The Myth of the Noncompliant Diabetic.

Some people think that an uncontrolled, noncompliant diabetic (said with the deep, dark voice of death) is just a myth that endocrinologists and diabetes educators use to make all of us feel like no-good delinquents who should be serving time in some kind of diabetic corrections facility.

But the truth is it isn’t a myth. Noncompliant diabetics do exist.

A high A1C always strikes fear in the hearts of people with diabetes the world over. Accusations of lapses in testing, not enough record-keeping, too many SWAG boluses and not enough sound nutrition are common among doctors. Have you ever had a doctor ask you, “Why were you 247 mg/dl on October 4?” But even if you do test regularly, take your insulin, try to exercise often, and attempt to count carbohydrates the best you can considering we eat in a society that up until recently prided itself on keeping nutritional content hidden, you can still have crappy blood sugars. It’s a fact of life. We all know that not just insulin and food influence blood sugars. I know this, you know this, and even your doctor knows this (even if he won’t admit it).

We have to move beyond the idea that an uncontrolled and/or noncompliant diabetic is someone who has an A1C outside of recommend levels or forgets to test their blood sugar or eats cupcakes. It isn’t the person who is suffering from neuropathy after thirty-eight years of diabetes, with half their time managing diabetes coming before modern tools like glucose meters, insulin pumps and fancy-schmancy insulins. It isn’t even about being burned out from diabetes, because you can hate diabetes and still manage it. Being burned out can lead to noncompliance and consistently high blood sugars, of course, but plenty of people are tired of diabetes and still do the best that they can.

Not perfection. The perfect diabetic is the myth.

Your results don’t make you noncompliant or uncontrolled. It’s what you do that matters.

The uncontrolled, noncompliant diabetic is someone who knows exactly what they are supposed to do and refuses to do it. The person who looks at the requirements to test blood sugar 4-6 times a day, to count carbohydrates or at least make an educated guess, to wear an insulin pump or keep insulin pens with them and they say, “I’m not going to.”

It is this - the complete forfeiture to manage this frustrating disease - that makes someone a noncompliant diabetic and leads to uncontrolled diabetes. They do exist. But if you are reading this blog, if you are sitting there thinking, “I really want to take care of myself and I am trying to do this the right way” then you are not a noncompliant diabetic. I believe that to control your diabetes means you are controlling your attitude and actions - not your test results.

Sometimes life gets in the way of diabetes and that’s okay. Sometimes you forget to test when you’re on vacation, sometimes you just can’t figure out how many carbs are in your Aunt Carol’s casserole, and sometimes you just can’t help eating the entire bottle of honey during a 3 a.m. low. What matters is that you recognize that it’s going on and you try to fix it. Even if you’re not successful on the first try, or the second try or the nine-hundred and twelfth try. As long as you are trying to do your best, you are doing great.

That’s really all you can ask for.