The Path To Great “Time In Range” Is Made Of Mistakes And Learnings

As a type-1 diabetic, my daily goal is to be in range for as much time as possible. My minimally acceptable personal target is to be in-range AT LEAST 80% of the time. My real target is 90%. Aiming high is critical to keep ourselves up to our best standards, and to force us to take the best direction at every turn.

Yet, we’re humans, and we make mistakes. The first kind of mistake occurs when we do something wrong simply because we had no idea that was wrong. “I didn’t know that this food would shoot my BG to the sky so dramatically. Now I know it, and I’ll consider it next time”.

The second kind of mistake, the worst one, occurs when we know which is the right thing to do and yet we go for the wrong one. “I know that eating a pizza will spike my BG and screw it for days. But damn this is so delicious, let me have another slice”. And then we pay the price.

I have principles that guide my actions as a type-1 diabetic, and my passion for running makes following them with discipline a key factor because if I mismanage my carbs or my insulin intake, my run can quickly turn into a dangerous adventure.

I know that optimal blood glucose levels for the longest time are critical for long term health.

I know that certain foods are bad for me because they so clearly alter my insulin need, my blood glucose management, and my mood.

I know that eating whole plant based foods (a.k.a. “Mastering Diabetes Green Light Foods”) is ALWAYS the best way to go.

A “90% in range over the past 7 days” is clear evidence of good choices and good behavior just as much as “65% time in range over the past 7 days” is clear evidence of us getting off the rails. I love the first and do my best to avoid the second.

BUT.

The path is not so smooth. Despite knowing all these things and having clear guiding principles, sometimes I still do things that are clearly inconsistent with everything I am trying to accomplish: I overeat processed carbs and perhaps some more fatty foods, I “guestimate” my insulin doses, I overeat my calories, I don’t pay attention to what I do.

And this can happen at any time, the most frustrating instance of it being when I’ve been on a good strike of time in range and ruin everything due to some mindless cravings and binge eating.

Why does that happen? In my experience, stress and mindlessness are the most recurring causes. When I am concerned about something, I snack on whatever is on the shelf while I my mind ruminates. In most cases, stressors and concerns turn my brain off and let it go hunt its short term hit of dopamine, which are found in (mostly processed) foods. Because my brain, the pilot, is not responding anymore, the ship is left on its own through the storm. No wonder it will hit some rocks and get damaged at some point.

And without me intentionally piloting myself to the destination (long lasting health) through the best path (maximum insulin sensitivity and time in range), things cannot go well.

I don’t have a solution or a life changing insight from this stream of consciousness, other than acknowledging that there are cues to bad behaviors that we need to be able to identify, observe and let go. Life will always be full of potential stress factors - I say potential, because they do not necessarily have to become real stress factors.

It is up to us to develop some skill to not be overwhelmed by them any single time.

It is up to me to take that extra second in a stressful situation and realize that my lack of lucidity is likely to lead me to the shelf and overeat what’s in there at the expense of my present and future self.

There is nobody else responsible for taking care of this: recognize the cue, recognize the situation I’m entering in, and make the right call.

Gio, recognize you’re stressed, take a breath and remind yourself why it is important that you eat what is needed for your long term health, and not what your short term craving dictates. Recognize that your time in range, the single best measure of your discipline, is affected by so much more than just food. If you live your life without slowing down and interrogate yourself about what you do and why you do it, you’ll never see an improvement.

If, however, you take that time and space, you’ll be living more intentionally, more mindfully, and you’ll have more time to say “this is my guiding principle, I committed to follow it, and I’ll follow it”.

Bad behaviors, those that work against us, can become a thing of the past. It takes intentional work and attention, such as redesigning the environment so that it is more conducive to the good behavior). It also takes some bold action on our part, because at some point we have to put an end mark somewhere.

As Ryan Holiday reports in “Discipline Is Destiny” about Eisenhower’s addiction to smoking:

“A lifetime smoker of three to four packs of cigarettes a day, Eisenhower quit cold turkey … and never touched a cigarette again.” “The only way to stop is to stop,” he would tell an aide, “and I stopped.”