Men With Type 1 Diabetes Are Better at Blood Sugar Control Than Women

[DeusXM]

If your insulin requirements are being met adequately then not sure why being able to stick to a diet would give better control.

It's not about literally following a diet - it's about the principle of being aware that you don't have the freedom to just eat and not think about it.

As someone who doesn't have diabetes themselves, you may or may not be aware of just how fundamentally draining it is to constantly have a mantra of "how's my blood sugar doing? How much longer has my Novorapid got to work in me? How's my blood sugar doing? Will the fat I ate 2 hours ago mean I'm going to have a delayed impact from the carbs in the meal? What's going to happen in a couple of hours time? How's my blood sugar doing? I did some more exercise than normal this morning so do I need to think about timing my next bolus to coincide at a later point on the digestion curve? How's my blood sugar doing? How's my blood sugar doing?"

That is what constantly plays through my head 24/7 and it only stops when I go to sleep and even then I end up having dreams about testing my blood sugar. To be able to put up with that and not drop the ball requires a superhuman level of discipline and to some extent, denial of food or activity. Fine, yes, I can match my insulin to that chocolate bar. But what happens after 1.5 hours when the chocolate bar is done and I've got another 2 hours of action from my bolus? In that situation, you may end up denying yourself the chocolate bar because you realise the hassle it'll cause you later....which is pretty much the exact same argument anyone on a diet will have themselves. The two processes aren't identical but do require quite a lot of cross-over. And yes I'm sure there are plenty of women who stick to diets. I can only speak from my personal experience (and I thought I made that abundantly clear) but from that personal experience, I would say that men seem to be able to detach the process from the result more effectively than women. It has NOTHING to do with willpower or a weakness of personality. It's about being aware that men and women may manage things differently in their heads with neither way having more value than the other in general terms, but one way may inadvertently confer advantages when managing D.

Another element to this is that managing diabetes effectively does tend to require a level of obsession and compulsion. Although OCD is equally distributed among adults, for adolescents it is males who are marginally more likely to present as an official OCD diagnosis. it may simply be that young men are slightly more predisposed to obsession and compulsion (if not to the extent it could be categorised as a mental illness). T1 tends to present itself in younger people, so it may simply be that men benefit from this predisposition to establish better blood glucose control habits at the age of diagnosis which then stick for life.

ANOTHER element is also the eating disorder side of things. I don't have stats ready to hand but there is a trend of people omitting to take their insulin to manage their weight. I would suggest that probably more women than men end up as DWEDs because women face an unbelievable amount of pressure to conform to a body 'norm'. This isn't to say there are no male DWED (far from it) but I would wager the trend is in the balance of women, and the impact of this is to distort the overall trend results for men and women.

 

[Northerner]

how fundamentally draining it is to constantly have a mantra of "how's my blood sugar doing? How much longer has my Novorapid got to work in me? How's my blood sugar doing? Will the fat I ate 2 hours ago mean I'm going to have a delayed impact from the carbs in the meal? What's going to happen in a couple of hours time? How's my blood sugar doing? I did some more exercise than normal this morning so do I need to think about timing my next bolus to coincide at a later point on the digestion curve? How's my blood sugar doing? How's my blood sugar doing?"

I hadn't realised how much of this was going on in the background until I came to a point where I no longer needed my basal insulin. It meant I was at virtually zero risk of night hypos, and even though I had been having them very rarely until then, I was surprised at the lift this gave me (and still does). Really brought home to me what a presence diabetes has, even when you are not thinking about it or think you are managing things very well. 🙂

 

[everydayupsanddowns]

It's not about literally following a diet - it's about the principle of being aware that you don't have the freedom to just eat and not think about it.

As someone who doesn't have diabetes themselves, you may or may not be aware of just how fundamentally draining it is to constantly have a mantra of "how's my blood sugar doing? How much longer has my Novorapid got to work in me? How's my blood sugar doing? Will the fat I ate 2 hours ago mean I'm going to have a delayed impact from the carbs in the meal? What's going to happen in a couple of hours time? How's my blood sugar doing? I did some more exercise than normal this morning so do I need to think about timing my next bolus to coincide at a later point on the digestion curve? How's my blood sugar doing? How's my blood sugar doing?"

I would imagine that many parents of CWD will have *exactly* the same draining monologue circling around in their heads... except that 'my' will be replaced by 'their' and they won;t have direct access to the sensation of hypo-warnings... they'll have to deduce that from moods/behaviour and risk upsetting a hormonal teen by asking them to test when actually they were just feeling a bit drowsy/hungry/irritable and their BG is fine.

Actually... for myself I think it *IS* about following a diet more or less continually. And as you suggest it's about picking the battles (choosing not to have carby snacks because the fall-out drains all the joy out of them and all that). By eating carefully and reducing the variables/meal sizes to some extent, it can be easier to spot when othre things (like basal requirement) have wandered off in a different direction

 

[Cleo]

how fundamentally draining it is to constantly have a mantra of "how's my blood sugar doing? How much longer has my Novorapid got to work in me? How's my blood sugar doing?

So true.

When ever people ask about how I feel about taking injections I always say that that's the least of my worries. The challenging Thing is having to constantly intervene to ensure that my pancreas mimics the function of a healthy pancreas. It's very tiring because you never get a break from it.

 

[Northerner]

I would imagine that many parents of CWD will have *exactly* the same draining monologue circling around in their heads... except that 'my' will be replaced by 'their' and they won;t have direct access to the sensation of hypo-warnings... they'll have to deduce that from moods/behaviour and risk upsetting a hormonal teen by asking them to test when actually they were just feeling a bit drowsy/hungry/irritable and their BG is fine.

Indeed, and draining in a different way no doubt, due to feelings of helplessness and possibly guilt if you feel you didn't 'get everything right'

 

[everydayupsanddowns]

I would need to read the original paper to work out whether the conclusions/methodology raise question marks but...

After my first year on the pump I switched infusion sets. Prior to that I'd been having quite a few set fails/absorption issues that played havoc with control. Probably about once a month or every 6 weeks. Having 'solved' that my A1c dropped by around 0.5%. So if menstruation is causing similar BG upheaval I can certainly believe that alone could result in statistically significant differences between the sexes. Even if periods are predictable time-wise and to some extent women can adapt their approach to help, it is still going to have an impact because this is biology, not maths.

Additionally (and again only my own experience and preconceptions) I would say that women tend to be the more selfless. Putting others' needs/requirements first and leaving their own needs lower down the scale. Men would be more likely I would think to be bullish and tend to their own needs as a priority.

It also seems likely that even in this day and age women are more likely to be doing the majority of the cooking. Whenever I'm cooking the meal in the evenings (usually my trickiest meal of the day to get right) I find it much less easy to focus on pre-dosing for a meal amid all the chaos of getting things all on the table at the right time, table laid etc.

 

[bev]

I would imagine that many parents of CWD will have *exactly* the same draining monologue circling around in their heads... except that 'my' will be replaced by 'their' and they won;t have direct access to the sensation of hypo-warnings... they'll have to deduce that from moods/behaviour and risk upsetting a hormonal teen by asking them to test when actually they were just feeling a bit drowsy/hungry/irritable and their BG is fine.

Actually... for myself I think it *IS* about following a diet more or less continually. And as you suggest it's about picking the battles (choosing not to have carby snacks because the fall-out drains all the joy out of them and all that). By eating carefully and reducing the variables/meal sizes to some extent, it can be easier to spot when othre things (like basal requirement) have wandered off in a different direction

Hi Everydayupsanddowns,

I couldnt have put it better myself thanks!I would also add that whilst I may not 'feel' a hypo or hyper - it most certainly does not mean I dont feel empathy or understanding of what Alex has to go through 24/7. And I think I can speak for a large number of CWD mums when I say that once diagnosed our lives change forever and there is not a day goes by that I dont think about levels - or whether that chocolate bar is going to spike - or whether levels are OK for an exam - or whether the growth pattern will stop after 3 weeks this time - or whether that TBR we put on overnight will be too high - or whether the food at the party will all be spikey food - or whether he will try alcohol when at the party - or whether he remembered to test before P.E. - or whether he will feel a hypo in his sleep - or whether he will remember to take off the TBR after many hypo's playing with his mates - or whether or whether or whether.......................

Whether you are a parent or not (and I have no idea whether you are deusXM) I can tell you that you NEVER stop thinking about your child - unfortunately we have the double whammy of Type 1 in the mix - and the worry that your child might be at possible risk from death. So - in a word 'yes' I can and do think about diabetes every day - and every night - it doesnt end because he is at School/with mates/asleep - so the idea that we cant possibly know what Type 1's go through on a daily basis is incorrect and insulting to parents/carers/partners who all live with the effects of Type 1 and all its ups and downs.

On balance I would say that I probably think about it more than Alex - he is busy being 15 and enjoying life which is how it should be - I am just there to remind and support him if he is struggling. I am happy to say that at the moment he is not finding it a problem and takes the view that he could have a worse condition - which I feel is refreshingly positive for a young person his age - so I must be doing something right!🙂Bev

 

[Northerner]

so the idea that we cant possibly know what Type 1's go through on a daily basis is incorrect and insulting to parents/carers/partners who all live with the effects of Type 1 and all its ups and downs.

That wasn't what was being said bev. I have tremendous admiration for all parents for a child with diabetes but DeusXM was very careful to stress that what he feels is something you can't feel, just as he can't feel what you feel as a parent and neither of us can know what it feels like to be a mother with diabetes in pregnancy. We're not here to challenge the notions of who suffers most or has the hardest time, we're here to support one another in a common cause.

The thread is about whether there are any innate characteristics that might explain the slight differences found in the study. 🙂

 

[bev]

That wasn't what was being said bev. I have tremendous admiration for all parents for a child with diabetes but DeusXM was very careful to stress that what he feels is something you can't feel, just as he can't feel what you feel as a parent and neither of us can know what it feels like to be a mother with diabetes in pregnancy. We're not here to challenge the notions of who suffers most or has the hardest time, we're here to support one another in a common cause.

The thread is about whether there are any innate characteristics that might explain the slight differences found in the study. 🙂

Hi Northerner,

Maybe not in so many words no - but it was inferred which amounts to the same thing.😉And I didnt say DeusXM said it - I was just reacting to the assumption that a non-diabetic cant possibly understand what diabetics go through - I can and do just from a different angle. Bev

 

[Redkite]

Additionally (and again only my own experience and preconceptions) I would say that women tend to be the more selfless.

Well I for one am not going to argue with that!!! 😛

 

[DeusXM]

Maybe not in so many words no - but it was inferred which amounts to the same thing.And I didnt say DeusXM said it - I was just reacting to the assumption that a non-diabetic cant possibly understand what diabetics go through - I can and do just from a different angle. Bev

Well, this interesting. I was in fact extremely careful to say "you may or may not know" - largely because I know you're an involved parent but I can't make any assumptions about your particular experience.

From my personal experience, I know my parents definitely did not/do not be aware of how draining this is for a person with diabetes. Nor indeed do those who I love and care about. I make no judgement about whether or not non-Ds understand this but as has been pointed out in this thread and by Dominic Nutt's excellent article in the Telegraph last month, the majority of non-Ds are not aware. That is also very different from saying "you can't know" inasmuch as anyone can know how much any particular issue affects any particular person.🙂
For the record, the fact that you do understand the mental process going on in people with diabetes puts you well ahead of 99% of people.

I would politely suggest though here is a greater disconnect between your experience and those of others with diabetes, as you described the idea of sticking to diabetes management being a bit like sticking to a diet as "tosh", even though at least two people with diabetes and one parent have explicitly said that they agree with my interpretation.🙂

 

[bennyg70]

Boy power!! *does the peace sign*