I really love questions like this.
My blood glucose levels have been rising, likely due in part to that weekly muffin or cookie and so many of my favorite fruits and berries being in season right now, so I've been thinking hard about this recently...
I test my blood glucose and begin preparing breakfast as soon as I get out of bed because if I delay, my body thinks my blood glucose is too low and my liver will release glucose, commonly referred to as a "liver dump". By the time I've taken my vitamins and finished preparing breakfast, a half-hour has passed, and I'll do my pre-meal check. Sometimes my blood glucose level is the same, other times it's gone up by 10 mg/dL (0.55 mmol/L). I have my tea with breakfast, not before.
Buy the cheapest test strips available and the glucose monitor for them. As someone else here said, "test, test, test." I test in pairs: pre-bed and upon awakening; pre-meal and post meal. Also pre- and post-exercise.
Something I've repeated doing a few times over the last month, typically when home on the weekend, is to test pre-meal, then post meal at 30, 45, 60, 75, 90, 105, and 120 minutes to get an idea of when blood glucose peaks, usually 60, sometimes 75 minutes post meal.
If I suspect a meal will spike my blood glucose, I'll test pre-meal, then 1 hour and 1.5 hours post meal. If high, I'll walk a high glucose level off. The higher the blood glucose, the more I can drop it: by 40 mg/dL (2.2 mmol/L) walking 1 mile, up 80 mg/dL (4.5 mmol/L) walking 2+ miles.
Walking 1 hour post meal may be too soon because I'm probably still digesting the food. Don't know. I'm now alternating between walking either 1 hour or 1.5 hours post meal to try to sort this out.
Periodically, I'll graph two months of glucose readings and calculate weekly averages. By doing this, I'm able to see how my blood glucose levels are trending over time, for better or worse. I find doing this more helpful than the A1c.
Nothing motivates me more than a high glucose level. I prefer to limit the length of time I sustain a high reading. If I have a high reading pre-bed, I might walk a quick 15-20 minute mile to knock it back down. Some nights, if I'm really too exhausted to walk, I'll opt instead to use the green olive strategy. I'll eat 10 small green olives, pimentos removed, in the hope that I'll produce some extra insulin to drop my blood glucose level while sleeping.
Walking pace. If on a long walk, I alternate between walking faster and slower. If I'm tired, I walk slower. If I'm suffering the effects of a cortisol surge, I'll walk faster, then slow my pace for the last half or so of the walk. If I'm feeling really good, and feel like a brisk walk, I'll do that too. It took a long time to get a feel for how to pace my walks. Checking my blood glucose levels before and after each walk provided helpful feedback. The goal is to reduce or maintain, not increase, my blood glucose level.
I include healthy fats with all meals to minimize cravings. Having black tea with breakfast, and green tea immediately following lunch helps reduce cravings for something sweet, as does a glass of red wine with dinner. If I'm working and hit a slump mid-afternoon, I'll have a handful of raw nuts and green tea for a snack, otherwise I may instead head to the vending machine to buy Reeses Peanut Butter cups, not good. I also use "sour" to combat cravings. If it's hot and I need something refreshing, I'll ream the juice from a lemon into a tall glass, spoon out the seeds, add 7 parts water (to the 1 part lemon juice), 3 drops of Stevita liquid extract, and ice. An alternative is to eat 1 or 2 slices of my favorite sweet pickle straight from the jar in the fridge.
If I experience low energy for more than a day, I'll drink a cup of hot water with a quarter teaspoon of salt for a day or two, and try to remember to add salt to some of my meals.
Sleep. If I don't sleep 7 to 9 hours, it wrecks my blood glucose levels the next day. I fall asleep easily but it's rare that I'm able to sleep through the night without laying awake part of the night. After an hour or so, if I haven't drifted back to sleep, I'll turn on the lamp with incandescent lighting and read until I feel like I can sleep again. It's not perfect solution in that my brain isn't resting, but at least my body is. Currently, I'm trying to go to bed earlier to see if that helps.
I eat a low carbohydrate ketogenic diet. I continue to be hesitant about fasting, but found that a daily 12 hour fast is easily done. I stop eating 3 to 4 hours before bed. This provides my body the support it needs to repair and rebuild as needed.
As much as possible, I eat only the healthiest foods, unprocessed, whole foods, organic, non-GMO. I eat animal protein - cheese, heavy cream, butter, poultry, eggs, fish, and seafood that eat as close as possible to their traditional diet. I'm very selective when eating out, which is perhaps once a week. I include lots of healthy vegetables and fats, such as extra virgin olive oil, coconut oil, olives, and avocado, with a variety of animal proteins at every meal. I've eliminated or greatly limit sugary and starchy foods: sugar, fruit, grains, legumes, root vegetables, and highly processed, seed oils that are high in omega-6 fatty acids - (corn, soybean, saffola, canola, peanut, cottonseed, and sunflower).
I take nutritional supplements: a whole food multi vitamin and mineral supplement, vitamin A (from cod liver oil), a whole food B-complex and vitamin C with digestive enzymes, vitamin D3, vitamin K2 (MK-7), magnesium citrate, alpha lipoic acid, fish oil, and CoQ10. In the past I've taken a probiotic and curcumin formulation.
I don't take any medications but am open to doing so in the future if needed.
I have lab work done periodically to insure my health markers are maintaining or heading in the right direction. One thing I haven't had checked yet is my insulin levels. This is something I want to start doing because insulin levels, not just glucose levels, provide helpful information about what's happening with our body.
And perhaps most important, I regularly participate on online diabetes forums and attend a local diabetes group. I also read daily about diabetes and how to manage it.
I wish I could say I have good blood glucose readings consistently. I don't. But I do more than I don't, and I'm reasonably pleased with where I am now. Still, I keep trying to do better.
Oh, and I should add here that I'm doing an excellent job of maintaining my weight, though I'd like to lose 25 to 45 more pounds. Perhaps next spring I'll give it a try again. Losing weight then maintaining for a year or more feels right for me, but we're all so individual.
I'm enjoying reading everyone's posts.
Edit...
After I went to bed last night, I remembered one more tip or strategy that I want to share...
How to test a lot without developing tender finger tips and calluses. I, like many of you, test only the
sides of my finger tips.
But I take additional steps.
Each hand provides 10 opportunities to test. Because I sometimes only test 4 times a day - (other times 10+ times if I have high glucose readings or am trying to figure something out) - I always start the day with testing my pinky finger first. That way, if I only test 4 times, I'm only using the fingers I use the least for picking up, holding things, etc.
Additionally, I have a bright, apple green card in my test kit with the word "right" on one side and "left" on the other side. Each morning, I flip that card so I know which hand I'm testing for the day (because I often forget which hand I was testing the previous day). This way, each hand has a full 24+ hours to heal.