Obsessive-Compulsive Diabetes Testing

04/23/08 Disease Basics

My fingertips look like a detonated mine field. Miniscule craters cover and distort the whorls of fingerprints in a disturbing image of the self-inflicted damage of diabetes testing. They are emblematic of the irony of this disorder that forces you to harm yourself in order to maintain care. Unfortunately, I am not daunted by this unfortunate consequence. In fact, quite the opposite. I monitor in an almost obsessive manner.

The definition for obsessive-compulsive disorder is “an anxiety disorder characterized by repeated intrusive thoughts and associated ritualized behaviors intended to alleviate that anxiety.”  When I began monitoring 17 years ago, my testing clearly fit the criteria. In spite of the fact that my strips were not covered by health insurance, which meant my parents had to cough up at least $300 a month to cover the minimum four, daily tests, I found reasons for performing more. The root cause was truly one issue—uncertainty.

If you consider the definition above, this uncertainty was the source of my anxiety, and the testing a way to alleviate it. I truly did feel a sense of order through the numbers, regardless of the results. At least I knew where I stood, and that had to count for something.

My compulsiveness did wane during adolescence. I became savvy about my overall disposition, and how it was a reflection to my glucose level. I’d frequently play a game of “guess the test result” just to verify how in tune assumptions were. Most often I was within close range, but in time, hormones raged, and coupled with my athletic endeavors, I lost my “sense of sugar level.” Fortunately, my strips were eventually covered by insurance, allowing me to strike at will, and strike I did.

Which is very much the position I am in today. One glance at my logbook reveals that I test an average of 12 to 15 times a day. On my “light” days, I’m checking around eight times. Apparently I’ve again found solace in the numbers, and need them to quell the anxiety roiling within.

As a husband, parent of two, full-time English teacher, and dedicated athlete, life is hectic. I cannot afford to have large gaps of time when I am unaware of what my level is. I need to know so that I can appropriately adapt physically and mentally to whatever demand presents itself. It is impossible to concentrate under the intrusive inner monologue: What’s my level? Should I test? I don’t know, I think I’m all right. Should I test? Therefore, I bludgeon away, in a sacrifice to sanity.

Is all this testing healthy? Am I truly obsessive compulsive? Honestly, I don’t know. All I am assured of is that it works.

Someday, maybe, I won’t feel so bound to know so often. Possibly I’ll get back in touch with my ability to sense my level. Or most likely I’ll apply for a continuous blood glucose monitor.

As the adage goes: Insanity is defined by repeating the same action and expecting different results. I already know the results will be a mixed bag, but the comfort of knowing is always the same.