Managing

Managing diabetes is what I do. It requires commitment, discipline and perseverance. The commitment is not really a choice if you have type 1. You are committed to it because it is committed to you. If you don’t commit to it, its commitment to you will kill you. I have diabetes whether I deal with it or not. The negative consequences of not dealing with it far outweigh the constant impositions of dealing with it. Dealing with it is the lesser of two evils, although dealing with it definitely has an up side. By dealing with diabetes in a way that best maintains a semblance of good blood glucose control, you are committed to eating right and getting exercise. Two very important aspects of a healthier life.

Through my journey I have had very long stretches with no exercise and because I do walk a lot everyday, pay pretty close attention to what I eat and monitor my blood sugar, almost obsessively; my average A1c is about 3.5. If I can do this over 30 years, so can you.

I did not ask for this. I would not have chosen this. If I was given a choice of which disease I would want for the rest of my life and I could construe dandruff as a disease, that is what I would chose. My gift, however, is type 1 diabetes. Since it has committed to me, I guess I am committed to it! Here is what that commitment means: Blood tests. There’s a movie called, “There Will Be Blood”, my movie is “There Will Be Blood Tests”. I have learned not to trust my own senses. Sometimes I have no idea that my blood sugar is 40. As a result, in order to stay upright, I test my blood between 8 and 12 times a day. For the last year I have committed to a Continuous Glucose Monitor(CGM) which has helped me to identify my daily patterns and greatly improve my diabetes control but I still do many blood tests each day. Why? My CGM is very good at identifying patterns but it operates on a delay and is not a true reading of what my blood sugar is right now. No one mentions that very important bit of information when they persuade you to start using(buying) it.It is very helpful and I have become somewhat addicted to it but I do resent the way the manufacturers obfuscate the negatives of this useful device… but it does help.

My discipline in dealing with diabetes never quite seems like it is good enough. Then I remember that most people do not have to “operate” their pancreas! I do. I am required, because of my condition, to have the skill to micro-manage my blood sugar without it interfering with the productivity of my day! If you don’t have diabetes, try doing 10 blood tests, eating 6 meals calculating how many carbohydrates are in each meal, giving yourself a precise insulin dose and exercising for just a couple of days and let me know how you do. You may do very well for a few days but when it will not stop, it becomes a whole different challenge. The discipline required is also unyielding.

Perseverence is probably the most important part of dealing with diabetes. If you do not persevere, the diabetes does. I persevere. I do what I have to do, minute to minute, day to day, week to week, month to month, year to year and 30 years later I still must maintain attention to health concerns that most people do not even think of. Excuse me, but right now my blood sugar is 49. I stopped writing to do a test because my CGM buzzed. I had 4 glucose tablets and shut off my pump… hang on, my blood sugar now, fifteen minutes after the glucose tablets is 71. My pump is still suspended. I’m going to go get some food…