Good Control

The question stumps me every time.  "Are her blood sugars in good control?"

It's asked by medical professionals in every office we visit: the dentist, orthodontist, eye doctor, pediatrician, specialist, lab.  No matter how it's asked, my mouth seems to open and close but I'm unable to form an adequate sentence."Is her diabetes under control?"  "Have her blood sugars been stable?" 

The first problem is how vague the question is.  What do you mean by 'good control'?  Are you asking about today?  This month?  Since you saw her a year ago?  Today, her blood sugar may be terrific, but it could be the first day in two weeks she's stayed below 200.  Is it her A1C you're looking for?  That may not reflect the past 2 months' work to bring it down by next time. 

It also strikes me as curious that a medical professional who should have some rudimentary knowledge of the disease phrases the question this way. By definition, her blood sugar is out of control.  We use many tools to control it as best we can, but she will get smacked by random highs and lows no matter what we do.  These are caused by factors like growth, illness, unanticipated exercise, stress and possibly a full moon.  These factors are out of our control, part and parcel of life with diabetes. 

Which leads to the ultimate problem with the question. No matter how it's asked, it's phrased so that 'yes' and 'no' are the only possible answers.  Yet neither is accurate.

Usually, I cobble together a response such as, 'pretty good...we do the best we can," or "most days."  I imagine neither of those is terribly helpful. 

The reason for the question is generally clear.  Doctors, nurses, and technicians need to find out if she's at risk for any complications they should be on the look-out for. 

Perhaps those of us who encounter this question could begin to use it as a conversation starter.  Instead of mumbling through a useless answer, we could formulate responses which could make doctors rethink the question.

"Are you looking for her A1C?  That was x.x last time, down from x.y the time before."  Or, "Do you mean the last couple of weeks?  She's been having random lows we can't account for...that's part of what brought us here." Or, with a tired smile, "Could you be more specific?  It's a big disease and it's hard to quantify how we're managing it with a yes or no question."

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