Continuing from a prior post, one of the most surprising byproducts of my experiment with wearing a continuous glucose monitoring system is my evolving understanding of what a blood sugar number can mean emotionally and morally. I’ve always felt like I’ve had a healthy perception of viewing the number as simply a diagnostic tool. When I started testing myself, however, I realized that every number had a moral judgment as well as a numerical value. Trying to make sense of my feelings, I’ve learned the following truths.
First, I know that one number that isn’t in range is no big deal at all and has little effect in the end on James’ ultimate health. But I know that if the numbers are consistently out of his target range, he will have some problems down the line. I have to reconcile the idea that to stress over every out-of-range number is to be counterproductive and can be psychologically unhealthy while recognizing that ignoring the highs and lows can cause problems over time.
Second, while a blood sugar number is only informative, it can sometimes inform me that I’ve made a poor decision. That poor decision could be something as tiny as a miscalculation while counting carbs or as serious as a conscious decision not to test before a meal. Every number not ideal has implications in that way.
I’ve realized that divorcing myself from the idea of blame or guilt associated with a number is extremely difficult; worth trying for, but difficult just the same. James is at an age where he is learning the numerical value of his numbers. Cognitively and emotionally, he is not yet valuing himself based on how good his numbers are. Will he start doing this? Will he start feeling hopeless because his numbers, unlike mine, are not always in the correct range?
It makes me wonder if a little bit of guilt — just a tiny bit — is occasionally warranted? Perhaps if he realizes that he needs to bolus a little earlier if he wants to eat his cold cereal breakfast in order to avoid the two-hour postprandial highs in the middle of standardized testing at school, maybe that’s a good kind of guilt? The kind that makes him become more responsible in the morning? Even still, it makes my heart hurt that he has so many opportunities to feel guilty about normal behaviors.
Then I think that I’m feeling guilty about the food I eat. I can no longer eat a supersized fast food meal with a big soda without wondering if my arteries are hardening or if I am developing type 2 diabetes. Food is just fraught with guilt these days, although it is clearly worse for children with type 1 diabetes.
The more I think about it, the more I realize that dealing with numbers and guilt is a huge part of the burden for a person with diabetes. What started as a musing on the “correctness” of eating a piece of pizza while wearing a continuous glucose monitoring system became an introduction into a new realm of worry. What is the right kind of balance in diabetes? It seems that knowing more about the minutiae of blood sugars all the time, while instructive, makes the process seem all the more daunting. After spending a good deal of time thinking about how to help James, the only solution I can see right now is spending more time carrying that burden for him. And of course, keeping the stoic, nonjudgmental look on my face despite what the meter reading says. After all, it’s only a number.
Disclaimer: The experiences and suggestions recounted in these articles are not intended as medical advice, and they are not necessarily the “typical” experiences of families with a child who has type 1 diabetes. These situations are unique to the families depicted. Families should check with their healthcare professionals regarding the treatment of type 1 diabetes and the frequency of blood glucose monitoring. Jen and Kim are real moms of kids with type 1 diabetes and have been compensated for their contributions to this site.