Friday, 9 April 2010

Seeing the wood for the trees

These days, there are so many tools available to a diabetic, it would seem almost impossible not to know what you sugars are doing all day long. From insulin pumps, to continuous glucose monitoring (CGM) and to glucose testing machines which come with free software in order for you to create charts, tables, diagrams and histograms, or full blood work which give you information about things your didn't even know you had in your body! What are electocytes and why do I have them??

So why can it be so difficult to see the wood for the trees? By this what I mean is why can it be so difficult to see the trends, blips and anomalous results which would help you obtain excellent control, if you could see them.

As a 'newbie' to the insulin pump, I am attending weekly specialist appointments at the moment so that my diabetes specialist nurses can look at my OneTouch Ultra software to see the patterns which may be occurring due to very small alterations in the amount of insulin my body requires. I have the same software at home, which I regularly look at and ponder, sometimes even pretending to have clarity on what's going on 'in there'. But most of the time, it looks to me as though a five year old has taken a biro, scribbled all over a chart and handed it to me in the form of a nicely packed histogram. My charts usually look more to be like a black and white picture of the alps than a clear and useful tool to consult and base my changes on

So this week, I sat down and counted how many of my sugars were under 15 mmol, under 12 mmol and under 10mmol, so that I could go to my appointment equipped with something useful to say when asked the question, "How did you get on this week". Imagine my surprise when I found out that 62% of my sugars are under 10, 85% were under 12 and 91% were under 15. Granted, 12 and 15 are not ideal. 12mmol is still leaning too high, especially if part of an upward trent. And 15 is by no means 'good'. But coming from someone who used to only test as little as possible because my sugars were over 15 so often that each test would eat away at me inside this is a good - no, A GREAT - result!

But had you asked me what my sugars were that week, I could only have answered "19.9" and "16". You know why? I do. Because as diabetics we have to strive to achieve the best results possible. Where possible, only 4-7mmol is good, everything else is 'bad', or 'wrong'. But in reality, any diabetic will know this is extremely hard, if not impossible. I know it. For years I've known it. The reasons I had no idea about that 85%, is that when I get a good result, I don't pat myself on the back, I don't say "well done, good going". Instead I say "right, when do I test again to check I've stayed there". I say "ok, it's good, but how long will it last". Why when I get a 19mmol, do I not say the same thing to myself. Why do I not say, "Right, that's fine, as long as I don't stay there". Or why do I not let myself off the back lashing and say, "You know what, it's still better than 25". Because I can't that's why. If I, or any of us, are going to whip this diabetes into shape, we never get to have a day off and we never get to say it's 'ok'.

That being said, it has only been 3 weeks on this new pump, and when I looked back at my results from 6 months ago, only 38% of my sugars were under 10mmol. That's an improvement of 24% in 3 weeks! I mean talk about progress!. And I haven't changed anything else. If I want to eat a giant burger or piece of pie, I still am, so the effort is minimal on the diet front. In fact, I had an extremely tasty piece of lemon meringue pie for lunch today. Do I regret it? Not in the slightest. Should I? Not in the slightest.

I will carry on being vigilant and giving as good a fight as I can, but next time I hit a 20mmol, I'm not gonna give myself such a hard time. Why? Because 85% is damn good in my opinion. Next week, I'm aiming for 86% and the week after 87%. I just need to keep reminding myself that 20mmol is not the norm. I don't sit there for days or even hours. I usually hit 20 and come right back down before the next test. It's just that I have to remind myself that the rest of the time, I'm still hitting 85%.


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