Читать книгу Transitions in Care - Howard A. Wolpert - Страница 21

As already mentioned, expanding your knowledge base and developing a sense of mastery of how all of these factors (insulin, food, exercise, etc.) affect your blood glucose level can take years of experience. Remember that despite the recent advances in the development of new insulins, pumps, and monitoring devices, the tools we have to manage type 1 diabetes today are still imperfect. There is no magic formula for getting perfect glucose numbers. No one living with diabetes can always keep their blood glucose numbers between 80 and 120. Having consistently perfect numbers is an unattainable goal—and so is being a Nobel laureate before the age of 30, or running a mile in under 3 minutes, or shooting a 50 in an 18-hole game of golf. Setting goals that are out of reach will likely cause frustration. There may be some periods in life, such as during pregnancy, where one’s energies and priorities are focused on ensuring remarkably tight glucose control. However, it is usually difficult for women to sustain these tight goals once the pregnancy is over and attention is focused on the needs of the newborn and the other demands of life.

Having realistic goals is the key to living well with diabetes and to living well in all aspects of your life. It is also important to keep in mind that if your personal blood glucose goal is 70–180 mg/dl, you should aim for the average of your blood glucose measurements to be in that range. This does not necessarily mean that all (or even most) of your individual measurements will be in that target range. The object of monitoring is not to “test” your performance; it’s to give you the information you need for the daily management of diabetes and to identify glucose trends that will be helpful in optimizing your treatment. It can become demoralizing if your performance is always being tested, so try to avoid viewing glucose monitoring as a test. Instead, try to think of your glucose monitoring (or “checks”) as a compass that gives you direction (“How much insulin do I need?” “Is it safe to drive?” “Do I still need to continue snacking to treat my low?”).

Also keep in mind that just because there is no way to achieve perfect numbers, it does not mean that you should give up trying to do your best. You actually have control over a great many aspects of your diabetes care, and the things you can control can make a huge difference in how you feel today and in your future health. Developing a sense of confidence that you have some control over blood glucose levels can come quickly, but this needs to be balanced with an appreciation that our bodies do not always respond as anticipated. Even individuals who have lived with diabetes for many decades will often be surprised by unexpected blood glucose fluctuations. Figure 5