Gary’s Top-10 (no, make that 14) DIABETES TRUISMS

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After nearly 30 years of living with type-1 diabetes and 20 years teaching patients how to better manage it, a few things have become apparent.

  1. Technology is only as good as the user.   Ask anyone who uses an insulin pump or continuous glucose monitor and still has crappy blood sugar control.
  2. You can out-eat any prescribed therapy.   I learned this from an old endocrinologist colleague.   Didn’t really believe it when I heard it, but it is true.
  3. Not everyone needs the latest and greatest.  This is where the FDA and the grassroots “accuracy” folks are missing the boat.  Those who calculate their insulin doses or calibrate a CGM based on fingerstick readings need the best accuracy possible.  For everyone else, traditional, less accurate, and less expensive meters do the job just fine.
  4. Half of diabetes management is 90% attitude.  Pardon the “Yogiism”.  Whether you’re talking about exercise, medication adherence, healthy eating or just about anything else diabetes-related, where there’s a will, there’s a way.
  5. If you’re told you can’t have it, you will crave it night and day.  It’s just human nature.  That’s why I don’t believe in putting restrictions on food choices unless there’s a very good reason.
  6. The formulas hardly ever work.  We have textbook standards for setting up everything from basal rates to insulin-to-carb ratios to correction dosing formulas.  But take it from me.  Everyone’s needs are unique.   The “usual formulas” are fine for a starting point, but they will need to be fine-tuned.
  7. Two-hour post-meal glucose checks are almost useless.   I have no idea who came up with the idea of checking BG two hours after eating.  If you want to know how high you “peak” after a meal, check one hour after eating.  If you want to know if your mealtime insulin dose is correct, check 3-4 hours after eating.
  8. Rapid-acting insulin is a farce.  Insulin produced by the pancreas works in seconds, not hours.  Now that’s rapid.  The mealtime insulin we use now is only “rapider than regular”.  Until researchers figure out a way to make mealtime insulin work much faster, we’re going to struggle to close the loop.
  9. We don’t need “painless” ways to take insulin and check blood sugar.  When done properly, injections, infusion set insertions, and fingersticks should cause minimal discomfort.   Companies working on needle-free insulin infusers, inhalers and blood sampling devices should put their time and energy into projects that produce more meaningful products.
  10. PWDs are some of the coolest people on earth.  Anyone who can live a full, productive life while managing a complex, diabolical chronic illness 24/7 deserves some extra credit.
  11. Hypoglycemia is Native-American for “Eats Like Hungry Wolf.”  No food is safe when we’re low.  If it’s at least semi-edible and not nailed down, it will be devoured.  Chewing optional.
  12. People with diabetes hate to be asked, “How’s your blood sugar?”   It’s nobody’s damn business!  Our brains are trained to incorporate a hundred variables into our daily diabetes decisions.   The last thing we want is to be judged by someone who just walked in in the middle of the third act.
  13. Everyone needs to chill out over the term Diabetic.  It only defines you if you let it.  Frankly, I’m tired of having to explain what PWD stands for.
  14. Lancets are built to last.  A laser-sharpened stainless steel blade versus your skin?  No contest.  Save some time, cost and medical waste.  Wait for the next full moon (or leap year) to start a new lancet.

*** If you have any “diabetes truisms” you’d like to add, please post them on our Integrated Diabetes Services Facebook Page

By | 2016-12-08T23:26:59+00:00 May 14th, 2014|Thinking Like A Pancreas Blog|14 Comments

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14 Comments

  1. Terry Jackson May 14, 2014 at 2:16 pm - Reply

    Fabulous….and so true. I can particularly relate to that hypoglycemic ravenousness….it’s hard to describe how insane that is, right? You’ve taught me much, Gary – and I have much more to learn. But it’s so good to have your expertise and advocacy. You, and a lot of the technology, have normalized things for me in so many ways. I like PWD a lot! GREAT WORK, as always….

  2. Julie May 14, 2014 at 3:09 pm - Reply

    Excellent list Gary. I will be racking my brain for more.

  3. Ginny May 14, 2014 at 6:14 pm - Reply

    This is great stuff Gary. All so true.

  4. Sheri Colberg May 14, 2014 at 7:51 pm - Reply

    No matter how many times you have done the same thing the same way at the same time, etc., your blood glucose will not react exactly the same way 100% of the time. There are too many variables that can affect the outcome!

  5. alison May 15, 2014 at 12:51 am - Reply

    Gary I just had to tell you that this list is priceless. Especially number 11. LOL

  6. Miguel Arboleda May 15, 2014 at 3:39 am - Reply

    Learning to say “No!” to anything that threatens your health, especially nonsense that keeps you from exercising or eating the right way, and “Yes!” to what you need to do to keep yourself safe and going, should be the first thing you learn as a diabetic. It’s part of what helps you develop into someone in control of their situation and sense of autonomous self.

  7. Kate Matthews May 18, 2014 at 3:28 pm - Reply

    Fab Truisms ! A Great read indeed. Loved especially numbers 4,11,12 and 14 🙂

  8. Rich the Diabetic May 18, 2014 at 4:09 pm - Reply

    My God? Someone who thinks like I do? I didn’t think it possible. Great post!

  9. Rolf Andreas July 1, 2014 at 6:18 am - Reply

    Excellent list, Gary. I couldn’t agree more. As per #10: Yeah, we are bad-asses, and deserve tons of extra credit.

  10. Alex July 26, 2014 at 1:05 am - Reply

    Wow. Every single one is spot on! A very refreshing read!

  11. Kim Rushik July 26, 2014 at 9:48 pm - Reply

    Great post! Love your writing. thanks for all your advice. Found out about this blog from your emails. thanks

  12. Jack norris August 29, 2014 at 6:41 pm - Reply

    Right on, Gary. So true.

  13. Liz November 21, 2014 at 3:48 pm - Reply

    You probably know WAY more about your diabetes than any general doc out there. Take charge whenever you can!!

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