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No pattern here
Two weeks ago I met with my CDE, and we were of course discussing my blood sugar log. Yes for other reasons I have been keeping a detailed log of blood sugars and insulin dosed. She had two weeks of data, though she could have had 6 weeks if she wanted it. She did not.
She wanted to look at Basal and Bolus data, carbs consumed, and outcomes. She was careful to look at the standard; scientific approach to diabetic management, which is to look at before and after eating blood sugars, bolus and basal doses. Of course one factors in exercise, a little dose of random guesses and wham you have a scientifically informed treatment plan.
Well except, when you don’t. I don’t. Mine looks like a dart board, throw 15 darts a day and see where they land some are high, some low, some close, and a race car effect. Race car effect, yeah that is when you eat and you blood sugar takes off like a race car trying to get to the end of the track. My biggest issue is milk. When I drink it or drink milk like drinks my blood sugar goes haywire. It always does, and always has. I mean it is not news.
Anyway, so my blood sugar log is a mess. She looked at it up and down, down and up and decided to make some very minor basal changes and wished me well and sent me on my way. On my way out she said, you know I do not see a lot people with no pattern. You are one of those. I agreed and said if we could find a pattern I would love to change things so I could get some consistency.
Then I mentioned the word that is natural to me but was not too her. I said of course I am a brittle diabetic. She almost came off the chair. We no longer use the word brittle to describe diabetics with problem insulin patterns. Great I said what do we call them? I mean I want to know what I am. She said brittle means someone who cannot be controlled, she assured me I could be controlled. So I asked, how do I get controlled?
Well first she advised (tongue in cheek) I stop eating. Well that sounds reasonable, but of course I cannot stop eating? I mean I guess I could, but I would get well hungry? Right? Yes right she said. We could put you in the hospital and study the matter, she said. Why would we do that I asked, so we can straighten you out was the answer. Wait I am straightened out I said. Hmm well I asked what does the hospital have to do with living outside the hospital? Nothing really she said.
So what should I do. Well she said be careful. I am careful I thought. Well be more careful. Ok, I can be more careful I guess, careful of what I asked? Of what you eat she replied.
I said let’s face it I am a brittle diabetic right? Well I suppose if you put it that way yes you are. And therein lays the crux of the issue. For many years now I have been brittle. I battle diabetes, one meal, one dose, one hour of each day every day. Yes we can say there are no brittle diabetics. I do not want to be one. Never did, never will. But I am.
You can take away the label, you can say all diabetics are management issues, not body issues, but in the end when any scrap of food raises your blood sugar you are brittle. One can even call my type of diabetes complex, unresponsive, nonstandard, if that helps the medical community but for me I will always call it as I know it to be, I am a brittle diabetic.
Now I am not complaining or hiding behind a label. I get how tough management of a brittle diabetic is. I get that milk sends my blood sugar soaring, why? Who knows? But for goodness sakes let’s not call this a management issue just so we can feel better. Call it what it is and stop hiding behind the science of management or lack thereof. Yes I wish I fit in a box. I wish my diabetes made sense. But I also wish my doctor would pay me to come see him. I do not believe either wish will come true anytime soon. Brittle or not, managed or not, carbs in carbs out, insulin used, insulin saved. No I do not want to be brittle nor do I want diabetes. So look there are two things I don’t want.
So here I am brittle no more. I am now a management issue. Good grief. A management issue by any other name is brittle. I’ll take the name I was raised to understand. They, my CDE in particular can call it what makes her happy it is after all the same thing.