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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

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