Last week at the 6th Annual Education Forum on Diabetes Prevention & Management conference, I witnessed clinical healthcare professionals learning and sharing about the impact of diabetes, issues from the patient perspective, issues from the healthcare professional perspective, and enough data and PowerPoint slides to make Bill Gates proud.
Two presentations really stood out to me. As a person with type 1 diabetes, or a type 1 diabetic if you prefer (you say “noo-tella,” I say “nuh-tella”), I gravitated toward those portions of the conference that I could identify with the most. I like hearing various perspectives of my particular flavor of diabetes, especially from the side of people who work with and deal with diabetes without having the disease themselves.
First, there was a presentation about numeracy.
Numeracy: adjective; able to use or understand numerical techniques of mathematics.
In other words, numeracy is the ability to understand and use numbers in our day-to-day lives. Those of us with diabetes, especially type 1 diabetes, do it all the time, seemingly without thinking because we’ve done it for so long that it has become almost habit. We can do carb and blood sugar math like it’s nobody’s business! For example, I know that my insulin to carb ratio is 1:8. That means if I have a meal or a snack with 20 grams of carbs, I’m going to have to take 2.5 units of insulin to cover it so that my blood sugar doesn’t spike and make my head explode. (Not really, but my blood sugar will go high, and I hate, hate, HATE being high.)
I loved this presentation because the presenter really linked it to the patient perspective of living with diabetes. She highlighted the fear of all the numbers that sometimes paralyze us to take action. That applies no matter what type of diabetes you have. She said, “Something that healthcare providers have to realize is that if we make a mistake in math in our checkbook, it’s really no big deal, but if a type 1 makes a diabetes math mistake, they can die.” There is not a lot of room for mathematical forgiveness with type 1 diabetes.
The next presentation I went to was awesome because the presenter was my endo. I love my endo, so pardon me a minute while I gush. I really appreciate him because, even though he doesn’t have diabetes himself, he gets what it is like to live with diabetes as well as anyone I have ever met. He was sharing with the room some of his experiences with helping children and parents adjust and learn to live life with type 1 diabetes. Having grown up with diabetes myself, since age 2, I could appreciate a lot of the stories he had to share; many of them could have been about me.
He opened his presentation by telling every single diabetes and healthcare professional in the room that “it is absolutely unconscionable what we ask people with type 1 diabetes to do to stay alive.”
Unconsionable: adjective; not in accordance with what is just or reasonable.
Yes, yes, and more YES! I’m paraphrasing here, but he explained that sustaining the constant counting and checking and pricking and poking and dosing and everything else it takes to live with diabetes is really not reasonable or realistic. He said, “Albert Einstein said that doing the same thing twice and expecting different results is the definition of insanity,” then added, “…except with diabetes.” A person with diabetes can do the same exact thing and eat the same exact foods for two days in a row and get totally different results. The best that can be hoped is that people with diabetes will do as much as they can.
Something that I’ve always appreciated about him, and the reason he is still my endo even though I am 32 years old (still a kid at heart people, don’t get it twisted!), is because of the perspective he shared at the end of his presentation. He said that in his practice, he refuses to tell a person with diabetes to “test” a blood sugar. A test you can pass or fail. A blood sugar check is just a check, returning a number that is neither good or bad, just possibly something that needs to be addressed. All these numbers that come with diabetes are just data. Just. Data.
What we have to do to live with diabetes may sometimes be unconscionable, but the numbers that we see staring back at us should never be that. We have to learn to use all of these numbers in our diabetes world to make decisions, and react to the best of our abilities.
That has to be enough.
The meaning implicit in calling them “tests” wasn’t anything I ever thought about until, well, right now. Huh.
Now I might need to adjust my vernacular.
Great post, Martin… I really like your endo too!
Man, I wish I had your endo! Great post, Martin, as always!
I. LOVE. THIS.
funny, i too, never really thought about the word “test”. i have been saying it for 37 years, but i think that is about to change. from now on i am going to ‘check’ my blood. but instead of “reacting” to those #’s, i will “take action”.
check vs. test. NICE. as well as the rest of it. thanks for sharing!