Not why, but what now?

As I mentioned in my last post, I learned a ton from William Polonsky during the CWD conference. There is an interesting thing about going as an adult to a conference originally designed for parents and their children. You find out that either 1) you never actually grew up, or 2) we never grow out of the things associated with daily life with diabetes.

Although there are many things we would all probably like to change about our meters, a session called The Great Meter Makeover is not about what you think it is about. According to Dr. Polonsky it is about “transforming that annoying little machine from foe to friend.” It is about changing how I think about blood glucose monitoring and changing what I do.

First, Dr. Polonsky reminded us about all the reasons we hate love our meters. Some of this, again, was supposed to be for parents and their children but I found it applied to me as well.

Let’s see:

  • you have to use it
  • it can make you feel bad about yourself
  • it gives your parents an opportunity to be angry at you (or in my case, for me to be angry with myself)
  • it reminds you and the people around you that you have diabetes
  • it is almost always inconvenient

That about covers it, don’t you think?

Many of the points of advice to ‘makeover’ those problems were family specific – such as making it an expected household chore like making the bed with the same results for failing to do expected chores. However, there were several other ideas that were certainly a great reminder for my daily control.

it is important to congratulate the act of blood glucose monitoring, not the result. How many times have I said that I need to test my blood sugar? If it is a test, what does that mean? It means I can fail. The act of testing assessing your blood sugar is what should be congratulated, not the result.

Along with focusing on the act and not the result comes being reasonable about blood glucose expectations. Do I want my blood glucose numbers to be perfect 100% of the time? Yes, of course I do. But the problem with perfection is that it is inflexible, rigid, and often unattainable, among other things. Perfection is not possible and not necessary

So if I am not not trying to establish perfect blood glucose results, what is my goal? According to Dr. Polonsky, that goal is safety. It is establishing that fine balance between the best blood glucose results possible, as few severe lows as possible, and having a life.

When I get out my meter and see a result that I don’t like (high or low), asking why only leads to frustration. Why could be because the temperature is changing, the fast food chain spiked my soda, or the fact that I am wearing blue socks – reasons that are beyond my control and/or things that I cannot change.

If I instead ask, what now, it is within my control. How does that play out day-to-day? In my opinion, it is not that different of a question, but the psychological implications are huge for me.

High several days in a row after breakfast? What now? Should I adjust my basal insulin to counteract my dawn phenomenon? Should I adjust my bolus because I might be less insulin sensitive in the morning? Should I start eating a different breakfast?

Expecting to be in range and surprised by a number on my meter. The number has already shown up on my meter – I can’t change it. So what now? Do I need to wash my hands? Do I take a correction dose or do I have enough insulin on board already? Should I delay my next meal to wait until I am in range?

It put me in control of a disease that is so often uncontrollable.


November 28, 2007 - diabetes365 - day 51February 18, 2008 - diabetes365 - day 133November 4, 2007 - diabetes365 - day 27February 19, 2008 - diabetes365 - day 134April 2, 2008 - diabetes365 - day 177April 16, 2008 - diabetes365 - day 191May 6, 2008 - diabetes365 - day 211November 18, 2007 - diabetes365 - day 41September 29, 2008 - diabetes365 - day 357

May 18, 2008 - diabetes365 - day 223May 2, 2008 - diabetes365 - day 207July 12, 2008 - diabetes365 - day 278

What about you – do you find yourself asking why or what now?

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  • Mark says:

    With the technological advancement of bg meters, it has increased my awareness and ownership of my diabetes. I look forward to the future in meters and/or CGMS.

    Great post! 🙂

  • jason preu says:

    this is a great article to which i will be referring many people. (i’m jealous i didn’t write it myself.)

  • Wonderful post Sara.

    So wish I could write as coherently.

    Every point was valid. Every one. I am so pleased the CWD conference exists.

    It’s so important to keep learning.

    Thank you.

  • Cherise says:

    Great Post!!!! I take control of my diabetes. I don’t blame the meter, ok let me rephrase that…I can’t blame the meter for something I did when I see a high number. Now the low numbers different story. Lol great post

  • Suzanne says:

    I LOVE Dr. Polonsky! I love his cognitive behavioral work that helps us change our thoughts about stuff like our meters and our BG readings. He is a super great resource for all of us. Great post!

  • George says:

    What a GREAT post! I always ask myself why. This is huge. I love assessing not testing. That is the way it should be. Not the number but the fact that I am checking is what should be celebrated.

    I hope my doctor sees this.

  • Rachel says:

    Excellent post, Sara.

    There’s guilt/anger and there’s improving on results. I’ll choose improving on results any day.

  • Great post Sara. I love the pictures at the end too. I think I’ll have to read this a few times to change how I think of those assessments!

  • JaimieH says:

    Excellent post Sara!

  • Nan says:

    I love this post, Sara! Great job! And happy assessing!

  • Jenny S. says:

    Totally spot on!! I cannot shoot the messenger 🙂 But I can learn from it.

  • Claire says:

    I completely agree! Great post! I love your last line, “It put me in control of a disease that is so often uncontrollable.” I have used something like that a time or two before, it just sounds so inspiring 🙂

  • Tricia says:

    Sara –

    You rock my socks off… not blue ones though… actually, none right now… flip flops… you rock my flip-flops off!

    I completely agree, but having been raised by pessimists, and being a pessimist (trying to be an optimist) myself… it’s so hard to reward yourself or be proud of yourself for doing what you truly NEED to do… *sigh*

    I’m working on it, and you’re helping me.


  • Elizabeth says:

    Very well said! I also love how the pictures you’ve got a lot of 104’s 🙂

  • Steve says:

    Great post and great thoughts on testing/assessing.

    Last year I attended a TCOYD conference and in his opening address Dr. Edelman wondered aloud about why magazine and tv ads always showed meters with only “good” readings and never crazy highs or lows.

    Still get a kick out of that every time I see an ad.

  • karen says:

    Yay, great post. I’ve never liked the ‘testing’ of our bg’s and prefer to ‘check’ mine. But test is the common word so I’ve learned not to hate it. One thing I can control is how I react to things. I LOVE all the 104’s! The 456 and 581 are going to cause me nightmares however!! I’m off to see how much control I can have today 😉

  • Jon says:

    I will take it to heart and check my BG now, since I’ve checked it once today, and don’t feel quite right. Excellent article!

  • Great post – I often find myself asking why instead of what now. That darn Dr. Polonsky guy is something else isn’t he!

  • cathy thompson says:

    sara you tickle me all the time . LOL !!!

  • k2 says:

    AWESOME and true on every level!

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