Sunday, May 6, 2012

Putting In the Time

Type 1 diabetes takes up a LOT of time.

Testing your blood sugar may only take a few seconds, but weighing and measuring food, looking up nutritional information, programming boluses, adjusting basal rates and other pump settings for activities, changing infusion sets and refilling pump cartridges, and logging all of this (whether on paper or digitally) all adds up. And that doesn't even include the time taken to review diabetes logs, refill and pick up prescriptions, treat extreme highs and lows, and going to doctor's appointments.

And this isn't even including all the waiting and watching the clock. Wait 15 minutes to re-test after a low. Bolus 20 minutes before eating. Test after two hours after a meal or correcting a high. Adjust basal rates an hour before exercise. Change sites every two days. Refill prescriptions every few weeks. Get blood drawn every three months. It's a wonder we have time for anything else!

In the past, I've sometimes found it a struggle to maintain a balance between diabetes an the rest of life. I've heard Type 1 diabetes compared to another job sometimes, and I don't think that comparison is too far off. (In Canada, you can even receive the Disability Tax Credit if you use insulin and can document that you spend 14 hours a week on diabetes-related tasks.) I've frequently found that either I get busy and my diabetes gets out of control, or else I put so much effort into diabetes that the rest of my life gets out of control.

It's a difficult balance to maintain sometimes. My diabetes control seems to get nudged out of whack every time there's the slightest change in schedule, food, stress, or any other variable. For the past few months I've been putting a lot of effort into consistently doing things like eating healthy and logging, trying to integrate it into my life so that it's just routine rather than an extra effort.

So I was pleased when I looked back at my logbook for the past week and found that I had actually managed to keep a decent handle on diabetes—and keep decent records of it all. Oh, I had highs and lows. I had an encounter with high blood sugar accompanied by large ketones, even. But overall my blood sugars weren't bad, for me; especially when you throw in the fact that I've been transitioning from one job to another and my schedule has been crazy.

I sometimes get frustrated and disappointed that, for whatever reason, I struggle so much with achieving tight control. I look at all these people running around online with their A1c in the 5% and low 6% range and wonder why I can't seem to do that, even after more than 20 years' experience.

More recently, I've realized that I put in a lot of time and effort into diabetes. In fact, I put in more time and effort into my diabetes than most other Type 1s I have met in person. And I've realized that there is only so much I can do. If I am putting in the time and effort to eat healthy (and limiting carbohydrates), accurately count carbohydrates (weigh/measure food or use labels), test eight or ten times a day, bolus for everything (including frequent corrections), exercise daily, record everything, and go to the doctor regularly ... what more can I do? Not much, at least not without making my life revolve around diabetes. That's a lot of work. And if that amount of work only gets me to an A1c of 7.6% (which was my result last week), then is that so bad? Sure, maybe it won't guarantee that I never get complications, but at least if I do get complications I can't say it's due to lack of effort.

Maybe if I keep up the efforts long enough it will pay off in a lower A1c at some point. But, even if it doesn't, I need to stop and give kudos to myself for the effort rather than beating myself up over a number. It's like grades: a person gains more pride out of taking a really hard course, working their butt off and putting in hours of studying and passing with a C+ than they do taking an easy course, hardly studying and skipping half the readings, and pulling off an A. As much as A1c counts, maybe this is one instance where putting in the time and effort should count just as much as the result.

1 comment:

  1. Thank you, i have never been able to get my A1C lower than 7, but i do put in great effort for it to not go over 7 either. That was a refreshing read to know that my effort does mean something!