Every day, or before I get out of bed, I immediately look at the clock. Every day, I have the same equation to calculate, with sometimes vastly different numbers. Then, there are some numbers that will never change much. 8,760 hours in a year. If I see my doctor every 3 months for a 15-minute appointment, then there are still about 8,759 hours a year that I am on my own to manage my diabetes. I am constantly sorting, adding, subtracting, multiplying, estimating all of the numbers and variables needed to maintain my health and my life.
The equation begins with my blood-sugar test results. This can range anywhere from as high as 350-400 mg/do (milligrams per deciliter), or as low as 20 mg/do, depending on many possible random factors. Sometimes it is even in the normal range of 80 – 120 mg/dL.
Then, regardless of the results, I take my daily 23 units of Lantus, a time release insulin, keeping track of the time I inject it, because of the roughly 24 hour duration of the Lantus and possibly “over lapping”. I try to take it at the same time everyday so I don’t “overlap” yesterday’s shot which can cause unexpected low blood-sugars. This number doesn’t change. It is supposed to last 24 hours, based on what I am supposed to eat.
Next, I prepare my “sliding scale” insulin, Humalog, with as many units are necessary to cover the amount of insulin I need to lessen the spike of blood-sugar I will get from whatever I will have for breakfast, plus a little more, depending on the reading I get with my before breakfast blood sugar test.
When I eat breakfast, I must add to the calculation of how many carbohydrates and proteins I am eating, how long what I eat will last before I might have to eat again, based on what type of physical activity I will have before lunch and how much Humalog I just took. Whether or not I “overlapped” on the 24 hour Lantus shot from the day before. I may not even feel the affects of an ”overlap” for a couple of hours, when I might get surprised with an unusual low blood sugar reading before lunch and have to either grab some juice, or whatever, to bring up my sugar in a hurry.
I often have to eat a snack between breakfast and lunch, but I don’t always have something handy, because of what I happen to be doing, or where I’m going, I forgot to bring something, or I just don’t have anything to bring, due to a lack of money, sometimes. I try to always try to keep a can of fruit juice handy, or some kind of candy with me for emergencies.
At lunch time I go through all the same calculation of my blood sugar reading, and taking the necessary amount of Humalog based on what my blood-sugar reading is how many carbohydrates I will eat for lunch, what activity I will be doing and when I might be able to eat next. I do all of the estimates on the time I ate lunch, when I might eat next, what I am doing, or going to do between lunch and dinner.
Around dinner time, I repeat the whole routine again. The sticking of the finger to test my sugars, to taking my sliding scale insulin, to eating a calculated amount of carbs, all over again.
Before I go to sleep I check my sugar again. I then have to try and have it at least 180 mg/dL, because that way I feel more confident that it will be close to “normal” as possible in the morning. I go to sleep in the “normal” range of 80 – 120 mg/dL, I will wake up soaked in sweat, weak and unable function easily, or at all. I then have to reach, or walk, or crawl to the closest source of sugar I can find, like a can of fruit juice right away. Right away.
Then, all those numbers and calculations get put into a computer called, “the A1C”, where they are tallied up. In the end, the answer is seldom “correct”, but close is usually “good enough”.
I was never that good at math, anyway.