a very steep price.

There are some relationships that we can’t get away from (like with an alcoholic parent). There are others where we can’t completely push the person out but we can keep them at arm's length, like coworkers or even church brethren. There are some relationships that we should get out of but the emotional attachments make it difficult. In all of these situations we need to call upon our God, asking for direction. We need to pray for the other person and for the grace to respond properly. It’s true that sometimes God puts us in a situation to influence people in the name of the Lord. But I believe there will be times when the Lord opens the door and tells us to move a person far, far away. When that happens, we need to pray for the courage to do so.

A Constant Glucose Meter Update

Back in August I wrote about how wearing a constant glucose meter (CGM) is a game changer in helping me manage my diabetes. I still believe that a CGM should be standard issue when someone receives a diabetes diagnosis but in this post I want to talk about one downside that I have experienced over the last several months. While the commercials for CGMs talk about getting away from finger sticks, in my experience it is prudent to keep the old lancet and standard glucose meter nearby.

Recently, after attaching a new CGM, I began to get numbers that did not make any sense. I woke up the next morning to an unusually high reading and just couldn’t seem to get the number back down. Over the next 48 hours I did what I would usually do when my readings are high but  nothing seemed to work. And then it hit me. I needed to get my old meter out to verify what the CGM was telling me. After a quick finger prick, I had my reading and it was significantly lower than what I was seeing on my CGM. Fortunately the Dexcom G7 that I wear has a function that allows for recalibration and within 5 minutes my CGM was back into agreement with my old fashion glucose meter.

The instructions for the Dexcom G7 warn that during the first 24 hours after inserting a new unit, there might be some readings that are off and on their website Dexcom advises taking a finger stick reading any time that the CGM readings don’t make sense or don’t match what you are feeling. While most of the time my CGMs are on target, there are times when I need to recalibrate. So while I wish I could get rid of my old lancet, I still need it and am thankful for the ability to verify the information that I use in managing my glucose levels.

Maybe one day we will have a CGM that does not need any recalibration or any other kind of back up reading. But for now, if you are thinking about getting a CGM, remember that you need to keep your old lancet and glucose meter, and yes you will still need to do the occasional finger stick. That being said, a good constant glucose meter is still the way to go when managing diabetes.

See Also: Continuous Glucose Monitors Are Game Changers

Continuous Glucose Monitors Are Game Changers

It has been almost two years since I was diagnosed with diabetes. Since that time I have made a number of life changes, all for the better. I’ve lost about 20 lbs and gotten my A1c down below 7. But during my last follow up visit my doctor still seemed a bit concerned. It seems that he still wants an A1c coming in below 6, plus my glucose reading of my last fasting blood test was still above 100. While these are big improvements, they are still not ideal, coming in the range of what someone would have if they had prediabetes. In response to his concerns I decided to appeal to my insurance company, asking them to pay for a continuous glucose monitor which I have received and it has been a game changer.

What is a continuous glucose monitor or CGM? Just as the name implies, CGMs are systems that give continuous, or at least close to continuous, blood glucose readings. I have the Dexcom G7 which sends a reading to my cell phone once every five minutes. The Dexcom sticks to my arm with a small filament tucked just under my skin, reading my glucose levels from my interstitial fluid (the fluid that is found in the spaces in between our cells). The G7 received FDA approval back in 2022 for use by anyone over the age of 2 and has replaced the previously approved G6 for use by people who have diabetes.

I had applied for the G6 a month or two after my diagnosis but was denied by my insurance company who sent a list of reasons for the denial. To be honest some of the reasons were insulting. For example, they accused me of not caring about my diagnoses, accusing me of not taking my own blood glucose readings. You would think that if this were true they would have wanted me to have a CGM in an attempt to get me to take these readings. They were wrong and I was taking my readings, poking holes in my fingers at regular (and painful) intervals. They also listed a number of other reasons most of which I probably could have successfully argued against on appeal but one stood out as a problem.

When I received my diagnosis my doctor suggested that I attend classes with a dietician. I declined because I’m a researcher at heart and I enjoy finding answers on my own. Over the last two years I have taken the time to dig into the topic of diabetes, including doing research on how to eat. It has been a lot of fun and I still have a lot to learn. (For the record, unless you are willing to put in the time to do the research, I do recommend going to the dietician if you are diagnosed with diabetes.) Because I would not take their classes, the insurance company initially said no to paying for a CGM. But this year something changed.

This year I asked my doctor to once again put in a prescription for a CGM and he did so just after my local pharmacist started carrying the G7. To my surprise the insurance company said yes without any push back (Thank God). It seems the insurance company’s policies concerning CGMs had changed and so this year I got my first Dexcom G7 and it is a game changer. In fact, based on my early experiences I think CGMs should be an automatic part of the treatment plan for people who are diagnosed with diabetes.

I was very diligent with my finger sticks and thought I was doing a good job controlling things based on the numbers I was seeing. Yet, my A1c seemed to hit a plateau in the upper 6s and I couldn’t understand why. Within the first 10 days of wearing the G7 I figured out what was going on. (Each G7 can be worn for 10 days before it needs to be replaced.) In between my finger sticks things were not going as well as I thought. This was leading to an average which was higher than I anticipated and my A1c was based on that average. The G7 told a story that I could not have known without taking finger sticks every five minutes (not recommended). With the information from the G7 I now have a plan for getting my A1c down to where my doctor and I both want it to be.

I believe that living with diabetes and not having a CGM was living with one hand tied behind my back. I wish I had one from the start but all is in God’s timing and He knows why I had to wait. I suspect that had I not had over a year of finger pricks, I would not appreciate the technology and benefits that come with a CGM. This is a tool that will help me improve my health and I believe it is a necessary tool for dealing with diabetes. I’ll say it again: my CGM is a game changer.

Whose Medical Team Is This, Anyway?

Almost two years ago I was diagnosed with Type 2 Diabetes. Since that time I’ve had my ups and my downs (fortunately mostly ups) as I work at keeping my glucose levels “in range.” I’ve gotten my A1C down below 7 and am at a point where the doctor says I have things under control but with room for improvement. I have goals that I have set for myself as far as exercise and weight loss. Hopefully I will still be able to push my A1C down even further by the end of this year. I believe I am on a good path but there’s just one thing bugging me: an area where I felt I needed to speak up and take control. That area rests squarely between the four walls of my doctor’s examination room.

Don’t get me wrong. I do believe that my doctor and his staff have my best interest at heart. Here’s the problem. My doctor likes to do things “By the book,” which means medications with occasional increases in dosage. That’s not my goal but at first I was afraid to say anything about it. Early on I asked what it would take to get off of the medications but my question was met with an answer that I did not like. Over the 1st year and a half I found myself wondering who is in charge and if we share the same goals. Yes, we share the goal of keeping me healthy but my goal is to do so with as little medication as possible and I’d rather not go down the path of a higher dose of this followed by a higher dose of that.

So here’s my question. How do you see your relationship with your doctor? Is your doctor your medical boss, giving out orders that you have to follow? At times I become a people pleaser and I think this caused me to see the relationship in these terms. God helped me see that my doctor is a medical expert giving me advice based on his experience but his experience is not alway a perfect fit for my situation. For example, he did not think I could lose enough weight to make a difference. I have. The bottom line is he gives his best advice and it’s my choice on what I do with that advice as well as with the advice I get from many other sources. Most of the time I will probably do as the doctor says but I want to have some input and I make the final decision.

I want to be clear about this. I’m not advocating for you or anyone else to ignore the advice of their doctor. I’m not on some power trip and do not plan to ignore my own doctor. What I am advocating is for all of us to become informed patients, learning all that we can including what the doctor’s “book” says. As I learn more about living with diabetes I plan to make my health a collaborative effort, one in which I do lean heavily on my doctor for advice. And I will recognize that 99% of the time it is the best advice but it is advice and not a command.

When it comes to my health I will not be a people pleaser. After all, whose medical team is this anyway? To be more accurate: Whose life is this anyway?