The diabetes rulebook 2 June 2014 If diabetes had a rulebook, and played by those rules, it would be a much easier condition to live with! There would be no need to guesstimate carb content or insulin doses, or spend hours wondering why-oh-why we have a BGL of 22.5 mmol/L after a lunch of a salad leaf and a glass of water. To add to the craziness, most of the time we’re doing this all on our own. In fact, people with diabetes spend an average of around four hours per year with a healthcare professional. But the rest of the time, the other 8756 hours each year, we’re going it alone! Rules made to be broken That’s a lot of time to be managing a condition that doesn’t play by the rules, in fact, it simply makes them up as it goes along. It means that every day I make dozens of diabetes decisions from what I will eat, how much insulin I will take, how to respond to BGL readings and how to respond to how I am feeling. Sometimes I get it right. A lot of the time I don’t. Diabetes is not a matter of simple (or complex) equations. There are times where things simply don’t make sense and they certainly don’t add up. The frustration of something not working when the previous day it worked perfectly well makes me want to throw my hands in the air and give up. How is it possible that when I started with the same BGL, ate the same carbohydrates, gave myself the same dose of insulin and performed the same amount of physical activity, the result one day is a BGL of a perfect 5.0 mmol/L and the following day 18.5, or 2.1 for that matter? Your chameleon companion Unfortunately, some think that diabetes is a ‘one size fits all’ condition. If only that were the case! However, it’s much more a ‘this size fits me only for today; tomorrow is another matter altogether’ condition. It’s for this reason the term ‘diabetes control’ is quite ridiculous. It’s impossible to ‘control’ something if you do not understand the working of it. And with diabetes, the mechanics change frequently. Managing the ridiculous randomness of diabetes is part of the daily battle. But for me, letting go of the expectation that things would turn out a particular way is one of the things that has made diabetes a little more manageable. When I stopped expecting things to work one way, I stopped getting disappointed when they didn’t! Accepting the unknowns Understanding the haphazardness of diabetes is impossible. But accepting there is much I really can’t control has been actually quite liberating. Ceasing to expect things to go right has meant that I am much more inclined to accept what is happening, try to fix it and move on. I certainly try to learn from mistakes (bolusing before eating and then getting distracted by Facebook and not eating will generally result in a crashing hypo, lesson learnt!). The ‘this works for me today but maybe not tomorrow’ attitude has been a breath of fresh air. And I’ve thrown the rulebook out the window. Renza Scibilia has lived with type 1 diabetes since 1998, and has used an insulin pump since 2001. Read her blog at www.diabetogenic.wordpress.com or follow her on Twitter @RenzaS This article was originally published in Conquest Magazine published by Health Publishing Australia
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