I'm a dog-lovin', music-makin', jewelry-creatin', lover of life... and I just happen to have Type 1 diabetes. I think of it diabetes as my sometimes challenging friend, who sometimes frustrates me, but overall~ I know she's a weird kind of blessing.
Typically, when I get an unknown call on my cell phone, especially if it’s from out-of-state, I don’t pick it up. But today, since I’m out of town, and have put out calls to some realtors that I desperately want a call back from, I picked up one of those “random” calls. And I guess, as they say, nothing is random or coincidental at all.
It was a person from GoDaddy just calling to make sure I was happy with the service they provide for this blog. (I am.) As it turns out, the guy who called me, Jason, told me he is a T1 also! He’s within a year of my age, and he also has had diabetes since his early 20s.
After he told me that, and I realized we had all that in common, I asked him if he also uses Dexcom’s CGM. He doesn’t. But he said he had been reading about it and thinking about it. Anyone who has visited this blog before probably can tell, without diving in too deep- I’m a big fan of Dexcom and know that I have tighter control now than ever thanks in large part to the information it provides.
I let Jason know that, yep- so far so good with the GoDaddy hosting stuff… but way, way more importantly, I loved having an unexpected connection today with a fellow Type 1 person.
Last week, as I was driving to my appointment with my endocrinologist, fighting horrible traffic to get there I started to question, really, why was this appointment even necessary. My last appointment was only 3 months ago.
My main reasons for these appointments have always been:
to find out my A1C and
to get prescription refills.
That’s pretty much it. But now, I have a Dexcom, and I look at the Clarity app often enough that I know what my “predicted” A1C is. Besides that, I think my trend graph is way more important than that A1c number anyway. An A1C could spit out an impressive number, even if someone didn’t have very tight control on their blood sugars. As long as the average works out to be something within a good range, the A1C might deceivingly seem “good”even if your control isn’t.
One thing I love about my endocrinologists office is that you get an immediate result of your A1c test. Last week, mine came back as .5% higher than what the Dexcom Clarity app predicted. When I told my doctor, he said “we pay more attention to Dexcom results than the lab work.” I didn’t ask why or for any further explanation, but it’s how I’ve felt about it all along and I’m happy with how things have been going so, I’m just sticking with what my Dexcom is telling me.
It seems like an A1C result isn’t as important as it used to be now that we have more advanced technology. I can see graphs of what my blood sugar is doing every 5 minutes of the day with my Dexcom CGM. I can get a predicted A1c for a 7 day, 14 day, 30 day, or 90 day period with the Dexcom Clarity app. Even better, if I access Clarity from my computer, I can see all sorts of trend graphs to see where where and when my “problem” blood sugars are. I pay a lot more attention to whether or not my blood sugars are staying within my target range than anything else. The actual A1C or average of those readings is far less important to me than simply staying in my ideal range as often as possible.
I’ve tightened that range little by little. I think when I first had a Dexcom, I had an alarm set for a high of 180- maybe even 200. Now I keep my low alarm set for 65 (that hasn’t changed), and my high at 150. These days, it’s a rarity for me to have a blood sugar that ever gets (or at least stays for long) above 170. Of course, it still happens from time to time, but thanks to having the alarm set for 150, I can be proactive and avoid those highs I use to battle. Treating a slightly elevated blood sugar is a lot more manageable than treating one that gets way up there.
My endo told me to make my next appointment in 4 to 6 months. Of course, I chose 6 months. Unless something new comes up, there’s no reason for me to go any sooner than that. I get more meaningful information about my blood sugars from my Dexcom than an A1c result is ever going to tell me.
There are a lot of misconceptions about Type 1 Diabetes. I’ve been told that I don’t look diabetic. I’ve been asked if my diabetes has gotten any better– as if I’m sick but on the road to recovery. I’ve had people assume I’ve had diabetes since childhood. Anyone that lives with Type 1 has probably heard these things and a whole host of others.
I was 25 years old when I was diagnosed. The misinformed often think this adult-aged onset of Type 1 is rare. But it isn’t. I think it’s the main reason why Type 1 is no longer referred to as Juvenile Diabetes. For one, not everyone is a juvenile when they get it. More importantly, it isn’t just a condition you have at a young age. Once you have it, you’re always going to have it. Changing your diet, losing weight, taking medication, or taking some supplement isn’t going to make Type 1 Diabetes go away. You don’t get Type 1 because of your lifestyle, and you can’t get rid of it by making lifestyle changes either. It’s an auto-immune disease.
I’ve met and heard from lots of other Type 1s that were diagnosed as adults. Many of them were first wrongly told they had Type 2 based on their age. Oral medications (often used in treating Type 1 Diabetes) and/or changing their diet did nothing to help reel in their ever climbing blood sugars. Of course, eventually, they ended up going to a doctor that actually knew a thing or two, and got the correct diagnosis before they died.
The bottom line is this. Type 1 is an auto immune disease. Type 2 is NOT. Age is NOT the defining difference between the two conditions. Type 1 effects people of all ages. It is not simply Juvenile Diabetes.
Whenever I’ve heard about the benefits of a fast, or cleanse, I’ve always thought, “That is absolutely NOT for me!” For one thing, I get pretty cranky if I go without food for too long during the day. Then there’s my Type 1 diabetes to deal with… these fasts I’ve heard about are usually not recommended for someone like me.
Intermittent fasting, however is a whole different thing.
In a nutshell, with intermittent fasting (IF),you get most of the benefits of a longer fast, but it’s much easier, in my opinion. You have a 8 hour window (you can tailor it, but generally an 8-10 hour window is ideal) during the day of when you eat all of your meals and you don’t have to worry about eating the rest of the time. There are all sorts of ways to do IF, and if you do a little research on Google, you’ll find many articles about it. I’m only writing about the way I do it, and how it works for me.
Don’t worry about that saying “Breakfast is the most important meal of the day.” It probably is! Break + fast = breaking your fast. Breakfast, also known as your first meal of the day, doesn’t have to be eaten early in the day, and it certainly doesn’t need to be pancakes, waffles or whatever you consider “breakfast” foods. As for me, I’m much more likely to include veggies, nuts and other proteins into a mid-day meal than I am a morning meal. In fact, for years (and years and years) my standard daily breakfast was a piece of cinnamon toast- Gluten free bread, butter, and a little cinnamon and sugar sprinkled on top. Does anyone believe that was my most important meal of the day? It certainly wasn’t my healthiest!
I eat lunch (usually a little after noon), occasionally an afternoon snack, and an early-ish dinner. At first, not eating a late night snack was hard, but that’s just because snacking at night while watching tv is fun! But it’s not necessary. And I’m not like a baby or puppy whose tummy needs to be full to sleep through the night. I’m sleeping at least as good as I was before changing my eating schedule.
The benefits of intermittent fasting for the average person is slightly different (again, you can read all about it online) but for me, here are the benefits I notice as a type 1 diabetic:
I can maintain a very steady blood sugar the longer I go without food… therefore, going a solid 16 hours without eating, I don’t have to worry about the effects food will have on my blood sugar. That’s over half the day. And that’s a good thing for my blood sugar average, and therefore my a1C.
I save time in the morning not having to deal with making and eating breakfast. I no longer concern myself with how my morning shot of fast acting insulin is going to effect my workout. Now, I don’t take any fast acting insulin until right before lunchtime.
Even though I’m not trying to, I end up consuming less calories. And it’s mainly empty calories that have fallen by the wayside… My morning toast and evening snacks were never anything that packed in a lot of nutrients anyway!
Occasionally, I wake up in the morning with my blood sugar a little lower than I like it before my morning workout. Obviously, if that happens, I eat to take care of that. I find I usually don’t need more than about 5-7 grams of carbs since I don’t have any short acting insulin in the morning.
With intermittent fasting, you’re not necessarily reducing the amount of food you eat each day, just the scheduling of when you eat it. And if you’re like me, you might see good results without making much of a change.
As a reminder, I’m not a doctor, nurse, or a nutritionist. I am just a person with type 1 diabetes that is trying to live my healthiest life and when I stumbled upon things that work well FOR ME, I like to talk about them. Everyone is different, and different approaches work for different people. Always consult your doctor before making any changes in your diet.
My night time blood sugars don’t always look like this, but when they do, it means I’ve slept well.
Last night, I was somehow able to go to sleep with my blood sugar right at around 100 and yet, it didn’t drop too low and demand a snack. I would love to know the secret formula to recreate this every single night!
Just as a side note, you can see on my Dexcom graph how my bs popped up from around 70 mg/dL to 100 around 9am. That was caused from just getting up and at ’em. No food. Ok, actually 2 cashews, which is not that carb heavy. I usually eat a couple of nuts because for some reason, I prefer to drink water after eating a couple of nuts. And I know it’s important to hydrate first thing in the morning after sleeping all night. I have read that you snore and breathe out a lot of water while sleeping. Sounds gross, but it’s just a human thing. Everyone does it. I’m not drooling in some out-of-control way anymore than the next guy.
Although I do drink water first thing in the morning, I skip “breakfast”. But I don’t think of it as skipping breakfast… I just delay when I break my fast until around lunchtime. It’s also known as intermittent fasting. And it’s been working really well for me since I started doing it about 6 months ago. But I’ll save that blog post for next time!
Like I said, my over night blood sugar graph doesn’t always look like this. But when it does, I have to show somebody. So thank you for indulging me!
A post meal walk almost always lowers my blood sugar. But in varying degrees that are sometimes unpredictable or at least, not obvious.
Last night, I ate Thai food at a restaurant we go to frequently enough, that I know (usually) exactly how much insulin I need to take, to have a happy result with my blood sugar post-meal.
Like I said: usually.
But that’s the thing, isn’t it? When it comes to diabetes and blood sugar control, what works perfect sometimes, even most of the time, can for whatever reason miss the mark completely another time.
And so was the case with last night’s Pad Thai Woon Sen. I went to dinner with my dad, my brother, and Fermin. We were sitting around after dinner, and my Dexcom started alarming me. I have it set to start nagging me at 150 mg/dL, so when it first started buzzing, I figured my insulin just needed a little more time to get in there and start battling it out with the carbs. But the alarms continued, and the trend graph was going nearly straight up. By the time I got home, it had risen to about 230 mg/dL. CRAP.
Once my blood sugar gets over about 170 mg/dL, it becomes more challenging to get it down around 100mg/dL. Which is why I was planning on a taking extra insulin PLUS taking brisk walks with each of my dogs. But I was in such a hurry to get out the door and walk, I realized I forgot to take my shot.
I figured I’d just take it when I dropped off Lucy and grabbed Ricky for his walk.
So Lucy and I went on our very brisk walk for about 20 minutes. It was easy to walk fast, because it was already dark into the night, and honestly, I didn’t feel 100% safe for some reason. I saw an opposum, and I heard the clanging collar of another dog that I couldn’t see at first. Luckily, once I did see the dog, I also saw that it was attached to a leash and a person. But those things made me feel a little edgy and kept us walking at a brisk pace.
And it felt great. When Lucy and I got home, my Dexcom was showing 153 with an arrow pointing straight down. That was a big fall in just 20 minutes time, so I decided not to take anymore insulin. That drop was a little shocking, and not typical for me at all. I figured I might be able to get it down around 80-100mg/dL with a second walk with Ricky.
And that’s close to how it turned out.
I think my glucometer actually said I was at 106 mg/dL by the time I got home from my second walk. I was happy with that, so I took my bath, and called it a day around 11pm. However, later in the night, once I had gone to sleep, I was having a slow upward trend that eventually got well above my 150mg/dL marker. I ended up taking a shot, going back to sleep, and it was around 85mg/dL when I woke up in the morning.
I don’t really know what that was all about. All of it was weird and a little out of the ordinary. But anyone who has Type 1 learns that you can never get things figured out so that one formula works every time. It just doesn’t work that way at all.
As an example, today I ate lunch and took my insulin. My blood sugar started to get up around 140 about an hour and a half after I ate. So, I did something similar to what I did last night… I took my dogs on brisk walks. And I actually walked a little further this time. I walked each dog for about 30 minutes. And look! Although it went down some, which I was hoping for, it was nothing like last night!
Ahhh, the mysteries of diabetes! It definitely keeps me guessing, and trying to figure it out. Just when I start to feel cocky and think I’ve got it, it changes it’s game. But I will never give up!
Having T1 diabetes has certainly never stopped me from traveling anywhere I’ve ever wanted to go. But it probably slows down my speed of packing my bag and getting myself out the door.
Tomorrow my husband, my two dogs and I leave on a road trip to Colorado. We’re driving the 12 hours rather than flying, so we can take our dogs, a.k.a The Ricardo’s, a.k.a. Lucy and Ricky. Although I’m not necessarily stoked about the long drive, it will be totally worth it to have them there with us.
Because the daily plans will look something like this:
And those are Lucy and Ricky’s favorite past times… and pretty much, mine too!
Typically, I do best not taking ANY insulin (other than the long acting Tresiba I have floating around in me 24 hours a day) before exercise. So on a normal day, when I’m at home, I do my main walk, run, yoga, or any other workout I do first thing in the morning before taking any insulin. I generally have a steady blood sugar of around 90 mg/dL in the morning, and although it starts to go up when I start my day (adrenaline? I’m not sure what it is that spikes it, but as soon as I get out of bed and put clothes on, it starts rising about 30-50 mg/dL). It’s kind of perfect, because as I exercise over the next hour or so upon waking, my blood sugar starts to fall. By the time I’m done, it’s (hopefully) around 80 mg/dL. If it drops a little too much, I grab a piece of fruit, or Mentos candy if I’m not near something more nutritional.
But I know on this trip, I’ll be hiking more often, and most likely at various times of day. Which means…
I need to remember not only to pack candy, but I’m going to have to be wearing my fanny pack looking like a dork so that I always have it with me. And I am going to try hard to always think it through before injecting my insulin pre-meal, “Will I be hiking within the next couple of hours? How active am I going to be?” Because I HATE having to eat sugar (or anything honestly) when I’m not at all hungry, but instead, just fighting a low. And inconveniencing whoever I’m with…
We’ll be meeting up with both my brother and sister, and although they know I have diabetes, they don’t really have to deal with it, and never have. So I hope I don’t slow us all down with the lows I’ll more than likely have to battle from time to time.
Whenever I travel, I bring about double the amount of everything diabetes related I might need- insulin, test strips, candy, etc. I make sure I have all my Dexcom supplies, and I bring a fresh sensor in case my current one loses it’s steam while I’m on the road. I check and recheck, because what a nightmare it would be if I forgot something I have to have.
Whenever my husband and I pack for vacations and are trying to figure out if we’ve forgotten anything– like sunscreen, phone chargers, underwear, etc– we always sigh and so, “Oh well, we’re not going to a third world country. If we’ve forgotten something we can just buy it.” This does not apply however, to my Dexcom, my insulin, glucometer and test strips. Although maybe I could buy those things, it would be ridiculous, and loads of trouble insurance wise.
So I spend maybe an extra 10-15 minutes packing for a trip because I have diabetes and I always need to be prepared. Not a big deal. And just like bringing the Ricardos on this upcoming adventure, SO WORTH IT.
Last July, I started My T1 Diabetes blog. (It began as a Blogger address, but has more recently moved and is staying here.) Now that I’ve been writing my blog for a year, I decided to reflect a little on why I started writing it in the first place, and why I plan to continue.
My History and Love with Writing
Since I learned how to write, I’ve kept a diary. I think I got my first one when I was about 6 or 7 years old. It was pretty sporadic, and sometimes there wasn’t a lot to write about. I have lots of reports regarding what the weather was like in Dallas back in 1978. As I got older, those diaries became more and more about boys! And fights with friends over boys! My best friend (then and now) and I have referred back to those diaries over the years, our bellies sore from laughing so hard reading about how boy crazy we both were.
As an adult, that diary keeping morphed into journaling, which is the exact same thing as keeping a diary, but journaling just sounds more grown up. I love that I have books and books and books of journals from all these phases of my life.
Once the online world came about, I had a website. I’m a musician, so it was sort of necessary when I was gigging a lot. I had a blog page on that website. I wrote about my music life, but lots of other things too… books I was reading, movies I loved, events and experiences that were challenging and/or awesome. I began blogging about a dozen years ago and have continued ever since. (You can visit that website and blog by clicking HERE)
But I never included much (if anything really) about my life with type 1 diabetes. Somehow, that stayed out of my narrative for many, many years.
What I know about writing- whether it’s a diary, a journal, a blog, or even a song- is that not only does it help me document things I care about, but also, it’s during that process of writing that I really look at something closely and come to understand it better.
Type 1 Diabetes Diagnosis
I learned a lot about Type 1 diabetes when I was first diagnosed, over 20 years ago. I didn’t necessarily want to, but I had to. I learned about shots, carb counting, low and high blood sugars, etc. I read all the books I could get my hands on about the topic, and I had a page full of questions for my endocrinologist at every appointment I went to during the first few years after my diagnosis.
Eventually, it seemed I had exhausted all the resources available to me. And it seemed to be enough.
Fast forward about 2 decades. I was on auto pilot with my T1 diabetes regimen. My doctors and I were going along with that idea of, “If it ain’t broke, don’t fix it”. Things were going pretty well with the routines and practices I had adopted all those years ago.
New Things To Learn About
About a year and a half ago, I went to an event here in Dallas hosted by JDRF called Type 1 Nation. There, I heard all sorts of new things that had come out in the world of diabetes since I had last tuned in- New ideas, medicines and technology. I realized that by not staying in tune and connected with the diabetes community, I had missed out on hearing about all of these exciting developments.
It was around that time that I started using a Dexcom CGM. I’ve written about the Dexcom on my blog a few times (here and here). Needless to say, I love it and now it’s hard to imagine how I got by without it for so many years.
Because of the Type 1 Nation event, and also because of the powerful tool of using a Dexcom CGM, I feel excited, hopeful and recharged with my interest in diabetes.
My Type 1 Diabetes Blog
So, why not write about it? Why not write for myself about the things I’m learning and the experiences I’m having all related to Type 1? When I really want to figure things out, I know writing about them serves me well. And hey! Maybe I can even help somebody else out along the way. Someone who is a little new to this diabetes game, or someone who just needs a little encouragement to tighten up their management. Or maybe someone who just wants to read about another person’s experience with similar challenges. I know reading other’s blogs, articles and books has helped me tremendously. Maybe my voice can resonate with other people going through some of the same things I go thru.
That’s why I started My T1 Diabetes blog last July.
Thank you so much for visiting my blog today. Please “follow me” by providing your name and email address (on the right) so that you won’t miss a single post. You’ll receive a weekly email when a new post has been published. Or, just bookmark my page and check back weekly for new articles. If you have any questions, comments, or just general feedback, you can get in touch with me anytime with an email.
(*This post originally appeared on my now defunct Blogger blog, but because this article still gets a lot of traffic, I wanted to move it to this current blog in the hopes that readers could find me!)
I got mine last week.
I was uber excited that:
1. All of the data from my sensor would go directly to my iPhone, and cut out the middle man, aka, the receiver. I misplace that stupid little thing often, and cannot tell you how much time I’ve wasted looking for it. At least if I misplace my phone, I can call it from another phone and it will ring. Also, one less thing to carry around?! Sign me up!
2. I was told that if I was out of range from my iPhone, once I was back in range, it would upload the data. This would be a big improvement, since sometimes I’ll forget my receiver when I go somewhere and will lose hours of data that will forever remain a mystery.
3. There is a phone app called “Clarity” that goes along with the G5. I have an older Mac and couldn’t use the other software that analyzed the data of the Dexcom G4. I had heard Clarity was very easy to read, and had lots of valuable info, including a predicted A1C.
After having had the new Dexcom for about a week now, my opinion is- it’s really not that different or improved than my previous G4 version. I am not blown away by any means.
1. Yep, it goes directly to my iPhone. BUT I actually prefer a few things about the receiver, which is surprising to me. It’s smaller than my ultra huge iPhone 6 Plus- I can’t even fit my mega phone into most of my pockets I’m now discovering. Also, with the receiver, I just touch one button, and voila~I can see my blood sugar reading! With the iPhone however, I have to hit a button to light up my screen, then hit my 4 key code to unlock (because just my thumbprint pretty much never works), and then hit the Dexcom icon. That’s between 3-7 button pushes compared to 1. It’s a small complaint, but it is a complaint. (And neither of these problems are Dexcom’s fault, I realize.) If I’m somewhere like my yoga class, it’s one thing to press one button on a little meter, but it looks pretty obnoxious to have my iPhone in class and press several buttons to see what my blood sugar is– I might look like some asshole texting a friend during yoga. OH NO!
One advantage the iPhone has over the receiver is that I can set my alerts to different sounds, and I can adjust the volume. BUT- and it’s sorta a big but- BUT, often the alarm only comes by way of a text alert, but not the sound. Maybe it’s a software glitch that will be cleared up soon, but for now, that’s not working consistently for me. Also, I have to remember to keep the volume on and up or I don’t hear the alerts anyway.
Another positive- I like the display on the iPhone- it looks like this:
Dexcom G5 quick glance graphic
And if you turn it to landscape, you can view it over the past 1 hour, 3 hours, 6 hours, 12 hours or 24 hours.
my last 12 hours graphed on the Dexcom app
If you run your finger over the little dots, it tells you your blood sugar for each individual dot.
(specific blood sugar readings for each dot on the graph as you move your finger along the line)
2. If I’m out of range, that missed data does NOT upload once I’m back in range. It’s just blank areas of the graph. (You can see that in the above graph- I was out of range for a while around 11am and so it’s blank.) The Dexcom rep who told me that was either wrong, or mine doesn’t work right. So in this regard, the G5 and the G4 are the same. Out of range is lost data and one of life’s great mysteries.
3. The Clarity app makes no sense to me. For one, I can’t turn my phone and see it in landscape mode, so I can only see an unreadable version that looks like this:
I’ve got great eyesight, but I need a magnifying lens to have any idea what this says.
I have no idea what that graph is all about, and it’s such a small amount of information, helpful or otherwise even if I could read it. However, that could change once it’s collected 14 days of data. But so far, 6 days in, this is ALL it shows me. And it’s not impressive at all.
So maybe I set the bar a little too high for the G5 before I got it. It’s more or less the same as the previous model. Having the blood sugar data come directly to my phone hasn’t made a big difference in my life, like I thought it might. Don’t get me wrong, I LOVE my Dexcom, and at this point, can’t even figure out how I had decent blood sugar control without it- and how I avoided daily severe low blood sugars, especially during the night. I’m just saying, the G5 hasn’t made me fall any deeper in love.
Although, I CAN eat anything I want, like any other sensible human being- diabetic or not, I try to be mindful. I try to eat things in moderation- Especially carbohydrates. And it doesn’t really matter if it’s cake, potatoes, rice, bread,… Carbs are carbs, as far as my blood sugar is concerned. All carbohydrates cause my blood sugar to rise. Depending on the type of carbohydrate, it may spike more quickly, or stick around a little longer, but like I said, carbs are carbs.
By the way, carbs cause everyone’s blood sugar to rise. Even non-diabetics. The difference is, a non-diabetic has a functioning pancreas with the ability to squirt out insulin to counterbalance that rise in blood sugar. (“Squirt” is probably not the most scientific word to use, but I am not a scientist, so it’s okay.) But for me, and the other Type 1 diabetics of the world, whenever we consume carbs, we need to inject synthetic insulin, hoping to mimic what the non-diabetic’s pancreas does naturally.
Here’s how I like to think about the whole carb “situation”.
The less insulin I have to take, the easier it is to not have extreme high and low blood sugars. And the easier it is to not make a mistake when dosing my insulin. I believe in that saying “Less is more.”
I know there are many T1s that swear by a strict carbohydrate reduced diet. For me though, just being mindful, and not overdoing it, seems to work best. Why deprive myself of something I love when I just don’t need to?
So, here’s my easy carb-reduction tip of the day if you’re a bread lover, like me.
If there is an option to “skinny” your sandwich (they do this at Which Wich, and Potbelly), do it! Lots of sandwich places will cut out some of the bread when preparing a sandwich so you end up with about half the bread that would have been there otherwise. I always tear away at even more of the remaining bread, and only eat what is really necessary for me to feel like it’s the perfect balance!
The same goes for anything else with a bread “element”- like a hamburger or pizza. My husband calls my method of tearing away at the bread on my plate the “Low-Carb Kerri” plan. I don’t feel like I’m missing out at all, but it certainly reduces what could be consumed if I wasn’t being mindful, and tearing away at what I just don’t need.
As you can see, my carbohydrate reducing method for bread is pretty simple and doesn’t look like I’m depriving myself of much. And that’s exactly why I don’t mind doing it.