Add to the challenge a new wrinkle: etiquette.
No, it isn't enough to do a blood test, count carbs, eat and test blood glucose two hours later. Now we have to consider how (and where) we do the blood test. Really.
A recent column that appeared in "Dear Abby" featured a complaint and request for advice by a reader uncomfortable by a co-worker who had to test their blood glucose. Here is the entire entry:
"DEAR ABBY: I like my job a lot, but I have recently been assigned a different desk. I now sit next to someone who regularly draws his blood with a lancet and gives himself a shot for his diabetes just a foot away from me.
I am extremely uncomfortable around blood and needles. I don't want to make waves because this person has been here a lot longer than I have, and apparently, no one has ever been bothered by it.
Am I being silly? Would it be improper to ask my supervisor to move me? Moving desks is a big enough deal that I will have to give a reason. Help. -- SQUEAMISH IN GREAT FALLS, MONT.
DEAR SQUEAMISH: Because the sight of blood and needles makes you uncomfortable, discuss this with your supervisor ASAP. While these are procedures many people with diabetes must attend to on a daily basis, you shouldn't have to watch if you don't want to."
With respect, SQUEAMISH is lucky she only has to look at this (if she chooses to do so). She could be forced to do it. To live.
When I was first diagnosed with Type 1 Diabetes 21 years ago, I was advised that in oder to avoid offending others, if I was out in public I should do my blood test and inject insulin in a bathroom. Think about that for a minute. I was to elevate the risk of infection by going into an enclosed space crawling with bacteria and sticking a lancet in my finger and a needle in my belly. Would you like your flu shot in the bathroom of a Texaco station? I don't think so.
Over time, I leaned how to do these things "hidden in plain sight." I could test my blood, draw up and inject a dose of insulin at a restaurant table and nobody was the wiser. Then after 13 years of shots from a syringe I got an insulin pump and now it looks to the untrained eye like I'm playing with a cell phone as I start the insulin flowing before a meal.
I get it that some folks are put off by this routine, but I am as well - if not more so since I am the one feeling cold steel as it invades my body - 45,990 times at the latest estimate (not counting 13 years of 5 shots a day). But etiquette is a two way street. SQUEAMISH doesn't want to see this, but speaking for many people with diabetes, we can do without unsolicited advice. "You shouldn't eat that." "Your skinny - you can't have diabetes." "My grandmother had diabetes. She went blind, they cut off her leg and then she died" are among some of the things I've heard.
Thanks for your help, but I've got this. Including the etiquette.