Hi and welcome from me too.
Really sorry to hear you are going through such a tough time but so pleased you have found the forum as it really is a goldmine of support and advice and knowledge and comradeship that you can tap into any time, so in many respects far better than the clinic because we are here every day if you need us and we understand the frustrations and idiosyncrasies that diabetes throws at us every day. I have learned far more from the good people here than I have from any nurse or consultant but most importantly, the people here understand the psychological impact of it all and just knowing that people here have been there and come out the other side really helps you to keep going.
It seems that perhaps you have fallen victim to your previous really excellent results and are not coping because you are unable to maintain that level at the moment, because other things in your life are taking more of your time and effort and understandably causing you stress. Most of us could not hope for an HbA1c of 4.8 which appears to be 29mmol/mol and would certainly not aim for it, so I think you are probably just putting far too much pressure on yourself. These days most of us go by Time in Range rather than HbA1c as it gives a better picture of how you are doing. A low HbA1c may mean that you are hypo far too much of the time, whereas your TIR will show how much time you spend hypo. I am absolutely not saying this is the case for you but I certainly hypo far too often even if I aim for mid 40s and I have really good management with TIR usually in the 90s and my consultant is delighted with that although I speak to him once in a blue moon on the phone. We are all different and our diabetes and bodies and insulin and the foods we eat and the exercise we take, all affects that. You have to work with where you are now, not how fantastic things were before and accept that you have other priorities in your life at the moment so really just keeping your head above water with your diabetes management is good enough for now. As
@Inka says, cut yourself some slack and lower your expectations. Once you have settled in and found your feet a bit in your new life, then you may want to devote a bit more time to improving your management again but you may have to accept that your previous amazing HbA1c results were a one off. Life is for living, not getting the absolutely best diabetes results you can.
I would guess that it is the lack of exercise which is probably bumping up your insulin needs at the moment.... and probably stress too. I am trying to push myself into getting back to daily exercise and even in just 4 days, my basal requirements have come down 7.5 units and bolus also reduced, so exercise can have a huge impact on how much insulin you need and if you were exercising regularly before and are not now, which is entirely understandable in your current situation, then it is totally expected that your doses and ratios will go up. The thing is that you can get them down again when you have the time and energy to start exercising again. In the meantime, you need what you need and you are clearly very capable of adjusting your doses and ratios to balance things, so in reality, you are doing great because you are adjusting things to manage your current situation. You just need to cut yourself some slack and accept that this is all part of the diabetes journey. Nothing is forever. You get good patches of management and rough patches. Enjoy the smooth waters where you can and learn to doggy paddle the rough bits until yoiu get into smooth waters again. If there is one thing I have learned about diabetes (and mental health for that matter) it is that if you hang in there and do whatever you need to do to keep your head above water, it will all come right again sooner or later.
Really hoping that there is some smoother water for you just round the corner.
