Tuesday, November 2, 2010

I Might Be A Diabetes Snob.

Recently, I attended an insulin pump class at one of my local medical clinics.  I've never gone to a pump class before, and I was hoping this could be a good place to meet some other people with type 1, while learning some new tricks.  In my most wildly imaginative version of how this could go, I envisioned us all bolusing simultaneously, comparing notes and strategies, with glucose tabs and test strips flowing freely.  Perhaps some diabetes-related cartoons or video clips would be shown.  Someone would finally reveal to me The Mystery That Is Bolusing For Breakfast Cereal, and I'd tell everyone about D-Prom.

 The title of the course was "Advanced Insulin Pump Class", and the description told me that I'd be attending a "holiday meal planning session that includes information on how to adjust bolus dosing".  And, there would be free dinner.

I don't want to sound like a know-it-all, but... in this class, I apparently did know it all.  I didn't learn a single thing, and I'm feeling disappointed. 

My top hat and monacle felt
slightly out of place.
Is it simply because I am a very engaged patient?  Is it because I expected, with a description like "Advanced", that we wouldn't spend time discussing the difference between a basal and a bolus?  Is it because I spend most of my free time blogging, advocating, and using social media (Facebook, Twitter, etc.) to discuss diabetes, and have learned so much more than your average Jane Diabetic because of it?  Is it because I actually read the manual that came with my pump (and downloaded a copy to my work computer for referencing)? 

Whatever the cause, I felt very out of place, and I wasn't expecting that.

My husband and I were the youngest people there by quite a margin.  Some of the people there already had insulin pumps, but didn't know how to use the extended/dual wave/combo bolus option.  (That was me at one time.)  Some people were considering getting an insulin pump.  (That was me at one time, too.)  One lady asked at the end of the class, "I need to ask, what exactly is diabetes?  Like, what does it do to the body?"  And then we all had to sit there while the dietician leading the class explained it to her.  (She said she had "pre-diabetes", and I wondered who had recommended an Advanced Insulin Pump class to her.)

I was also shocked to find that there was no nutritional information provided about our meal.  I mean, come on.

There were so many times I wanted to interrupt the dietician teaching the class.  I kept wanting to add something to what she was talking about, or to rephrase it.  For instance, when talking about extended boluses, she showed a slide of the different types of extended boluses, but then only explained what the combo bolus is.  What about the square wave?  What about the super bolus?  (I love that it sounds like a superhero, by the way.)  At another point, she told someone that if they "programmed their pump right", their blood sugar should be back in normal range at the two-hour mark after a meal - as if the pump user's ability to program would be the only possible issue at play.  She also remarked that when eating pizza, she "definitely wouldn't recommend testing every hour or anything".  It was at this point that my husband and I both involuntarily let a chuckle escape.  We couldn't help it.

It got me to wondering...  is my level of knowledge in handling my own disease really that advanced, or am I just a Diabetes Snob?  Am I engaged to the point of being arrogant?  Is it out of line to think that I might know more about the subject at hand than the person teaching it? 

And would anyone else attend a class for the So Super Advanced We Don't Know What To Do With You?


  1. This is the Elephant In The Room with many of us DOC'ers with diabetes: we actually do know more than many of the so-called "professionals" -- but because we don't own the piece of paper they do, and because the organizations that give them that piece of paper don't teach them the stuff we learn just by living with diabetes, and because those organizations don't require sufficient updating of credentials, we often end up with professionals who (in our eyes) don't know what they are doing.

    The second question is, how much of what you do with your pump, and how much of what was (or wasn't) covered in that class is, or is supposed to be, covered by one's pump trainer?

  2. I've heard about "advanced" classes and what they entail and found them not so advanced.

    But the class is geared toward a very wide population. I would say you are not at all a snob. Just a very engaged patient. There is a mass of people out there no where near as involved as you in their care and this class is for them. Not you. :)

  3. Oh no, you are not a snob. I'd say you are a very knowledgeable, active patient who has taken the time to seek out the support and information you need!!! Like you, I have yet to find any class on diabetes that can teach me anything new. Yes, part of me gets disappointed by that. But when I really think about it, we should be very proud of ourselves for taking the initiative to learn all we have about taking good care of ourselves. And yes, maybe we *should* be up there teaching those classes - LOL!!

  4. OMG. This was being taught by a dietician? WTF? ANYWAYZ, I agree, we are more advanced than most anyone because we ARE active in our care - 110%. I would have loved to have been a fly on teh wall... or the bee buzzing in your ear. You woulda slapped the mess outta me b/c I would have been pushing you to say something if the dietician needed correcting. That's one of my pet-peeves - someone spreading incorrect information or information that has only been "skimmed".
    Props to you and your husband, though, for making the effort to go. :-) At least you got a laugh out of it! :-D

  5. Kim, I definitely want to go to the So Super Advanced We Don't Know What To Do With You class with you!

  6. I honestly do think you're pretty advanced, and I also think it's because you're so engaged. I feel like I'm approaching that pretty quickly, also because I'm so engaged, involved, and interested.

    Since I've had diagnosed D for about 6 months, I've been to a lot of trainings. They're all clearly "dumbed down," which has often frustrated me. My first CDEs commented to me at the very first intensive insulin treatment class that I would clearly do great because I was "much smarter" than their average patient... I think the truth is that I was already reasonably educated on D (which still wasn't much!) in the first place and had been reading and reading and reading ever since my GP's first test showed such a high BG. I was determined to learn how to do this right, and I'm a natural born learner that thrives on the teacher/student dynamic (on either side of it).

    Despite what they said, I don't think it has a great deal to do with "smart." I'm betting TONS of people smarter than me don't do as much "advanced" stuff as I've already started to do. It takes a reasonable level of brain power, PLUS the desire to learn as much as you can, PLUS the ability and willingness to put forth the effort.

  7. Oh I was 2 days behind on reading, but this is AGAIN a blog that could be written by me. I once had a lady from the pump company coming at my house to teach me how to work with my pump. That was 4 years ago. I asked her to teach me (bcs I needed that, I didn't know, it ws my first with that option) the bolus wizard. She said I'd better not ask bec it would be too difficult. WTF?? Why do I buy a car with 6 gears to use only 4? So I think sometime they try to keep the papients unknowing. Bcs that is more easy. Even at the endo it is sometime hard to ask them advanced questions bcs they seem just not want to explain to you. I searced for a good endo for years and finally they know more than me! Which I find shocking also, LOL.

  8. I find most "advance" classes aren't actually advanced in generally, whether about diabetic tools or a cooking class or something. Even some computer courses where I have learned a bit but not a lot, where called "advance".

    I think they call them that because it's not as basic as "this is the pump. the pump delivers insulin."

    It's stupid, but I generally don't expect to learn anything, or at least not much, when I go to an "advance class".

  9. I'm right their in Pump Snobiness with you, and would so attend the So Super Advanced We Don't Know What To Do With You class. Yep. My wife and I've been there, too, and let our more than our share of "You're an Idiot" chuckles to those leading the sessions. Same with the advanced carb-counting class, where we actually got a 1970s meal-exchange booklet... I threw it on the floor and left. Had I paid, I would've demanded a refund. I'm not sure it's our level of engagement, I think it's more the fact that we know WTF we're talking about and the medical establishment can't get past the fact that we're smarter than them even though we don't have the letters after our names. Yep. I'm a snob. Not ashamed to admit it.

  10. This post is right on! You are not a snob but an active patient. When my daughter was diagnosed last year, I was a super jerk and said I already knew what to do, give me doses and then send her home. (my brother has been T1 for almost thirty years and his daughter has been T1 for 20.) Needless to say this was not new territory for me. Luckily once our endo realized I was telling the truth, she has treated me with respect and has never talked down to me. Be active and aware and you will stay healthy!

  11. Being a d-snob is awesome, and you do sound like one, and you have every right to be one! ;) I'd so join you in the "So Super Advanced We Don't Know What To Do With You" class. If you've been awake during your appts, read the manuals and simply pay attention these long years, you've got it covered. (I'm at 30 years w/ t1, and just this year decided to pull the control in much more than before.)

    In fact, we could just take the AP D-Snob final exam, get a top grade w/o studying (we might miss a couple just b/c we'd get to rockin' those questions a little too fast), and head out and have some diet coke instead of some dumb "class" that doesn't even cover anything relevant. Good times.

    Advanced d-snobs unite! <3


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