When @Terry4 posted about the 70-180 post, it really has finally helped me come to terms with just letting go.
I lurked here for a few years before I started posting. I learned a lot and continue to learn things. But when thing I have found was the comparison amongst us can be brutal. And I would let it happen to myself. I was told very early on that I wasn’t trying hard enough, I was cheating/lying, I needed to work harder. After a few years of that horrible doctor, I thankfully moved on but the damage was done.
I fight with this often but am in a much better place. But wow, I read the numbers some of our very smart, dedicated poster write and start down the rabbit hole. I know in my heart I am in a good place but I can be a bit competitive and can be a little bit of a perfectionist when it comes to my numbers.
So, like most everything in my life, I have control here. I don’t have to respond to the post or even read the post. Just like not using Facebook or Twitter or cable news or Instagram or the current best seller or top movie. I have the choice to what I let in. I am going to start posting and reading less and I am going to continue to work hard on the not comparing myself to others. I know better but it sure is hard. I will be lurking around and will continue to post but not as much as I use to. I have already started pulling back but I have let go of a few chat lines that had people who thought their way was the only way and if you weren’t on their page you were wrong. Thankfully I have not run into that here! But a break is needed. Love all of you and know I am still here just going to be selective on which posts I read and what I engage in. Mental health will always be on my must read as I still firmly believe this disease is 99% mental.
Very good and healthy perspective. Once you post to a topic, it is just human nature that you are somewhat vested in the outcome and will cause stress. Like with COVID topics I pretty much ignore as they are stressful to me.
I don’t find those ‘flatliner’ posts stressful, but they do cause me some emotional and intellectual conflict, and not because I feel ashamed. Over the years, I have seen several studies showing higher all-cause mortality in people that maintained lower blood sugars, under 6.0, with a U-shaped curve with an optimal value, lowest mortality, at 6.4 or 7.0.
My conflicts are two-fold. One is the concern that the information is inaccurate or ill-defined, since some studies mix Type 1 and Type 2, and some come with caveats mentioning that they do not know the causes of higher-mortality and are just reporting a statistical relationship. The second concern is that I will scare those that are quite proud of their sub-6 HbA1c values.
For the latter, or in those forum threads, I specifically ask for studies clarifying this one way or another - I am agnostic as to the science of control, and only care about scientific accuracy - but no one does, and those that maintain lower blood sugar values dismiss my calls for more supporting information. I certainly have tried to research the issue but have found nothing objective that would clarify the issue, just the studies of which I am already aware.
As I grew older, and I am 81 now, I learned that I don’t have to expose myself to situations nor people that make me uncomfortable. It is my choice and I decide with whom I associate and what I read, view, and believe. Granted, that did limit my associations. But it also limited my exposure to irritants, sometimes physical as well as emotional. You cannot imagine how good it feels to never have had a Facebook nor Twitter nor any “social media” account. Nor any recent exposure to television nor radio. Nor people whose “friendships” make me grit my teeth. Antisocial? Perhaps. But personal calmness and lack of anxiety makes it all worth it. BTW, I also refuse to read any posts that are more than two paragraphs long no matter how much I like the poster.
Interesting. I’m old enough to remember the old T1 whipsaw, when you’d get yelled at for high A1Cs but also for A1Cs under ~6.5 because in olden times, especially using the R/NPH stuff, it was regarded as impossible to do without a lot of lows to bring the average down—bearing in mind that A1C is an average, and what that actually means. But with better insulins and newer tech, in particular CGMs you get a graph of what your BG is doing in 5min increments over whatever time period you want to select, which makes the whole thing much safer and “too many hypos” less of a concern than when A1C was all we had. So it’s interesting that there may be an argument against “too low” A1C based on outcomes, irrespective of the too-many-hypos concern.
OTOH CGMs are still by no means universal, and hypos have their own deleterious impact. So it may be that a lot of the surveyed population are getting those lower averages because of poor control, not tight control, just like in the old days, and the “too many hypos” caution still obtains for the broader scope of T1s, as opposed to self-selected groups like TUD.
I would like to see causes of death before I gave a lot of credence to a statistical study. There are lots of variables to consider.
In the 1950s people who lived 30 miles from a doctor were less likely to die of cancer. Yeah, they died of other stuff and were too far from medical help. It is just too easy to lie by omission when using statistics.
I have a different take on seeing flatliners and the excellent control some are able to achieve. It gives me hope that I may, too, achieve control. When I joined this group, I had almost zero knowledge on how to manage D, despite years with the disease. I had no idea near normal control could be achieved. I learned so much from everyone and I so appreciate those who shared their own strategies whether or not I could apply them to myself or not. I know only too well so many things effect BG that it isn’t so simple to apply just ONE strategy. At least for me, I need to pick and choose to see what works. I don’t compare myself to others very often because I know we each have our own unique environments and issues but I am thrilled to know that it is indeed possible to achieve near normal BGs, and have a better quality of health in the process. I do, however, as @Sally7 suggests, get very disappointed in myself when I don’t achieve the sort of results I’m aiming for - near normal. I think that is just human nature!! Thank you, @Sally7, for all of your postings, too. I hope you will indeed continue to post your thoughts!!
This is my take on pretty flatlines, too. There are many people, unfortunately, who get depressed looking at other’s achievements and they often conclude that they are just not capable of that performance. Yet, for those who apply a few of the untried tactics, they often surprise themselves.
That’s what happened for me and I am so appreciative that some members here long ago inspired me to just give it a try. I was not successful right away; some things took years to bear fruit. It may strain credulity but I just don’t post glucose graphics or figures to simply brag; I do it to inspire and encourage people to believe in themselves.
I would love to see a copy of that study. Do you have a link?
Once, my a1c was in the 5s, and my regular MD was just thrilled. Even gave me a high five. It felt like someone cheering me on for running a marathon. But, it was also as though I was better, and possibly more valuable even, than I was before, and that made me pause. My good endocrinologist from back then was concerned about my lows for very good reason, and it never went that far down again with their help. For me, flatlining just isn’t advisable because I’ve got so many other medical concerns to balance, and when my body decides it’s going low, it goes dangerously low. I’m talking 20-40. I hate it But, the general doctors oversimplified it into normal a1c = best = best character, trying the hardest, not a lazy stereotype. I felt sick once I realized this.
I think that diabetic experience can be one of the experience of “judgment” from the outside world. A lot of people discuss their frustration with this in a lot of different capacities. But, I think this is a common patient experience for people from a variety of different illness/disability communities. Turns out, people with perfect bodies also struggle with perfectionism.
Perception of your own performance probably has very little to do with actual performance and very much to do with personality.
I think of you all as the Gold medalists of chronic illness, but its not necessarily based on performance, but on everyone’s ability and interest in engaging with the topics and challenges that envelop illness. You all are great.
There might be value in remembering where the term for the ‘flatliners’ club originated from on the forum. I was teasing Terry a little bit about some possible influence of “perfectionism” personality trait. I told him that, in medicine, “flatlining” was not a positive event (a reference to cardiac rhythms) and not necessarily an indication of health. One example, There is no flatline BG data when I am skiing at a high level. That’s the most dangerous data I see, but just being able to get through those weekends without catastrophic medical events COULD be viewed as success. That’s how I choose to view it because I know how difficult it is to manage really chaotic, unstable data that comes from engaging in certain lifestyles/activities. I don’t feel bad that the data is unstable. I might feel scared, but its the process of learning how to do something challenging that is interesting and fun. A lack of ‘perfect’ data is not evidence that you are doing something bad, it might just be evidence of ‘pushing’ yourself to learn about yourself and diabetes. Confronting the Devils in Your House | Jordan B Peterson - YouTube
Perfectionism is something that should probably be discussed more within our community of Olympic diabetics. Things aren’t ‘perfectly’ black and white. Being able to manage ‘non-perfect’ data is a skill in itself that took me many years to figure out and still scares me. Sometimes my goal is just survive the weekend without crashing a car driving across the country and not fall of a chairlift to my death. Flatline data does not even enter the realm of possibility for those weekends. Sometimes the goal is to remain in a state that I can help less experienced skiers around me when they get hurt - that’s a different algorithm. Sometimes I can’t keep the system stable enough to participate. Sometimes I put burden on people around me when I f*ck up. That’s life. Data analysis should not be a source of shackling. Its a tool that should free us to do more things we want to do.
Thanks @mohe0001 you have stated much than I did where I need to be.
My mental health care team once told me diabetes and perfectionist behavior is a no win situation. Because even and your best day, it will never be where you think it “should” be.
Every time I answered a question with “should” they would stop me.
The “should” can be a killer, I should test more often. I should exercise more. I should make better food choices. I should go to the doctor every 3 months. I should check my feet everyday. I should, I should, I should. The list is nightmarish!
And to follow up with the “I shouldn’t”, there is the being so hard on ourselves. I would never be as hard as I am on what I am doing or not doing with my diabetes, with someone else who has diabetes. I would show the compassion, empathy and understanding that all of us with diabetes have. But with ourselves, nope.
So I have got to get back to my good enough state of mind and not worry about everything and everyone else. I have to get back to my own good enough and be very happy that myself and my mental team have me in a very good place for me and my life. I don’t have any problems with people sharing their successes! We need to see others making it work even if it’s for that one tough exercise session. I just need to remember that, I have figured it out for my exercise situation and realize that that solution is there when my current one stops working.
The “should” for me have been so very hard for me to overcome. So when I see those people with A1C’s in the 5’s, I think that’s where I should be. That is a normal person with no diabetes. But for me I have to comes to terms with the fact 5’s are just not going to happen for me and where I am in my life. Maybe when I retire and can spend more time with my diabetes,sure. So I should be in the 5’s, but do I need to be in the 5’s?! And I am realizing that where I am is ok for me.
So here I am talking with all my friends when I said I would be pulling back, but I did say mental health (this) and trials, I would be posting. So thanks everyone for your insights. Again, there is help out there when you temper it with some-nope, not interested, thanks!
Very good post. I think you are doing good and this disease affects everyone differently. I suggest your next stage is to read more but judge what you read as something you want to absorb or not. You can’t learn anything new if you shut everything off and there is something new on this everyday. You have become very disciplined and I suspect you can handle the info and either throw it out or internalize it. That’s what self confidence does for you
Thank you for posting that, Sally. I genuinely admire and appreciate your wisdom and perspective on this subject. I agree it’s sometimes challenging on this forum to read posts from people with super tight control and very low A1cs. If that gratifies them, I’m truly glad.
But if I were to aspire to that with my daughter’s control, I would definitely make both her and myself crazy. Our quality of life would suffer because mental health would suffer.
So, again….Thank you!
This is a terrific thread. The summary of my 25-year diabetic journey includes many years of numbers way out there and, more recently, some sense of control. The only difference between the out-of-control me and the doing okay me is my life at this point allows for different priorities. I now have the time to do a better job of it. I wish I could say I’m smarter or less lazy or more motivated or something like that, but, it wouldn’t be true.
When I read most diabetic social media groups it breaks my heart to watch the bullying that goes on when people admit to having a high A1c, a low TIR, or for eating carbs. I suspect many seeking advice aren’t up to the task of running such a gauntlet and leave, frustrated and hurt. This group, actually, is far more understanding and compassionate than most. Kudos to all those who carefully listen and then gently respond with helpful advice from personal experience.
If you think about the non-diabetic homeostasis we are trying to mimic, we are actually giving the wrong insulin, in the wrong place, at the wrong time and in the wrong quantity, so isn’t it absolutely amazing that any of us do as well as we do?
One time (among too many to count) when I was feeling overwhelmed by it all, I read a letter in our diabetes magazine from a man who said that his life heroes were the world leaders, superheroes, etc, until his young son became type one diabetic. He said that watching his little boy deal with diabetes, his son is now his hero.
So if you are putting one foot in front of the other and dealing with diabetes YOU ARE A HERO!
I find it really weird cause there are times when my blood sugar behaves like I have some insulin production. The one area where my blood sugar goes nuts is when I have a high in early morning around 5 a.m… I’ve learned to bolus big for a blood sugar of 12.2 - for me that is just 0.8 of a unit. Have to add more boluses after to see how it sits.
But if it continues to rise, that’s when I have trouble. I used to only bolus 0.4 for a sugar of 0.8 and it used to work. But now I’ve learned to bolus more than I expect to bolus. It seems to be working too.
I’m lucky cause I take such low insulin. After 51 years of this I’m only on about 12 units of fiasp per day.