Monday, December 3, 2012

DiabLaziness



I was laying in bed several nights ago, and it struck me: "I am diabetically lazy". A shocking realization, it is not. An epiphany when examining those of us with chronic disease lazies after decades of just "dealing", YES.

It all started when my new Dexcom G4 Platinum {Yes, I IS fancy} required a finger stick for calibration. This would have required several actions on my part, including getting up to grab a new vial of test strips. It was then I decided my bed was just too comfy...my book just too enchanting...the soundness of my sensor, just not THAT important...So I did it. I calibrated my CGM with a MADE UP NUMBER of my choosing. GAAAASSSSSSPPPPP. I calibrated my sensor with a number close to what it was already reading, hoping it wasn't that far off from what my actual sugar was reading.
Now, why is this a BAD idea?? What if my sensor was WAY off? I could have just caused my sensor to continue to read "off", and thus miss any important shift changes in my sugar, rather that be low or high. This could have resulted in a missed "LOW" or "HIGH" alert, rendering my sensor useless. At the time, I seriously couldn't have cared less. But in retrospect: DiabeDUMB.

We have all been guilty of DiabeLaziness. Changing our lancets only when the clock falls back or springs forward, using a new pen needle or syringe only when it begins to bend into our skin from over-use, or simply skipping out on a fingerstick or insulin dose all together, what about injecting in the same area over and over? Using a pump site past 72 hours??. Do I condone this behavior?? Certainly not. Do I partake in these behaviors? DUH, I'm human. Remember the old addage "Do as I say, not as I do?", yes, precisely.

Will these things harm you? Possibly, and that is a risk we all take with our bodies. Re-using lancets sets us up for pain and infection, same with re-using needles for injection. I've had patients who have had a needle actually break off in their skin. What about re-using the same injection spots/pump site areas repeatedly: insulin is a growth hormone and will antagonize the growth of tissue, the technical term being lipohypertrophy. Lumps and bumps from over insulinizing a site can also prevent you from fully absorbing your insulin dose, the tissue becoming sponge like, sucking up the insulin and preventing your body from using to lower the sugar. And we ALL know skipping out on insulin doses is bad dog behavior: and will absolutely result in a higher A1c, which results in a grumpy Endo, which results in sad face immediately following said Endo appointment. I am reminded of the genius comedy website DogShaming.com. We need a DiabeticShaming dot com. Ok, so maybe not. As my patients would probably get pretty upset when I force them to wear their bad habits around their neck while I crack up and post their mugs on the site. Hmmm Ok, so probably a bad idea wrapped in pure awesomeness.

I know we are all guilty of SOME of these offenses. Some of the milder ones like putting a bloody finger in your mouth or not using an alcohol wipe before an injection. Overtime I think we learn what we are able to "get away" with, and which of these rules truly matter. There is scientific evidence that wearing your pump site past 72 hours decreases your ability to fully absorb your insulin...so...DON'T DO THAT! But if over time, not changing your lancet works for you AND you've weighed the risks involved, then be my guest. Balance your smarts with your dumbs, and all will be well with the world.

What are some of YOUR worst offenses???

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