Diabetes and an Irregular Schedule: What’s a Girl to Do?

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Diabetes is a disease that thrives on routine: the more consistent your schedule is, the easier it will be to manage your blood sugar. Okay, so “thrives” is a strong verb to use here, but you know what I mean — if you eat, exercise and go to bed at the same time each day (and, even better, eat roughly the same thing for each meal) you will have a much better time managing your blood sugar than if you don’t have a regular routine. 

As a freelancer who works on her own schedule, this has always been an issue for me. I don’t have an office to go to, so I don’t have a regular walk to and from work. I exercise at different times each day. As for meals, while I eat roughly the same thing for breakfast and lunch each day, the conditions vary: sometimes I will have exercised beforehand, so I’m more sensitive to insulin, but sometimes I will have been sitting in front of my computer all morning, which means I’ll have some insulin resistance. Usually I love the flexibility that comes with being my own boss — it’s nice not to have to stick to someone else’s schedule. But there are times when I think that having a more traditional career and regular schedule might actually benefit my diabetes care. 

I’ve been thinking of this a lot recently because of something seemingly unconnected to my pancreas: our house’s thermostat. Peter recently bought a Nest, which is this really cool Apple-esque device that bills itself as a “learning thermostat.” Basically, you spend a couple weeks adjusting the Nest manually and the Nest keeps track of what you’re doing. “Ah,” it thinks to itself (in its clever, digital way), “These people have turned on the air conditioning from 7-8:30 in the morning. They seem to like it cool while they eat their breakfast.” Likewise, it will note similar patterns when you get home from work, or before you go to bed. After a couple weeks it starts to anticipate your schedule, and turns itself on and off without your having to do anything. It’s very clever, this little thing. There’s even a motion sensor that helps it tell when you are not at home, so that it can go into “Away” mode and turn off the air/heat. 

I love the idea and the look of the Nest, but I realized as we were setting it up that the fact that my schedule is so irregular means that — much like my blood glucose — the “learning” feature of the thermostat is never going to work as well for me than it would if Peter and I both had predictable, regular jobs. That’s annoying. 

But at least the Nest is trying. And that got me thinking something else: wouldn’t it be nice if there were some sort of diabetes device that actually tried to learn something about your routine and schedule and then adjusted itself to you? I mean this both as a total fantasy (which I think is funny — the idea of your body anticipating your insulin needs would indeed be nice, but it would also mean you didn’t have diabetes)  and as a design idea: surely there is some way to use sensors to help diabetes devices (or, even better, drugs) “learn” more about your schedule and activities, and adjust itself accordingly.

I know this is the goal of the JDRF’s Artificial Pancreas Project, and more power to it, but I have a feeling there are other areas in which this idea could be applied as well. One way to do it would be to mimic the Nest, and have the device pick up on the regular aspects of your schedule. But another way would be to add more flexibility — to use the aforementioned sensors to adjust things on the go, so that you don’t need to be bound to a tight schedule in order to see the benefits. 

So there are my whimsical thoughts for the day. Oh, and also? The Nest was designed by some guys who used to work at Apple — which means it looks sleek, is user-friendly, and actually makes me *excited* to adjust my thermostat. Would that some of those people turned their attention to diabetes. 

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Laura G.
Laura G.

Ah, how I love to hear from other people with variable schedules/bodies/lives!  But now that we have pumps and sensors, pretty fantasy-esque in their own right:  can’t patients be taught how to adjust insulin constantly based on their own sensor readings and experience (like the AP does!) instead of teaching them that they can fit into preset I/C ratios, basal patterns and sensitivity factors if they can just identify what they are? I’ve gotten decent at this skill over time, but I feel so deviant at the doctor’s office since to them it looks like I’m “just guessing” how much… Read more »

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