The Three Keys to Control

Think Like a Pancreas: Chapter 4, Your Cheat guide!

Ultimately, quality control = balanced blood sugars and achieving the lowest possible A1C without frequent lows. 

Your A1C represents the % of red blood cells that have glucose stuck to them. With normal blood sugars, approximately 4-6% of red blood cells will have glucose attached.  For a visual: Think of a donut (a red blood cell). Even though this seems sad (when it comes to donut talk), ideally you want minimal sprinkles (glucose) on your donut (red blood cell). The more sprinkles, the more stress to your red blood cells.

Your mission for your diabetes journey is: minimal glucose stuck to your red blood cells. 

The 3 keys to help balance your sugar are: Tools, Skills, & Attitude.


Insulin—via injection or pumps, medication (if needed), glucose monitoring system (meters, cgm), supportive health care team (endocrinologist and other necessary specialists—mental health, dietitian, naturopathic, etc.). 


Self monitoring.  While you don’t want to be obsessive, being in tune with your sugar levels throughout the day is crucial. Minimal monitoring during the day is the same as missing 90% of a movie. You miss the big picture—the full context of what is going on with your bod.

Record Keeping. Are you experiencing trends in highs and lows that you may be unaware of? Maybe! You won’t know unless you keep record. If your goal is gain better control, logging your: foods, dosing amounts, physical activity, stress, etc. are all factors that directly affect your A1C. 

Questions you may be able to answer with sufficient logging:

Do lows tend to occur after highs? Maybe you are over-correcting.
Do highs tend to occur after lows? Maybe you are over-correcting.
Do glucose levels frequently drop overnight? Maybe your basal insulin needs adjustment.
Do certain foods constantly trigger high blood sugars? Maybe you need to avoid them. 

Carb Counting.  All carbs covert into blood glucose fairly quickly. Having a handle on conversions of carbs and correct dosing is important. The more accurate you are at carb counting, the better control you will have. 

Dietary discipline. 

Space. Spacing between meals is crucial to allow blood sugars to normalize. Constant snacking (especially on carby/sugary items), creates a constant “stream” of glucose into your bloodstream. Gary suggests spacing meals and snacks at least three hours apart. 

Fat. Large amounts of a fat slows digestion and blood sugars from rising as quickly. Keep this in mind to avoid sneaky falls and rises in blood sugars. I.e. That pizza you had for dinner. The (fat) cheese will slow the absorption of sugar (carby dough) which can cause a drop in blood sugars (if dosed timing is off) then a rise hours after the meal. 


You can have skills and the tools to manage your blood sugar levels but if your attitude is poor, your management will suffer. Problem solving, persistence, discipline, and acceptance are crucial traits in successful blood sugar management. Set goals & realistic expectations for yourself to help improve control. Changing too many behaviors at once can = burnout & let down. Write out your goals (seriously, do it today… or even better, right now) and take baby steps towards better control! Idea: Grab a piece of paper and start writing down the carb counts of your foods along with your blood sugar and insulin doses. 

Until next week...