Welcome to Diabetic Algebra 101, the class nobody signed up for—yet once you’re diagnosed with diabetes, you’re automatically enrolled. No syllabus, no orientation packet, just a lifetime subscription to the strangest math club you’ll ever join. Suddenly, your life is no longer measured in birthdays, anniversaries or even bank balances. It’s measured in numbers. Glucose numbers. Carb counts. A1C scores. Fasting sugars. Postprandial sugars. Before you know it, you’re juggling more digits than an accountant at tax time.

And the crown jewel of it all? The mighty A1C. That three-month average that every doctor, nurse, dietitian and diabetic support group leader wants to know before they’ll even ask your name. 

Forget about your horoscope or your Social Security number; your A1C becomes your identity. You don’t say, “Hi, I’m Mike.” You say, “Hi, I’m 6.5.” And the reply? “Oh nice, I’m 7.2, but I’m working on it.” It’s the diabetic equivalent of small talk. Forget the weather; numbers are our weather forecast.

Now, for the uninitiated, the A1C isn’t just another blood test. It’s the big to-do of diabetes. It’s not about what your sugar is right this second; it’s the average of what it’s been for the last three months. Three months! That means every bite of chocolate cake, every midnight peanut butter raid and every time you swore to yourself, “I’ll just take a little taste.” It  all comes back to haunt you in one neat little number.

Doctors say you should keep it under 7. “Seven is heaven,” they like to chirp. Over 7, and apparently every organ in your body throws up its hands and starts packing for the afterlife. Under 7, and you’re a star student in Diabetic Algebra 101.

The numbers club

Here’s how it works in real life. You run into your diabetic buddy down the street. You don’t even bother with “Hello” anymore. It’s:

“6.4.”

And they nod knowingly, and respond:

“Nice. 7.1.”

Then you both smile, exchange an imaginary fist bump, and go about your day. That’s the diabetic version of small talk.

But here’s the catch—if your A1C is over 7, you will absolutely lie about it. Guaranteed. Nobody admits to an 8, or heaven forbid a 9. If asked, you’ll suddenly develop amnesia:

“Oh, I don’t remember my last one…I think I’m due for another test soon.”

Translation: “It was bad. Real bad. Let’s change the subject before I have to admit it.”

Maintaining a decent A1C is hard enough during normal life. But throw in holidays? Forget it. Thanksgiving is basically a three-day math exam where you’re trying to calculate how much turkey you need to offset the stuffing, how many units of insulin you’ll need for one piece of pie versus two (because, let’s face it, you’re not stopping at one), and whether you can somehow “exercise it off” by walking from the couch to the fridge during football halftime. That ain’t going to work

What about all the other holidays? 

Holidays=Final exams

Speaking of holidays, let me break it down:

• Thanksgiving: An advanced calculus exam disguised as dinner. You’re expected to figure out how stuffing plus cranberry sauce minus turkey equals something survivable. Don’t forget pie. (Nobody forgets pie.)
• Christmas: That’s graduate-level algebra. Cookies, fudge, eggnog—Santa doesn’t care about your pancreas. He’s probably diabetic himself.
• Passover:  You have any idea how many carbs are in a board of matzoh?  Moses forgot about the diabetics, or better still, maybe they needed the carbs for energy to cross the Red Sea.  But that’s when the commandment should have ended.

• Easter: Jellybeans. Chocolate eggs. Marshmallow treats. It’s basically a blood sugar nuclear test.
• Fourth of July: BBQ plus beer equals fireworks inside your bloodstream.

Every holiday is a pop quiz you didn’t study for.

Now, about technology. You’ve seen the commercials: a happy diabetic couple frolicking through fields, twirling around like they’re in a perfume ad, with a voiceover saying, “You’ll never have to stick your finger again!”

Bull____.

If you’re diabetic, you know that’s pure fantasy. Yes, we have these fancy discs we stick on our arms that talk to our phones. They measure glucose in interstitial fluid—basically the sugar floating around the fluid between your cells. That’s nice and all, but let’s be honest, it’s not always right. Sometimes the disc tells you you’re perfectly fine, while your body is screaming, “You’re dropping like a stone!”

So what do we do? We stick our fingers. Because if you really want the truth, that’s where it lives, in those poor little pincushions at the tips of our hands. And every diabetic hand tells the tale. Tiny scars, little calluses, the proof that we’ve been playing Diabetic Algebra for years.

Don’t get me started on the commercials for wrist watches that supposedly measure your blood sugar. A watch? Really? Watches can count steps, fine. They can nag you to stand up every hour, fine. They can let you answer a phone call like you’re Captain Kirk on the Enterprise, fine. But sugar? Nope. Not happening.

“Introducing the new SugarWatch 3000! Tired of pricking your fingers? With our revolutionary technology, you’ll never need blood again. Just glance at your wrist and get an instant sugar reading!”

Fast-talking disclaimer voice:
“Warning: SugarWatch does not actually measure blood sugar. Readings may be based on moon phases, barometric pressure, random guesses, full bladders, length of your hair, and the silver fillings in your mouth.  Consult your doctor, or a Magic 8 Ball, before making insulin decisions.”  You’ll probably come closer to your reading with a crystal ball or a tarot card reader.

There isn’t a watch on Earth that can read your true blood sugar. Any doctor will tell you that, but people love to believe in gadgets. Gimmicks sell. And if you tell someone there’s a device that means they never have to prick their finger again, they’ll run to the store waving their credit cards or surfing the ‘net to get the cheapest price. 

And then there are doctors

Let’s talk about doctors. No matter what specialist you see, the first thing they want to know is, yep, your A1C.

Go to the eye doctor for glasses? He’ll squint at you and say, “So, what’s your A1C?”

Dentist? “Before we start, what’s your A1C?”

Even the podiatrist doesn’t care how long your toenails are until you confess your A1C.

At this point, I’m just waiting for the barber to say, “Before I start cutting, what’s your latest A1C?” That’s when I’ll throw in the towel.

Being diabetic means you don’t live by the seasons or by the days of the week. You live by the digits. Wake up in the morning? Check your sugar. Eat lunch? Check your sugar. Go for a walk? Check your sugar. Think about dessert? Oh, you’d better check your sugar.

Every part of life becomes a math equation. That slice of pizza? Twenty carbs per slice. The soda? Another 30 carbs. That ice cream sundae you swear you’ll only have on your birthday. Forget it; your carb count has now reached graduate-level calculus. Your phone starts ringing, or your meter starts flashing and buzzing,

And the funniest part? We don’t even trust the numbers half the time. Because we know our bodies. We can tell when sugar’s high, when it’s low, when the meter is lying, and when it’s telling the truth. After a while, you don’t even need the numbers; you just feel them. The math becomes instinct.

Yes, diabetes is serious. It’s about health, discipline, and constant awareness. But it’s also about laughing at the absurdity of living your life as if you’re a walking calculator. It’s about bonding with your fellow diabetics through numbers instead of handshakes. It’s about admitting you sometimes fudge the truth about your A1C, just like people shave a few pounds off their driver’s license weight.

We eat, sleep and breathe numbers. And in the end, those numbers don’t just keep us alive; they give us endless material for comedy. Because if we can’t laugh at Diabetic Algebra 101, then the joke’s on us.

So, fellow diabetics, here we are, enrolled in a lifetime course we never asked for. We’ve got our textbooks, our meters, strips, sensors and lancets. We’ve got our pop quizzes: every random sugar check throughout the day. We’ve got our final exams: the dreaded A1C results.

And how do we grade ourselves? By the numbers, of course.

But let’s be clear: while doctors may think A1C is everything, we know better. We know it’s about balance. About enjoying life, not just surviving it. About laughing at the absurdity of checking your sugar so often you could practically run a lab out of your living room.

So here’s to us, the unwilling students of Diabetic Algebra 101. May we keep our A1Cs under 7, our fingers relatively unbruised, and our sense of humor intact. Because at the end of the day, if you can still laugh about it, you’re already winning.

Michael Kossove is professor emeritus and adjunct professor of microbiology at a university in NY.