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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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