The thing most elusive to people without diabetes is how much constant work it is, I find. When others see me using a lancet or pushing buttons on my pump and react with that ooh! look, I feel like shouting: "It's no big deal, I do this more than a dozen times a day! Every day of my life!!" So why isn't my @#$! glucose control perfect?

As recently noted, there are just too many things we need to do "perfectly": food, exercise, dosing, timing of dosing, logging results, more food issues, scheduling lab tests, obtaining the results, extracting meaning from the results, acting on the results... Ugh. Where to start?

So I was lamenting about all this work in a recent telephone interview with the newly elected president of the American Association of Diabetes Educators, Amparo Gonzalez -- a lovely Columbia (South America) native now based in Atlanta, GA. She does a lot of work with diabetes patients in Mexico, where care is often low-quality and hard to come by. How the heck do they manage their blood sugars without all the devices and support available here, I wonder? Still, I was having the audacity to feel sorry for myself that day.

Simplify And then, somewhere in middle of our interview, Amparo said something really simple and really smart. And really helpful. She said: "I do an assessment of all my patients' behaviors, and then we select TWO THINGS in the way that person lives to change. We take it step-by-step... you have to be ready to change, but don't try to work on more than two things at a time."

"I myself am working on two things right now: flossing my teeth*, and exercise. I'm going to focus on those until I get them right. And this is what every person with diabetes should be doing," Amparo added. "You should always be working on something. There's always something you can improve."

Innovation 2015

Right! In fact, I wrote a lot about the "step-by-step approach" in our book last year, but clearly reporting and writing do not always translate directly into DOING.

So after our interview, I thought it over good and hard.

Here are my Two Things for the time being:

1) testing BGs more diligently post-meals, and

2) dosing more aggressively for every speck of carb I ingest.

My only fear is, if I focus on these two things until I get them right, I may never move on. Ugh! These are my pain points. I may be be chasing these goals when I'm 90 (if I'm lucky to live so long). Sigh.

Still, it's quite comforting to have a clear & simple strategy for the weeks ahead.

[*Editor's note: flossing teeth is a bigger deal than you might think, given PWDs' tendency to develop periodontitis.]

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