I was talking to a member the other day and he said he could not understand what his doctor wanted him to do. Apparently he was to readjust his carb ratios with a band of new service in the middle of the day with a higher ratio of sensitivity to reported blood sugar reports from 10AM to 2 PM, backing down his new level to the preexisting amounts thereafter. For some reason the member was confused. His question to me (a fellow Medtronic user) is what does this mean? I completely understood his frustration.

When I first got my pump my CDE told me to increase my sensitivity level. I bought 4 romance novels at the used book store and read 14 chapters with my blood sugar hovering in the high 200’s. It did not help. I called my CDE back and reported that blood sugars were still high even after 5 hours of reading the romance novels. I also told her I was crying a lot since she directed the change. I just did not understand how Jason had chosen to leave May who was desperately in love with him and take off with that hussy Veronica.

The CDE corrected my misconception and explained the sensitivity she was discussing was not found in the romance novel. I was so happy I did not have to read those books anymore. I spread the joy of those books to Goodwill so I could give that particular misery to some bargain shopper.

What my CDE wanted me to do was adjust the sensitivity on my pump, but she never said that and frankly I still have no idea why medtroinc calls that setting sensitivity. In this case sensitivity means the existing blood sugar to carbohydrate ratio, the term “sensitivity’ makes no sense to me. Why not blood sugar to insulin ratio (BSIR), or maybe dial down illness ratio (DDIR)? I mean if we are going to talk cryptically about things why not use initials and really foul things up? Why go half way when the initials could really make the conversation crazy?

So where do terms like sensitive come from? I don’t know about the entire world but I believe such craziness actually starts in college. I know I found the most confusing writer of all time in a college class about International relations. Here is a section from his classic book which I was assigned as a freshman in college:

“When the human mind approaches reality with the purpose of taking action, of which the political encounter is one of the outstanding instances, it is often led astray by any of four common mental phenomena: residues of formerly adequate modes of thought and action now rendered obsolete by a new social reality; demonological interpretations of reality that substitute a fictitious reality—peopled by evil persons rather than seemingly intractable issues—for the actual one; refusal to come to terms with a threatening state of affairs by denying it through illusory verbalization; or reliance upon the infinite malleability of a seemingly obstreperous reality” (Morgenthau & Thompson, 1993, p. 6).

Yeah I don’t know what it means either. I did not know in 1976 and I still don’t. Mind you this one sentence which was lifted almost verbatim from the original 1975 edition of this book and reinserted in the revised 7th edition in 1993. Now I know I am not a really smart guy but this is like reading enhanced Greek to me. In fact the romance novels made more sense and those (like the second Sex in the City Movie) were never going to be clear to me.

Which brings me back to the member and his question about what the CDE meant, I helped him find his sensitivity (at least on his pump) and he felt better. It is another fine day in diabetic management. I also suggested he might want to look into “Ten Things I Love About You” (Bevelstoke, #3) by Julia Quinn for information about the sensitivity setting on his pump. I mean I don’t think it can hurt? Can it?

What words do or did you find confusing about diabetic management?


Morgenthau, Hans Joachim, & Thompson, Kenneth W. (1993). Politics among nations : the struggle for power and peace / Hans J. Morgenthau ; revised by Kenneth W. Thompson: New York : McGraw-Hill, c1993. Brief ed.



i never knew what SENSITIVITY meant, either, i just KNOW i need more BOLUS than pump says, sometimes
i use my brain, too, not only my pump.
Rick you're a great writer.

I have a sign hanging on the wall next to me that says "Dry Paint". Really.

As for that textbook . . . when people write inflated drivel like that I simply dismiss them as self important stuffed shirts. The purpose of writing is to communicate, not to impress. Any writer who forgets that deserves not to have any sales. (I realize this was a class textbook and you had no choice; just making a general statement.)

As for which words about diabetes confuse me, they all did until I chose to stop following medical instructions by rote and start learning on my own. To control this beast well, you have to become your own expert. You're the only one who's there 24x7 and you're the only one who can.

well said about diabetes, david.

Thanks! hahaha, sensitivity....
Well... "What words do or did you find confusing about diabetic management?" The word "balance" has always and will alwyas puzzle me. This is a non-existing word for me.