We are doing an impressive job

Given all of the odds that are stacked against us, it blows my mind how well many of us are doing at managing diabetes. There are so many variables involved in managing blood sugars, and many of them are nearly impossible to quantify. In a treatment that requires formulas and figures, things that can't be quantified become a big guessing game. I'm talking about stress, being sick, getting angry, or startled -- just to name a few.

What about the unknown variables? Are there things that might be affecting your blood sugar that aren't even on your radar?

Allowing for inaccuracies

Meter accuracy. Your blood sugar meter is allowed to be inaccurate to a certain degree. Each meter varies a little bit, but the standard (ISO 15197) states that blood glucose meters must provide results that are within 20 percent of a laboratory standard 95 percent of the time. Don't forget that those laboratory standards that we're comparing to may also have a window of allowed accuracy.

I have to admit that I have a relaxed opinion on this issue. As much as I agree that we need tighter accuracy, I will gladly accept the inaccuracy as long as I don't have to test my urine for sugar anymore.

Nutrition label accuracy. Food labels are another big area. Catherine Price wrote an eye-opening piece recently about the regulations for food labels. I was surprised to see that the carbohydrate count can be anywhere from 80 percent of actual value up to, but not beyond, a 'reasonable excess.' Guess who gets to decide what a 'reasonable excess' is? The food manufacturer.

Want to take this to another level? Who do you think is responsible for the accuracy of the nutrition label? The food manufacturer. There's no check and balance. There's no monitoring or required calibrating. Nothing. Wow.

On our own. How many hours in a year? 24/day x 365/year = 8,760 (not counting leap years or clock changes). How many hours, per year, do you spend with a clinician getting help with your diabetes?

We are given some basic training (many people with type 2 don't even get that) then kicked out into the world to figure out this complicated thing called diabetes on our own. It's absolutely inconceivable how crazy that is when a single miscalculated does of insulin can kill.

It is hard for even the most health-conscious person to stay healthy today. We don't move enough. Food scientists are working hard to make sure we eat more of whatever it is they make. Schedules are crazier and more hectic than they've ever been. There's a fast-food joint every few blocks. It all combines to make a food system that is driven more by marketing and money than by our hunger and need for fuel.

The tools to do the job are crude and expensive

I know we have come a long way in diabetes management. But at the end of the day we are stabbing ourselves to measure our blood on devices with questionable accuracy, and squirting some liquid under our skin hoping we got the dose close enough to not kill us in the next few hours.

It's crude and pretty barbaric, isn't it?

(disclaimer: I am thankful for every last one of the tools I have available, but they're still barbaric!)

How many of you can comfortably afford all of the tools you'd like to have for managing your diabetes? What's that? No hands in the air?

Diabetes is expensive.

(disclaimer again: I am thankful for every last one of the tools I have available, but they're still too expensive!)

Looking at all of the craziness we deal with, and the variables and factors and accuracy and whatever else affects us, we are all doing pretty damn good. If you're reading this, you are an empowered patient. You are seeking out information to help you do a better job. You are trying to understand this monster we call diabetes, and you're working to master the parts we can master.

You are doing a great job. Like everything in life, there is room for improvement, but overall, you're doing a great job. No, actually, you're doing an impressive job!