As I described in my post yesterday on uncertainty, diabetes can be a roller coaster ride of high and low blood sugars. As a result it can often feel like you have no control over your body or, depending on how grandiose you feel, your broader life.

However, the fact is that that could not be further from the truth. Yes, there are an ever increasing number of variables that science has tied to metabolism and blood sugar. Sleep being just one of many. However, at the end of the day, diabetes treatment is a science - with enough data and enough understanding of the variables you have complete control over blood sugar.

Theoretically, if you knew exactly the number of carbs you were eating as well as the precise ratio of carbs to insulin required for you at a given time of day (dependent of course on activity level, hydration, sleep, caffeine, and many other factors) you could maintain a steady average blood sugar throughout the day. There would be spikes but you could always return to just where you started.

Taking that a step further, if you knew exactly what you were going to eat in advance and the precise carbohydrates in the food you could maintain a perfectly flat blood sugar as you would inject in small increments in advance to preempt any spikes.

The above is the premise behind the artificial pancreas projects which are underway in labs and now in testing around the world. In fact, with knowledge of relatively few variables, scientists have been able to create artificial pancreases that are incredibly good already. And that is just the start - the systems in use today rely on blood sugar measurements from inaccurate and time-delayed CGMs and use slow acting insulin, but technologies are advancing quickly.

My point is this - what we view as a roller coaster is at its core a biological system in progress. Given an input, either sugar or insulin, blood sugar rises and falls accordingly. The magnitude of change can vary based on other variables, but the premise remains the same. Once we realize that, the key is setting up experiments so that we can find the appropriate ratios and amounts of sugar and insulin to compensate correctly and maintain the ideal range of 80 mg/dL to 120 mg/dL. In my next post I'll talk about one tool I've found particularly helpful with that.