I've become obsessive

As many of you are now well-familiar, I went from wildly out of control, sick, killing myself T2 to hyper-controlled with CGM and Omnipod dude about six months ago.

I'm starting to wonder if I've become a bit too obsessed with this, for one reason: I get anxious any time I go over 140.

Now, I do all the time -- it's pretty common to hit 150, 160 after eating, flatten out there, then drop back down over the following few hours to the 80s. Everything I've read tells me not to sweat 150 90 minutes after eating, especially if it's flat or starting to head down.

But I still sweat it anyway. I have to hold myself back from juicing a bit more (on top of my properly calculated bolus), because the rational side of me knows the insulin I took will start to work, and everything will be fine.

But it just bugs me until I'm back below 140, and see that little 45 degree down arrow in the G4 display.

Anyone else feeling they've become just a little too obsessed with all this? It's not wearing me down or anything (that's covered in a different discussion already!), but I do think I could probably safely chill out a bit, don't you?

Hey Dave:

I think blood sugar control is very much a personal choice and personal balancing act of weighing incremental efforts against incremental results. If you're hitting A1c targets you are happy with and the results are mitigating developing secondary complications - all without driving you crazy in the process, you should be good. If getting that 0.5% point improvement in your A1c requires 5x the effort from where you currently are and the incremental health benefit is debatable, it's probably not worth it. If you want to reduce the spikes in your post-meal BG, however, the easiest way to do that is by minimizing the fast-acting carbs in your diet. I rarely break a 100 after eating by following a low-glycemic diet. But again, it's not for everyone and a matter of choice.

Christopher

You can chill out a bit. In fact, you should chill out a bit because you cannot reduce your diabetes related risk to zero no matter how tightly you control your blood sugars. You may think like a pancreas but in fact a pancreas doesn't think and that is its advantage.

That's not to say you can't improve your line over the first 90 minutes. Experiment a bit if you like but take pleasure in your success and don't worry if you're not perfect. You might read "What the tortoise said to Achilles" by Lewis Carroll for some not entirely on point perspective.

Happy New Year!

Obsession is definitely in the eye of the beholder, Dave. Only you know the balance of effort vs result and result vs anxiety level. If you are spending a lot of time suffering anxiety than your quality of life is negatively impacted and it may not be worth it for the difference between say 150 and 130. I am also subject to obsession and so I make choices to keep that balance intact. That's why I don't want a CGM. The obsessiveness it would cause me would negatively impact my quality of life, far beyond its value.

You know the answer to your own question.

I would do everything you need to do to minimize being too obsessed because it can become too stressful which makes matters worse. I don't like to spike either but after some severe lows I would much rather hit 140 or above that than worry about calling an ambulance etc. These incidents aren't related but in the grand scheme of things a little high is definitely better than severe, unresponding low imo or any fast dropping low. I know I can always get myself back down with correction, water, walking etc. over time. I eat low carb but this doesn't stop me from spiking unfortunately. Have you tried drinking water and going for a walk after your meal? I find activity soon after a meal will help stop a spike for me a lot of the time.

I like being obsessed like that. It doesn't wear me down at all. Maybe occasionally I'm distracted but I think through these things so reflexively that it doesn't get in the way of much. I will sit on my A1C all day...

every person has a different point at which they become 'obsessive'. i try to maintain the bgs of a nondiabetic for as much of the time as possible. this involves numerous small correction boluses over the course of a day and a very strict diet. many people, including doctors, would consider this obsessive, but it works for me without detracting from my quality of life. it has become second nature, something i dont even really have to think about much anymore.
For me, if i would loosen up on my diet and overall control and would start to see higher bgs as a result, then i would be worrying constantly and become obsessed!

AHHHH! I'm started to get frustrated when people use terms like obsessive, extreme or over-the-top to discribe good good control. It seems to imply that bad control is the target and anything better is ridiculous. Sorry if this post is late or redundant, but what you're doing is AWESOME! Your methods should be on the posters in doctors offices. I say keep up the good work.

As I've said before elsewhere, you're in my "gold standard" group of fellow diabetics. Honestly, I read your advice/exploits/trials/tribulations with an eye to learning, every time.

I also hate your CGM graph pictures... stop posting them. j/k, or course

One of the tough differences between T2 and T1 (or more accurately, diabetics with IR and those not) is that insulin is a much less efficacious tool for us.

First, the quantities are scary in comparison.

Second, when BG is high, it just doesn't work nearly as well. Even though this phenomena affects those without IR too, the impact just isn't as big.

And yet, insulin is the ONLY effective tool to really control BG in a diabetic, T1 or T2.

The key word there is "really", which is opinion-laden. In my view, true control is achieving normal BG profiles. Others don't take as narrow a definition.

Thanks, Gene!

A good deal of this is just my personality, so I'm unlikely to stop. I'm a data-driven, gadget-loving, engineer (although in management the last 20 years), so slap a cool device like a CGM on me, and another like the Omnipod, and I simply will not be able to refrain from checking and playing with them whenever I'm conscious.

To everyone -- thank you so much for your helpful thoughts! I'd already decided -- as Zoe so skillfully and wisely discerned -- I need to mellow out a bit.

Really, I need to relax about post-meal spikes, and keep my focus on fasting BGs. Key word there is "relax" -- not ignore. IOW, if I spend 30-60 minutes after a meal in the 150-160 range, but am back under 140 2-3 hours after eating, and back under 100 3-4 hours postprandial, as Marty points out I'm probably in the range of rapidly diminishing returns for the effort and distress.

Again, thanks for the good thoughts and advice, and as always, thanks for being there to talk, brothers and sisters!

I agree with you, though, as was earlier mentioned, much tighter control is not necessarily beneficial enough to be worth "obsessing (sorry, can't think of a better word)." That said, I, too, tend to be a bit obsessive; however, I start to get headaches for 'highs' over 140/145. As I see numbers approaching 140 on my CGM, I start to get a little concerned, as a result. Regardless, that bit of obsessiveness hasn't seriously impacted on my life and has resulted in better control. As time goes on and I learn more about what works and doesn't for me, it is becoming less of a concern - in the end, maybe a win-win?

Yes it is!