Tricks of the Trade With Type 1 Diabetes

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This is the last day of Diabetes Blog Week, and today’s topic is “Tips and Tricks.”

Let’s round out the week by sharing our best diabetes tips and diabetes tricks. From how you organize supplies to how you manage gear on the go/vacation (beach, or skiing, or whatever). From how you keep track of prescription numbers to how you remember to get your orders refilled. How about any “unconventional” diabetes practices, or ways to make diabetes work for YOU (not necessarily how the doctors say to do it!). There’s always something we can learn from each other. (Remember though, please no medical advice or dangerous suggestions.)

I have 2 quick little tricks to share that work well for MY T1 DIABETES…

I used to take my “fast” acting insulin about 15 minutes or so before eating, as recommended by my endo.  It wasn’t until I got a Dexcom CGM that I became aware of how slow that fast acting insulin actually is… at least in my body, with my metabolism.  Some days, it’s a little faster, some days, a little slower- I’m sure, for a whole host of reasons.  I now typically take my insulin shot 30 to even 45 minutes before eating.  It depends on what I’m going to eat (how fast will it spike my bs), how active I’ve been, etc… But I use my CGM to see when that trend line starts to travel south- But I don’t let it get to the point of taking a dive, or reaching an uncomfortably low number.  This is NOT advice, but it’s just the way I do it, and for me, it serves me well.  It’s one of the things that’s helped me to bring my A1C from the mid 6’s to the mid 5’s, while staying in my target range 80-85% of the time.

There have been the occasional unintended lows from this method, for sure!  But it’s always treatable, not a big deal because I see it coming (thanks to the Dexcom!), and it always teaches me something. I’ve gotten more and more in tune with my body and the way it reacts to all the things that effect the timing of the rise and fall of my blood sugar.

My 2nd and final tip for today’s post is just to be as active as possible.  I’ve got a couple of high energy dogs that keep me active- I walk briskly with them about 2 to 2 ½ hours a day.

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Lucy McGilicuddy
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Ricky Ricardo

I take Ricky and Lucy on separate walks, and they each get two walks a day.  It’s easier for me to handle them one at a time, it gives us a little one-on-one bonding time, and it ups my activity level times two.  SO, it’s a win-win. I use to run anywhere between 6 and 8 1/2 miles daily, now I walk it instead.  It takes a larger chunk of my day, but has the same over all (great) effect on my blood sugar.  I never have to take a day off, because it’s just brisk walking.  I’m never sore from it, or I feel like I need a recovery day. I’ve read, and believe based on my own experience, that those long daily walks keep me highly sensitive to insulin.  And the less insulin I need to take, the easier it goes for me.

Those are just a couple of simple little tricks I’ll share today- I can’t wait to visit other T1 blogs to see what others have to say on this topic!

One Simple Wish

Today’s topic for the “Diabetes Blog Week” is about healthcare.

Most people who live with a chronic illness end up with a lot of experience when it comes to dealing with healthcare. How would you improve or change your healthcare experience? What would you like to see happening during medical visits with your healthcare team? How about when dealing with your health insurance companies? What’s your Healthcare Wish List or Biggest Frustration? Today is the day to share it all!

I go to my endocrinologist every 3 or 4 months, but it sometimes seems like an unnecessary cost to go so often.  Now that I have a Dexcom CGM, I have a pretty good idea what my A1C is these days, even without the lab work at the doctor’s office.  That used to be my main motivator to go to my quarterly appointments.

Since Type 1 Diabetes is a self-managed condition, especially after having it for 20-something years, I’m not waiting for my doctor to tell me how to adjust things when my blood sugars start to get a little jacked up.  I trust myself to make adjustments in my management… because that’s really what Type 1 is all about– constant adjustments! So really, why am I still going to those endo appointments as often as I do?

I’m happy with my current endocrinologist and I especially like the diabetic educators he has staffed at his office.  The thing I used to dread the most about my appointments at my previous endo was getting my blood drawn for lab work.  Needles, combined with veins, is just something I’ve never gotten used to.  And saying it’s just “something I’ve never gotten used to” is actually a huge understatement.

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This kid is handling it much better than I usually do…

I get pretty nauseated and there’s a big dramatic build up. Then, because I get so nervous, I tend to freak out the nurse that has the unlucky task of drawing my blood. It’s usually not pretty, or easy. But the great news is, at Diabetes America (where my current endocrinologist practices), they use a simple finger prick to give me A1C results.  It’s only once a year that they do a more thorough panel that requires the dreaded vein drain.  And that has been a dream come true for me!

Although I don’t dread the appointments nearly as much as I used to, they do consume at least half of the day, require me to “fast” for 4 hours (which depending on time of day, and my blood sugars, can be challenging), and they are costly! And they give me little to no new information. So again, why am I going to these appointments on a quarterly basis?

Maybe it’s because I want to be a “good” diabetic and follow the “rules”.  (A little lame, I know.) Maybe it’s because it keeps me motivated to have a “good” A1C that a health care professional is going to look at and hopefully praise me for. (A little shallow, I realize.)Maybe (and this reasoning actually seems to have some value), keeping regular appointments keeps me very accountable and makes me feel like I’m doing everything in my power to say on top of diabetes.  And that’s important to me! But maybe, “regular” appointments could just as well be every 6 months, rather than every 3 months.

So I guess I’m putting that idea on my wish list… The wish list I’m pretty sure is going to come true!

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Language and Diabetes

Because I was out of town, and then in a training class the week I returned from vacation, I’m late to the game of  “Diabetes Blog Week”.  I didn’t realize it was going on until I visited a few blogs I follow just last night.

This is my first year to participate, because, well, it’s the first year I actually have a blog about diabetes!  I’m so excited to participate and write about the remaining topics of the week.

So, here we go!

Language and Diabetes. There is an old saying that states “Sticks and stones may break my bones, but words will never hurt me”. I’m willing to bet we’ve all disagreed with this at some point, and especially when it comes to diabetes. Many advocate for the importance of using non-stigmatizing, inclusive and non-judgmental language when speaking about or to people with diabetes. For some, they don’t care, others care passionately. Where do you stand when it comes to “person with diabetes” versus “diabetic”, or “checking” blood sugar versus “testing”, or any of the tons of other examples? Let’s explore the power of words, but please remember to keep things respectful.

There are very few words that offend me.  And personally, whether someone wants to refer to me as a “diabetic” or “a person with diabetes”- I totally don’t care.  I prefer the word NOT be pronounced like this though: “die-a-BEET-us”. But does it offend me?  Not at all.

The only “language” that sometimes frustrates me in my  world of diabetes, is that although Type 1 and Type 2 have so many major differences, they are both referred to as diabetes.  I feel a  little ridiculous clarifying and saying “I have TYPE 1 diabetes”, however the distinction  seems necessary.  I wish there were just two completely different words for the two conditions.  I don’t at all expect people to know all about my disease, but often times, they mistakenly think they know more than they do. I guess that’s  because Type 2 diabetes is so prevalent.  (about 95% of people with diabetes have Type 2)

Type 1 diabetes is an auto-immune disease.  I got it in my early 20s. I cannot reverse it, or make it go into “remission” by changing my diet and exercising more.  And actually, I do look like someone with diabetes.  Trust me.  And yes, I have to take shots (or be on a pump) because my body mistakenly attacked my cells that produce insulin.  If I want to live, I need insulin, and I need to take synthetic insulin since my body doesn’t make it’s own.  But no, I don’t think of Type 1 diabetes as “the bad kind”.

That’s it.  That’s my only beef with the language around diabetes.  I think, as a rule, each disease should get it’s own, distinct name.

Diet Coke is My B*tch

First- I would like to begin this post by saying:

I know Diet Coke is apparently a terrible thing.  I read the posts on Facebook about the dangers of Aspartame. But like a heroin junkie, I just can’t give it up.  I have  tried to quit.  Numerous times.  But little by little, it sneaks it’s way back into my life.  It starts with a, “Oh, I’ll just have it this once with popcorn,” when I’m at the movie theater.  The next thing you know, I’m indulging when I’m out eating pizza because it goes so good with pizza.  Then, I’m allowing it when I eat Mexican food too. And then, the next thing you know, I’m back on the sauce.  Daily.

While on vacation this past week, I had a lot of time to sit around and think. And I kept thinking about Diet Coke.  I kept thinking how it just doesn’t seem like something I should be putting into my body as regularly as I do. I eat a pretty healthy diet… but that damn Diet Coke. Not only does it contain unhealthy chemicals, but for some reason, for me at least, I crave it the most paired with unhealthy, salty foods. I’m sure Diet Coke my worst vice.

So, I decided I would cut down on my diet soft drink consumption, and possibly cut it out completely (we’ll see…), once I got back to real life.

Well, here I am.  First day back from vacation. Back to real life. And really… I’m cutting down.

But tonight— was Mexican food.  (…to celebrate our return from our vacation in Mexico, which didn’t have Tex-Mex, and tonight I was craving it!)  And as stated before, Diet Coke tastes so good with  (unhealthy, salty) Tex-Mex.  So how could I not treat myself completely?

When the waiter brought my Diet Coke out, it looked a little funny.  Very light in color and a few too many bubbles.  I know my Diet Coke.  Especially at Mariano’s, one of my favorite and most frequented Tex-Mex spots here in Dallas.  And this is not it’s normal look.  Or taste!  Something was off.

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A little too light, a little too bubbly.

So I told the waiter it didn’t taste right, and he offered to bring me another from their other fountain machine. The second Diet Coke came out looking much the same.  And tasting just as weird.

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Ok, so this IS the same photo. But the two Diet Cokes pretty much looked the same, and I forgot to photograph both of them. Both: a little too light, a little too bubbly.

I told our server I would just have ice water instead.  I then said to my husband, “Maybe this is the Universe’s way of telling me not to drink Diet Coke tonight.  I was planning on really cutting down on it anyway.”

So there you go.  I was drinking ice water, and I felt good about it. Thanks, Universe! 🙂

But then.

But then the manager showed up with a new, slightly darker and less bubbly, more normal looking Diet Coke.  She told me that earlier in the day, someone had accidentally combined the Coke and Diet Coke in the fountain machine, but then they cleared the line, and now, finally, it was back to normal.

Oh what?!  I’m a diabetic, so actually if that was a real Coke that’s really something I need to know.”

She assured me, “Oh no! No, no, no.  Much earlier in the day it had Coke in it.  But yours didn’t.  No worries.”

But I did have some worries…

Although I drank a little of that new Diet Coke, I didn’t drink all of it.  Or even that much of it.  I told Fermin that if my blood sugar spikes, the Diet Coke would be the culprit.

I know that when I eat Tex-Mex, I don’t get a quick rise in my blood sugar.  I usually get a rise about 3 to 4 hours later.  I think the fat and protein must jack things around.  But this is what my trend line looked like from that “meal”… I took my insulin at about 6:25pm at home, and got my Coke about 30 minutes later…

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See how my blood sugar has an immediate blast off, with just a few sips of my drink?  I’m pretty sure the Universe was trying to tell me not to drink that “Diet” Coke after all.  Why didn’t I listen to the Universe and ignore the restaurant manager?

Diet Coke and the drinkers of all diet drinks are all too common.  Most servers don’t take it seriously that it really needs to be DIET for someone like me, that takes insulin based on how many carbohydrates I’m consuming.  They just think I’m some silly girl that eats fattening Mexican food, and likes to make herself feel better by ordering a Diet Coke.  It’s probably how people with Celiac disease have to contend with the importance of emphasizing that a dish be gluten free- as in absolutely none at all, even cross-contamination.  For people with Celiac, it’s not just a trendy thing to cut gluten out of their diet… They have to or they will really suffer.

Anyway, I’ve now injected more insulin.  The Dexcom graph is looking a little better.  But this really annoys me.  If that Diet Coke likely had sugar in it, or if there was even a chance, I’d prefer complete honesty so I can do what I need to do!

Maybe the bottom line is this:

It’s not so much that restaurant manager that led me wrong.  It was me!  I ignored my instinct to not drink that weird looking Diet Coke tonight.  My addiction won tonight.  But it was a good lesson for tomorrow…

 

 

 

 

Type 1 Nation Summit Hosted by JDRF

This coming Sunday,here in Dallas, JDRF is hosting the Type One Nation Summit.

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When I went to my first Type One Nation Summit this past year,it was educational AND inspiring!  I wouldn’t say I had gone through a time of “Diabetic Burnout”, but I (wrongly) thought that since I had lived with diabetes for so much of my life, I didn’t really have anything new to learn.

Of course, I was totally wrong!  There is always something knew to learn, because there are new treatments on the market and big ideas on the horizon all the time!  Although I expected that my endocrinologist would keep me in the loop of anything and everything important, that was not the case.  If we want to really stay on top of our health, we have to be our own advocate.

Besides all the information I learned from attending the event, it was great to meet so many other Type 1s and/or the people who love them!  Who knew there were so many of us out there?  Sometimes, we wrongly start feeling like, “I’m the only one…” But that simply isn’t true.  Hearing other people’s similar stories, and just hanging out all day is such a great feeling.

So if you’re wanting to hear all about all that’s available to best live with Type 1 Diabetes right now, and learn about the exciting things on the horizon, and meet a bunch of cool people, then this event is most certainly the place to be Sunday, May 1st. Hope to see you there if you live anywhere near the Dallas/Ft. Worth area! Details from JDRF are listed below.

Summit Summary:
The JDRF Greater Dallas and Greater Fort Worth-Arlington Chapters are excited to be hosting TypeOneNation, an educational and inspirational summit designed for people who are impacted by Type One Diabetes (T1D). We will provide education, connection and support for those living with T1D, their families and their alternate caregivers. We will have fun and meaningful activities for children (5 -10) and teens (11-16). Guests will be able to choose between various learning tracks and 13 speakers throughout the day. An exciting keynote speaker will be featured during lunch. Our key industry partners will be in Resource Row where participants can learn about the latest in resources and technology.

Logistics Overview:

Where: Sheraton DFW, 4440 West John W Carpenter Freeway, Irving, TX 75063, (972) 929-8400

When: Sunday, May 1, 2016, 11:00 – 5:30

Cost of tickets:  $25 per adult, $15 per youth 16 or under

Registration: www.TypeOneNationNorthTX.eventbrite.com

Cookies on Occasion

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Often, neighbors or friends (one just last week, as a matter of fact!) will say, “Oh I made cookies the other day, but I didn’t bring you any because I know you can’t eat them.”  As the above image implies, I can eat cookies, as long as they don’t contain any poison.

I don’t eat a lot of cookies.  Or cupcakes. Or cakes. Or other sugary concoctions. I don’t indulge in them often, but I do occasionally treat myself.  There is no morning more exciting than when my husband surprises me with blueberry donut holes!

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donut holes. because a hole of something doesn’t count, right!?!

The reason I eat these foods only on occasion rather than at every meal, is because I am a human being- And no human being was meant to eat these foods in abundance.  They shouldn’t be a big part of anyone‘s diet, right?

Even if you’re a non-diabetic, sugary foods (as well as all foods that consist of carbohydrates, but that’s a whole other post for another day) cause your blood sugar to spike.  If you’re non-diabetic, you have a well functioning pancreas that has cells that squirt out insulin as needed to lower that spike in your blood sugar.  (I realize the phrase “squirt out insulin” isn’t very scientific, but I am not a scientist so it’s fine.) The healthy pancreas is such a fine tuned machine that it knows just exactly how much insulin to squirt out, and it knows exactly when to do it… Amazing!

As a person with T1 diabetes, an auto-immune disease that has destroyed the cells in my pancreas that produce insulin, I have to inject synthetic insulin anytime I eat food with carbohydrates (one example would be sugary foods), and my goal is to mimic what a fully functioning pancreas would do. Sounds relatively simple, but actually, it isn’t.  It’s hard to know exactly how quickly the food I consume is going to spike my blood sugar, and how quickly the insulin will take effect. There are so many variables that change- on any given day, and on given minute of that day. It’s a difficult balancing act.

Since I save sweet treats for somewhat rare occasions, they’re that much more exciting and delicious to me when I indulge.  If I ate donut holes every day, not only would I put on a lot of unhealthy extra weight, but the donut eating events would become less special.  My taste buds probably would get so use to the sweet taste, they’d start taking it all for granted.

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less is more

I like to keep it simple: The less sugar I consume, the less insulin I have to take, and the less margin for error I have when it comes to my dosage.

Sugar negatively affects our teeth, our bellies, our blood vessels, our hearts, our mood, and some people think it even attacks our brains. I remember taking Mom to a nutritionist during her cancer treatment. When she was listing off the types of foods we should avoid, at the top of the list was sugar. She referred to it as “toxic” and told us that sugar  feeds cancer cells.  I’m not sure that’s exactly true, but I’m not a doctor, or a nutritionist.  All I know for sure is that sugar gets a LOT of bad press.

So, just like other fun or delicious things that may likely be bad for me, I consume sugar mindfully and in moderation. Not just because of my T1D, but because I am a human being!

Let’s Not Get Overly Alarmed Over this Dexcom Recall

By now, anyone who uses a Dexcom CGM has most likely received a certified letter regarding the problems with alarm on the display device.  I got mine about  a month ago.  Some of the display devices have an unreliable alarm. I followed the instructions to check mine, and as I already knew, it works just fine.  I thought it was nice that Dexcom was going to all of this trouble about something that for me at least, isn’t even a big deal.  In the letter, they also said they had alerted the FDA about what was going on.  I felt like Dexcom was being very cautious and doing right by all of their customers.

Then yesterday I saw this FDA recall announcement, which might just look alarming to some…FullSizeRender 2Especially that part that says this is a Class 1 recall, “The most serious type of recall.  Relying on this device may cause serious injury or death.”  That is pretty dramatic. You can read the full FDA post here.

But can I please voice my two cents about all of this?

First of all, the “brains” of the Dexcom system have not been recalled.  Most people who use the Dexcom 5 use their iPhone as their display device.  I like to use both, during different circumstances.  And although my alarm does work on the Dexcom device, it’s about the least important thing the Dexcom provides for me anyway.  I usually try my best to silence all alarms. I look at my Dexcom display very often during the day, so I don’t need an alarm going off when my blood sugar gets out of range.  At night, I prefer my iPhone as the alarm anyway because I have a choice of alarm sounds, and I can adjust the volume. (Calmer, and quieter for me, please.)

So yes, they’re recalling all of the Dexcom display meters, and asking that everyone check to make sure theirs in working order.  But I have a feeling, the majority of them are just fine.  And the as for the ones that aren‘t working, Dexcom will send out a replacement.

So really? What more can we ask of a company?  If there seem to be any problems, they alert the public.  The alert the FDA. And they make amends.

Dexcom has changed my life for the better, and given me far better control over my blood sugar than I ever thought possible.  I can’t imagine ever going back to life without my Dexcom.

Check out this recent article that not only talks about this current alarm problem, but also the exciting updates.  This recall is just a hiccup. Dexcom still has my gratitude and support.

 

Hello Again

I started a new Type 1 diabetes blog,  called MyT1Diabetes last year, but over the past few weeks, I took a little break from blogging so I could create a website and move everything over to this new web address.  So, welcome to it!

Hello, Again…Hello! How can I NOT comment on the above video?! Whoa.  Neil Diamond in some movie called “The Jazz Singer”, which I’m going to have to get my hands on soon.  It looks sort of amazing. In a funny kind of way. But I digress….

Back to the new website. The name of my blog is still the same~ “My T1 Diabetes”, with just a slight change of address. And my intentions here are still the same, which is simply to share everything I know about  My Type 1 Diabetes (yours maybe slightly varied!), having lived with it for over 20 years.  And to write an honest but hopefully upbeat account on the day to day minutiae of my diabetes,and how I choose to see it as a positive thing my life.

Things might look just a bit wonky around here for a while.  I will work hard to get all the kinks worked out, but mainly, I just wanted to start writing again!  So as I’ve been building this site, my mantra has been “Done is better than perfect.”

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So it’s done.. enough to get going! Yay!!

If you had bookmarked my previous blog, or subscribed to it, first of all- Thanks!  I sure hope you’ll subscribe, or bookmark this one, right now!

There’s a bar across the top of the page where you can learn more about me, about this blog, and you can contact me.  I really hope you’ll join in on my conversations about Type 1 Diabetes and leave comments on any posts that you have a reaction to.