Bad Diabetic

Guilty as charged. I am a bad diabetic... Rotten. The worst.

Seasonal Fruit Crepes by Planet Raw

These past few months you'd wonder where my head's been. I forget to wear my medical ID bracelet, and I don't always remember to check my blood sugar. I miss occasional support group meetings with fellow diabetics just trying to manage their condition. I defy doctors' orders, refuse to take their drugs, and am the regular recipient of scolding letters from my insurance company reminding me how important it is that I take the recommended daily dosage of a whole smattering of prescriptions I don't even need. Furthermore, I routinely and shamelessly devour honey, ice cream and other desserts (all raw), and I resist taking insulin and even disconnect from my insulin pump altogether at times.

That's right. I did it. I do it... It's all true.

So then why do my doctors continually insist they're so impressed and amazed by my performance as a diabetic? Maybe it has something to do with the fact that my highest A1C ever (so far) was just 5.9, that my sensitivity to insulin is increasing, that I'm producing slightly more of my own natural insulin, and that my energy levels and overall zeal for life are so dramatically on the rise. Curious, isn't it?


The way I figure it, much of the mundane diabetic maintenance is less on my mind these days, because I no longer identify myself by it. I suspect this new perspective on my condition makes me a bit of an outsider in diabetic support groups. Maybe I leave my medical ID bracelet at home because it just doesn't match my hiking gear. Must it be a fancy reason? Perhaps I forget to check my blood sugar because I'm too busy living and loving life, and because, when I do check it, it's almost always within the normal range. Besides, I've come to trust as a general rule that, when I feel good, my blood sugar is usually good too. Mind you, this is my own body I'm talking about, and everyone is different.

In fact, I have a very sound reason for choosing to disconnect from my insulin pump more often, and that is that I don't want to risk the automated delivery's dropping my blood sugar too low. It seems I'm so sensitive to insulin now that I can hardly lower my basal dosage anymore. To give you an idea, my average insulin intake for the last 21 days is 6.04 total units per day. That's 4.39 units of basal [long-acting] insulin and 1.65 units of bolus [short-acting] insulin all day. I'm no doctor, but I'd say that's quite an improvement over about a year ago, when I was taking 6-8 units of long-acting insulin per day and 3-6 full units of short-acting insulin per meal. (I'd also say that calling it an "improvement" is understating it a bit. 'Damn miraculous' might be more appropriate!)

Keep in mind, too, that the more recent numbers I just presented were a calculation by my insulin pump, which doesn't always work properly. Sometimes, like this past weekend, it fails to deliver the insulin I need, even while it records the data as though I received it. In essence, I'm actually using less insulin than even these numbers suggest.

During the weekend, I was headed to Hollywood to meet a friend when I realized something was wrong. I had just given myself a correction bolus, but my post-meal blood sugar continued to hover at right around 185 for an hour or so. I had been checking my sugar and re-attempting the bolus at every stoplight where I had the chance, but the number wasn't budging.

That's when I saw that the adhesive holding the reservoir connection to my body had pulled away slightly. This was typical behavior of any adhesive after several days, but when was the last time I had changed the infusion site? The company recommends changing it every three days. I checked the log in my pump, and surely enough, I had been using the same insulin reservoir for nearly six days.

This meant the same amount of insulin that once covered me for three days had this time been covering me for almost twice that long, and there was still some left in the reservoir. I couldn't get to it, though, because the adhesive had come away, and - like the bad diabetic that I am - I didn't have any back-up supplies with me. In short, I couldn't get the insulin I needed, and I wasn't planning to be back home for several hours; so I'd just have to wing it. Another few minutes to my destination, a brisk walk to lower the blood sugar, a very small bite for lunch, a few finger pricks and several hours later, I had just spent the whole rest of the day with both normal blood sugar numbers and no insulin.

Now, in keeping with the rebellious thinking seemingly inherent in a bad diabetic, I can't help but feel this means I should be spending more time separated from my insulin pump. What's all the fuss anyway? If my numbers are mostly normal, as long as I'm watching them closely, wouldn't I heal more quickly and effectively if I'm pumping less synthetic hormone into my system? 

Well, I think so. I've already reduced my insulin take by about 60-75% since this time last year. Each new reservoir I fill is, by comparison, only half full at best - or half empty, for the optimists among us.

In any case, if being bad at having diabetes makes me better at healing from it - and, in this context, I believe it does - then I'm happy to receive a big, fat F for 'Fail' in the diabetes curriculum... because I'm already sitting in on the life lessons I want to learn.