Q is for Quality Control

I’m going to take a break here from discussing a word that fits me to discuss a word that is directly related to my diabetes at this point and time.

qual·i·ty con·trol [kwol-i-tee] [kuhn-trohl]
  –noun
  a system for verifying and maintaining a desired level of quality in a product or process by careful planning, use of proper equipment, continued inspection, and corrective action as required.

Yes, that’s right, Quality Control. Last year was all about obtaining control of my diabetes (instead of letting it control me), this year is all about improving that control.

I had a phone conversation last week with a couple of friends (who coincidentally are also diabetics) and they gave me some questions to go in and ask my CDE so that I can go about getting some things straightened out. In particular those low blood sugars that constantly plague me (the ones I’m afraid are going to kill me in the middle of the night).

Part of my quality control procedures was to try and get 8-10 checks a day into my schedule. I’m getting 6.5 checks a day in because I’m not diligent in checking every 2 hours (I hate being connected to the clock, it pisses me off, why should I have to run my schedule around a 2 hour blood check? EXACTLY, I SHOULDN’T!) Regardless of my lack of due diligence in testing my blood as often as I really probably should, my A1C is 6.5 (which is down .5 from the 7 that it was back in January.) That’s progress for me, it’s the lowest A1C that I’ve ever had in almost 16 years. Granted, it’s mostly due to all the low blood sugars that I have, but still, it’s a good A1C.

My thought though is that I shouldn’t have to be having all those low blood sugars to get my A1C that low. I theoretically think that I should just be able to run normal sugars 100% of the time and BAM! I’ll have a perfect A1C. (is there really a perfect A1C or just a desired one?)

For me to even have a chance at seeing this work, or come close to working, I have to get rid of the low blood sugars *rolls eyes* One thought thanks to my lovely friends was to do some basal testing to make sure that my basal rates are right. So far, I’ve done 1 night of basal testing. The worksheets that were mailed to me say I need 3 and that they don’t need to be consecutive (we’re looking for patterns here I think). I have yet to do a morning, noontime, or evening basal test simply because I can’t be doing something like that on a weekday (no food = grouchy Courtney). At this rate, it’s going to take me 3 weeks to get all my basal testing in.

But basal testing is step 1. After basal testing then I need to make sure my bolus rates are correct. When all that is said and done, then I’m gonna have to start doing something I loathe and that’s measuring food to determine the carbs in it if it’s not marked on some kind of packaging (which in my opinion is a royal pain in the ass and well, just a royal pain in the ass, I hate it).

Once I have all my rates in proper order and I’m counting carbs with insane accuracy, by my calculations, my numbers should run perfectly (on a non-exercise day). Now the reality of this happening is pretty slim to none, I have no problems with getting my basal and bolus rates correct, but beyond that, well, everything else is just a load of malarky. I really have no desire to be checking around the clock and I really have no desire to be measuring my food perfectly so that I get an exact carb count.

As I write and think about all this, I can’t help but thing about Six Sigma. Six Sigma is a concept I learned in Operations Management in college. Six Sigma is basically the measure of quality that strives for near perfection. I could get really geeky and go into how it’s all about trying to get no more than six standard deviations between the mean and the nearest specification limit (which in my case, the specification limit would be a blood sugar of 100). I think if I remember correctly there was a lot of qualifications that went along with six sigma but it was all about the processes that go into place in an attempt of achieving Six Sigma that made me think of it.

Tagged as: Diabetes Control, Quality Control, Six Sigma