It’s Amazing What a Little Knowledge Can — or Could — Do

It seems to be more difficult than usual to adjust my basal rates[1], insulin-to-carbohydrate ratio[2], and correction factor. I suspect it’s because I got a urinary tract infection and was taking antibiotics for that on top of the antibiotics for the bone infection in my heel[3].

Whatever the reason, there has to be a mathematical formula somewhere to figure out ratios and correction factors. If I ever get my basal rates figured out. My endocrinologist will help me, but I have to give him some data. I collected a couple of day’s worth, then went out of town, then spent a couple of days in a hospital with my grandson. Darned if I know what I was eating while out of the house.

Aside from the frustration of trying to figure insulin dosages out, it was a lazy weekend. No grilling because, due to the nature of his oral surgery, Grandson can’t chew yet. I kept my husband company while he trimmed some tree branches and planted a fig tree. (If you could call it a tree: It’s maybe six inches high now and living in a pot on the deck rail.) I managed to avoid hearing the name of the Indy 500 winner before the race was shown here. We live in the blackout area and don’t get to see the race until hours after the checkered flag comes down.

And I tried to figure out what to say in this blog entry.

As I said last week, I’ll tell you this week what Liz had to say about changing her attitude toward people with Type 2 diabetes[4]. And the change can be summed up in one word: Education.

“Not formal,” she said, “but talking with people who have Type 2 and finding out what their experience really was. Reading about it in books, on IP ([5]) and on the Internet. Realizing that most of my false assumptions about Type 2 were the result of inaccurate portrayals of the disease in the media. Seeing the same inaccurate portrayals repeated over and over again.”

She wrapped up her list by noting that she knows several skinny, active people who eventually were diagnosed with Type 2, and there was also my theory that Type 2 diabetes comes first, causes the weight gain and, when blood glucose gets high enough, contributes to lethargy.

One of my granddaughter’s friends was diagnosed with diabetes when her mother took her to the doctor because the child was falling asleep a lot. Nobody has accused her of “getting lazy” and causing her diabetes. She has Type 1[6]. If high blood glucose can result in lethargy for a Type 1, it can certainly have the same effect on a Type 2.

When you run across a Type 2, do you automatically discount that person’s knowledge and self-care? It could be that the person really doesn’t know much about diabetes, and I suspect I know why.

There was the doctor who told a man “you have diabetes; watch what you eat.” End of education. Luckily, his mother had Type 2 and filled him in — while she was recuperating from surgery for a diabetic complication[7].

And how about my husband’s former (and I emphasize the word “former”) doctor, who told him: “Oh, look. Your fasting level is 160. We’re going to have to keep an eye on that.” (You don’t “keep an eye on” a 160 mg/dl when diabetes diagnosis is a fasting level of 126 mg/dl or higher.)

I know a bank CEO, a former college president, several professors, and a reporter or two with Type 2 who’ve never been sent to learn about diabetes. With their education and knowledge, you’d think they would have studied up and learned something about diabetes. You’d be wrong.

It’s a common occurrence, even among those of us with Type 2. We think we know about it because of what we’ve heard or because we grew up with family members with Type 2. You know: Back in the dark ages, when dinosaurs roamed the earth and there was only one anti-diabetes oral medicine[8], no home blood glucose monitoring, no HbA1c[9]s, no realization that a carb is a carb is a carb. Even Type 1s likely only did one daily injection — of NPH, which is an intermediate-acting insulin — back in the day.

Because I didn’t know anything, but believed I did, and believed Type 2 wasn’t “real” diabetes, and because the local attitude was that you saw an educator when you began using insulin, my HbA1c climbed to 17.4% before I began to learn. (I was beyond lethargic and heading toward comatose!)

As it happens, I was blessed with a wonderful educator[10]. I wish everybody could have somebody like her. It was also, by the way, the first time I’d ever seen diabetes magazines and I decided on the spot that when I learned enough, I wanted to write about diabetes.

It wouldn’t hurt Type 2s to learn about Type 1, either. I will admit that, when Granddaughter’s friend wasn’t yet to the point of taking care of herself, it was a bit frightening to me when she came over or I took the girls someplace. I could fudge a bit with my doses, but not hers!

If you come across somebody with diabetes who is somewhat clueless, then educate that person. Tell the person about diabetes self-management education in your community. Explain what diabetes is. Explain why everybody needs insulin and what carbohydrates and exercise do to your blood glucose levels.

Be observant. I was waiting for some lab tests recently and noticed a woman in a wheelchair who looked a bit shaky. Turns out she lives in a nursing home, where they gave her insulin, then carted her off to the lab without breakfast. Then another woman spoke up, saying she had diabetes, too, was taking insulin, and couldn’t understand why her glucose was all over the place. Her doc was having her take the same dose of 75/25 twice a day and nobody had ever explained about intermediate-acting and short-acting insulin. Well, not until I did, that is. I told her a few other things, too. Her doctor is not going to like me.

The bottom line is, we all need to watch out for each other and we all need to help others understand diabetes and the differences among the different types. That goes for people with diabetes and “civilians” as well. We need to contact the media when we see or hear a mistake — or, as Liz said, an “inaccurate portrayal.”

Perhaps eventually we’ll get through to people and there will be a lot more understanding. Wouldn’t that be great?

  1. basal rates:
  2. insulin-to-carbohydrate ratio:
  3. bone infection in my heel:
  4. Type 2 diabetes:
  6. Type 1:
  7. diabetic complication:
  8. oral medicine:
  9. HbA1c:
  10. blessed with a wonderful educator:

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Jan Chait: Jan Chait was diagnosed with Type 2 diabetes in January 1986. Since then, she has run the gamut of treatments, beginning with diet and exercise. She now uses an insulin pump to help treat her diabetes. (Jan Chait is not a medical professional.)

Disclaimer of Medical Advice: Statements and opinions expressed on this Web site are those of the authors and not necessarily those of the publishers or advertisers. The information, which comes from qualified medical writers, does not constitute medical advice or recommendation of any kind, and you should not rely on any information contained in such posts or comments to replace consultations with your qualified health care professionals to meet your individual needs.