In most people with diabetes, lows occur either because we've overcalculated the amount of insulin we need, or because of an impaired, inhibited, or insufficient glycogen response. While this is obviously an oversimplification, I remember reading that either autoimmunity or modern insulins did weird things to the glycogen response in people with type 1 diabetes, and I know that at least one class of oral diabetes drugs works by inhibiting, if not completely blocking, that response. Then there's the issue of undereating, or not eating sufficiently, for there to be glycogen stores that can be easily converted to fuel our bodies — and, of course, drugs such as glipizide which work by stimulating additional insulin release.

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In one of my high school English classes, we had to read Samuel Beckett's play of this name. Thirty-some-odd years later, I don't remember the details, only that it centered around two men who seemed to be relatively old, penniless, and alone. They met at a particular spot each day, left each evening, and could only remember one day past and think towards one day forward. They awaited a third character, the eponymously named "Godot", who never arrived. The style was considered existentialist in that there wasn't all that much character development: what you saw was what you got. While I never read the French original, in English, "Godot" seemed a thinly-veiled metaphor for "G-d" — and since old, penniless (and possibly homeless) folk have always had the shortest from-this-point life expectancy, it made sense — at least on one level — that these two characters were waiting to die.

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Yesterday, I responded to the question about "things you wish your doctors knew about diabetes and the daily task of living [with it] by mentioning that many healthcare providers' knowledge of diabetes is incomplete and/or out of date. Rather than be a part of the problem, I've proposed a first-draft solution — some things I would put into a Continuing Medical Education (CME) syllabus to fill in some of those gaps. I'm sure I'm missing rather a chunk of stuff, but then again, this is a first draft.

If I were to develop a syllabus to fill in the gaps in professional diabetes education, as I perceive they exist today, these are some of the things I would consider:

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I got a bit of flak from a number of folk in the type 1 community for juxtaposing the You Can Do This project with the "you CAN eat this if you have diabetes" mentality of, well, many of the same folk. The issue is, the same folk who are, on the one hand, encouraging us to test and inject and correct are the folk who are talking about Food Police and Diabetes Police and how we, as people with diabetes, have to fight against those stereotypes by -- well, by eating all those things we should never touch with a ten-foot-pole.

This may work for people with type 1 diabetes, but it can be deadly for those of us with type 2.

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You can do this.

That's a campaign, started by Kim over at Texting My Pancreas, aimed at telling us that self-care is neither so painful nor so difficult to understand that we cannot do it. It's also, for many -- particularly those in the Type 1 community -- a rallying call for ending the traditional dietary restrictions for people with diabetes. The problem is, when it seeps through to Type 2s like me.

I can haz cupcakes? I haz BIG Crumbs cupcake.

I can haz pizza? I haz many slices.

I can haz chocolate? I haz large chocolate bar.

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One of the earliest "grown-up" movies I remember seeing in the cinema was a comedy called Cold Turkey, starring Dick Van Dyke. The premise was that a small town would win what, for them, was an obscenely large amount of money if everybody in the entire town could stop smoking, "cold turkey" — that is, suddenly, as if the "off" button had been pressed and the power disconnected — for an entire month. The lengths the town fathers went to, to win, and the lengths the tobacco company went to, to ensure they didn't, made for laughter and hijinks that were accessible to even middle-school children.

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