# Guesswork and Diabetes

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As a kid, planes absolutely fascinated me — I was amazed that we could build something out of metal that could FLY through the air. I’m still fascinated by it, really. It’s a pretty remarkable thing to pull off. In any event, I really wanted to get a clear explanation of WHY planes were able to fly. So, I went to the library to find some answers. (For those under 21 — in the olden times, we would have to go to this big building where they kept books and magazines, where we would search through a listing of said books and magazines, write down coded numbers, and then go find the actual book or magazine that had this code written on it. If we wanted to keep reading the book or magazine, we could check it out of this big building and then return it a few weeks later — I know, crazy.) Anyway, the popular theory stated that the shape of the wing causes air to move faster over the top than under the bottom, and therefore the air on the bottom has more force, causing lift. I went “huh,” and was satisfied.

But then I went to an air show with my dad, and I saw some planes doing that thing where they fly upside-down. And that just blew apart that first theory. After all, if the wing is designed to make the BOTTOM create more force than the top, and you turn that thing UPSIDE-DOWN, shouldn’t that make the plane crash IMMEDIATELY? I mean, now you’re applying downward force AND gravity at the same time!! What gives!! So I went back, and I found some more theories in some more books. And then, finally, I read a quote in one of them that summed up the whole thing. A Boeing engineer actually said something to this effect: “We have a lot of theories, but really what makes planes fly is the PM factor — pure magic.” I decided if the guy who builds planes for a living had given up on figuring out what makes them fly, there was no way it would ever make sense to me.

Diabetes has a lot of PM in it, too. We have mountains of data at our fingertips, and we do our best to make sense of the patterns. But sometimes, we just don’t know. I am currently making my second attempt at switching to the pump. My first go-round was kind of disastrous. I started with the standard plastic cannulas and had constant occlusions. Then I switched to the steel needles, which initially seemed OK, but then they started giving me weird blood sugar surges, too. In the end, I gave up on it. I talked to my doctor and the pump trainer. None of us could really understand WHY I was experiencing that roller coaster. Scar tissue didn’t really make sense since the surges didn’t happen immediately after insertion of the new site. It wasn’t because of occlusions and bent cannulas — they were steel needles this time around! It just didn’t make a lot of sense.

Now, about a month later, I’m on round two. I’m still using the steel cannulas, still using basically the same ratios (though tweaked slightly), and still using largely the same sites for insertion. And it’s working. Sure, it’s still a work in progress as I fine-tune the ratios and basal rates, but the results are, 95% of the time, within the ballpark of reasonable. The only difference is that I’m trying to ping-pong between right side and left side every time I change the site, just to make sure the problem isn’t oversaturation, but it’s not like I was staying in the same spot before — I was always moved at least 2 inches away from the previous spot, just like I was instructed to do. And who knows — maybe that was the issue. The point is, we don’t know. I don’t know; my doctor doesn’t know; the pump trainer doesn’t know. All any of us can do is speculate, suggest theories, and be grateful that it’s deciding to cooperate better this time around!

Diabetes really is full of guesswork and partial answers! And I suppose we just have to accept that. We’ve just got to accept it the way that Boeing engineer did when he admitted that in the end, they really hadn’t figured out why planes fly. They had theories, but there really was no absolute, undeniable explanation. And there isn’t one for me, either. The first time, the PM factor just wasn’t there for me. This time, the PM is kicking in. And I’m glad it’s here, even if I don’t know how I got it to show up!

A new classification describes Type 1 diabetes as having three distinct stages. Bookmark DiabetesSelfManagement.com and tune in tomorrow to learn more.