Control. It’s a dirty diabetes word for patients who do not produce any insulin. To be “in control” means having no excursions with blood sugars (up or down) and achieving a near perfect HbA1c. Control = overcoming diabetes with the use of exogenous insulin. (Anyone else reading, you may be free of diabetes or have the ability to reverse your diabetes so you are the master of your universe or shall we say “in the driver’s seat.”)
Many doctors ask, how is your control? They need to know because for many doctors our control reflects on their ability. They do not ask, how are you doing? We are confronted by the question of control because being out-of-control means a person with insulin-dependent diabetes isn’t taking care or managing well. Or does it?
I attended a school lecture last evening on how to help teenagers manage stress, and the speaker told the audience of parents that understanding which things are controllable in life and which are not is key to maturity. The lecturer, an adolescent psychologist, also suggested that parents ask teens “if they can control” whatever is making them worried, anxious or upset. He advised parents to help the teen decide whether the answer is yes or no, because often letting go or finding solutions all starts with one answer to that tricky question.
“Can I control it?”
I listened carefully and thought about my preteen daughter who is growing up fast, but then immediately after the presentation began to think how this question applies to certain forms of diabetes. Like I said, CONTROL is a very abused and misused word in diabetes medical-speak. It can be dehumanizing and often it has a negative connotation when used in other arenas. For example, parents demand children to “Control themselves!” Certain governments control freedom of speech or other human rights. Senior citizens who have lost control, must wear adult diapers, and so on.
Here is a list of possible answers if someone asks you if you can control your diabetes. Which one would you choose?
a. YES, I can control diabetes, even though it means controlling my body without one of the most intricate and important hormones for life – endogenous insulin.
b. NO, I cannot.
There is just no possible way that YES can be right.
If you accept that you cannot control diabetes – it actually yields a quite astonishing fact for any individual. If I can’t control diabetes, then I am neither a good patient nor a bad one (good control versus bad control).
Try and say it aloud. “I am neither a good patient nor a bad patient. I am just a patient who suffers from diabetes and I must use insulin for life. It is not a perfect system, but I do the best I can.” Feels right, yes?
I say this everyday. It allows me to figure out what I can control and what solutions are available to me for success. Here are mine:
1. I cannot control diabetes, because when I eat food, my brain may try to signal the release of insulin to break down the sugar in my blood (thereby giving my cells energy or life) but there is nothing there. I try my best to mimic this complex physiological system. Because injecting or infusing insulin is so rudimentary, it fails me sometimes. I can control my feelings about not having any endogenous insulin. I can control my feelings about my condition. I do the best I can.
2. I cannot control diabetes, but I can check to see what my blood sugar is by sticking my finger for blood and testing for a result. Although my body can’t regulate what is normal, I can check whenever I want. I can control how many times per day I check the percentage of sugar in my blood. I can control my need to know and base my requirement for insulin on that result. I can control my confidence.
3. I cannot control diabetes, but I can decide what to eat and what not to eat and how that relates to my blood sugar. I can control my choices.
4. I cannot control diabetes, but I can exercise and help my body become stronger. Healthy muscles uptake exogenous insulin much more efficiently than weak muscles and this helps that rudimentary process of injecting and infusing insulin. I can control my physical activity. (See exercise photo – sometimes I have to convince myself to do it. Funny thing is – I never regret exercising,)
I do not believe “Are you in control of your diabetes?” has EVER been the right question to ask. Once the body stops producing any insulin, human beings have a very difficult time sustaining (controlling?) a life.
Instead of focusing on what is uncontrollable, start focusing on all those other things that you can control which turns what should be a life cut short into something alive, beautiful and vibrant.
Focus on what you can control, not what you can’t. Focus on sustaining life.