My career has always been in the area of training development, training facilitation, systems and procedures development and implementation and Quality Assurance. Looking back over my work career I have identified that the value I added and, consequently, the value I received back in the form of compensation was when I was in a position to assess and transform an existing process that was not working into a “new” and different process that would work.  I have a knack in seeing what is wrong and how to fix it.  Not always, but usually when it is not working.

One of the the jobs I had was that of Training Director for a small company that sold financial products.  I called the new training manual The Yellow Brick Road.  I called it that because the new process was a step-by-step process and needed to be followed step-by-step if it was going to work.

The diagnosis of either Type 1 or Type 2 Diabetes means that a system of the body (a critical system) is not working.  A new system with different procedures must be put in place.  The system that is not working is the endocrine process.  It is the process that converts food (carbohydrates and fats) into glucose.  Just like when business systems slow down in performance or stop working it is not everything within the system that has gone bad.  It is usually one or two things that are the cause of the dysfunction.  In Type 1 Diabetes it is the inability of the body to produce insulin.  In Type 2 Diabetes it is the reduction in the effectiveness of insulin to keep blood sugar in the “normal” range.

My approach to my own diabetes has been a step-by-step process on many levels.  And that is the hidden nuance of this disease.  My approach in assisting others with diabetes will also follow a step-by-step process.  The Yellow Brick Road ends with the discovery of the true source of the wizard and a journey back home.  It is the path from the unreal to the real.  When you have engaged in the process you will begin to awaken to a deeper truth and will be closer to h-OM-e.

See “The Work” page above for more details on what I do and who I work with.  This work is the path to our ultimate goal of total transformation and liberation.

I have sometimes used addiction as a metaphor for Type 1 diabetes. Think about it for a minute………

A Type 1 Diabetic (T1D) must inject insulin daily. If still taking shots then a Type 1 diabetic might have to partake in a “fix” up to 8 or more times a day. If on the pump we are constantly “hooked” up to our “drug of choice.”

But, Michael, a T1D doesn’t  crave insulin?? Try not taking it for a day or two and see if you begin to crave it.

But, Michael, it is good for us unlike being addicted to something like drugs or alcohol?? Yes, it may be good for us but we are addicted to it. We need it. Without it we will have symptoms of withdrawal.

What I am asking you to do by contemplating being an addict by being a type 1 diabetic is to hold a mental perspective that you may not have thought about. When thinking of our disease as an addiction there are a few pathways that may open up. Explore these. Think about the people around you. Are they acting like co-dependents or enablers? Are you treating them like co-dependents or enablers?  Do you hide your disease? What is it that caused the addiction in the first place? Do I own any responsibility for the onset of my situation? Is the goal to overcome my addiction?

Check out the 12 steps of AA. The first step says…..”We admitted that we were powerless over alcohol and that our lives had become unmanageable.” Does having diabetes imply we are powerless over something and that our lives have become unmanageable? What is the something that we are powerless over? For sure the goal is manage our disease. If we don’t, our lives do become unmanageable.

I don’t bring this thought exercise out to be provocative. No, my intention is to offer a momentary shift in the way  we see our disease so we may obtain additional tools to combat it. I have had type 1 diabetes for 39 years now. I can tell you with 100% certainty that if you are able to increase your level of awareness you will increase your ability to respond (RESPONSE-ABILITY) to your disease on a moment to moment basis. Denial is one of the hurdles in the recovery of an addict. Some say the opposite of denial is acceptance and it is acceptance that will “set you free.”  Screw acceptance.  I don’t accept this dis-ease.  However, I am willing to be aware.  Work on awareness and the quality of your disease control will increase and you will be on the healing path………..

Total Accountability and Total Feedback constitute the minimum and only perpetual motion system.”  Buckminster Fuller, Critical Path.

In order to re-create the system that has been compromised due to the onset of Diabetes we must determine what it is we have to account for and then receive and assess the feedback (results) we get.  There are so many things we need to account for.  Read the “Transforming Diabetes Series” in this blog to get a breakdown.  There is really one thing we want feedback on and that is our blood sugar level.  There are continuous glucose monitors (CGM’s) on the market and I think every person with diabetes should have one.  But even with a CGM we must finger prick test multiple times per day.

If you are Type 1 I believe you should be testing a minimum of 10 times per day.  If you are Type 2 you should be testing at least 10 times per day until you have reached a balanced state.  Then you can spot check throughout the day a minimum of 4 times per day.

Testing/Checking Blood Sugar levels is like taking a photograph.  It is a moment in time.  If you have eaten and are not confident of how many carbohydrate and fat grams you have digested then you may want to test more often.  If you have a lot of insulin on board then you may want to check more often.  If you are testing your basal rates you want to test your blood sugar every hour for a period of time.  If you are engaging in exercise or physical exertion you want to test more often.  Testing more often begins to transform the photograph into a video.  You can detect trending and effects of certain foods, emotional states, exercise etc.  This is important information for you to have in order to make good decisions in both the present moment and future.

Testing your blood sugar is a critical component to the system we are asked to re-create and monitor constantly.  If you are not testing 10 times per day talk to your doctor and get a prescription for 300 strips per month.  Tell your doctor you are committing to testing your blood sugar because it is the critical feedback you and he/she need in achieving a deeper understanding and mastery over managing your condition.  More feedback is good.

The primary goal in managing diabetes is to achieve blood sugar levels as close to normal as possible.  There are several subgoals:

1.  Achieve primary goal without experiencing too many lows.  Lows are blood sugar levels that drop below, let’s say, 75 mg/dl.

2.  Achieve primary goal without experiencing much time in the high blood sugar area.  High blood sugar is, let’s say. 240 mg/dl to 300 mg/dl.  Anything over 300 is an emergency situation in my book.

3.  Achieve primary goal and be able to eat well and satisfy hunger needs.  This can mean several different things for each individual.

4.  Achieve primary goal and be able to live an active and purposeful life.  Again, different strokes for different folks.

Normal blood sugar’s range for a human body is between 80 mg/dl – 120 mg/dl.  It may, at one time another, fall  a bit below or rise slightly above.  However, normal 4 hour fasting blood sugar should be around 80-100 and at most 120.  Type 1 diabetics do have an opportunity to stay in the normal range for hours at a time.  Some may be able to extend that for a few days.  It takes great skill to achieve normal range for hours at a time.  A Type 1 diabetic’s blood sugar will rise many more points after eating than a person without diabetes.  That is why the upper limit of the goal’s range is 240.  And the Type 1 diabetic is always in danger of falling too low.  Blood sugar monitors enable us to “check” our blood sugar.  Checking is just that.  It is a moment in time.  Multiple testing over short periods of time will reveal trending.  Trending and the rate of trending is critical information to the ongoing management of the disease. A1C blood tests provide the average blood sugar over a period of 2-3 months.  An A1C result of 6 represents an average 3 month blood sugar of 136 mg/dl.  An A1C result of 7.0 is an average blood sugar of 172. Continue reading The Diabetes Equation →