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Second Verse, Same As the First.

As Albert Einstein once said, "Pbbbbbbbblllt!"Monday morning, I woke up at a blood sugar of 82 mg/dL. I had a cup of coffee, half of a banana, and two scrambled eggs for breakfast.  I took 2 units of Humalog insulin to cover my meal, and then spent the morning playing with Birdy and doing some writing.  Two hours after eating, I was at 143 mg/dL. 

Tuesday morning, I woke up at a blood sugar of 98 mg/dL.  I had a cup of coffee, half of a banana, and two fried eggs for breakfast. I took 2 units of Humalog insulin to cover my meal, and then spent the morning playing with the Birdzone and answering emails.  Two hours after eating, I was 285 mg/dL.

What.  The.  Eff?

Albert Einstein once said, "The definition of insanity is doing the same thing over and over again and expecting different results."

I think the definition of diabetes is doing the same thing, over and over again, and waiting to see which way the wind is blowing that day.  Or maybe the definition of "insanity" is "diabetes."  ;)


You are not alone! This happens to me weekly!

One time when Lauren was little she had a perfect week of D #'s etc. At her endo appointment I showed the endo the chart -- with all it's beautiful in-range #'s on it. I said, "so, we have to just recreate this week over and over, right?" And he said 'No, what you need to do is just frame that lovely chart so you can look at it and always remember that perfect week!" LOL

So familiar.
My patience is tested every time I speak to the diabetes nurse educators - they're always pointing the finger in terms of "mistakes" ("WHY did you bolus before bed?" Um, because I was at 19.5 and felt like crap?). Those judgements *might* be okay if results were consistent, but that's what's so maddening: 1 + 1 = 2 on Monday, then 1 + 1 = 17 on Tuesday, then 1 + 1 = 4 on Wednesday. Nutty. I wish the nurse educators would get that.

Totally agree. It's not the testing or shots. It's the "insanity" that makes diabetes such a hard disease to manage.

Ugh, this is absolutely one of my biggest frustrations. As a matter of fact, I was just talking with a few diabetes friends about it over lunch yesterday. At least it helps to know we all go through it. :)

Love, love, love this post.
After 30 years of Type 1, What makes ME insane is when people who don't fully understand it think you're a failure for not being able to just "figure it out" after having it for so long.

Thus is what I think about D on a daily basis. The only constant with D is that there is no constant. Hah!

So SO true! I have been going crazy. The past three mornings, I have woken up at 3am with a low blood sugar of 57, the next morning I woke up at my normal time at 337(!!!!) and the next morning 178...so freakin frustrating!!!

Oh, this happens way too often for comfort. That is, for me, the by FAR most frustrating thing with diabetes, and it can drive me insane. Hence, "diabetes"="insanity"! ;-)

I'll echo the rest... it's the MOST frustrating thing about diabetes and the one I don't think many non-D's understand. Yes, we can take our medicine, test our sugars, eat right, etc., but sometimes the numbers just don't make sense!

Well, apparently reading emails takes you higher than writing... ;)

The definition of diabetesis doing the same thing over and over again and getting different results :)

You're still amazing, Kerri. You stopped after one cup of coffee. I could never do that!

did you know that the photo you posted of Einstein is entitled
"YES, I chewed and swallowed ALL 6 glucose tablets, SEE !!!!!!"

I also hate when you do things differently, expecting a different, hopefully improved result but keep getting the same thing. I just want to eat sushi without going high!

Ain't it the truth? Ain't it the truth? The first time my endo looked at my meter readings and said "It's not a mystery, ya know", I bit my tongue. The next time he said it to me, I said "ya know, sometimes it absolutely is a frickin' mystery". My diet is pretty monotonously consistent and my numbers are anything but.

Almost every second day this happens to me!

I agree that the definition of diabetes management is truly insanity. The notion of control when we have influence over just 3 (food, insulin, activity) and expecting consistent results each time seems like a fool's game. When will the medical profession come to this realization, and shift it's fixation away from chronic management towards prevention (of type 2 at least) and reversal?

Maybe the banana was one day riper on the second day. Or your pump site was one day older. Or you had a bigger dinner last night. Or you're one day closer to your period. Or you exercised 2 days ago and not yesterday. Or the sky is blue today and gray yesterday. Or yesterday's date was an even number and the day before was an odd number.

Sometimes it is a miracle that we do as well as we do. What always frustrates me is these differences are not 10 points from day to day, but 50 to 200 points difference.


I went to nursing school "back in the day," and was taught that all you had to do was balance food intake with the correct insulin dose and everything would be peachy! Fast forward 18 years and I became the mother of a T1 son. Only then did I learn the truth: diabetes is not a linear disease. If you do A, B will not necessarily follow. It might, mind you, but only if you aren't stressed out or last night's pizza (fat) still isn't working on you, or you aren't in a growth spurt, or you don't have a cold, etc., etc., etc.

I now teach in a nursing school and try to get all of this across to my students, but I still think that they see diabetes as that linear disease.

Good to know I'm not the only one who this happens to!

Hysterical - same thing happened to me Sunday and Monday evenings. Had the EXACT same dinner, but on Sunday I couldn't get below 300, and on Monday I couldn't get above 50.

(And by "hysterical," I mean "If diabetes had a body I'd stab it.")

This happens to me all the freaking time and it drives me nuts. Too many people, including doctors, assume that diabetes management is all about food and insulin. We all know that there are so many other factors that affect blood sugar, including weather, hormonal fluctuations, stress, sleep patterns, exercise, etc. That's why it is so freaking difficult to manage.

Wow, you could homeschool with research like that...

This goes back to your post on solving for the "why" - there are a staggering amount of variables that creates some mind boggling combinatorics....And creates sooo much frustration.
The view of treating diabetes with only three variables (food, insulin, activity) is inadequate to the point that its almost laughable. If you lived in a bubble it *might* work. Haven't met an endo or DE that has shown this understanding.

@Deb - "Diabetes is not a linear disease"; will be using that one :)

Shared this with all of my med school friends. If health care providers could get it through their (our?) heads that this is not a linear disease, the world would be a much happier place. Thanks for writing what we all feel everyday in an understandable way.

I thought there was something seriously wrong with me when this happened! Same food. Same insulin dose, low one day and high the next. WOW. I thought I was the only one. So does this mean I have normal diabetes? By normal I mean whacked out frustrating and annoying diabetes?

Insanity = Diabetes. I like it. Let's go with it. Goodness knows it sure drives me effing crazy! :)

Also, am I the only one that thinks (on those days that the same food sends you over 200), "I should have just ate the whole damn banana!"?

No? Just me? Okay, fine. :P

My daughter's school nurse once asked me why her BG was so high one day, and my answer was, "I don't know. The wind may be blowing out of the east instead of the west, or she put her socks on the wrong feet this morning." She thought that was hysterically funny, not realizing that I was COMPLETELY serious.

This must be so frustrating. Has anyone ever looked into natural remedies?

Also, let us not forget that the meters lie.

Little too familiar:) I love submitting my logs to my peeps and hearing them say "I can't find a pattern. Are you sure you are counting your carbs?"

The first time I heard this used to diabetes, it explained everything. :) Still does. As Homer says, it's funny because it's true!

Thanks Kerri, this happens quite often and it just never makes sense. It is "Insanity"!

*this* happens to me all. the. time. One of my biggest pet peeves about diabetes. Why can it not just be logical?? As a self-proclaimed control freak, this makes me want to throw the stupid meter across the room...but I haven't...yet. :)

Kerri, thank you so much for this blog post. I have included an email I sent to my endo, bringing it to his attention. In the email I refer to an occasion when he was going on about how if you get all the control parameters right, it will all just work out A-OK, and I pointed out that he didn't have this condition, did he? He bristled and got a bit defensive. I think because of your blog post, he and I are now more on the same page. He emailed me back saying, thank you, very insightful. My email to him follows:


If you wouldn't mind, please read the blog post here (titled: Second
Verse, Same as the First):


It's very short.

This is why I commented to you recently, "You don't have this condition,
do you?" and why I believe that fact is relevant. Its relevance in no
way disparages your knowledge and expertise, and there is no need for
you to feel defensive. But those of us who actually live with this
nonsense day in and day out have all had experiences like this. There's
theory, then there's practice, and then there's diabetes!

Have a great day, looking forward to our next meeting.

Thanks for putting a word on something all of us experiment so often ... 'Insanity' is also a door to ... another way to look at the world... xx

@princessladybug-No it's not just you. Except maybe I'd say I should've eaten a whole bowl of ice cream instead of the banana!

This happened to me just two days ago! Glad to know I'm not crazy.

Yes, me too, for 32 years.

Two thoughts: Other people's autoimmune diseases have "flares." Do ours? All those holistic health/self care/dietary strategies that reduce the severity and frequency of autoimmune "flares" if it's Crohn's, or MS, or RA...do they have helpful effects on us too?

Next question...Do I have a tiny number of living beta cells? If my general health and my BGs have been excellent, they contribute and whoa, I'm "cured" and need hardly any insulin that day (19-20 u). If I'm stressed and inflamed and exhausted, forget about them and bring on the exogenous insulin (32-35 u or more.) Is that it?

I'm convinced that this variability we patients are seeing contains important information for understanding the disease! I wish our doctors were spending time learning about it and gaining experience with it.

Or maybe that's just up to us.

Great post, Kerri!

Ah, this just made me feel so much better!

Yesterday: 7am, wake up, BG = 89. Arrive work (before bkfst), BG = 110

Today: 7am, wake up, BG = 95. Arrive work (before bkfst), BG = 230

I rarely get frustrated but this morning I wanted to throw my stapler across the office.

My endo says it right: "It's God's system, we're doing our best to model it." It's maddening that 2+2=4 today and 7 tomorrow. We just do the best we can!

Thank you, thank you, thank you, for posting this!! My daughter is about a week away from her 1 year diagnosis anniversary and I have came to realize there is no consistency in Diabetes! We have spent weeks trying to figure it out and then spent weeks trying to figure out why we can't figure it out.
It is so comforting to know we are not alone...thank you again!

I would love it if diabetes was a linear disease. I would be ecstatic if I could eat the same meal multiple times knowing that it wouldn't spike my glucose. It helps to read this, and all the comments, and know I'm not alone. :)

When I first started dating my current girlfriend she took a great interest in everything diabetes. She's a very logical thinker. A software engineer. She would see me do the same thing each day and get wildly different results, and she'd say "I don't get it! WHAT WAS DIFFERENT?". And I'd smile and say "Welcome to CrazyLand. Don't try too hard to figure it out." Two years later, she's stopped trying to figure it out.

So true and so frustrating!!! Day to day, week to week, everything seems to change. I randomly needed 130% basal a couple of weeks ago just to stay below 300 and then suddenly, no longer needed. I'm not glad that others are in the same boat, but it does make me feel less crazy!

Thanks for this post, Kerri. And thanks to everyone who's chimed in with their own similar experiences. It helps me feel slightly less insane! I'm on MDI and mostly doing okay with that. But today my body is ignoring insulin. I'm not too high, I'm just not able to bring the number down where I want it. After one injection, my BG went up. Others, up and down and back up again. I should be snacking on handfuls of jelly beans and drinking orange juice from all the insulin I've taken so far. Grrr!!!

This. Week. Was. In. Sane.

I blame the full moon, or the early spring, or the impending 2012 apocalypse, or the fact that "the sky was blue" as someone commented, because THIS WEEK MY BG MADE NO FRAKKIN SENSE AT ALL.

And since I'm seeing my endo tomorrow, and just downloaded my charts from the last two weeks, I've had a great time looking over my craptastic numbers and feeling awesome about myself. Yep. Just awesome.
So thank you for this show of solidarity, as always. And full moon? You can just go bugger off and leave our bolus wizards in peace.

Last week and the week before were tough for me to stay in check (actually called my endo which is rare for me), as looks to be the case with a lot of others... I wonder if there really is something common to all of use for that time frame? I can't shake the feeling that this is too convenient for a coincidence... or maybe I'm just getting low pre-lunch!

As always, thanks for the blog and post. I wanted to say something to @Laura G above, in regards to the beta- cells question. Have you heard of Faustman labs? They are in Boston, and have discovered that even long-term diabetics are still producing beta cells, only detectable with a certain test. They are doing a huge amount of good work there. Here is the link: http://www.faustmanlab.org/

The truly bizarre element in all of this is that the medical profession knows quite well that countless phenomena influence blood sugar levels apart from insulin dosing, exercise, and food intake, but when it comes to managing patients, it pretends that things are all just a matter of matching food to insulin. The only reason for this deliberate ignorance must be to contrive a reason to blame the patient rather than modern medicine for the manifold problems of this disease, which is coming up soon on a century of no real progress. If the unavoidably unmanageable nature of the disease were honestly admitted, then suddenly Mr. Endocrinologist would no longer be the prestigious expert and the patient the subordinate fool, ruining his life through indiscipline or stupidity. What an uncomfurtable shift in the balance of power that would be! Diabetes medicine, in short, is profoundly political.

Do any of you have experience with a low carb diet, say around 100 grams per day, and whether such a diet helps moderate these unpredictable, frustrating and dangerous swings in blood sugar level?

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