• Michelle Law

The endless diabetes to do list



Scrolling Twitter one morning a couple of months ago I saw a tweet from @RenzaS that included the line "no one wants to do diabetes".


Sh*t, I thought. I kept thinking about it for days after. I don't want to do diabetes!


It's a boring, relentless list of UNFUN chores that never ends. After 15 years with type 1, what can I do with this realisation?


Before I carry on, I know I'm extremely fortunate to have the luxury of even thinking this way. I don't have to worry about getting access to basic care or paying for insulin like too many people in the world do.


But Renza's tweet made me stop and think for a minute and acknowledge that this demanding self-managed condition is something I'd much rather not have (obviously) and it comes with a list of things I'd much rather not do (but still have to whether I like it or not).


The boring and tedious diabetes to do list


When the routine stuff of diabetes self-management is listed out it's no wonder people with diabetes get fed up.


I haven't got room to list absolutely EVERYTHING like "making sure you have your diabetes gear whenever you leave the house" and "plan for every trip away from home as a potential disaster" or "spend ages on the phone chasing essential supplies."


My ultimate goal is to keep my blood sugars in range as much as possible while keeping the burden of diabetes management to the absolute minimum. I want to spend as little time, brain space and money as possible dealing with diabetes.



Outsourcing, automating and digitising


In my professional life I work in corporate strategy. If a company was being impacted by something that was essential but draining resources, it would be sensible to look at how to do things more efficiently. Same goes for me and my diabetes. I've been trying to make my diabetes admin machine run as efficiently as I can using all the systems and processes I can think of. I want to remove the need to remember and decide, and cut down on the time things take.


First up - outsourcing. Two massive daily burdens that used to be on my diabetes to do list were finger pricking (which I hated) and correcting high sugars. I've outsourced the blood sugar monitoring and correcting to the Medtronic 780G hybrid closed loop system. The time and brain space this has freed up has been immense. No more information overload and decision fatigue, but it is costing me more money and I still have the burden of EVERYTHING ELSE on the diabetes to do list. The loop can't do that stuff for me.


Next is automating, which is great when it goes to plan. I have an online account with Medtronic which lets me set up a recurring automatic delivery of my insulin pump infusion sets and my Guardian 4 sensors. This should be one of those "do it once and it's done for good" scenarios, but sometimes things don't arrive when they should and time is needed on the phone to sort it. Thankfully it's not often but it's a pain when it happens. Other little automatic things I appreciate are my finger prick monitor wirelessly sending the results to my pump. I don't like manual faffing about if I can avoid it. I can also view my pump and CGM data on the same software platform as they are both Medtronic products so this streamlines things too.


Options for digitising have expanded over the last couple of years and I've taken full advantage. I use the NHS app to order repeat prescriptions from my phone in a few clicks which literally takes only a few seconds and I get the medication delivered to my house. I've been doing my diabetes consultations virtually since 2020 which has saved travel and waiting room time. All my data is shared with the clinic when I upload it from home. Doing things this way saves hours every year.


I've also got some simple systems and processes that help me save time and energy:


  • Bulk buying. I get a big pack of AA batteries for my pump and a decent hypo sweet stash at once. I got fed up of hunting around the house or raiding my husband's camera bag every time I had a "low battery" alarm.

  • Keeping everything in one place. Apart from my unopened insulin which stays in the fridge, I keep everything diabetes related in the same plastic tub under my bed. I used to keep things in a few different places but that created just enough friction to stop me from doing things like cannula changes on time. Since I consolidated it all I've been doing my cannula changes every 3 days more consistently than I have for a long time.

  • Half fill my insulin reservoir. I don't use a lot of insulin and a full reservoir can last me 6 days. Half filling it means it runs out in 3 days and I have to change it on time. No more little "should I do it now or tomorrow" debates with myself about it.

  • Checklists. I've started making these for things like going on holiday or preparing for Christmas. There's so much to remember, diabetes-wise, both the normal stuff and planning for curveballs, and there's too much other stuff going on at these times to really focus on that. I keep my checklists in my notes app and refer back to them so I don't have to think about the same thing over and over again.


What would make diabetes less of a pain?


Even with the very best diabetes technology out there, diabetes is still a heavy self-management load to carry, and some of that load is outside our control.


Things are often harder than they need to be, and other people have the power to change it. That's another story for another day.