Focus.
I’m pretty wired, as far as people with diabetes go – CGM, insulin pump – all hooked up like a tow truck. But it wasn’t always that way – there was a time not too long ago that I was on Multiple Daily Injections (MDI) and a plain ole glucose meter. Granted, I tested 10 times a day and took about seven insulin injections a day to maintain tight control, but still, I wasn’t on what’s considered “cutting edge technology.” And at the time, my A1cs were pretty damn good – under 6.5 for a long while in fact.
So now, here I am about a week away from my next A1c blood draw, and I’m hoping that my A1c is down from a number that disappointed me (Side note: I am not judging people’s version of a “good” A1c – that is a personal number and goal for every person with diabetes, so I’m only speaking for what I shoot for), even with all the latest technology. In fact, my A1cs have been bouncing around between a low 6.6 and a high of 7.4 since I turned in to the bionic woman. How can that be? How can my toughest diabetes management challenges come when I have the most technology at my fingertips? Was I better off without it? Should I go back to MDI and fingersticks because I had better control in those days? If only the answer was that easy – which we all know it never is with diabetes.
For one, the rise in my A1c in the past two years has directly correlated with some personal struggles – relationships, changing jobs, carpal tunnel and other nerve issues- you know – life. In fact the six months after I started on a pump were some of the toughest I’ve had in years – and the A1c showed it, pump or not. That’s a diabetes variable we don’t all have control over, and I know it’s been a major contributing factor.
The second thing I’ve noticed with using a pump and a CGM is that even though I know full well that I am completely in charge of managing my diabetes and my devices won’t do it for me, there’s still a tendency to let things slide a little when you have those tools. Snacking at a party? Forgo the fingerstick and dial in two units while you casually chomp away. Take a half unit before bed for the 175mg/dL? Nah – the Dex will wake me up if it keeps going up. When I didn’t have those tools, I was micro-dosing and correcting with needles that reminded me of every decision I made – and it was a little easier to pay attention. With my gadgets, it’s way easier to slip into auto-pilot because they’re so, well, easy to use.
I’d love to go back to MDI/fingersticks only for a week and see how I manage – have I gotten so use to the ease of my technology that it would be impossible? What if I lost my insurance tomorrow and I had to – no choice? As diabetes gets “easier” to manage with the gift of technology, we can’t ever forget that machines will never be able to do what the human body does with effortless perfection. Everyone with diabetes has been tasked with a job of constant vigilance and rationalization that is a life long job. I’ve been shown time and again that the slightest negligence can take you off course for longer than you think. I need to get back to the precision management that I had when on MDI – because then, the tools and technology I’m lucky enough to have will truly be maximized for the best diabetes care possible. Back to work!
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