Monday, 28 March 2011

Variety is the spice of life? Not if you're diabetic...

I've had a week of absolutely shocking BGs. I had a bit of a cold, but no worse than others I've had, and colds don't normally affect me too much. This time, however, I was seeing the high teens at least once a day, even with constant testing and correcting and temp basals. I was starting to get really worried and considering getting in touch with my DSN, or possibly my liver doctor (since the last time my numbers went nuts like this it was a sign that my liver was under attack), when I woke up on Friday with a BG in range, and they stayed like that all day, without need for temp basals or anything.

It got me thinking. I've said before that one of the things that I find most frustrating about living with diabetes is the apparent randomness that creeps in and affects your numbers.

There are so many variables to consider when we see a BG that is higher or lower than we'd expect. Is it a one off, or is it a run of them? If it's a one-off, you start trying to work out why - did you mess up the carb count of a meal? Did you forget to bolus? Have you been doing exercise/sitting doing nothing? Has something happened to stress you out? Is it a bad set? Have you somehow managed to kill you insulin? Is there a bubble in the tubing? What about insulin absorption or the kind of food you had? If it's a series of highs/lows, then a whole other set of considerations come into play - are you getting sick? Is it hormones? Is it a change in the weather? Have you changed weight? What about activity levels? Is there a pattern or is it just random? Basal or bolus? And a myriad of other possibilities.

Then, if you spot a pattern emerging, you have to deal with it. Sometimes it's straightforward - you're rising every day after lunch, you know your basal is right at that time, so you increase your insulin at lunch and that sorts it out. But then there's the other tricky little buggers. The ones where you've notice that it happens when you eat pizza, or do a particular type of exercise, or have a stressful time at work or some such.

So you have to try and sort it out, and the way to do that (like in so much of diabetes) is through trial and error. You can talk to other diabetics to see what they do, you can try altering an insulin dose or use a temp basal, alter carbs, or the timing of bolus. There are so many options, and even within those there are yet more variables - you decide to try a temp basal but how much? and for how long? You try things, test to see how they're working, and then you tweak, or you try something else. It's the only way to really do it, but the cost of making a mistake can be so huge - you end up low or high, and maybe it's only a little bit and quickly sorted out, but then there's the time it goes really wring, and you end up with a low that just won't come up, or you end of with ketones, or something else goes wring and you end up sitting there feeling like crap and wondering why you even bother.

Someone once told me that trying to manage diabetes is like trying to do a jigsaw puzzle when the pieces keep changing, and it just struck me as so true. What fits one day might not necessarily fit another, and we have to do this every single day. Things that other people take for granted we have to think so much about. Going for a wander around town, going to the cinema, having a drink with friends, having a busy day at work, eating, exercising, and a million other things. We do this every day, trying to cover for a part of our body that's gone on strike, that should do this automatically, responding to changes in our body and tiny little signals and information in increments that we can't possibly hope to achieve.

And yet we do it. We soldier on, we do our best, and we go on with our lives and refuse to let this condition defeat us, and (most of the time ;)) we do it without complaining or asking for any kind of recognition, or turning into babbling wrecks rocking in a corner.

And you know what? I think that makes us pretty damn amazing.


  1. I love the jigsaw analogy - it's so true!

  2. I wish I could remember where I heard it - it struck such a chord with me!