The accuracy of the ‘180 decisions a day’ stat is somewhat questionable. Once, a long time ago in diabetes land, a blog post from Stanford University claimed a study showed that people with diabetes make that many health-related decisions each day. And it stuck and became folklore. It gets thrown around a lot! I’ve used it. Whole diabetes awareness campaigns have been built around it (guilty! I’ve co-designed them). And I couldn’t start to count the number of times I’ve seen the stat flash up in a presentation slide deck.
But, where is the evidence behind this specific number? Who knows‽ It’s murky.
While it does matter, it kinda also doesn’t. Accuracy is important (and no one knows the importance of accuracy more than someone dosing insulin). But so is the framing of what the number tells us. It says that people with diabetes face so much each and every day of our lives and with that, we are forced to make many decisions that people without diabetes simply don’t have to consider. Whether it’s 180 extra decisions, 120 extra decisions, 50 extra decisions – the number is … extra.
And while we could count and keep a tally of the specific decisions we make each day – the decisions of what, when, where, why, how to do things that impact our diabetes – there are decisions that go beyond being counted. Like the constant, underlying decision we make every single minute of every single day.
Everyday we make the decision to live. We do the things, we take actions that mean that despite what has been thrown at us we decide – deliberately – to live. We choose to live. Sometimes, things get in the way that make that choice almost impossible – the expense of diabetes, the lack of access to care, tech, medication and support all make it more difficult. But despite that, every time we do something to manage our diabetes, to treat our diabetes, to think about our diabetes, we are making the decision to live with diabetes using whatever is available to us.
The privilege to not have to make these choices is not available to people with diabetes. And because it is just what we do, it becomes normalised and becomes part of the fabric of our everyday. But I think it is worth recognising. The effort of making the decisions that mean we choose our life over and over and over again is quite remarkable. We may not really know exactly how many decisions it is each day, but, really, who cares.
After all, diabetes is about more than numbers. We keep telling you that!
