Like a tidepool

People with diabetes, especially type 1 diabetes, live in a sea of numbers; blood glucose (BG) values, insulin doses in units, carbohydrates in grams, A1c, low numbers, high numbers, and more numbers: insulin to carb ratios, correction factors, target BG, basal rates, and the list goes on. Some numbers are set for them to manage their diabetes, some numbers they generate, and at the end somebody has to look at all those numbers and extract some sense out of them to adjust the insulin regimen. Especially in children with diabetes this process is continuous, for they are constantly changing and their insulin needs must be adjusted.

We study their numbers often, look for trends and correlations, learn from past experiences and come up with new insulin regimens that work better (i.e. result in better numbers), only to find out a few months later that we need to start over again because their lives have changed, their activities, their environments, and their bodies have changed.

So we collect a fresh sample of their most recent numbers and study it again and go through the same process. Sometimes we find the same data as last time, and sometimes we discover something new. Kinda like a tidepool, every time the ocean fills it and recedes, it leaves behind a small but informative sample of what’s out there in the vast waters.

Some of it we’ve seen before and some of it is new. Each time we look we learn something.

Looking at diabetes data is like looking into a tidepool, it seems calm, small, and logical, it is possible to understand it if we took the time to study it, but we know that as soon we understand it the ocean will come back again and change it and make us start all over again. That's diabetes.