Diabetes Is Never Easy, But It Is Simple

When I was first diagnosed with type one diabetes, at the age of 11, I spent ten days in the hospital. On the day I was sent home I made a point of seeking out a nurse, named Cathy. She was kind and upbeat and beautiful with long black hair. She helped me learn how to do injections, how to cope with low blood sugar, and how to count carbs. But more than that, her positive attitude made the terrifying prospect of living the rest of my life with diabetes a lot less terrifying. I looked down halls and went into rooms looking for her because I wanted to thank her for instilling in me a positive attitude before being sent into the world as a freshly minted diabetic.

I finally found her busy with another patient. But she made a moment and stopped to hear my shy thank you. Then she squatted down to eye level and said to me, “Remember: Take your medication, watch your diet, and test your blood sugar religiously.” Then she kissed my cheek and rushed off. I never forgot what she said because for me she made diabetes simple. Not easy, but simple.

As Nuke Laloosh said about baseball in the movie Bull Durham: “A good friend of mine used to say, ‘This is a very simple game. You throw the ball, you catch the ball, you hit the ball. Sometimes you win, sometimes you lose, sometimes it rains.’”

Often diabetes seems like the most complicated and confounding condition in the world. You can have high blood sugar all day on Tuesday by doing everything exactly as you did on Monday when your blood sugars tested perfectly. You have to do math like Pythagoras just to figure out how much insulin to cut or food to increase or Gatorade to carry to try and make sure you don’t lapse into a coma after your daily five mile run.

And the technology associated with managing diabetes can be called many things—amazing, impressive, advanced—but simple is not one of them. Off the charts not simple is more apt. This is a description by Michael Aviad of a fascinating product that might become available this year: “For anyone not familiar with the CGM-enabled Vibe, it’s an insulin pump that combines state-of-the-art Dexcom G4 sensing technology with all the features of the Animas pump. The Vibe is durable and waterproof and has a color screen which, like the Dexcom G4, shows where your glucose is headed and how fast using color trend arrows and lines. The color-coded trend lines (blue, red, or green) indicate that glucose levels are low, high, or within the target range relative to the low and high alerts set in the pump. You can also customize alerts to tell you when you’re going high or low. The Vibe has a non-adjustable hypo safety alert set at 55 mg/dl.”

Okay.

In this increasingly and maddeningly complex world, I never fail to be reassured and helped by remembering Cathy’s words. If I don’t feel right, if something is off or just wrong, I first look at my diet, I test my blood sugar, or I look at my medication. Ninety nine times out of one hundred, the reason my diabetes is out of control can be found by looking at those first.