After being diagnosed with diabetes when I was 21 years old, I was immediately thrown into a world where I had to track a variety of numbers. That was in 1977, when continuous glucose monitors and test strips weren’t plentiful, and we didn’t have the benefit of the internet for connecting with other diabetic people. Now that I’m 67 and technology has advanced, I’ve found new ways to monitor my A1c levels.

One of the first things doctors tell you about diabetes is to keep your blood sugar and your A1c levels under control. Whereas blood sugar measurements can tell us where our numbers stand at any particular moment in time, the A1c levels demonstrate an average glucose standing over several months. This shows doctors how well we’re controlling diabetes in general. My doctors have typically advised me to keep my A1c below 7 percent.

When I was younger, I tried to change my diet to control my A1c levels. My doctor advised me to stop drinking completely and to go on a 1,200 calorie diet to get better control, but I was miserable. Halfway through the day, I’d realize I had already hit 1,200 calories and still felt hungry all the time.

I knew that diet and exercise were key to controlling A1c, so I then tried a ketogenic diet under my doctor’s supervision, which meant that I cut most carbohydrates out of my diet. I was able to eat more than I could on the 1,200 calorie diet, but it was all protein and fats.

It was helpful, but when you only have diet and exercise to control your A1c, it takes a tremendous amount of focus and effort to keep those levels low. ​​I also admit that I really missed basic foods in my diet, like pizza — which I could not eat while I was on the ketogenic diet. If I fell down even once with my diet or exercise routine, my numbers shot back up again.

As I got older, it became harder and harder to manage my A1c. Just the normal process of aging brings along with it the challenge of developing other conditions. These aren’t always related to diabetes, but just due to getting older. The older I got, the more health problems entered the picture, and the harder it has been to keep the focus on managing diabetes.

Eventually, my doctors and I both accepted that diet and exercise alone weren’t going to help me keep my A1c where we needed it to be. I went on insulin, with the particular goal of stabilizing my blood sugar so I could start a family — I later gave birth to two beautiful daughters. Being on insulin allowed me to control my A1c, which I’ve been able to keep around 5.9 percent on a pretty steady basis.

The advancements in technology since my initial diagnosis in 1977 have also helped me keep my diabetes under control. I now have a continuous glucose monitor that delivers results right to my phone and my Apple Watch. I can look at my watch any time of day and see how my glucose numbers are looking.

Between taking the right medication and using the technology available to me, I’ve been able to keep my A1c consistently under control. I still do try to eat right and exercise as much as possible, and I never drink alcohol, but knowing I have ways to keep my blood sugar under control has been a great relief for me after living with diabetes for 45 years.