In a non-diabetic body, the pancreas sends out just the right amount of insulin to keep your blood sugar in a safe, normal range throughout the day.
In a diabetic body, you have to do this by guessing and calculating all day long the carbohydrates you eat, impact of any activity and medicine you take.
Every day it’s: How many grams of carbohydrate were in those 10 pretzels? Is my blood sugar still going up? Is my bike ride from yesterday still lowering it? Will half a unit of insulin cover that mini Reese’s peanut butter cup? S#&T! I should have remembered my insulin hasn’t peaked yet, why did I take another two units of insulin? Now I’m dropping and have to eat again!
Don’t even ask me about the angst I experienced last night over eating two-thirds of a sweet potato. Doing so at 10 p.m. I worried if I’d taken enough insulin so as not to wake up at 300 mg/dl (16.6 mmol/l) the next morning, yet not so much that I wouldn’t wake up at all.
Of course sleep, stress, sickness, meds and multiple other factors, including biomedical reactions rarely talked about, also impact blood sugar’s rise and fall.
This idea that diabetes can be “controlled” contributes to the general public’s ignorance. Too many people think, “Well, can’t you just avoid sweets?” It’s not their fault, they keep hearing we can “control” diabetes. This myth of control also keeps those of us who have diabetes frustrate because I’m sorry, but no we can’t “control” it.
Unfortunately too, many health professionals themselves don’t understand the complexity of managing blood sugar. Those who tell patients to eat healthy, drop weight start moving and take these meds, highly underestimate what goes into regulating blood sugar in the human body. A body that, by the way, gets weary of being on diabetes patrol 24/7, and happens to also have a life in which maybe that body just lost her job or her boyfriend.
I’d really like pharmaceutical companies to stop paying celebrities big bucks to tell me, “Diabetes doesn’t control me, I control it!” I know advertising has its own barometer for truthiness, but this is just a smear campaign against those of us who have diabetes.
That said, I’m not saying you can’t influence your blood sugar by your actions. You absolutely can. On a day where I do pretty much the same things I usually do, my influence is largely positive: routine being one of my most critical tools. On other days as hard as I try my influence is not as positive.
After bristling at the word “control” for years, in a recent issue of diaTribe, Adam Brown wrote a superb article highlighting 22 factors that impact blood sugar. He confirmed just how complex managing blood sugar is, and frankly, that you can only “get it” if you have it.
Adam went on to share his four game-changers that help him manage his diabetes, so I want to share five of mine.
Here are five things I’ve done over my 42 years living with Type 1 diabetes that have helped me significantly — not control my diabetes, but positively influence it.
1. Reading Dr. Bernstein’s book, Dr. Bernstein’s Diabetes Solution. While I didn’t go as low carb as he suggests, I did remove a great deal of the carbohydrates from my die Dting so stopped me from “riding the roller coaster” of high and low blood sugars. If you have Type 1, it’s required reading.
2. Going to health conferences. My first was TCOYD (Taking Control (yikes!) of Your Diabetes. There CDE/psychologist Bill Polonsky said 12 words that changed my diabetes life. He asked the 80 of us sitting in the room, “Who thinks diabetes is the leading cause of heart disease, blindness, amputation and kidney disease?” Everyone raised their hand, including me. Then he said, “You’re wrong. Poorly-controlled diabetes is the leading cause of these things.” In that moment 32 years of diabetes stress rolled off my shoulders and I knew, while I couldn’t control it, what I did to influence my health mattered.
3. Fix blood sugars in real time. When I used to check my blood sugar between meals and it was high, I would wait until the next meal to add a correction dose of insulin to my mealtime dose. Now I take a correction dose in real time.
4. Get some diabetes friends. One or two may do. Belonging to the A1C Champions peer-mentor group I have 79 and I’m grateful for each and every one. I said it before, no one “gets diabetes” like someone who has diabetes.
5. Portion control. I’ve lost 35 pounds and kept them off. I started by leaving two bites of food on my plate, every meal. Then I married a Dutch Indonesian man who is six feet tall and weighs 125 pounds. Truth is, while there’s nary an ounce of vanity in me, weighing more than him, well it’s a motivator.
I’d like everyone who has diabetes to stop suffering from this lie that we can control blood sugar. We can’t. And, I truly wish everyone diagnosed with diabetes from this day forward would hear this from their health care professional.
“Taking care of diabetes is hard, but doable. Forget the idea that you’re going to do this perfectly! You are now manually performing a bodily function that your pancreas use to do automatically. Your blood sugar will fluctuate.
“You won’t always get it right, but I will help you figure it out and know what to do. You’ll do well enough that you’ll have an excellent chance to live a healthy, full and happy life. I want to commend you for taking this on. Now let’s get started.”
I’d hire that doc in a minute.
Originally published in The Huffington Post.