The number, the whole number and nothing but the number

Imagine, for a moment, an adult attempting to explain to small child, in appropriate terms, where babies come from. Or how Santa Claus makes it round the whole world in a single night. The course of the conversation will doubtless be punctuated by frequent buts, whys and hows on the part of the child. Small children have an uncanny knack of seeing straight through any confustication and sadly the skill of explaining complex things in simple terms is not widespread.

Imagine, then, trying to explain not only the concept of blood glucose values but also the information CGM and/or knowledge about past and future food and activities adds to those values, to the uninitiated. A comical situation rather like that between a father and his small son could easily ensue. In most areas of daily life, mathematicians aside for a moment, a number is just a number. If someone asks you for three pounds/dollars/groats, three is what they want. But a number in diabetes? Is a number ever just a number?

So let's start with the real basics: Under 4 is low, requiring sugar. Over 8 is high. Or sometimes over 7, or even over 12.  What's that? Why? Well it just depends. Different people have different needs and different situations require different targets. Yes, it is a bit like shooting. We're aiming for a target. Yes, that's right, it sometimes moves.

But anyway, high numbers need insulin. Got that?

OK.

Whats my number now? Well, yes, 3.9 is low and yes, normally that means sugar. But hold on, I just ate 10 minutes ago and look at this line on my CGM - it shows I'm going up. So yes it's low, but no I don't need sugar.

You want me to test your number? You're at 3.5. No, no. That doesn't need sugar either. You see, you don't actually have diabetes, so your body will take care of your numbers for you.

A little later...

See - I came up just fine. I'm 8. No 8 isn't high today. Yes, I see from the graph that it's going up, but I'm just on my way to the gym. So 8 going up very slowly is just fine today.

Later still...
What's that? You want to know what my number is now? Hold on...

Oooh... 5.5.

Yes, yes... I think you understood the basics and yes, that is a normal number. But look, my pump says I still have one whole unit of active insulin from what I gave earlier and look how far my CGM graph has dropped in the last hour. So I'm normal, but actually I need to eat.

What do you mean you think I' making it up as I go along? I'm really not. It's quite simple and logical when you look at it. We have low numbers and high numbers. But we also have normal numbers that can act like low numbers if we are falling, and normal numbers that can act like high numbers if we are rising. And a high number isn't always a high number, for example if we are about to drive a long way or do something where it is really important we don't have a low. And a falling number is...

What's that? You just want to know where babies come from? Now that's a much easier question to answer...

Comments

[Penny]

Yet another great post.

This disease is so hard to explain to other people.

I learned this when I sent Riley off to school. You can give the teacher a range for his sugars, but that range isn't always the range. What you do about certain sugars can't really be taught. It depends on so many factors.

And, even another Type 1 couldn't care for your diabetes as well as you do because everyone is different and responds to insulin differenly.

[Caro]

Thanks Penny.

Obviously I never got how hard all this was for my parents when I was Riley's age - the constant explaining about variables and factoring them in.

I didn't really get it when I first took over all responsibility for my care, either. I had no worries about explaining since, I was still in a environment where my parents had laid the groundwork (and they were keeping a watchful, if slightly distant eye on me too). They also let me discover at my own pace the many different variables that affect control. I'm glad they did that, rather than trying to 'teach' it all to me. I think I've ended up better equipped in my adult life to deal with all these things diabetes throws at me.

And it also means I've probably spent at least half my 24 years of diabetes without worrying about the frustration I expressed here.

You parents absolutely rock. I just don't know how you do it.

[Scott K. Johnson]

Great post Caro!