Dia­bet­ics need every incen­tive we can get.  The more dif­fi­cult or pro­longed a par­tic­u­lar goal may be, the more effec­tive a reward sys­tem will be.  For exam­ple, the com­mon a1c test for dia­bet­ics can and should be used to improve and reward blood sugar control.

Most doc­tors rec­om­mend a1c tests for their dia­betic patients every three months or so. This test rep­re­sents the aver­age blood glu­cose lev­els over the past two to three month period. It does so by mea­sur­ing the amount of gly­cated hemo­glo­bin, or glu­cose attached to cells in the blood. Higher amounts of gly­cated hemo­glo­bin indi­cate higher blood sugar lev­els, while lesser amounts indi­cate lower blood sugar lev­els on average.

The test is not fool­proof nor nec­es­sar­ily accu­rate. If there have been ele­vated highs and low drops in blood sugar lev­els that we would call uncon­trolled, it could pos­si­bly give the same a1c result as good con­trolled lev­els. Nev­er­the­less the a1c is a reli­able test. After all, you are the patient. You should know whether you have been con­trol­ling your blood sug­ars or not.

All things being equal, if the test results are higher than they should be, the doc­tor will likely urge you to lower your blood glu­cose lev­els. If the test results are good, the doc­tor will con­grat­u­late you and urge you to keep up the good work.

In either case, good or poor, the test results should be used to improve and/or reward blood sugar control.

Let’s start with the good results and the rewards. I am a firm believer in the reward sys­tem for good dia­betes con­trol. In the realm of weight con­trol, for exam­ple, if a per­son needs to lose fifty pounds, they could estab­lish a reward for every ten pounds they lose on the way there. A night at the movies might be a suit­able reward. Then a larger reward when they reach the fifty pound tar­get, maybe a week­end at the beach.

That’s the idea with reward­ing a good a1c test result. Since a good result requires three months of dili­gent blood sugar con­trol, the reward should be suited to the effort. It should be more than a night out at the movies, but a week­end vaca­tion might well fit the bill. If you have kept your blood sug­ars con­trolled and your a1c is, say, below 6%, that is terrific.

You should be rewarded. Not only is the week­end vaca­tion a reward for what you have done over the past months, but it spurs you to do well over the fol­low­ing months as well. So it serves not only as a reward but as a moti­va­tion for future performance.

Now let’s apply the sys­tem to a poor or unsat­is­fac­tory a1c result. First, if the lat­est read­ing is bet­ter than the pre­vi­ous result, there should still be some reward for improve­ment, though not a vaca­tion. You don’t want to award the full Monty for a lower level of achieve­ment. Maybe a steak din­ner at a nice restau­rant would do. In any case, the week­end vaca­tion reward for a good result should serve as a moti­va­tion to improve when the test result is poor.

One last thing: where does one get the money four times a year to take a week­end vaca­tion? Why, save it up over the three months. Putting a lit­tle money in the bank each month for a good a1c reward can only serve as a fur­ther moti­va­tion to achieve it!

The Dia­betes Book That Could Save Your Life!