When you live with type 1 diabetes, figuring out exactly what constitutes a good A1C can be tricky.
It used to be that any A1C under 8.5 for young children and 7.5 for adolescents was considered “good.” Now, largely due to the use of tools that help avoid extreme hypoglycemia, that number has changed to 7.5 for all diabetic children.
Most doctors agree that T1D adults have an even loftier goal to reach: An A1C below 7.
If that number seems like a joke to you, you’re not alone.
How A1C Goals Become Toxic
A recent study published by Diabetes Technology & Therapeutics found that only 17% of youth and 21% of adults are meeting these standard A1C goals. Despite all the advancements in diabetes management and blood sugar tracking, most T1Ds are still struggling to get their blood sugars where they need to be.
If your A1C is currently much higher than these goals, then meeting them can seem overwhelming, if not completely impossible. Even if your number is not that far off, but has been stuck where it is for years, reaching that goal still might seem like something you aren’t capable of.
That’s why it is so important to remember that your A1C goal should be exactly that: YOURS.
Sure, all diabetics should strive to reach the goals set by the medical community. But you don’t have to bite that number off in one way-too-hard to swallow mouthful. To avoid the toxic feelings that come with “impossible” goals, instead set goals that you feel are attainable.
That may mean dropping your A1C just a tenth of a percent. Or maybe one full number. Whatever you and your doctor choose, make sure it’s a goal you feel confident you can reach.
And when you do reach that number, you better celebrate! Reinforcing the idea that you CAN DO THIS is the most important factor in eventually getting yourself to an A1C below 7. Even if what you can do is drop half a percent every six months, you’ll still get there eventually.
You may even find that your momentum improves the closer you get to that final goal. Once you break through that overwhelmed, “I can’t do this” notion, then there’s little left standing in your way.
Beyond Positive Thinking
Mindfulness and a positive outlook, however, can only get you so far when it comes to blood sugars.
You also need a solid plan of attack.
And this often means making changes.
We all resist change, especially when it means giving up things we like or doing things we don’t like. But part of your mental preparation for reaching your A1C goal needs to be understanding that change is not only necessary but good. After all, if your current tactics and lifestyle were the right approach, then you would have already met your A1C goals.
Once you’ve embraced the need for change, it’s time to get started. Just like with your goal number, changes should be made in a way that feels doable for you. You are setting yourself up for failure if you expect to drop a two-hamburger-a-day habit overnight. And that only breeds more feelings of doubt and negativity.
Instead, start small. Shoot for one hamburger-free day a week. And when you make it through that day, congratulate yourself. Revel in your awesomeness. And when you’re ready, then up that goal to two hamburger-fee days a week.
Small Steps You Can Take Right Now
What changes will lead to you reaching your A1C goals will depend on your lifestyle and your willingness to try different approaches.
Here are some ideas worth considering:
- Get more active. This doesn’t mean you need to join a gym. Instead, you could start taking short walks around the building during your breaks at work. Or add a few extra blocks to your dog’s nightly walk. Don’t have a dog? See if your local shelter allows volunteers to walk adoptable dogs. You’ll be so distracted by puppy love you won’t even notice you’ve increased your activity.
- Track your sugars. When I was diagnosed, I wrote down every carb count and every blood sugar. Now you couldn’t pay me to keep a journal of all that information. But, if you have a CGM, you likely have access to a database of numbers. Make a point to sit down once a week and review your stats. If you can make even one adjustment to bring down a recurrent high each week, you’ll succeed in bringing down your A1C.
- Make changes to your diet. We all know diabetes isn’t just about sugary snacks. Eating nutrient-packed foods and healthy, low-glycemic alternatives will keep you healthy and your blood sugars stable. Start by switching out one meal a week for something better. Take a cooking class that focuses on healthy food prep. Or find a diabetic friend and switch off cooking healthy monthly dinners.
- Take a more active role in your diabetes. If you struggle to even do the basics of good diabetes management, then that’s the best place to start. Get a second meter and keep it in your desk or in your bedroom to make checking your blood sugar easier. Set your phone alarm to help you remember to meter or to pre-bolus for a meal. Or talk to your doctor about new management options like CGMs or phone apps that might better work with your lifestyle.
Don’t be afraid to get creative when motivating yourself to make the changes needed to bring down your A1C. And most importantly, don’t be discouraged by changes that seem too modest, whether they’re in your lifestyle or your numbers.
Your successes will be small at first, but it’ll grow as you realize that you can indeed do this. That you are, in fact, already doing it.