“Half a teaspoon,” she might tell you.
Then again, it might be something like: “I set a 150% temporary rate for two hours.”
Either one works, right? As the hashtag goes, #itmakessenseifyouhavediabetes.
Diabetes has a language all its own, and that language has a way of working itself into so many aspects of our lives. Generally, it’s a helpful integration – but at its worst, it can make you feel like diabetes is eating your brain.
The basal/basil thing is more common than I would have ever expected, even if it’s just the spelling. I can’t write a grocery list without checking that one twice, there are times when I honestly can’t remember which one comes with an “i” and which one has the “a.”
When technology’s involved, the word “carb” is almost always replaced with “crab” by autocorrect or spellcheck. “Bolus” turns to “blouse.” “Prick” and “stab” and “lance” stay the same, although their meanings vary in intensity. That’s something the grammar and usage robots haven’t gotten to yet.
Then there are all the acronyms to keep straight. A1Cs and ACE inhibitors; CHOs and CDEs. Mmol/L and MG/dL. IDDM, T1D and LADA. Even if they’re not your terms, they have a way of getting stuck the mind – especially if you have a habit of keeping in touch with your fellow diabetics.
I once heard the mother of a child with diabetes express her disgust with the word “bolus.” As it turns out, a bolus is “a small rounded mass of a substance, especially of chewed food at the moment of swallowing.” A mouthful of chewed-up pizza at the back of your throat, basically. And while the visual isn’t appealing, the double-meaning serves as a nice mnemonic device when you’re trying to keep “basal” and “bolus” straight in your mind. Boluses of chewed-up pizza get boluses of insulin, see?
For me, the most dramatic period of diabetes doublespeak came shortly after my daughter was born. I was (and still am) a member of several different Facebook and online groups: some for people with diabetes, some for mothers with diabetes, and some for (non-diabetic) mothers of very young children. In each of these groups, the terms “pump” and “pumping” were thrown around often, with dramatically different meanings.
Some new mother would ask a desperate and panicked question about pumping at work, and before I could respond with a reassuring word about back-up syringes and batteries at the office, I realized she wasn’t talking about insulin.
But it’s the same with other simple words, too. An acquaintance mentions feeling high, and instead of thinking “drug user,” your mind goes to “DKA danger!” Someone who’s feeling low isn’t depressed, they just need a handful of glucose tabs. “Shots” aren’t for fun; they’re medically necessary. When I hear people talk about infusions of olive oil, tea or vodka, I automatically picture pump tubing and needles and adhesive and wonder how they affect the flavor.
On the flip side, it’s possible to have a full conversation in front of a person without diabetes – without them knowing what you’re talking about. “I can’t wait for the closed loop. I’m all over the place with units and ratios. And these pricks are killing me.” “I know! I just wish my CGM showed by IOB and estimated my A1C. For F’s sake.” It’s a secret diabetes code! I’ve heard fellow diners in restaurants discussing preprandial glucose levels, and my ears perk up. I have to stop myself from crashing the conversation: “We don’t know each other, but we speak the same language! Hi!”
Clearly, diabetes has invaded the language center of my brain, and it’s just another aspect of the condition I’m living with. I’m choosing to see these terminology mix-ups less as a sign of my own flightiness, and more as a symbol of my dedication to diabetes care. Our daily routines, our words and our health can’t be kept separate from each other – or from the outside world. There’s probably a fancy psychological or linguistic term for this collision of word worlds, but I’m afraid to find out what it is; I’m not sure I have the mental capacity.
I’ll just continue to let these little word slips entertain me. As long as I don’t end up with breast milk or macerated pizza in my insulin pump, I think I’m safe.