Walking the Line

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Diabetes and CGM

I’m about to try a continuous blood glucose monitor (CGM) for the first time. My doctor and I decided to pursue the CGM after several early morning low blood sugar scares, both hoping the continuous monitor might track my blood sugar overnight and wake me up with an alarm should it slip again, and also hoping to see the patterns that were leading to these low numbers.

One of the first things I did when my doctor suggested getting the CGM was to look online for others’ experiences of using them. One of the most common challenges I came across was “information overload.” That makes sense, of course. As someone with diabetes, I’m used to checking my blood sugar about 5–8 times a day. That’s not nothing, but it’s a far cry from seeing my blood sugar every five minutes, 24 hours a day. Nevertheless, even those 5–8 readings each day represent a lot of information, and it’s easy to become overwhelmed.

As Diabetians, we’re always walking a thin line between knowing everything we need to know, and becoming overwhelmed and overpowered by the collection of numbers that can start to dominate our lives. There is such immediacy about blood sugar readings, and they can carry such a harsh feeling of judgment for us — a “bad” number must mean we either have a “bad body” or we made a “bad choice.” I know I’ve struggled with that, and heading into this world of “every-five-minutes” blood sugar readings is going to be not only a practical adjustment, but an emotional one, as well.

Attaching versus analyzing
With every new piece of information we receive, we face a multi-layered decision. On the surface level, or the practical level, we have to decide an immediate course of action based on the information. If our meter reads “107” we probably don’t need to do anything. If our meter reads “241,” we need to lower it with some correctional insulin (assuming we don’t have insulin on board that is actively lowering that number already). And if our meter spits out “37,” well, we better get some sugar in us quickly!

This immediate practical level is usually fairly simple. But beyond the immediate decision, we have to look at the wider pattern, and try to understand how the number we are reading fits this pattern. This is the layer of meaning, and it is both an analytical task and an emotional task when we’re talking about a chronic health condition. If these numbers were abstractions (as an analyst reading stock reports might experience them), the task would be purely analytical. But because each number represents our ongoing health status, analyzing our patterns is also an emotional task for us.

The trick to working skillfully with this level, in my experience, comes down to how well we work with attachment. An unhealthy pattern will never be something we want to see, but the extent of the power it has over us is directly correlated to how strongly we attach ourselves to that pattern. The more we identify emotional meaning in a pattern (i.e. “I’m failing,” or “It’s hopeless and it won’t ever change,” or “My body is simply incapable of finding balance”), the more we attach to it; the more we align our sense of self with the pattern. The more we can cut off those emotional value judgments and relate to the pattern with the same objective distance as a financial analyst looking at stock market trends, the less power it will have; the less we will attach our sense of self to the numbers.

Of course, it’s not easy. But it sure is helpful. It’s helpful not only because it helps us maintain a more even emotional state, but because that lack of emotional attachment helps us look at the pattern with a clear, calm head. And that’s exactly the kind of view we need if we’re going to actually understand a pattern!

Great advice, but…
So that’s all well and good, but talking about it is one thing; putting it into practice is another. When I start up with the CGM in a few days, my capacity for objectivity and detachment is going to be thoroughly tested! As much as I’m sure the numbers will be useful, the Zen Buddhist in me is equally interested to see how well I handle this potential information overload and the challenge of skillfully handling my human instinct for attachment. It’s sure to be interesting!

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