A Human Pincushion

Next January I’ll be 20 years into my career in data analysis.  I actually have “data” in my job title.  So of course when I was diagnosed with Type 1 Diabetes I figured I had an advantage.  I don’t know if that’s actually true in practice, but it certainly means I spend a lot of time thinking about numbers.  What I hadn’t really thought about was getting a little more perspective on those numbers.  I know how many units of insulin I take for different foods and how many needles and test strips are in the prescriptions I fill every 3 months…but I never thought about what that all looks like.  With that in mind, I decided to spend the month of March finding out.  I saved every needle and every test strip for 31 days to see what I do so I could share it here for perspective.  I’m the one poking all these holes in myself every day, but seeing the volume of them was shocking.  And the exercise left me with something of a biohazard on my hands!

Every day in March I put all of my needles into a plastic cup in my kitchen.  If the month extended to 32 days I wouldn’t have been able to maintain the delicate balance at the top of this pile.  For context on size, the object behind the cup is a Kitchen Aid mixer with the awesome cover my mom made for me.  It only took a few days for me to be awed by the volume accumulating at the bottom of the cup.  

At the end of the month I counted the needles and set them up in rows to get the full effect.  How many?  That’s 248 needles, an average of 8 per day.  Most days are less and a different month would be somewhat lower.  March had some weekends away from home that included beer, which means I was dosing more often than usual.  Things don’t take long to add up.

I also kept all my test strips throughout the month.  There’s no cute way to display these, and I kept them in a Ziploc bag until it was time to count.  Even with my CGM keeping tabs on my blood sugar, I test a lot.  That’s 292 strips almost filling half a cup, an average of over 9 per day.  I’m actually curious as to whether that number would go down if the beer I mentioned hadn’t happened.  I was testing an average of at least 9 times a day before I got my Dexcom, and I’m not conscious of testing that frequently now.  I’ll probably test it again for a week some time to see how the numbers come out.

Between injecting insulin and checking my blood sugar I poked 540 holes in myself during March.  That’s somewhat surreal to realize, and I’m the one actually poking each of those holes.  I poke those holes every day with no time off for good behavior.  I don’t do it to cure my disease; I do it to stay alive and healthy.  I downplay what goes into T1 pretty regularly, but make no mistake – this is a lot of work.  It’s also a whole lot of puncture wounds.

For some additional context I thought I’d show what I mean when I talk about insulin doses. One example was when I described accidentally injecting 27 units of Novolog (fast acting insulin) instead of Toujeo (basal insulin).  With all the images of the needles and test strips that I go through in a month I thought it might be meaningful to show a unit of insulin.  The pictures below shows a single unit of insulin in the same measuring cup the test strips are in above.  That’s it, one unit down there in the center.  Making a miscalculation in a dose of just one or two of those units can be the difference between normal blood sugar and a shaky, scary low, or even a trip to the hospital.  That’s my margin of error, a drop you can barely see in a photo.  I zoomed in so you’d be able to see it at all.

What’s my point with all of this?  My goal was and is showing the scale of what goes into managing T1.  I’m not complaining; I didn’t know what to expect when I started saving all these scraps.  But in hindsight I can also say that the next time I say “it’s fine,” or “it’s no big deal,” I might also remember I have to stab myself over 500 times a month to stay alive.  So yeah, I’ve got this.  But 500 holes a month is 6,000 holes a year.  That’s kind of a big deal.