We know there is such a thing as too much when considering ills of the world. But is there such a thing as too much technology — as in too much diabetes technology? Can you have too much information? It’s a good question and one our community hasn’t seriously discussed. This post was first drafted in October of 2012. I’ve let it steep over time, but then this Atlantic article came out, and the idea of t0o much technology is on stage.
I wear an Animas insulin pump and I used to wear a Dexcom continuous glucose monitor. (I stopped wearing my Dexcom in November of 2013.) I love technology because of the freedom and control it offers. The question should be this though:
- Is our diabetes management and control rooted in history and experience and augmented by technology?
- Or is technology the driver, the starting point from which you base your management?
It’s a subtle and very nuanced question, but one worth talking about.
Ask yourself, if you lost all technology today – your pump, your CGM and meter – would your life with D be in crisis? Would you be paralyzed and consumed by fear and uncertainty? Or would it be only a minor inconvenience and not a major threat to your health? How you answer this question reveals your relationship with technology as part of your management. The answer can shine a light on a new way of thinking that might be worth examining.
When I chose to go back on the pump in early 2011, it was because I had a horrible A1c and what I’d been doing for years was no longer working. I chose the CGM first and lowered my A1c by nearly two points in three months. I added the pump shortly thereafter and lowered it even more. The two pieces of technology worked for me. They still do. As a cyclist, the CGM was instrumental in me finding a system that works on the bike. When I decided last year to no longer wear my CGM, it took a few weeks to feel comfortable without it.
Comfortable. That’s the key word. With these two pieces of technology, have we become more comfortable with our diabetes? And by comfortable, I mean complacent?
These two amazing pieces of technology mean I don’t have to focus on diabetes as much. They do much of the work for me, requiring little to no effort on my part. I can eat whatever I want because at the push of a button, I have insulin. I can do as I please because with a glance toward my CGM, I know whether I’m rising or falling. The responsibility of diabetes has been diminished with technology. While I understand that’s a great thing, I worry our accountability may have exited along with the responsibility?
Without my CGM, I check my blood sugar more frequently. I’ve charted (or logged) foods, blood sugars and exercise to learn how things affect my blood sugar. And I have a wonderful A1c to show for the hard work, and I know exactly what something (exercise, a particular food, etc.) will do to my numbers. Nearly every single blood sugar is explained, and I like that. I didn’t feel that way with my CGM, mostly because I relied on it too often.
I see great value in technology so please don’t misunderstand. For people who have frequent and/or dangerous lows overnight, CGMs are great resources. For people with active lifestyles, pumps are easier. For small children or those who experience hypoglycemic unawareness, technology is a literal lifesaver. For me, I wonder how much technology has taken away from my accountability to diabetes. I think it often becomes a crutch or an excuse to do what I please.
It begs the question — in our quest to live a life burden-free from diabetes, have we lost sight of smart management?
Within the DOC, we quickly share with anyone who will listen how we can eat anything we so choose, be it a cookie, ice cream or a cupcake. But the truth is, we can’t. At least not all the time. And no one should. Dessert is not meant to be had after every meal — diabetes or not. Yes, I can have a cupcake, but I can’t have it anytime I want. If my blood sugar is 300, eating a cupcake is not a smart decision. Would you take insulin if you were 34? Of course not, so why the double standard for high blood sugars?
In an effort to advocate and share the advances of diabetes research—including what we are allowed to eat—I think we’ve missed the point. Having diabetes is easier than it used to be. I know; I’ve had it nearly 20 years. Technology has allowed us to live a less-restricted life. It’s allowed for better management possibilities and more freedom in food decisions. But did it also eliminate the need for self-control and self-management? How do we marry the two again?
It’s not my intention to offend anyone, but I think this is a topic worth discussing in this community. With all the gains from technology (which I think outweigh the losses by far), have we lost sight of the main goal of being healthy WITH diabetes?
I do plan to start back on my CGM within the next year as I begin training more for an upcoming event. For now, I’m happier without it (and I have significantly more money.)