WRITTEN BY: DAVID BERNSTEIN
You’ve just eaten. You’ve taken your insulin. In less than an hour, glucose and insulin will meet for an epic battle: The Face-Off at the Insulin Corral!
Whoa! Let’s back up a bit! Diabetes is a serious topic. Our lives depend on what we do. How we dose insulin and what we eat are vital to our health.
But let’s not forget the value of humor. Sometimes taking a lighter approach to our disease can help. Don’t you sometimes just want to laugh at the ups and downs of diabetes? I do. Humor can take the edge off our disease.
Thus, this discussion. It is meant to make readers smile…and maybe take a lighter look at diabetes.
I’m a person with type 1 diabetes, like so many of you out there. Our daily effort, simply stated, is to match glucose intake with insulin. I say “simply stated” because as we all know, it’s easy to miss the mark when it comes to dosing.
We are always fighting battles. We dose, we eat, then we wait. Then sometime after the meal, the glucose and insulin meet.
In a perfect world, they will blend in perfect harmony. If so, your CGM line will not budge. But more likely, the two will duke it out for supremacy. Your numbers will go up or down.
This got me thinking….
It could be fun to compare our insulin struggles to the famous face-off at the OK Corral. Readers who know western history are aware that the Earp brothers and Doc Holiday faced off with the cowboys, the McLaurys and Clantons. The event became the most famous face-off of the wild west.
If we wish to compare our insulin and glucose face-off to the OK Corral, we have to admit that there are no good guys or bad guys. Insulin and glucose are both good. We need them to live!
To push the amusing comparison a bit, the battle between insulin and glucose is always present in our lives. It’s daily—starting about an hour or less after each meal. It is also present throughout the day and night, every time we bolus.
In other words, we visit the OK Corral many times a day!
Both sides in the insulin/glucose face-off need to be well prepared for the fight. On the glucose side—often, we try to arm ourselves with those “complex” carbs.
A lil’ ol’ reminder: complex carbs are “whole” carbs. They are unprocessed and contain natural fiber that comes with the food. Among the most popular are vegetables, whole fruit, legumes, whole grains, and potatoes. Yes, potatoes! Real food.
Sometimes we arm ourselves more tenaciously when we’re choosing more refined carbs such as fruit juice, sugar-sweetened drinks, white bread, white pasta, white rice, cakes, pastries, and, alas, SO much more! I am personally fond of homemade chocolate chip cookies!
So back to our face-off parable. Once you have “armed” yourself with whatever you’ve chosen to eat, you ingest them and send them off to do to battle.
Enter the other side: your insulin cowboys!
You have only two choices about how to arm your insulin cowboys: size of the dose and time of the dose. Both are significant. First, we must always determine how much insulin to take. Every meal is different. Every day is different. Fact is, sometimes the same dose for the same meal will yield wildly varying results.
As we opt for the number of units to dose, we try to think of all the factors that go into dosing. We do the normal ratio calculations. We also try to consider emotional or mood factors. Are we tense? Tired? Irritated? Worried? Stressed? If so, we need to be strategic about finding the right dose.
We must consider the types of carbs we’ve eaten. Apples? Oranges? Beans? Cookies? Pizza? Sally Jo’s homemade oatbread? Some meals digest quickly, others are slowed by fiber, fat, and protein. Some meals shoot our sugars up. Others are gentler.
Then, we need to figure out when to dose. Right at mealtime Fifteen minutes before? A half hour before? Maybe we need some when we eat, and the rest of the dose 2 or even 4 hours later! It all depends on just how quickly that meal is going to digest.
I am constantly trying to figure out when to dose. The decision changes day by day. Ultimately, we send our insulin cowboys to the OK Corral!
The goal: Insulin and glucose need to meet at the OK Corral in a perfectly matched face-off!
They must arrive at the corral at the same time. (Let’s hope their horses gallop at similar speeds!) They must confront each other on a level playing field, where carbs and insulin present arms!
What’s the best result? A no-winner outcome! In other words, a DRAW! We root for both sides to win.
We know that in the crazy imperfect world of diabetes there are often only half-victories. Wasn’t that how it was at the OK Corral? History buffs will recall the outcome of the famous gunfight: Two Earps were wounded and three outlaws were killed. Hardly the perfect outcome!
Wyatt Earp and his brothers were brave indeed. They risked their lives for a cause.
We have to be brave, too, facing-off with diabetes every day. We are warriors of sorts. We make a million decisions around food. We strive to dose insulin in the right amounts at the right times. We juggle other lifestyle factors like exercise, work, stress, family, etc. We do everything we can to put the odds in our favor.
Every day we take up arms against the disease. Every day we send our glucose and insulin off to wage war. Next time I check my glucose, especially after a meal, I’ll smile if there’s little change.
I’ll just figure everything turned out fine at the Insulin Corral.
David Bernstein was diagnosed with type 1 diabetes at 68 years old—after being misdiagnosed with type 2 at 65. With a Ph.D. in French language and literature, he was a professor in the Oregon state system before turning to high school teaching, which became his true passion. Today he spends his time on music, art, and movies. He has been married for 52 years. He has two children and three grandchildren. Type 1 diabetes has been a part of his life for over 10 years. David does his best to enjoy every day and never let the disease control his life—the glass is always half full!