A Disease of Little Decisions

Diabetes is such a unique condition.  While the basics are the same for all of us living with type 1, and many of those living with type 2, our bodies are all very different, and we all have to adopt different management techniques.

I think that everyone being different makes it harder to deal with.  Nobody can tell you what to do, only what they have done and learned through much trail and error.  There is a lot of uncertainty involved with that, and a lot of time and energy (both mental and physical) is needed to figure it out for your body.

Think about all of the decisions you make during the day about your diabetes.  Are they big decisions (such as chemotherapy or radiation or surgery)?  Or are they little decisions (such as eating those extra few crackers or not, with or without cheese)?

For me, it is a lot of little decisions.  A lifetime of them in fact.  What to eat?  How much to dose?  I’m playing ball later, do I eat more or reduce my insulin?  Both?  I could go on and on with this – you all know the drill.  It is little decisions all day and night long.

I’ve been thinking about these little decisions a lot lately, and they cut both ways.  If they are such little decisions, shouldn’t they be easy to decide in a positive direction?  Or because they are little decisions are they easier to blow off?  Maybe a little of both.

Related to this, I was watching a TED talk last night.  This one was Peter Donnelly, an Oxford mathematician, talking about statistics and the common mistakes humans make in interpreting them.  A few things he said (at about 19:13) really resonated with me.

it’s very well documented that people get things wrong, they make errors of logic in reasoning with uncertainty“, and “we are not good at reasoning with uncertainty“, and “it is something we are bad at“.

Wow.  There is nothing certain about all of the decisions we make through the day.  And here is a Very Smart Person talking about how we as humans are not good at reasoning (the mental powers of forming conclusions) when uncertain.

In some ways this explains a lot!  It’s not that I’m extra dumb when it comes to getting it right with my diabetes – but rather my makeup as a human being is not very well equipped to reason with uncertainty!

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12 thoughts on “A Disease of Little Decisions

  1. Wow- I’ve been reading for a bit now and your posts always resonate in such a big way. It’s reassuring to hear someone dealing with similar issues.
    PS- Your older post about depression & diabetes was the one that made me realize I had to own and deal with the consequences of the “little decisions” I’d been making- Once I faced the fact that I was regularly running in the high 220’s/low 300’s, I sought some help- things are going better now. Thank you!

  2. This is why I keep canceling my endo appt.
    Every day is different and it is not an exact science.
    I don’t feel like chatting with him or spending the money to chat.

  3. Seems to me, if we knew exactly how are decisions would affect us every time, there’d be no “excitement”, or “wonder”, or “surprise”. After all, variety is the spice of life! (And, yes, I do hate the variety that comes with diabetes just as much as everyone else.)

  4. “…we as humans are not good at reasoning (the mental powers of forming conclusions) when uncertain.”
    At times T1 folks are asked to do that reasoning when variations in blood sugar impact those very powers of forming conclusions. Even some actions, that normally (can we use the word normally with type 1?) appear to be reflexes from repetition, don’t function when sugars are out of whack.
    What I find impressive as a parent / observer is extent of good decision making that happens in these little choices with the double whammy of humans not being so great with uncertainty and diabetes variations that make the process even less easy.
    It is tough as a parent to see all the successes of these choices as opposed to seeing the mistakes. More importantly and more difficult is to see past the diabetes choices to the passions in the life that are happening despite diabetes’ best efforts to make us focus on diabetes and not helping kids find and pursue passions.

  5. Excellent point.
    I like to think that, with having to make all those extra little decisions (even if in uncertainty), that it allows us to be more aware of ourselves than most.

  6. So, so true. What’s right for one isn’t right for all; what seems right now, may not seem right later. Thank you for putting this out there.

  7. Hi Scott,
    I always appreciate your authenticity, transparency, and insights.
    Isn’t it funny how a series of poor little decisions can add up to some big consequences?
    I wonder about my years of near-apathy and T1 management, and all those poor little decisions. Luckily, we’re still here, able to fight and make good decisions!
    Thanks for all you do.

  8. No way are Any of us dumb.
    The uncertainly comes from the simple fact that doing and eating the same thing Every Day never has the same outcome while trying to manage T1.
    Thanks for this great post Scott.

  9. Very nicely said! It would be so much easier if we knew for a fact that, if I eat this, give myself this much insulin, the result will be this. But then you have to factor in, stress, activities, sickness etc etc etc etc….. here comes the uncertainty. I have yet to perform the same action twice to the same situation while dealing with diabetes and have the same end results.
    None of us are dumb!