Thursday, October 20, 2011

Just a game of chance . . . .

MM900236314I’ll admit it, I’m kind of a casino nut.  I have a lot of fun playing slot machines.  Yes, I know, slots are mostly games of luck.  But I like to think there is a little more to it.  Like when you are on a winning streak, you have to decide when to keep playing and when to take your winnings and walk away.  When you aren’t hitting, you have to decide if you should give the machine a chance to turn it around or if you should cash out and move on.  You follow your instincts . . . and sometimes it works and sometimes it doesn’t.

This is what came to mind when I thought about the DSMA Blog Carnival topic for this month.  We’re writing about the types and frequency of diabetes related decisions we make in any given day.  Do you sometimes feel like all you do is make diabetes related decisions during every waking moment?  Because I sure do.  And it often feels like those decisions are just like playing the slot machines . . . . I can follow my instincts, but it won’t always work.

First thing in the morning, I take my fasting blood sugar.  And if I’m a little bit low, I have to decide if I should eat something right away.  Or if I should skip my 1 unit coffee bolus and just wait for my hot mug of love the caffeine to bring my blood sugar up.

Now it’s time for breakfast.  Maybe I’ll have a healthy bowl of oatmeal.  But oatmeal always spikes me, do I really want to deal with that today?  I could have a Greek yogurt.  That spiked me last week but yesterday I ate one and my blood sugar was fine.  Should I push my luck and go for it a second time?  Maybe I’ll just have some toast.  Should I put some peanut butter on it for protein, or should skip the peanut butter in favor of keeping the carbs down?

Am I going to exercise today?  Because if I am, I need to start making some decisions about that.  Do I feel like going out for a run or walking on the treadmill?  Both of those will make my blood sugar drop.  Or do I feel like weight training?  That might raise my blood sugar.  Should I decrease my basal a bit before I workout?  Or should I eat a snack instead?  Maybe I should work out right after breakfast, and just under bolus for that toast.  But then I might end up going too high.

And on and on it goes.  Which finger should I test my blood sugar on?  If I’m planning to knit today testing on my pointer fingers sometimes makes them sore when I hold the needles.  Should I change out my pump site right now?  I’ve still got quite a bit of insulin in my reservoir, so maybe I’ll wait until later in the day so it’s not so wasteful.  But then there is a chance that my site will crap out and my sugar will spike.  Oh, and my CGM sensor!!  Do I change it out today, like the FDA recommends, or do I leave it in for another three days since it’s working well (and is damn expensive)?  Do I cave in to my craving for a bowl of ice cream and possibly suffer the blood sugar consequences?

Life with diabetes is full of decisions.  And they aren’t always black and white.  Sometime the right decision turns out all wrong.  Sometimes it’s all a gamble.  You just use your best judgment, spin the wheels, and hope Lady Luck is on your side today.

This post is my October entry in the DSMA Blog Carnival.  If you’d like to participate too, you can get all of the information at


  1. So, so true! I don't know how T1's handle all the decisions you have to make in a day. I thought it was bad enough when I have to decide whether or not I can eat or if I should exercise for lunch. You do an amazing job of staying positive, Karen. Keep up the great're an inspiration!

  2. Today I woke up and faced the bolus for coffee or wait guess because my BS was 60. I guessed right. Maybe I should buy a lottery ticket!

  3. ohmygosh YES! why is it that i could eat the same freaking thing for a week and my bgs would still be crazy? and don't even get me started on exercise.

    thanks for the reminder that so much of this is out of our control. do your best, and pray the rest works out. :)

  4. You read my mind! (Scary, isn't it?)

  5. I am in constant awe of you guys. Seriously.

    PS: vegas has slots. And I'm here! ;)

  6. i was just nodding and nodding and nodding along with all of this. i love how you've explained everything so matter-of-factly. multiply all this consideration by hours and days and years and it's no wonder there's depression and burnout.

    keep on spinning those wheels! :)

  7. it's a great post. I'm planning to show it to everybody who wants to try and understand what living with the D means sometimes.

  8. I hadn't thought of it before, but you are so right that diabetes decisions are like games in a casino. It's such a good analogy and one I'm going to hold onto & use when I'm talking to people who want to know more about type 1.


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