Why You Should and Shouldn’t See a Number as a Number

What was your favourite subject at school? Mine were always the arts – English, Drama, Arts, Classics. In year 11 I was put into the Academic stream which meant English, Physics (AKA Maths), Chemistry and DOUBLE Maths….suffice to say it was a year of misery for me. When I got control of the reins in year 12 and could choose, I went for Art, Drama, Classics and English and as you had to choose one science if you were doing all arts, and vice versa, I chose chemistry, because it was kinda an art making all of those pretty colours in test tubes. I am reasonably ok at maths now. I don’t love it but I have dealt with the trauma of year 11 and now understand all of the important things about maths in our lives. I also realised as I grew up that my life is basically hinged on maths. When you have diabetes, you are a walking, talking, thinking Mathematician. Life is ruled by numbers, targets, tests….an example of this I like to talk about is one day when I was on a treadmill at the gym and looked down to see 5.5 – “oh that is great” myself said to me in my head…and then I realised it was not my current BGL but the speed at which I was walking…. So yeah, numbers are pretty much front of mind for those of us who live with diabetes, and they are really really important.

The thing about arts that I love is the uncertainty and randomess and unique creativity of it all. Numbers are so certain, so black and white. If you have read any of my thousands of  posts across my various blogs over the years, or one of my books – you will know that I love words. I love writing words, speaking words, hearing words. As a child I had my head in a book most of the time and if there was nothing to read I would read the back of a cereal packet. I was reading before I went to school according to my mum, and I still have the book I won as a prize in year 2 for a book I wrote, as well as that little book, written in my 6 year old hand. I would send poetry to the newspaper and collect certificates for the “Possum Pages” club. I participated in school plays and musicals and have always marveled at the power of film and literature in our lives. Words make you cry, they make laugh. Words make you think, and they make you feel. But numbers are far more important in our lives than you may think. In this article, the author says in relation to the universe that:

Behind all of those fantastic realizations, there is a mechanism at work that allows for us to discover all that you enjoy learning about. That mechanism is mathematics, and without it the universe would still be shrouded in darkness.

Numbers underpin the very world on which we are spinning. Mathematics enables us to understand our world and make sense of it. In diabetes this is exactly the same. Whilst very important, numbers are not really the end point if you think about it. They are a way to understand what is happening with your body and how to deal with it. It is so easy to think that numbers are the goal however – that flat line on your CGM, the fasting BGL in target range when you wake up each day, your HbA1c sitting smack under the magical 7%. And yes this matters. But if you consider that life with diabetes is all about reaching these numbers, you are making a mistake and potentially affecting your mental health and wellbeing. You are missing all of the words and pictures and moments in your life that are unrelated to numbers. I have seen all too many times people sharing their “perfect” numbers on social media, and I have worried about how crushing this may have been to another person, silently struggling in diabetes numbers hell at that given moment. I have seen all too many times people beating themselves up about a number on a machine and promising to “do better” next time. I have spoken to lots of people telling me of the shame they feel about their numbers, or the confusion, or the fustration, or the agony….

The thing with diabetes is that it is not predicatable. For no reason at all it can do it’s own thing, and you can end up tearing your hair out, which can lead to lowered motivation, feelings of “I’m not good enough, this is hopeless”  and diabetes burnout. And no wonder! There are so many tests and targets tied up with diabetes and this can lead to less focus on your wellbeing. Sometimes diabetes can become a low priority in your life, or on the flipside it can become overwhelming, taking over everything and things can get out of balance. Feeling comfortable with where diabetes sits in your life and getting perspective on the numbers can help you to better manage under times of stress and prevent burnout.

Numbers matter but diabetes is not just about numbers

Diabetes is like a “job” and the day to day effort to manage can become overwhelming, especially when the results are not what you would like, which can lead to diabetes burnout. Burnout can occur at many points, can last a short time, be ongoing, or come and go. Studies have shown that a majority of people living with diabetes experience worries, fears and negative feelings like these at some stage. Most of us get tired of doing everyday tasks and diabetes sure adds to those! Few people can maintain all the tasks of diabetes care week-in, week-out AND keep blood glucose and HbA1c’s in the narrow target range all the time. Without realistic expectations and practical strategies for managing the thoughts, feelings and emotional side of diabetes, the risk of burnout is higher.

The way you think and talk about diabetes has a major impact on how you feel and manage diabetes. A great way of trying to shift the way you look at the numbers is to change your words – use high and low instead of good and bad when it comes to your blood glucose results and CHECK instead of the word TEST when talking about blood glucose monitoring. I have practiced it so much over the years that it is second nature to say ” I checked my BGL and it was a bit high”,  rather than “I tested my BGL and it was really bad…”. Can you see the difference words can make?

Here is a practical example

• Let’s say you checked you BGL right now and it’s 18.2mmol – how do you feel?
• What if it was 5.5 mmol – how would you feel?
• Did you feel bad or negative at 18.2 and much happier when it was 5.5?
• Do you think of a BGL of 18.2mmol as ‘bad’ and 5.5 as ‘good’?

Another key here is to allow yourself to react and respond emotionally to the numbers.

I have heard well meaning people over the years (who usually don’t have diabetes) recommending that you see numbers as numbers and don’t react to them- just deal with them and move on. However as someone who also lives with it, I think this is impossible. Numbers are SO important to us, whilst they are not the end game, they most certainly impact the results at the end of the game, and the game play strategies. So, most people have an immediate reaction to high/ low BGL – that is normal, that is cool – rant and rave and shout and cry and storm around the house telling everyone in earshot how pissed off you are – but then move on to looking at the number. After the initial reaction, rather than staying mad or upset, look at your BGL results as information to help you decide what to do next. If it is low – while having that rant, treat it and then later when you are back to being a calmer human rather than a hypo person, try to consider if you can find a reason for it and if it is happening in a pattern try to find some strategies to prevent it happening. If it is  High – again treat that, and then see if you can work out why. If you know it is because you ate an entire block of chocolate then you know why – so move on. If it is happening a lot, and you can see a pattern, make some changes and always talk with your health care team if you need help.

The other possibility here is that maybe it is just one of those days – and that is ok too, letting it go can be the way to deal with these days. Let yourself float in the emotions of it all because it is not fair and it does suck. Then try to let it go and move on – tomorrow is another day and the numbers will always start again in the morning. Don’t waste time punishing yourself over a number. Blaming yourself will also lower motivation and may lead to burnout …often people beat themselves up – “ I should have had less/more food; less/more exercise; less alcohol” and so on and so on. Remember it is not an easy job!!!!! Making hard and fast “rules” = “shoulds” and these are unhelpful. Sometimes you can make changes, sometimes you need support to do so, other times,it is not within your control and it is just the way diabetes is. And you are only human!

So do numbers matter in diabetes? Absolutely yes. Are they the destination of your life? Hell no! Try to see your life as a sunset not a maths problem. Life with diabetes is not all about solving problems. Sometimes it is about lying back and watching the sky while the waves roll in and out.

Helen