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Diabetes by the numbers

My editorial calendar said that I’m supposed to be writing a post about how I use Google Calendar. That post has been progressing…OK, who am I kidding. I haven’t really done all that much actual writing about Google Calendar. I’m going to save that post for another day.

You see, something’s been bugging me that I really want to write about. In my last post I wrote about goal setting and the impact that the SMART system has had on me. I have known about SMART in various incarnations for a while. I’ve even tried my darndest to use it. Where I’ve really struggled though is in making my goals measurable. I try and fail. Then I try a different approach to setting measurable goals…and I seem to fail again. Rinse and repeat.

But the measurement phase is not only important to the ability to achieve those goals, it’s intrinsically vital to me.

I’ll admit it, I’m a data guy. I want to put numbers to everything. While I look at the letter grades on the kids’ report cards, I always get online to see what the numerical backing to those grades is. When I was in college, Notre Dame had a somewhat unique grading system where an A was worth 4.0 points, but an A- was worth 3.5. A B+ was 3.25, B equaled 3.0, and a B- meant you’d earned 2.75 points. This differed from the standard at most other universities where any A was a 4.0, any B was a 3.0, etc. Of course, I’m acutely aware of this because I was the king of the A-. I would work my way through a course, only to fall one point shy of an A. My parents seemed pleased with the A- on my report card, but I knew that a tiny bit more effort and a bit of luck and I’d have had that A. Where it mattered most to me was at graduation where I was 0.04 points shy of highest honors. If I’d been at any other university, with a normal grading system I would have been a lock for highest honors.

diabetes-592006_1280I’m also a diabetic. I was diagnosed in 2008, but quickly discovered that if you have to have a chronic disease, this is the data guy’s dream. To control your diabetes, you measure your blood sugar and then act on that measurement. You blood sugar’s measurement is fairly easy (as long as you can stand the pinprick of a lancet), and the devices have digital displays that pump out a number that is easily compared to prior numbers. You can also count calories, especially calories of carbohydrates, to help keep your blood-sugar numbers under control. If you pump in a lot of carbohydrate calories, you can be assured that your blood-sugar numbers will rise. That’s a bad thing. Over time, I learned the number of carb calories I could consume at any one time and what the impact would be on my numbers. I also learned that various forms of exercise could positively impact the numbers. The more intense the exercise, the better my numbers were. More importantly, if I wanted to pig out on some cake or pie, I could turn around and literally burn it off with an intense session of exercise.

For a while, I was testing my blood sugar in the morning, just after waking; I also tested it before every meal; then I tested two hours after every meal; and finally I tested it just before I went to bed. Needless to say, my fingers were raw from the 8-10 lancet pricks. But I was able to monitor my blood sugar. During the early days, I was injecting two different forms of insulin (fast-acting, and slow-release) and the quantities that I injected were directly related to my blood sugar results.

Over time, I managed to negotiate with my physician for a decrease in my insulin intake. Eventually I got to a point where I was able to stop injecting insulin entirely. That was actually on Christmas Eve just over a year after my diagnosis. Needless to say, it was a really great Christmas present to myself!

Over the years, I’ve taken to testing my blood sugar less and less often. I used to actually play a game with the kids where I would write down what I believed my blood sugar number would be and then test it. It had gotten to the point that I was within 1% every time. I could tell what my body’s state was…and that was fine by me. I kept up the exercising to minimize the impact of my food intake. I kept my eating under control. When people would ask what foods were off my diabetic-diet, I would tell them “I can eat anything in moderation“. I believed that then, and I believe that now. I know that if I really go crazy with foods that will impact my blood sugar, I have to do something to counteract that effect.

The problem is that I’ve gotten lazy! My food consumption has increased. In fact, it’s increased a lot. I’ve become less aware of what I was eating. I was testing my blood sugar very infrequently. To compound matters, the numbers were higher than I liked, and higher than they should be. More distressingly, I couldn’t guess what my blood sugar was anymore. In fact, the first few times that I tried to return to the game I was off. I believed my blood sugar number was dramatically lower than it was.

In short, I’ve lost touch with my body.

And you know, diabetes doesn’t take a day off. It’s still inside me, lingering, waiting, wreaking havoc with my body’s systems. I’ve put on weight…in fact, a lot of weight. And that weight has made exercise more difficult. In addition, the added weight has made my diabetes harder to control.

So as I contemplated my health goals for the start of 2015, getting my diabetes back under control was one of my goals. I even added by summer to put a timeframe on it. And then I started work on defining under control. My wife (who is a physician) would like to see my blood sugar under 100 when I wake in the morning. This was possible with medication, but when I was off medication I hovered closer to 120 in the morning. She usually quit nagging me about it if I could keep my sugars below 100 once I got active during the day. I was good about that before, but I’ve fallen off the wagon. And I’ve languished in the mud. And I’ve had a pie in one hand and a bag of donuts in the other. You get the idea…I need to make drastic changes.

I’ve been fighting this post for a while. I didn’t want to throw numbers out there until I’d been monitoring for a while. I defined a while as three weeks, then four, then six. But my Mom brought me up right, and the guilt has gotten to me.

So I’m admitting, again, that I have diabetes. It’s not all of who I am. In fact, it doesn’t really define me. But it’s one of the facets of my persona. It’s a chronic disease that I have. One that stands up and shakes it’s ugly head often enough that it scares me. A disease that impacts lots of my life decisions. But not a disease that is going to control me entirely.

You see, I’m a data guy, and diabetes can be managed through the collection and analysis of data. I’ve got the collection part back under control. I’m working on the analysis. And I’m getting ready to make an appointment with a new doctor to help me on the journey. I would go back to the doctor that I had before, but he moved away about the time I stopped my insulin injections. In fact, I saw another doctor for about six months and we came to an agreement that as long as my diabetes was under control I didn’t need to see her anymore. Then she moved her practice. I fell off the wagon with my donuts and pie, and I’ve been an awful patient.

More importantly, I’ve made some crappy decisions about my health.

But I’ve come out of the diabetic shadows. I’ve put it out there on the internet, in my blog. So now I’m accountable to you, dear reader. I’m going to get my diabetes back under control by this Summer so that I can get back to enjoying life in so many ways that I haven’t been able to.

Keep me honest, eh?