Diabetes and the Control Paradox

As soon as you get diabetes you’re told to become a mathematician, a statistics expert, a systemic data analyst, an expert nutritionist, an attentive carb and calorie tracker, a workout regular and a skilled cross calculation performer. Your life is expressed in numbers, graphs, statistics and trends.

“The same way a composer creates beautiful music.”

114mg/dl, rising trend, 15 basal + 6 fast acting insulin, wait 15 minutes, brush and floss teeth, 45 carbs / 325 calories breakfast, 1 glass of water, vitamins, 170 pounds on the scale, yoga 10 minutes, meditation 5 minutes. That’s a quick look at my first 30 minutes since I opened my eyes this morning. From then on out, it continues more or less with the same intensity of data, calculations and projections, for every moment of every day. When I go to the doctor the data increases significantly. If you have T2 diabetes, you might be able to lose a few numbers, but the basic concept remains. We have to keep track of ourselves. We have to be knowledgeable and aware. We have to replicate the work of our pancreas, as best we can to maintain a healthy and well functioning body.

In an optimum world, our self awareness is totally sharp, our knowledge of nutrition is all encompassing and our hunger comes and goes with no emotional component. Our life is active or we get to exercise everyday, and we have great mind control allowing us to live stress free. We wouldn’t need much else.

But in everyday reality we need to keep our metabolism under control to be able to manage diabetes and be healthy. The demand on ourselves is high and it easily feels taxing. It often generates a rebellious reaction that makes us skip on our blood glucose tests, not pay attention to our nutrition, not compensate or overcompensate for what we eat, forget or refuse to track data, all the way to neglect to take insulin or medications and avoid doctor’s visits. All of this puts us on the deceptively comfortable “couch” of denial. But we really are on the rocket-ship for “the land of miserable days.” We live in the throws of too high or too low blood sugar levels, heading for a bleak future health.

The bottom line is simple: If we want a good and healthy life we have to be in control.

But how can we be in control and keep ourselves from drowning in the swamp of data and repetitive calculations? How can we enjoy our life and still do the work necessary to have diabetes in control?

We can do this the same way a composer creates beautiful music, or a writer a mesmerizing story, or a sports champion becomes a hero. They’re experts in their field, and they fully express themselves within the parameters of their craft. They are free within the rules of their game. If the best basketball player in the world, all of a sudden ignores all, or even some, of the rules of the game, he/she will immediately get fired.

I must know everything important to my reality. I must know the rules of the game of my life. I want to know, because I want a good life. I want to know what’s good for me and what’s not. I want to know how different carbs affect my blood sugar levels, and how different insulin types work over time. I want to know if there are foods that are good for me and which ones can be harmful. I’m interested in finding out what physical activities are good for me, and pick the ones that are fun. I want to know what stress does to  me. I want to know how to minimize it, because it affects my blood glucose levels. I’m curious to find out my lab tests when I go to the doctor, and see how I can do better. I want to be fully supplied and never run the risk of being without insulin or glucose. I care to pay attention to how many calories I eat because I feel better when I’m not overweight. I’m interested in keeping my blood sugar level in control because life’s easier when I’m balance. I’m interested because it’s part of my life, it’s part of my “game.”

Once I do all this, I’m free to be and do anything I want.

The paradox is that I have to be in control, so I can be free. The better the control, the freer I am. Yet, diabetes control is never absolute or complete. It’s always a work in progress, always adjusting, changing, trying, fine tuning. The key is, I have to show up and do it.

The irony is that if i neglect diabetes, diabetes becomes the most relevant thing in my life, because it makes me miserable. But if I take full responsibility for diabetes, it becomes just one of the many components of my life, and I am free to live my life.

The easiest way to do this is with passion. If I’m passionate about something, it never feels like work. Managing diabetes well is key to my health and to my well being, so it would be natural to be passionate about it. But if passion’s not available, as it happens, then I have a simple three-step remedy.

1. Just do it. I know what I have to do. Even if I don’t feel like it, I do it, anyway. For example, once I check my blood glucose level and take the necessary actions, I can go on with my life and forget about it, instead of being miserable because of hypo or hyperglycemia. I call this, action.
2. Forget perfection – don’t judge. What makes managing diabetes unbearable aren’t the necessary actions, but the demand for perfection. Who cares if I make mistakes. We all do. Diabetes management is never perfect. It can’t be. It’s better to do something imperfectly, than not at all. It’s better to keep a scattered log than none at all. It’s better to have one healthy meal per week, than none at all. It’s better to check blood glucose once a day, then never. It’s better to workout once a week then never. It’s better to take a five minute walk every other day, than not move at all. I do what I can and I don’t judge myself. I call this attitude.
3. Be honest – don’t judge. It’s easier and it helps. If I’m honest with myself I can’t be in denial. The key is to not judge myself while I’m honest. For example: Did I eat to much? Yes. Great. What do I need to do now? I take the actions and move on. No dwelling on it. No resentment. I call this awareness. 

Action. Attitude. Awareness. If I do this, I can be in control and live my life. The more I do this, the more I experience the benefits of living in good balance. This will make me more and more passionate about taking better care of myself. It’s a virtuous cycle. I experienced it, it’s real.

Nowadays, there’s a plethora of apps, gadgets, software programs, products that make diabetes management and tracking easy, if not fun. Try one. When it tires you, try another one. Don’t be perfect, just do it. You might need more or less control. Find what works for you. Most blood glucose meters can download data to the computer and you can send them to your doctor. That’s easy. If you don’t like any of those things, try to find a way that’s fun for you. For example, I like to paint. I’d get a piece of paper (or a canvas). I’d put a red dot for every BGL over 200mg/dl, orange between 150-199, green between 80-149, yellow between 50-79 and black below 50. New week, new paper. I’ll get an immediate idea of how I’m doing just looking at it. I can show it to my doctor. This is much better than nothing.

Find whatever works for you. Keep it simple, but do it. A little bit of work goes a long, long way. It’s worth it, because this is your life.

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This article first published by exclusive permission on Diabetes Daily Post.