Cutting it short

If there’s one thing all people with diabetes have in common (or, who’ve had it for at least a year), it’s that we take shortcuts.

At one time, it was shameful and embarrassing. I remember my father once giving me a stern lecture about my taking shortcuts. (Maybe it was about diabetes, maybe it was about homework. I really don’t remember).

Nowadays, taking shortcuts aren’t only tolerated, but they’re expected. They’re celebrated. Shortcuts are a sign of confidence and independence. Only the timid and hesitant do things the long way.

(Last week, I attended a demo of ShugaTrak, a simple and easy way for parents to keep track of their kids’ blood sugars via automated text messages. I’ll write more about that sometime soon. When the presentation began with the loading a new lancet in the Delica device, I sarcastically asked what that step was for, much to the amusement of the crowd).

But where do these shortcuts come from? Are they learned or taught? There was a time when I did everything by-the-book, and I’m not quite sure what made me change.

Remember: I’m not a doctor and this isn’t medical advice. In fact, everything discussed below is wrong, and should never be done. Never, ever, ever. This post is written only for the purpose of telling stories of my past, and I disclaim responsibility from any ideas or actions someone else might try as a result of my own rebelliousness.

The lancet

Yes, they came in different colors, but mostly blue

Perhaps the most popular of shortcuts is the changing of lancets after each blood sugar test. And I used to do that — all the time. It wasn’t tough. There was no cap to unscrew, because the Autolet kept the lancet in plain sight : all the time. And you couldn’t put the device away with the old lancet in place, because there was no protection from the sharp point.

I think they wanted you to change the platform – the thing you put your finger up against before it got speared – each time, too. But those things would always snap when I tried to pull it out of the slot, leading me to try to pull the broken tab out with some combination of tweezers, screwdrivers, paper clips, and old lancets. That “rule” was dismissed quickly.

Regardless, my meter was so cumbersome and my bag-o’-crap was so damn big that it was really no big deal to throw a few handfuls of lancets in there with everything else.

Then the meters shrunk, and the lancers became safer. When the Autoclix replaced the Autolet, I realized that I could stash my lancer in my bag without worrying about poking myself accidentally. And then I got lazy replacing the lancet, and so it began….

Drip,  drip, drip…

But even before the Autolet and the blood tests was Clinitest, the little paper cups, and the eye-dropper full of pee. Get the test-tube, add two drops of urine, then ten drops of water.

Who has time to count out ten drops of water? So I would estimate it. I’d quickly fill the test-tube with an amount of water I eyeballed to be ten drops. In reality, it was probably more, since my 5% bright-orange glucose concentrations often came out as less (green) – or none (blue). If urine tests were really worth anything, it would explain why my logs from home didn’t match the A1C’s from the lab.

Besides, I was justified. A “drop” is an imprecise measurement, and I was playing with poison. The box itself said so: POISON, in big red letters. Once I started the test, I had to get the hell out of there, fast.

The insulin

This may not have been a shortcut as much as it was a way to avoid a lecture. But back in the day, we took prescribed amounts of insulin, and ate prescribed amounts of food to match the insulin. There was no dosing insulin to match the food — it work the other way.

At one of my pediatric endo appointments, a young student-doctor who was trying to gain my trust asked me (while the regular endocrinologist was chatting with my parents in anther room): “did you ever sneak more insulin so you could eat more food and not get caught?”

Umm…. no, but that’s not a bad idea… thanks!

The pen needle

This shortcut was just asking to be taken. The insulin pen was supposed to make my life easier, so I could just carry a pen in my pocket rather than rummage through my bag-o’-crap. Of course, the pen needles didn’t fit comfortably in my pocket, and they were a real bitch to re-cap after use anyway (I think you are supposed to throw them directly in the sharps container after use rather than re-cap them… like anyone carries one of those red buckets around with them.) I believe that use of insulin pen needles was the first set of directions given by medical professionals with an undocumented wink, wink, nod, nod.

The sensor

The Continuous Glucose Monitoring sensor is probably the second set of directions given with a wink, wink, nod, nod. They might as well have just put a “Restart Old Sensor” menu item in the receiver. Pride and comfort in doing the right thing completely goes out the window when it comes to the CGM. I think there’s a line in the manual that says “Selecting Start New Sensor will reset the 3-day clock to the beginning and will require an immediate calibration if the sensor has already been worn for the two-hour warm-up period. Per FDA regulations, it should only be used with new sensors and not previously worn ones.”

In closing

I’ll bet you saw the title of this post and figured it wouldn’t ramble on and on like most of the things I write. I’m sorry to have disappointed you. But I did skip the part about overfilling reservoirs and treating to CGM readings. Not to mention SWAGging (am I supposed to double the “g” in that word?). But to my original point, some shortcuts are learned, some are taught. Taking them means you’re confident in doing so, and encountering the risks they may entail.

There’s no shame in that.You’re welcome.