Insulin therapy requires a lot of daily decisions

I have learned from my patients with type 1 diabetes that there are many things that I take for granted that they think about daily.

In fact, multiple times a day.

And while on some days these thoughts and decisions are no big deal and easy to address, there are also days or weeks at a time where these frequent decisions can feel like a lot.

Like, a real lot.

For those of us who don’t use insulin, I think we benefit from gaining some insight into the difficulty these decisions pose and the decision fatigue they can cause.

Reach out to someone with diabetes on insulin and see if these questions are familiar to them. They may be so relieved to have someone to talk to about this.

Remember, not all questions need answers.

Sometimes, individuals just need validation that the questions are difficult.

How am I going to monitor my blood sugar?

a. Will I prick my finger multiple times today?

b. Will I wear a continuous glucose monitor?

c. Will the alarms on my monitor interfere with my plans?

d. Do I want people to see the monitor I am wearing?

e. Am I ready for the questions I may be asked about the technology I’m wearing?

Do I have enough insulin?

a. Am I going to have to take an extra pen or vial with me?

b. Do I have enough insulin to last me through vacation?

c. Do I have enough syringes, pen needles, or pump supplies to get the insulin in me?

d. Are any of my medicines or supplies expired?

e. Do I have a refill on file at the pharmacy?

How much is my trip to the pharmacy going to cost this time?

a. The cost of diabetes includes:

b. Insulin

c. Test strips

d. Lancets

e. Meter

f. Continuous glucose monitor sensor

h. Glucagon

i. Insulin Pump

j. Infusion set

Is it ok to exercise right now?

a. Am I going to do cardiovascular, resistance training or both?

b. Do I still have insulin active in my body from my last meal?

c. How long ago was my last meal? Should I eat again?

d. Should I exercise in the morning or evening? How will that affect my blood sugars?

e. My blood sugar is low normal, is it safe to exercise now, or do I need to wait or just skip it until tomorrow?

Did I give myself insulin for food?

a. Wait, I know I wanted to give myself 4 units of insulin when I ate, but did I?

b. What if I split the difference and give myself 2 units, just in case?

What should I eat?

a. I don’t have the slightest clue about the carb content of these foods

b. My blood sugar is dropping – what can I have that prevents a low, but doesn’t spike my blood sugar high again?

c. I’m about to exercise and my blood sugar is fine now, do I still eat something just in case?