I’ve got an interview up today with Dan Hurley, author of the new book, Diabetes Rising — and wanted to write a quick blog post to mention one of my favorite parts of the book: Hurley’s ear for analogies for life with diabetes that are so spot-on that I made my husband listen as I read them out loud.
Consider this simile, courtesy of a systems engineer working on the software to control a closed-loop insulin pump, about why controlling blood sugar is so difficult — especially since, as Hurley points out, it involves only two variables: insulin and sugar level.
“The glucose you measure with a continuous glucose monitor was accurate fifteen minutes ago,” explains the engineer. “The insulin you take does not start acting for twenty minutes, ahs a peak of action around forty-five minutes, and it continues to act for up to three hours. So you are acting on out-of-date data, and you’re using a mode of action that will only kick in much later on. It’s like you’re driving a car down a winding road — but you aren’t able to see that the road turned until you are fifteen yards past it, and turning the wheel will have no effect for two hundred yards more. If you’re driving a car like that, you’d better have a good map.”
So true. Thanks again, Dan, for speaking with us about the book.
That’s a great analogy but one part of it doesn’t hold up and that is the final comment about you better have a good map. For roads there are indeed good maps available. For blood sugar levels and insulin behavior there are no maps, only patterns. And those patterns are only semi-predictable at best. So you’ve got to figure out a way to create a map from those patterns and then use it to figure out the correct action to take, with the risk that an incorrect action could lead to coma or DKA in some of the worst scenarios.
Going slightly off original topic here but to me it just points out how amazing the human body is. When everything is working as it should, the human body is able to keep all this in balance quite well. But one little microscopic set of cells lose their ability to do their job and the greatest medical minds in the world today can’t come anywhere close to replicating the functionality of those tiny little cells.
I really enjoyed his interview on NPR. I really related when he said something like, living with diabetes is so exhausting. It’s like living with a crying baby that just won’t stop crying.
The baby can’t tell you why it’s crying or what it will take to make it stop crying. So, you keep trying different things hoping for a happy outcome and the baby just keeps crying. Whew. . I get it and happily, so did some of the people I shared this with. He was very good about putting familiar feelings and frustrations into words.