It used to be that "back to school shopping" meant two or three new outfits, new shoes and sneakers, and a short handful of "school supplies" -- one or two notebooks, paper and dividers, writing implements, a pencil case, and maybe a ruler.

For good or ill, those days are long gone.

This past month has seen our somewhat quiet office-supplies superstore inundated by hordes of mommyshoppers and their prepubescent offspring, carrying lists as long and as detailed as an induction-phase Atkins diet, with as many variations to The List as there are to a "proper diabetic diet". Whether it's color-coded folders, 12-count boxes of brand-specific pencils, or separate (still color-coded) looseleaf binders for each course in the child's schedule, many schools and teachers are conspiring to send frazzled parents on credit-card-breaking shopping sprees to support the latest fads in learning theory.

What makes it worse is that both parents and children may be penalized by teachers for an "infraction" as minor as purchasing store-brand pencils or giving the child 12 pencils from a more cost-effective box of 72. In some school districts, students and parents are actually assessed a daily "unprepared" fee for every single item that is missing from, or is not identical to, the items on The List.

In some ways, this echoes the increasing pressure on people with diabetes (or hypertension, or high cholesterol, or any of a myriad of chronic medical conditions) to perform series of increasingly-complex tasks to keep our bodies within increasingly-narrow ranges of "normal".

Now, please understand -- I am not calling for a return to the "Dark Ages" of urine testing or "just letting Nature take its course". I am, however, wondering whether or not "good enough" really is good enough-- or whether our ability to monitor ourselves and (in theory) moderate our quantitative test results has made us (or our care teams) obsess over maintaining perfect blood glucose levels, perfect blood pressure, perfect blood lipids, and so on, 100% of the time.

"It's just a number"

And it's just a notebook, just a pen, just a folder -- it's what we do with them that give them meaning. If color-coding notebooks helps a second-grader learn the difference between a Social Studies lesson and an English lesson, that's useful information -- just like knowing if your blood glucose is dropping at 54 or rising at 240 tells you whether or not you should even contemplate eating that very-tempting jelly donut sitting defiantly in front of you. It's when teachers tell sixth-graders to take out "your green folder" instead of "your English folder" (when last year, green may have been for Science) -- or when dieticians tell you to eat a serving of vegetables without telling you that potatoes don't count as vegetables -- that things start going wrong, very wrong.

"Jumping through hoops"

It's not too difficult to understand the medical paranoia surrounding our (hopefully) outlier readings -- there is overwhelming evidence that these extreme states cause often-irreparable tissue and organ damage. It's harder to understand how having store-brand pencils with yellow shafts will hinder a child's ability to learn when they are identical in every way (except label) to the recommended-brand pencils -- or how having 12 pencils from a box of 72 (enough to supply a family with three grade school students and have extras, for less than twice the price) should cause a child to flunk out of class. On the other hand, I've seen enough reports from the online diabetes community about how "Brand X" glucometers are more accurate than "Brand Y", and how the "friendliness" of "diabetic-friendly" products varies from brand to brand...

(continued in Part 2)