How to Be Bad at Diabetes: A Confession

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From the outside, it’s easy to assume that diabetes is a numbers thing. Eat this much food, give this much insulin, exercise this many minutes, aim for this A1C. But those of us who live with it (and have internalized all the “old” ways of thinking about diabetes) know that that there’s a wide range of emotions tied to the things we do to manage diabetes – and to the outcomes.

Even if we don’t admit it – or phrase it in the unhealthy black-and-white terms – we’re all trying to be “good” people with diabetes. Some might even say (gasp!) “compliant.” And though I’m decades past my years of teenage diabetes rebellion, it can still get hard to try my best every. single. day. Every once in a while, you have to be bad, just for the teeny tiny thrill (or convenience) of it.

 

Here are a few of my favorite ways:

 

Rip off all of my devices. Just for a few minutes. If I’m in a responsible mood, I’ll leave my old infusion set on for a few hours after I put a new one in, just to eliminate any lapse in insulin delivery. But if all my contraptions are due to be changed out at the same time, I’ll take them all off while I shower or get ready for bed, and dance around the house without worrying about catching a tube on anything.

Go way too long without calibrating my CGM. It’s not the lack of calibration that’s so thrilling. No, it’s when I finally decide to check my blood glucose with an actual meter and discover that the number on my CGM is within 5 points of the one on my monitor. Yay technology!

Count carbohydrates extra precisely, and then eating a few more bites of whatever I just counted. You know, just to see what happens. So far I haven’t passed out or gotten violently ill, but don’t say I didn’t warn you.

Refrain from uploading numbers from my meter and CGM before an endo appointment. Inevitably, the technology messes up at the last minute and I get way more stressed out than is necessary. Plus, it’s more of a surprise when my diabetes educator uploads everything herself and prints out the results in her office.

Go absolutely nuts on Skittles and cereal when I’m low. You could say that this isn’t really a decision – in fact, I’m happier blaming a Lucky Charms binge on the animal instincts that start to show themselves any time my blood glucose dips below 60. Cereal does way to much damage on any other occasion, so it tastes extra delicious when I’m eating it for a reason.

Keep the same infusion set on for more than three days. You know you’re a serious rebel when you come up with environmental issues to excuse your treatment-related laziness. “Yes, I’ve been wearing this infusion set for 5.25 days, and I can totally tell the insulin absorption is suffering, but I’ve managed to keep this tubing out of a landfill for at least 48 extra hours. Someone get Greenpeace on the phone.”

Not correcting for a kind-of-high blood glucose level. I applaud those people with diabetes who will diligently beat down a 144 mg/dl in the middle of the afternoon, but that’s not always me. If I have to work, or drive, or be in charge of a preschooler, or sleep, I’ll let a higher-than-normal blood glucose slide. Partly because it makes me feel safer from hypoglycemia, and partly because I don’t feel like pushing all those buttons.

Wear inappropriate footwear. I know plenty of folks who think that people with diabetes should not wear flip flops or sandals, but most of those people do not live in Florida, where I do. I know the risk of, say, tripping over a fossilized megalodon tooth and getting an incurable infection in my right big toe, but I still wear flip flops.

Try and wait out a low when I’m sleeping. It’s 5:43 AM, and my CGM mercifully beeps me out of a dream where I’m on The Apprentice but have forgotten to complete my assignment and will shortly be humiliated before an audience of millions. I’m low, but I’m also still tired and cozy and not in the mood to walk 40 feet for a juice box or several bowls of Lucky Charms. Instead, I’ll suspend my pump and try to enjoy my last 77 minutes of sleep while my CGM continues to alarm, and wake up in a horrible mood anyway. Sleep is the enemy of successful diabetes control.

Not check for ketones. I know, I know. But when my blood glucose is high enough to check for ketones, I’m usually already doing the things I would do if I checked for ketones and had a positive result. Drinking tons of water? Check. Monitoring my blood glucose? Check? Not exercising? Not a problem at all. Also, ketone strips seem to expire like crazy, and I’d hate to add anything else to a landfill.

Of course there’s more, but I can only admit to so many diabetes sins before I guilt myself into eating a pint of ice cream and under-bolusing for it. I just remind myself that living with diabetes is a balance, and without the “bad,” I might not be able to value all the good, honest work I put into it – every. single. day.

 

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Rose

This article is very misleading and incredibly condescending. Some of us really struggle with “bad” days and you write something about taking a few extra bites more than you bolused for? Seriously?

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