TSD Mainfesto

Firstly, I am not a scientist by trade. If anything, I am more of an arm-chair scientist.

But personally, I feel there can be a little bit of a scientist in each of us.

I am in fact a diabetic. I was diagnosed as a Type 1 diabetic over 23 years ago.

Over the years, I have followed certain practices that, when added up, become a certain diabetic manifesto.

Many of these practices have their roots in science - in some sloppy measure following the scientific method.

A few of my beliefs:

1,) Diabetes complications are additive, compounding over time. To me, this means in simple english that the more time I spend in the normal human blood sugar range (70-140) the better off I will be in the long term. And that time spent high or low, for example 4 hours each day, adds up to significant numbers over the longer term. For example, I would not want to be in a high blood glucose range (say 230) for 33,580 hours, but that is what happens if I was to be there 4 hours a day over 23 years. So paying close attention to staying normal on a DAILY/HOURLY basis is important if you are concerned over the longer term health of your body.

2.) Type 1 diabetics can eat food with the belief it will have no consequences. I call this "eating without consequence." I think that this phenomena is actually a very bad thing; let me explain. If you accept my fist belief, then the goal is to stay within normal range as much as possible. When you have Tyoe 1 diabetes, you must inject insulin for any and all foods you eat - and to do this you must learn how much to take with certain volumes of food. The science of diabetes treatment has evolved to the point where we can now calculate our insulin doses based on the volume of carbs consumed, and so we each learn our personal carb ratios - mine is 6:1 - or for every 6 grams of carbohydrate I consume, I must take 1 unit of insulin. Easy - so where is the problem? Well, for this to work - I have to count food in 6 gram units, and the more grams I eat - the more units I must take - and hence the problem - EATING LOTS AND LOTS OF FOOD creates a problem where you have to take more and more insulin - the larger doses allow for larger errors in getting the numbers right, Meaning take too much or too little - you are out of your normal range again. So as a result - I try and not eat without consequence - reducing the margin of error.

3.) Test, test, and test again. Without a meter, a Type 1 diabetic is blind to his or her blood sugars. Testing is so vital, it needs to be done before you eat - and before you ever inject. Never guess your blood sugar based on how you feel, because all too often you may be wrong.

4.) Keeping records, every once in a while, helps us stay on track. I try to keep a log for a week, every few months, and I record every gram of food eaten, every meter test - and every injection. Keeping a log book is invaluable for making adjustments and ensuring you are staying on course.

5.) Do no be afraid to question what you have been doing in the past / your past beliefs / be willing to embrace and adopt new ideas or techniques. For example, I was on MDI - or multiple daily injections - for years and was under the belief that keeping your A1C between 6.0 and 7.0 was the idea. TIME CATCHES UP. Now days, there are MANY diabetics who achieve A1Cs between 5.0 and 6.0. So you must consider that your thinking could be out dated, and be willing to test / try new ideas. This model will allow a more open thinking / approach and allow you the ability to contually question and test / try new things. I am now using the Pump / Sensor technology - and love it. Although I was perfectly happy on MDI, being open to change has helped me achieve slightly better results. So keep an open mind!

6.) Listen to others, but with a skeptical ear. There are many voices on the internet - many other Diabetics who will proclaim that they have eaten without consequence, have A1Cs in the 7s (if they are willing to share) and other not conventional ideas - like eating the sugary Acai Berry juice as a potential cure. I take the time to read their ideas, but I also read even conventional thinking with a skeptical eye. Not keeping your sugars in check, for example, may not have caused you any visible complications to date - but is not doing everything you can to control your disease really the best approach? I have managed tight control, and I too show no visible complications. But as we know, microvascular complications are additive, cumulative, and will progress unseen for many many years. Know that there are voices that suggest diligence is not required. Many of those voices have yet to see complications that could be waiting to catch up. Knowing you did everything possible, to me, feels better than slacking off. And it is a given that we are all not perfect - just do not fall prey to slacking off as a norm.

7.) To become a better diabetic, we must be willing to become a little bit of a scientist. Willing to test, document, and observe. Willing to call things into question / question conventional thinking, willing to embrace new ideas. And we must strive to read and learn from others observations.

Here, I hope to share my personal observations, with the stated goal of helping other Type 1 diabetics.

TSD