Can "consistency" of diabetes self-care be seen?

Stephen W. Ponder MD, FAAP, CDCES

2018 ADCES Diabetes Educator of the Year

Can you “see” diabetes self-care consistency? I think you can. As I discuss in the book Sugar Surfing™, the three “virtues” of the art of dynamic diabetes management are 1) patience, 2) consistency and 3) resilience. By periodically reviewing your own CGM data, a picture of your consistency often emerges.

To me, consistency is reflected in the CGM info shown here. These include the time in range (TIR), the standard deviation (SD, a measure of the overall variability in your daily blood sugar values), and the average blood sugar. These are displayed here in three “windows”: 14 days, 30 days, and 90 days. Notice how robustly similar they remain over time.

Consistency is what I would describe as an integrated measure. It is the sum of all your actions measured over a swath of time. In my opinion, it’s a reflection of your unique approach to decision making combined with whatever self-management tools/devices you choose to use. These tools include a CGM, glucose meter, physical activity, meal planning, stress management, a standard insulin pump, or a hybrid closed loop insulin pump system. Or, as in my case: old-school multi-dose insulin management using Tresiba and Humalog (maximally leveraged by my wits and experience as a Sugar Surfer).

Consistency is a tremendous diabetes self-care asset. But to make changes in your own consistency these actions must be sustained over time to have an impact. If you made an analogy between consistency and “style” you would not be wrong.

Dynamic diabetes management (aka Sugar Surfing) reflects the sum of your choices, proactive and reactive. Short spurts of increased attention to your self-management choices may result in temporary benefits, but diabetes is a marathon, not a sprint. Make whatever daily changes in your self-care “style” lasting and consistent ones, not just passing fads.