During our many discussions over the years, Dr. Stephen Ponder and I have had fun identifying the false idols, unicorns and 'pillars of truth' pawned off on us as state of the art diabetes care. You've seen these pillars I'm sure. They have been made to look like magnificently carved stone, polished frequently and with candles lit at their base. Yet, they are actually fabricated out of paper mache. In other words, it's a bunch of bunk.
While not a doctor myself I do have a pretty good list of credentials which helped me to arrive at this conclusion. The one I am most proud of is taking over another Med Staff's kids when an intern had to go home sick early from camp. Let me tell you for a fact that I was managing in the moment for 12 kids with type 1 diabetes in the Texas heat. Yes, they were safe - lots of other support standing by and I increased the frequency of blood sugar checks. In fact, that's what made it feel like Sugar Surfing. The fact that camp is a highly dynamic setting meant I needed to know more and frequent checks was a good way to keep them safe. Armed with this frequent bg data we (me and the campers) could live in the moment and it got easier every day. You could also try Sugar Surfing with a meter but I wouldn't recommend it.
Anyway, it was through experiences like this that it became clear that much of what we're taught as parents of kids with type 1 diabetes are lies. White lies perhaps but lies nonetheless. These lies are taught to us as if they were a broken piece of wood floating in the ocean after our ship had been torn apart on the reef. So, we grab it and hold on for dear life and without question.
For example, when my daughter was 2 yrs old and highly sensitive to insulin (a small dose went a really long way), we were told her blood sugar would drop 200 points for every unit of insulin. Got it. I know math. And, because of that 'fact', pre packaged snacks seemed like a good idea because it has the weight and carb info right on the box, right? Well as you may already know:
A 1:200 insulin sensitivity factor (ISF) is only a guess at best and changes based on lots of circumstances;
Her meter is allowed a +/- 20% variance and even more than that 5% of the time;
Insulin action changes every day;
Insulin action changes depending on how long her blood sugar was standing at a certain range (ie - high blood sugar and insulin resistance);
If ISF is just a guess well insulin to carbohydrate ratios must just be a guess, too (True); and,
The real kicker for me nearly 13 years ago was finally weighing an entire box of her pre packaged granola bar only to learn that there was a +/- variance of 30% of the weight and therefore a same or similar variance in the # of carbs she'd been eating. So much for labels.
Over the next several weeks we'll be exposing these untruths and making the case for a better way of managing which we all know now as Sugar Surfing. Knowing in no uncertain terms that much of what we've been taught needs to be dismissed or at least marginalized. In some cases not entirely thrown away but viewed only as something that might serve as a starting point. Only after you've committed to this can you ever expect to become a Pro Surfer.
What have you been taught in diabetes as if it were a sacred truth? How many of these false idols have you already identified? And, how have you managed to replace these lies with something that actually works?