Stuart, you are absolutely correct, and yet we still hear all the time from the diabetes control idiots that “there are no brittle diabetics, just diabetics who don’t control their disease.” But in fact, the utterly unpredictable way the subconscious mind chooses to release stress hormones in response to various situations, subtle changes in the speed of digestion, subclinical infections, spontaneously varying degrees of insulin resistance, and ten thousand other influences too subtle to measure make blood sugar levels impossible to master, unless the patient has considerable endogenous insulin production to respond naturally to the demand and even out the bumps. I remember reading a medical text on diabetes once which had the unmitigated gall to say, “In diabetics who choose not to control their blood sugar levels, complications may develop.” “Choose”?!!
I know one diabetic who says every night he has a nightmare, his blood sugar is nearly double normal when he wakes up. What is he supposed to do to ‘control his disease,’ guess what nights he is going to have a nightmare and take extra Humalog before he goes to bed? In my case, sometimes when I deliver a lecture to students, my blood sugar rises by 80 points, and other times, it doesn’t change at all. So what can I do beyond trying to compensate after the fact, by which time a lot of time with hyperglycemia has passed.
And this is exactly why most doctors supervising diabetics are utter and absolute fools who do infinitely more damage than good. They simply don’t understand that blood sugar levels spontaneously fluctuate, so instead they prefer to blame the patient for every upward spike they spot. You try to make this clear to them, and they just smile, pat you, and say, “There, there now.”