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glo's diaTribe

by gloria yee

Gloria Yee, RN, CDE is a certified diabetes educator at the Diabetes Teaching Center at the University of California San Francisco. Her clinical focus is diabetes technology. Gloria has type 1 diabetes.

I have always recognized that diabetes is a big part of who I am. After 20 years of living with it, it has been integrated into my daily life. I don't really think about it... Or do I? Just how much time and effort is spent on diabetes?

On a normal day, I test about 9 times. It takes my meter 7 seconds to provide a reading. I can whip out my meter, prick my finger, and have my blood sugar result in less than 1 minute. (It takes longer to locate my meter. Why do they always make the case black?) That's nine minutes, let's round it up to 10. How about counting my carbs? That averages to about 30 seconds per meal. If I did that 6 times per day, that will be 3 minutes. Let's round that up to 5. Then there's the button pushing to deliver my insulin. Once again, 30 seconds times 6, that will be 3 minutes. Round up again to 5. 10 + 5 + 5 = 20. Twenty minutes? That doesn't seem right. I must spend more than 20 minutes a day doing diabetes stuff. It certainly feels like its a lot more time!

During a recent diabetes workshop, my patients and I were discussing the above. Those were just the visible chores. There's got to be a lot more! There is, and we came up with the following list:

  1. Check blood sugar

  2. Count carbs

  3. What kind of food? High fat? High protein?

  4. Insulin on board - How much? How long?

  5. Activities - Any physical activity coming up? Or just finished?

  6. Health assessment - Am I feeling okay? Any recent lows?

  7. Mental assessment - Am I upset about something? Would that affect my blood sugar?

  8. Deliver insulin

  9. Record keeping - I have to write it down or else I'll forget

  10. Problem solve high and low blood sugars

  11. Access to all diabetes supplies on person - Do I have enough test strips? Do I still have candy in my purse?

  12. Appointments - Am I due for a check-up? Eye exam?

  13. Prescriptions - Am I running low on supplies at home? How many infusion sets do I still have? How many vials of insulin? Will the insurance allow more test strips?

Wow that's kind of overwhelming. I've never seen it quite like this before. This mental checklist of to-do's - I'm surprised it hasn't taken over my life! No wonder I'm tired at the end of the day. No wonder there's a book called Diabetes Burnout.

What am I going to do about this, this THING, this MONSTER, this list I've created?

First, I'm going to meditate more. Second, I'm going to thank my family. I know they share some of this mental burden. Third, I'm going to print out the list, and keep it in a visible place in my office. My respect for living with diabetes grows. Fourth, ummm, I think that's enough lists for the day.