Wait and See

As you may know, I’m a recovering perfectionist. Often “recovering” looks like slipping back into old patterns and then praying and accepting my way back to a place of surrendering and peace. I sometimes ponder which came first (as in “the chicken or the egg”), my desire for control or my diabetes. When you have diabetes, the hallmark of good care is “well-controlled blood sugars”. Truly, there couldn’t be a higher virtue than “control” in diabetes management.

Over the years I’ve used a continuous glucose monitor (CGM) several times. As I’ve discussed with my endocrinologist on countless occasions, the constant information on my blood sugar often felt overwhelming. I felt like I was riding a blood sugar roller coaster on days I used a CGM. Over the years, I realized that the issue wasn’t the information, but how I processed it. Psychologically, seeing a high blood sugar after a meal would prompt me to correct with insulin, even if I’d just given an injection an hour earlier. I couldn’t handle seeing the high blood sugar (and the feelings of failure it triggered) for an hour or so while my meal bolus brought my blood sugar down.

What happened when I stacked two injections close together? My blood sugar would plummet and I’d have to consume more carbohydrates to raise it. I’d then monitor the CGM data carefully for the rebounding high, which I’d then aggressively respond to with more insulin. See how the roller coaster feeling arose?!

In contrast, with finger stick blood sugar monitoring, my blood sugar might rise between meals, but I wouldn’t see that information until I tested a few hours later, so I wasn’t triggered to give extra correction doses. The downside? High blood sugars wouldn’t be detected for a few hours. Also, I couldn’t anticipate low blood sugars unless I became symptomatic.

As I’ve dealt with retinopathy the past few years, my desire to keep my blood sugar even more tightly controlled grew. I knew that the Dexcom provided the best standard of care for diabetes but was tentative to try again. So, I prayed for peace and a renewed understanding for how to interpret and respond to CGM information.

A couple months ago, I had one demo Dexcom sensor handy and decided to wear it for 10 days. Something finally clicked. I was able to receive the continuous glucose readings without overreacting to the information! Somehow my years of experience and awareness of how my body responded to food, insulin, exercise, etc. comingled with the continuous stream of blood sugars. I was able to watch the trends, allow for a reasonable “turnaround time” and wait (somewhat patiently) for highs and lows to return to range.

The timing of this breakthrough was fortuitous. Dealing with retinopathy impressed upon me how important tightly controlled blood sugars would be for my long-term health. With the CGM information, I could correct highs more quickly and keep my blood sugar “in range” more consistently. It’s not inexpensive, but again the benefits for my health and quality-of-life in the future makes the investment more than worth it.

As the weeks turned into months, I noticed a side effect of using the Dexcom. My cell phone was always within arm’s reach! The data is available through an app, which is obviously more convenient that using a separate receiver. However, once the phone was in my hand, I reflexively checked my email, instant messages, and social media much more than I’d like.

So, last week I got an Apple Watch so my blood sugars are constantly available right on my wrist! I’m being diligent not to start using other tracking features of the watch, because I know from experience that they are triggers for my performance orientation. When I start tracking things like the amount of water I drink or walking 10k steps a day, I feel like a robot ticking off all the “to do” items from my daily list.

But, it’s nice to glance down and see my blood sugar level and trend arrow without having to pick up my phone. I imagine it’ll be very helpful during classes! It’s funny how this constant stream of information used to feel overwhelming and burdensome, but now it feels freeing. The trick is constantly reminding myself, “wait and see what happens” before reacting to a potential high or low. Just because my blood sugar is 110 mg/dl and dropping right now doesn’t mean I’m headed for a low that I need to preempt. Likewise, a 160 mg/dl and climbing may not need intervention, depending on the timing of my last meal, when I’m planning to exercise, etc.

Over the years, “wait and see” has been a helpful reminder to stay in the moment instead of trying to control my future feelings. Just because my mind is telling me that I should act now to avoid feeling something unpleasant in the future, in reality I can “wait and see” how I feel in the moment, when it arrives. This life strategy only really works when you know that you can trust God for his grace and provision in all the moments of life, especially when things are out of control.