@TiaG’s picture essay has been in my thoughts a lot in the past few days. It was a great essay because it captured so much of our daily lives. I will get back to it multiple times in the next few weeks, because it is so hard to respond to, and because I want to focus each post on a specific thought inspired by her essay. I am focusing this one on the discussion of multiple causes.
One aspect @TiaG discussed that I LOVED was how she outlined the polymorphic nature of the many issues that hit our everyday lives and make diabetes management harder. It is clear to everyone from her essay (and from what we, parents with D children, know of our lives) that there are many causes in a week that cause a high (or a low), some of them being purely physical, such as an activity, some others being totally different, such as a social obligation or occasion.
I am very hopeful that, as we progressively distill the issues that hit us, both as individual families and as a group on this forum, we will eventually find structural solutions to many types of problems: playdates, school rules, sleep deprivation, etc. What is clear to me is that there is not ONE solution to solve EVERYTHING that hits us.
Early on in my life as an engineer, I discovered the notion of kaizen, a core notion of incremental improvement for engineering products and processes, which has become the rock of my engineering life, and probably the source of whatever success I have had in my career. Every since we (my son) were struck by diabetes, I have lived our lives as a diabetic family immersed in the notion of kaizen – diabetes kaizen.
To me, as an engineer, the life of an engineering product or process is made of very many cycles of improvement, each of which hits a single, specific point, and makes it a little bit better. The sum of all these cycles is what can make a product great.
And, as the father of a child with T1D, I see the life of my family made, in the same way, of very many cycles of improvement, each of which hits a single, specific point, and makes it a little bit better. It is the sum of all the many kaizen cycles that makes a difference.
It is my hope that, in this life of mine as a father, I can figure out enough diabetes kaizen, bit by bit, cycle by cycle, so that I can bring my son, in each part of his life, to the right A1c, SD, glucose average – whatever metrics we live our lives by. And it is also my hope that this forum can and will make a big difference to both my family’s lives and many others, by building that book of diabetes kaizen practices.
Because this is exactly what I expect from this forum: a “book,” a collection of diabetes kaizen practices and recipes, that, together, take us all to lower and flatter A1cs, fewer complications, and longer lives.
Many years ago, the French poet Boileau wrote two verses that I have always remembered: “Ce que l’on conçoit bien s’énonce clairement, et les mots pour le dire arrivent aisément,” which means “what is well understood can be expressed clearly, and the words to tell it come to you easily.” As a consequence, to be able to clearly understand the right concepts, you need the right words for it – which is why, in philosophy, for instance, you have to learn the vocabulary before you can be at ease with the theories some words underlie 
So, the purpose of this post is to introduce an expression, which encapsulates what I think is a critical concept in diabetes management, that we all practice, and wich is the only way for a newly diagnosed diabetic to become a low-risk patient with a long life expectation: diabetes kaizen.
Diabetes kaizen is what drives me!