I’ve been trying to think of an appropriate metaphor to explain the importance of test strips with respect to diabetes management but my mind keeps going back to the plane crash sequence from Die Hard 2. In it, the bad guys recalibrate sea level for one of the plane’s automated landing programs by 200 feet. Because the weather is bad, the pilots have to rely on their technology to land safely. But, since the bad guys tinkered with the system, when the plane thinks it’s at 200 feet, it’s actually crashing into the runway.
This is incredibly morbid and hyperbolic, but if you stay with me I’ll bring this back around.
The key here is that the pilots had to trust in the tools at their disposal, namely the computer system tasked with landing the plane in inclement weather. The computer system relied first and foremost on the altitude of the plane to govern the entire landing sequence. But because that core piece of data was flawed every action taken based on that number was not going to succeed. (I hope you forgive the casual language of ‘not succeeding, even if it’s just a movie, a plane crash is serious business.)
If you ignore the Hollywood factor, the basic premise still holds: actions informed and influenced by a flawed piece of data will not succeed as intended.
And this is why I haven’t been posting Dexcom pictures lately
I tend to think of my over-sharing of Dexcom photos as a form of accountability. By being open about my highs and lows I think it helps keep a degree of focus about my diabetes management. That was part of the reason for starting the Daily Dexcom Tumblr – to show genuine ups and downs of this disease, as told by Dexcom graphs (and potentially pretentious image filters). But what happens when I start to second-guess my decision to share? What happens when I hold back?
I will say up front that this story has a happy ending. I received my re-up of test strips, insulin pen needles, and insulin when I got home from work and immediately tested my blood glucose after relying on my Dexcom, and only my Dexcom for the entire day. For what it’s worth, my Dexcom was only 3 mg/dL off from my meter when I tested it after a day flying blind.
My concerns are still the same with all of this. My Dexcom is only as accurate as my meter is only as accurate is the technology is capable of calculating. Hardcore diabetes advocates know the FDA’s mandated accuracy for meters is nothing close to acceptable for the people that are directly impacted by these liberal data ranges. The result is a flimsy, but necessary, measure of trust that this technology will live up to the standards and can withstand the tremendous burden placed upon its metaphorical shoulders: keeping me alive.
Count the corrections
Clearly, I’m doing something wrong.
Relying on 1. my Dexcom receiver to accurately monitor my blood glucose, 2. my ability to acknowledge low alarms when they happen, and C. my ability to properly treat lows if they occur is a dangerous combination.
You’d think seeing numbers like 347, 413, 320, 292, and a bunch of other numbers well above 250 mg/dL would motivate me to put a Dexcom sensor on. But you’d be wrong.
I decided to take full advantage of the three day weekend and cared as little as possible for my diabetes during the 72 hours. I took insulin for my meals. I corrected for lows and highs. But I didn’t obsess, I didn’t worry, I didn’t…care.
I had a pretty gnarly low this morning during my commute in to work that stemmed from trying to correct for a post-workout high and a pre-breakfast bolus. Of course traffic didn’t cooperate and I ran on adrenaline for the last 15 minutes of my drive. I made to my desk safely and presumed to overtreat the low, like you do, and eventually got on with the rest of my day.
My big problem with the morning, aside from my stupidity, was the fact that I was operating at half speed (even for a Monday) as a result of this low. Even after I (over)treated the low and had a Diet Coke to jumpstart things, I still couldn’t avoid the sweat-soaked shirt on my back and the general lethargy that lingered until lunch time. I know you’re supposed to wait 15 minutes before retesting after you have your juice or candy or ritz crackers with peanut butter or whatever, but it’s not just the 15 minutes that you have to wait.
Before we get going, I did this during my lunch break today. Yes, I have a problem.
Glancing at my Dexcom receiver today I realized that I hadn’t received a low alarm in over 24-hours. This meant I hadn’t needed to snag an extra peppermint pattie in the past 24-hours. I hadn’t struggled with a Capri-sun straw insertion in the past 24-hours. I hadn’t carelessly overcorrected with too much food, inevitably resulting in a rapid climb above 200 mg/dL in the past 24-hours.
I think that’s a good thing.
Not pretty. Not ugly. Noprugly?