Resolved: A Sterling Gameplan for the Non-adherent Diabetic

by james s. hirsch

Kelly and I were talking about how difficult it is to maintain New Year’s resolutions. In diabetes, every day you resolve to eat better, to exercise more, to improve your blood sugar numbers. Sometimes your resolve weakens, compromises are made, failure looms. I think it’s important to resolve not to get discouraged, even if it means scaling back on some of the resolutions. Here I offer one person’s Sliding Scale for New Year’s Resolutions. It’s only a whimsical guide, so take it with a grain of salt, or, as the case may be, a tall glass of wine.

January 1, 2009
I will test my blood sugar 10 times a day, download all data on my computer, and run a regression analysis to fine tune my insulin-to-carb ratio.
Upon waking up, I will abstain from food for four hours to conduct a basal evaluation test on my insulin pump.
I will eat organic.
I will keep my continuous glucose sensor in my body six days a week, four weeks a month.
I will run four miles a day three times a week and lose 15 pounds.
I will have an ophthalmologist scan my eyes.
I will stop drinking alcohol.
I will get my A1c under 7.0%.
I will read a good book about diabetes.

April 1, 2009
I will test my blood sugar 6 times a day and map out the results on a color-coded computer chart.
Upon waking up, I will abstain from food for two hours to conduct a partial basal evaluation on my insulin pump.
I will give up bagels, waffles, hamburger buns, and pizza.
I will keep my continuous glucose sensor in my body 5 days a week, three weeks a month.
I will run four miles once a week and lose 10 pounds.
I will have my general practitioner scan my eyes.
I will only drink beer and wine.
I will get my A1c under 8.0%.
I will read a good magazine about diabetes.

July 1, 2009
I will test my blood sugar twice a day and write the results down in my logbook.
Upon waking up, I will only eat protein and fat to attain a quasi-basal evaluation on my insulin pump.
I will give up glazed donuts.
I will keep my continuous glucose sensor in my body two days a week, two weeks a month.
I will walk around the block twice a week and keep my weight steady.
I will have a neighbor check my eyes.
Vodka and bourbon.
I will get my A1c under 8.5%.
I will read a good newspaper article about diabetes.

October 1, 2009
I will test my blood sugar once a day and try hard to remember it.
Screw the basal evaluation.
I will give up vegetables.
I will ship back the sensors.
I will stop weighing myself.
I will check my own damn eyes.
I will keep the green olives out of my martinis.
I will divide my A1c score by two and call it even.
I will rent “Steel Magnolias.”