Fighting with Perfection
Balancing perfectionism and diabetes
March 2010 — Diabetes is a thing surrounded by numbers. Everything is a number, or is used in a calculation. We have blood sugars, units of insulin, and grams of carbohydrates. Then we take those numbers and stick them into more numbers. There is the insulin to carb ratio, the duration of insulin action, and our correction factor.
With all of those numbers, it is easy to expect the math to always "net out". What I mean is if I do the math, using all of those numbers, I expect my result (in most cases "result" means my blood sugar) to come out pretty darn close to my target blood sugar.
I think that all of us realize there are many areas of inaccuracy in all of those numbers, especially with the glucose meters and food label information we use. There are so many more areas around these numbers that don't fit nicely into our calculations. Did you know that the size of your bolus affects how long that bolus lasts (duration of insulin action)? That's some ugly math, which our current devices don't deal with.
To be fair, all of this math does a pretty good job, most of the time. I know I cling to it because it helps me make some sense of manually mimicking a pancreas, even if it doesn't always work perfectly.
I'm no scientist, or doctor, or even a very educated person, but I don't think the human body always fits into mathematical equations. There are "things" happening inside us that can't be strapped to a quantifiable number. Stress, emotions, sickness, infections, sports. There are more of these types of things (un-quantifiable factors) than the ones we CAN put some numbers to.
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Well maybe not so much a furor as a controversy. The question, bluntly put, is whether or not a single HbA1c reading should be sufficient and adequate to diagnose diabetes — and whether the conditions under which the test was conducted should have any bearing on the diagnostic or non-diagnostic value of the test. The lede from