Resources for Eye Care, Exams, and Glasses: How to See More and Pay Less

By Marie Tetsu and Kira Wang

Cost can sometimes be a barrier to proper eye care, but a variety of programs offer free or low-cost eye exams and other resources. Are you eligible? 

Most people rely on their sight every day, making eye care essential to our health. For people with diabetes, annual dilated eye exams are especially necessary to catch early signs of eye disease. But eye care can be expensive: adults with diabetes report that associated cost or a lack of insurance are some of the main reasons for not receiving eye care in the past year. While cost may prohibit people with diabetes from getting vital care, there are many programs that offer free or low-cost eye exams and glasses. Given the added financial burdens that so many people are facing as a result of COVID-19, we’ve built a list of resources designed to help people with diabetes and support those experiencing vision loss.

Note: to qualify for many of these resources, you or your family will need to meet certain criteria. Each organization has different requirements – which we’ve done our best to lay out – but be sure to check each website!

1. EyeCare America

EyeCare America offers medical eye exams to qualifying people in the United States, often with no out-of-pocket cost. Two main programs are included in EyeCare America: the Seniors Program and the Glaucoma Program.

  • The Seniors Program connects people over the age of 65 with volunteer ophthalmologists in their area who provide free eye exams, and it offers up to one year of follow-up care for any diagnosed conditions. To qualify, you must:
    • Be a US citizen or legal resident
    • Not belong to a health maintenance organization (HMO) insurance plan or have Veterans Affairs (VA) eye care benefits
    • Not have received an eye exam by an ophthalmologist in the last three years
  • The Glaucoma Program provides a free glaucoma exam to qualifying people who are uninsured. If you have insurance you may still request an appointment through the program but will be responsible for any co-payments. To qualify, you must:
    • Be a US citizen or legal resident
    • Neither belong to an HMO nor have VA eye care benefits
    • Not have had an eye exam in the last 12 months
    • Be at an increased risk for glaucoma, which is true if you have diabetes, have a family history of glaucoma, are African American and over the age of 50, or are Hispanic and over the age of 65

Regardless of insurance coverage or income level, anyone can use the EyeCare America Drug Discount Card in English or Spanish. Unfortunately, EyeCare America does not cover eyeglasses or services such as surgical operations.

2. Lions Club International

Lions Club International provides access to eye care and assistance with purchasing glasses for people who are considered low income. The non-profit also offers classes and services for those who are blind or have limited vision. Lions Club presents many of these vision programs through OneSight eye care centers located across the US and around the world. Lions Club International also provides a limited number of vouchers for free glasses, and offers mobile eye care services to children. You can find your local Lions Club here.

3. VSP Eyes of Hope

Eyes of Hope through VSP Global provides eye care and gift certificates for eyeglasses to children, adults, and people affected by disaster. Unfortunately, because of COVID-19, the distribution of new certificates is currently paused.

  • For children: Sight for Students gift certificates provide free eye care and prescription glasses from a local optometrist to people under the age of 19. To qualify, children must have a family income at or below twice the Federal Poverty Level for their family size, and cannot have received care through VSP in the last 12 months. To acquire a gift certificate, parents can find a local partner here.
  • For adults: Adults who make less than twice the Federal Poverty Level and have not received care from a VSP program in the past year are eligible for vouchers. Mobile Eye Care Clinics are also available to people but are suspended until 2021 due to COVID-19.
  • For people affected by disaster: If you have been affected by a natural disaster (like fire, hurricane, tornado, or flooding), are in need of eyeglasses or eye care, and do not have vision insurance, you can qualify for a VSP gift certificate. Contact your local American Red Cross chapter.

4. Medicare

Medicare Part B covers an annual dilated eye exam for people over the age of 65 with diabetes. Dilated eye exams are extremely important for monitoring vision in people with diabetes. Medicare does not provide free routine eye exams or eyeglasses. Under Medicare, you’ll pay 20% of the Medicare-approved amount and the Part B deductible. If you are receiving care in a hospital outpatient setting, a co-payment is also required.

5. OneSight

OneSight is an independent non-profit that provides eye exams and glasses to people, and establishes permanent vision centers around the US. People can take a free online vision exam here. While this online exam does not replace an in-person visit with an eye care professional, it can provide useful information about your sight.

6. New Eyes

New Eyes offers prescription eyeglasses to children and adults who are at or below 2.5 times the Federal Poverty guidelines. You can sign up with the help of a clinician or social worker and use vouchers on the New Eyes website.To qualify, you’ll need to meet the financial requirements, have had an eye exam within the last two years, and not have received other charitable or government resources to pay for eyeglasses. People financially affected by COVID-19 can apply directly here (without the help of a social worker or other health advocate).

7. Mission Cataract

Mission Cataract USA offers free cataract surgeries one day a year to people of all ages who have no insurance and don’t qualify for Medicare, Medicaid, or other forms of government support. Cataracts cause the lens in your eye tobecome cloudy, and your vision may become blurred or less vibrant. Aging is the most common cause of cataracts, however, people with diabetes have a higher risk of developing cataracts.

8. Operation Sight

Operation Sight is another group that provides free cataract surgery to US citizens and permanent residents. To qualify, you must be at or below twice the Federal Poverty Level, and uninsured or underinsured (this would indicate that your insurance does not cover cataract surgery). If you receive Medicare Part B you will not be eligible. You must also have a formal cataract diagnosis. Fill out this form to find out if you qualify.

9. Support Groups for Vision Loss

If your vision, or that of a family member’s, has been harmed by diabetes-related eye disease or other causes, you might consider joining a vision loss support group. VisionAware helps adults adjust to life with vision loss. Whether in-person or online, support groups can offer a space to share your stories and concerns, and it is a space to learn from others with similar experiences. Check out VisionAware’s featured support groups here and find your local chapter.

Learn more about the risks diabetes poses to eye health in our recent article, “Seeking Healthy Vision: Eight Strategies For Caring for Eyes.” If you meet the qualifications of any of the programs we’ve listed, make sure to inquire and apply. Prioritize your vision and keep your eyes as healthy as possible for a long lifetime of use!

About Marie
Marie Tetsu is a rising senior at the College Preparatory School in Oakland, California. She is an eye-care enthusiast, and has been wearing prescription eyeglasses for the past ten years. In college, Marie plans to double major in English and Biochemistry on the pre-med track.  

About Kira

Kira Wang graduated summa cum laude and Phi Beta Kappa from Duke University with a degree in psychology and minors in biology and chemistry. At Duke, she wrote a senior thesis on the coping strategies of parents and youths with chronic illness and spent over two and a half years researching retinal imaging techniques in the Duke Eye Center. She’s currently taking a gap year and plans to go to medical school.


One Year into DIY Looping

One year ago, I built a DIY hybrid-looping insulin pump, using my Dexcom G6 and Omnipod. For those who aren’t in the know, DIY “looping” is basically “hacking” your insulin pump with a single-board computer, such a Raspberry Pi or Riley Link, to make it communicate with an existing continuous glucose monitor (CGM) to make basal adjustments accordingly.

It’s important to note that this is NOT FDA approved, but the #WeAreNotWaiting community has been sharing information on how to build your own DIY looping insulin pump for years now, and I took the plunge in 2019.

In July I celebrated one full year on my looping system, and wanted to share my thoughts on 365 days of looping.

I Still Have Diabetes

I remember when I first set up my Riley Link and switched on “auto-mode.” I had this magical vision of never counting carbohydrates again, limitless runs without lows, and forgetting what the thirst of a high blood sugar felt like. Then I realized, just as quickly, that I still have diabetes.

Even though my Dexcom continuous glucose monitor (CGM) readings now communicate with my insulin pump and make basal adjustments accordingly, the “hybrid” part means that it doesn’t anticipate, nor account for, any carbohydrates eaten. I also need to tell my pump when I’m about to exercise, and for how long. Since the insulin pump does not operate on artificial intelligence (AI), it cannot anticipate what I’ll do next.

So yes, I still have lows on runs and I still have highs when I eat something that isn’t appropriately accounted for. I still have to count carbohydrates and no, I haven’t forgotten what the Death Valley-like thirst of a 350 mg/dL feels like, although it happens less frequently.

My HbA1c Isn’t That Much Lower

I have always been maniacal about tight diabetes control. My A1cs have hovered in the low 6s for the last 10 or so years. With Loop, I immediately thought that my control would be *perfect* and I would ride out the 4s and 5s into an eternal sunset. NOPE. My latest A1c was 5.9%, which I am rightly ecstatic about, but it’s less than 1% point lower than I was on MDI and a CGM.

The key difference is that my time in range has increased from around 30% to 75%, and the number of lows that I experience has gone down from around 3 per day to 3 per week. It’s easy to have a low HbA1c when you have highs and lots of lows to average it out- it’s much harder (and healthier!) to have a lower HbA1c with few lows. And plus, I just feel healthier. And that has made all the difference.

Dexcom graph by Christine Fallabel

It’s a Mental Vacation

Being a human pancreas 24/7/365 is not easy (why didn’t anyone tell us this at diagnosis?!). In addition to running a household and having a full-time job (and texting everyone back, and maintaining some semblance of a fitness routine, and trying to eat something green at every meal), being an organ all of the time is hard work.

More than anything, a year into looping has given me the mental break I didn’t know I needed. Sure, I still have to count carbohydrates, adjust for exercise, and dose for meals, but hours can go by where I don’t think about diabetes at all, and that never used to happen. My mental distress has gone way down, and I don’t experience diabetes burnout at nearly the frequency I used to. This also helps maintain my motivation to continue to take care of myself and my diabetes.

Dosing Is More Discreet

As I make my way through my 30s, this is less of an issue (if you have a problem with me dosing in public, the problem is you, not my diabetes), but looping has definitely made checking my blood sugar (read: checking my phone) and dosing (also read: checking my phone) way more discreet in public than manually testing my blood sugar and dosing used to be. It’s also more hygienic (I change my insulin pump with plenty of alcohol swabs every 3 days from the comfort of my home), and more convenient. This is perfect when I’m out at a crowded concert, or squeezed into a small table at a restaurant.

It can also cause issues. For instance, if I’m in a public place where cell phones aren’t allowed, sometimes it’s difficult to explain that my iPhone is actually durable medical equipment (DME) that I need to survive. Let’s just say there have been some teachable moments.

Loop app screenshot by Christine Fallabel

I Am Happier

When I was diagnosed with type 1 diabetes in June of 2000, my doctor told me that the cure was just 5 years away. I thought the cure was just around the corner, we all did. And learning that the “cure” is still out of sight, 15 years hence, has been a hard pill to swallow.

I’ve dealt with anxiety and the impending depression of only someone who has a chronic disease with no cause and no cure can experience, but having something like Loop feels like someone is finally on my side, looking out for me, and making things just a little bit easier when the load becomes too heavy of a burden to carry. I can go to sleep and know that my basal will immediately shut off if I start to go low overnight. I can relax if I’m digging into dinner at a friend’s house and I don’t know the exact carb count for a meal, knowing my basal will tick up to cover the difference.

Having a Loop feels a little bit like you have a certified diabetes educator (CDE) and best friend just sitting on your shoulder, making constant adjustments, never judging, and ensuring that you have a better go of it, a little bit of help when you need it. And that help has been life-changing. The cure may never have been 5 years out, but with Loop, I finally feel okay waiting just a little bit longer.

Do you DIY Loop? How has your experience been? Share this post and comment below; we would love to hear from you. Follow the #WeAreNotWaiting hashtag on Twitter to learn more about the DIY movement.


Top 5 Low-Carb Swaps for High-Carb Favorites

A diagnosis of type 1 or type 2 diabetes means you should be mindful of what you eat and how different foods affect your blood sugars at all times. Enjoying some of our favorite foods can be more challenging when we have to factor in the impact on blood sugars. People who are insulin-dependent have to be very precise about their insulin dose and timing. Others rely on oral medication and high blood sugar may take hours to come back down, if diet is not considered. With that said, you can still enjoy some of your favorites thanks to so many new healthier options available both to make at home and in stores.

Here are my top 5 low-carb replacements for high-carb favorites:

1. Edamame Pasta

If you told me pre-diagnosis that I would be trying substitutes for pasta such as zucchini, black bean and edamame pasta, I would not have believed you. Yet here I am, more than six years later, having never touched real pasta once after finding these delicious substitutions. My favorite is edamame linguini, I find the taste and texture to be most similar to the real deal. I add in some ground beef, turkey or some grilled shrimp and the result is a protein-packed, low-carb and filling meal without having to worry about blood sugar spikes.

2. Mashed Cauliflower

Who doesn’t love to indulge in comfort food? One cup of mashed potatoes is 35 g of carbs and has a little over 200 calories. With most people also adding butter, cheese, and other toppings, this can result in a “perfect storm” of high-carbs and high-fat that is very tricky to bolus for and can lead to stubbornly high blood sugar levels. Stubborn highs can make you more insulin resistant, so for those on insulin, you may require more than your usual dose to bring it down. For those who aren’t on insulin and rely on exercise to bring down blood sugar spikes, you may have a harder time getting your blood sugars back in range. The good news is not only can you make this yourself but you can now find it in many freezer aisles as well.

3. Chicken Crust Pizza

This one is a best-kept secret among keto lovers! I have seen so many recipes for low-carb pizza circulate through the diabetes online community and I have tried several. I enjoyed the “fathead” recipe (many variations exist online) but found it very high-calorie and filling. I found the cauliflower options to be very grainy and not the texture I am used to when it comes to pizza dough. But using ground chicken meat as your pizza “dough” actually has the right consistency and also gives you upwards of an extra 20+ grams of protein per slice making this delicious option my top choice!

4. Protein-Packed Low-Carb Ice Cream

I miss the days where I could sit down with a bowl of ice cream and watch mindless TV while I mindlessly ate. Now, while I am sure I could still do that, albeit tricky when it comes to blood sugars and wanting to fit into last summer’s favorite jeans, I choose not to. There are so many alternatives that taste just as creamy and delicious and don’t contain a ton of calories and carbs. While a lot of these recipes require an ice cream maker, this one is simple and foolproof with just a blender needed. Simply blend 1 scoop of protein powder, ¼  cup almond milk, ¼ cup water and 1 tbsp. cocoa powder. I personally also add 1 tbsp. of chunky peanut butter for a great flavor and bite! Next, freeze it until ready to eat it and then leave it out for about 10 minutes before eating for optimal consistency and the most authentic ice cream experience!

5. Chocolate Peanut Butter Smoothie

Smoothies sound healthy, in theory. Many contain yogurt, milk and fruit, all which on their own offer plenty of nutritional value. But throwing it all into a blender, while it makes for a refreshing drink, it can be loaded with calories and carbs. Instead, opt for unsweetened almond milk and Greek yogurt and protein powder as your main ingredients and add in berries that contain the lowest amount of carbs of all fruit. You can also use peanut butter. There are low-sugar versions now available on the market, like Legendary and many others.

While I love having delicious treats, I also enjoy normal blood sugars and feeling good in my own skin. Using lower-carb and lower-calorie substitutes for some of my higher-carb favorites allows me to satisfy my sweet tooth without sacrificing my health and wellbeing.


Keto Chicken Strips

This content originally appeared on Caroline’s Keto Kitchen. Republished with permission.

Chicken strips are one of my very favorite finger foods! I’ve explored numerous recipes over the years, but many have pork rinds as breading, and let’s just say I am not the biggest fan of pork rinds (mainly because I can’t get past the smell).

On our last family vacation, I learned about a restaurant that had keto chicken strips on the menu, and even though it was about an hour drive, my dad and I went two days in a row. They were fantastic and have been on my mind ever since. I finally got around to experimenting in the kitchen to re-create them. They came out fantastic – not identical to the ones we had on our vacation, but I’d say close to equally good (minus all the fun of finding something like this on a menu, of course).

It’s rare I bring out my deep fryer, but in an effort to make them as similar as possible, I did. I later tried this recipe both oven-baked and oven-baked + air fried to finish. All three cooking methods work out well, though I will say I like deep fried best (though I could have told you that before I started). I’ll continue making the baked ones on a fairly regular basis, and I’ll likely save the deep fried ones as a special treat from time to time.

Keto Kitchen Strips


Keto Chicken Strips

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Prepare these deep fried chicken strips as a special treat for yourself and loved ones from time to time.


  • 1 cup heavy whipping cream
  • 2 eggs large
  • 1.5 tsp salt
  • 9 oz chicken breast tenders boneless, skinless (or cut your own from breasts)
  • 2/3 cup almond flour
  • 1/2 cup walnut flour you can also make this by putting 3/4 cup raw walnuts in a Ninja
  • 1 tsp salt
  • 1/2 tsp garlic salt
  • 1/2 tsp onion salt
  • 1/2 tsp garlic powder
  • 1 tsp pepper
  • 1/4 tsp cayenne pepper
  • frying oil if frying (I used avocado oil)


  • In a bowl, mix together the heavy whipping cream, eggs and 1.5 tsp salt. Stir well.
  • Put the raw chicken tenders in the mix, and make sure they're all fully submerged.
  • As the tenders soak, make the breading mix in a separate bowl by mixing together the almond flour, walnut flour, garlic salt, onion salt, garlic powder, pepper and cayenne powder. Stir well.
  • Dip each chicken tender in the breading and press down on the breading slightly to help it stick. (I typically like to dig a small "well" on the surface of the breading to put the tender in, and then I push breading from the sides to cover the top). Repeat until all strips are coated.
  • Line strips on a non-stick surface, and put them in the refrigerate for at least an hour. (This helps the breading stick – don't skip this step.)

How to Cook

  • → If you're deep frying, fill your fryer with oil to the minimum line and heat to 400 degrees. Once it's reach 400 degrees, put your strips in the frying basket (lined single file), and cook for roughly 5 minutes and 30 seconds or until done.
  • → If you're only oven baking, cook for about 23 minutes at 425 degrees or until done.
  • → If you're oven baking and air frying, cook for about 19 minutes at 425 degrees and then air fry for around 6 minutes or until done.


You will have excess breading mix, but it can be hard to coat them well if you don’t have enough. If you hate wasting ingredients, you can cut everything in half (except for the amount of chicken).
While you can air fry alone, I don’t recommend it, as the breading sticks to the chicken much better if it’s cooked in the oven first.
Normally I provide nutrition facts, but for this recipe they really depend on the size of your chicken pieces, how much breading you use and the cooking method. Given the variance (especially if you deep fry, as it’s hard to calculate how much oil is absorbed), I am not including nutrition facts for this recipe.

Please note that the nutritional information may vary depending
on the specific brands of products used. We encourage everyone to check specific
product labels in calculating the exact nutritional information.

Keto Chicken Strips Recipe


Teenage Boy Receives Novel Stem Cell Therapy

Editor’s note: This article was updated on 7/31/2020 for accuracy regarding the specific stem cell treatment used. 

A lot of research is ongoing to develop novel therapies for type 1 diabetes. Many investigators are now focusing on the potential of various stem cells therapies. One approach involves using mesenchymal stromal cells (MSCs) (which can be obtained from the umbilical cord) and directly injecting them into the pancreas in an effort to induce insulin production. These kinds of treatments are still in the early experimental stages, with some clinical trials ongoing.

Seeking an Experimental Treatment Abroad

Just last week, Vera and her son Aaron set out to have the procedure done at Cryovida in Mexico. After having a difficult time managing his diabetes, Vera vowed to do whatever it took to lessen the burden for both her son and herself. Since Vera first posted about their upcoming journey, the diabetes online community became intrigued. Vera even started a Facebook page where people could learn and ask their questions. I thought it would be good to hear from Vera about the whole experience and how Aaron is doing now.

At what age was Aaron diagnosed with type 1 diabetes?

He [had] just turned 15.

How have Aaron and your family been managing with his diabetes leading up to this life-changing procedure?

Probably the hardest time in our lives. In the honeymoon stage, my son’s attitude was almost impossible to deal with. As he got used to monitoring and stabilizing, he improved. My son is on the spectrum, so he was always difficult. He would forget to take his long-lasting insulin, not cover for the junk he would eat, and his sugars were almost always over 500. It was living in hell. Six months ago, my son came to live with me in Mexico (he was living with my mom in NJ, because he wanted to finish school, and we moved to Mazatlan, Mexico 3 years ago). When he came his blood work was so bad that the doctor didn’t know how he was walking. His A1C was over 20, his triglycerides were over 700! The doctor immediately changed his insulin. He said they had him on such a low dose, no wonder we could never control it, and put him on cholesterol meds, which my son never took. Just two months later my son’s triglycerides went down to normal (and he never took a single med for it; It is just the fresh food here), and his A1C was down to 18. By the time we went for the procedure, his A1C was down to 15.9. My son still doesn’t listen, and eats tons of junk, does not cover for it. I have to be on top of him 24/7 to check his blood and take his insulin. So, if this works I may retire from my position of a drill sergeant.

What prompted you to start looking for possible cures or treatments? How did you hear about Stem Cell Educator Therapy?

My son [was] almost dying, and his dream to go into the military was taken away from him. My husband is a retired Vet, his father is a retired Vet, my grandfather was a retired Vet. We are a military family. This may give him the opportunity to serve, which is all he wants. I heard about it from research. I started googling diabetes cures and ran across different articles for stem cells. I always read everything, I rarely follow what is being pushed by news or politicians. I sit and read.

What are the benefits of this procedure for a patient living with type 1 diabetes? And what are the risks involved?

Well, ultimately a full cure, but for those that do not get cured, it lowers their need for insulin substantially. Risks… honestly not much [from] the procedure itself, but the normal risk, possible bleeding, pain in the area. Long term, diabetes can come back. Scientists still have not figured out how to protect the new beta cells from being attacked again by your immune system. For me, that is a risk I can live with. Even if he gets a year diabetes-free, I would pay and do the procedure again. The longest known case has been diabetes-free for 3 years now.  I am hoping [the]  next huge development will be scientists figuring out how to protect the new beta cells.

How did Aaron feel about it? Was he nervous? Excited? Or a little bit of both?

OMG, he was a mess. At first, he was stoked about it. He couldn’t wait. Then came time for the procedure, and he was like, “nope”. He was sitting in the huge cat scan room where they were doing the procedure saying “no, I don’t want it”. I had to tell the anesthesiologist to get him sedated ASAP, or my son was about to run out of the hospital in the gown down the street!

How was it dealing with Renu and Cryovida? How were the doctors? Were they able to speak English so they could communicate with Aaron?

First, I am lucky enough to live in Mexico, but I speak horribly. We were able to set up the full thing in one week. The reps did everything. They spoke perfect English. Once at the hospital, the doctors spoke English, Went through every piece of paper I signed, explained everything to me and my son. Let my husband and I be in the room until the procedure started (even though the hospital had a rule; one person per family due to COVID). After the procedure, all the doctors came in, explained everything. Gave me all the paperwork. The reps from Renu came with us from Mazatlan to Guadalajara, a six-hour drive, and stayed the whole full three days with us to make sure everything was okay. It was an overall great experience.

Image credit: Vera Mazatlan

How long did the procedure take and generally speaking, how is it done?

They were done in an hour, but most of the time was prep. The actual procedure takes 10 minutes. They make a hole in the femoral artery and lead a scope into the pancreas, where they then inject the cells.

How does Aaron feel now after the procedure? Did he have a lot of pain right after?

He feels amazing. The first thing he noticed is that his eyesight was no longer blurry. He was only in pain on the first day. Now he is back to his crazy self. He also has tons of energy. He was so sluggish before. That is the biggest change.

Have you noticed any changes to his blood sugars yet? Do you notice any fewer peaks and valleys? Has he tried experimenting with new foods or is this too soon?

When can he expect to see some results? I have noticed his blood sugar is lower, even after he eats junks. He is 17, controlling him to eat right is IMPOSSIBLE! They said I should start seeing a real difference in about 45 days to 6 months. Depends on each person.

Now that is it over and behind Aaron, how is his perspective looking forward to living with this disease? Is he glad he did it? I bet he can’t wait to see the results!

He is beyond grateful to possibly be given a chance to be diabetes-free. He still wants to go into the military. To him, this is a gift he would never get. I made him a promise [that]  if there was a way to cure him, I would pay any amount of money, and go anywhere to do it. I have fulfilled my promise.

What would you share with our community who has been so intrigued by your story, any advice you could share having gone through this with your own child?

Never give up hope, and never take no for an answer. If the doctor is not giving you the answer you want, get a second, third, fourth, doesn’t matter how many opinions. There is always hope and new science out there. Yes, it can be expensive, but ask yourself, what is your child’s health worth to you? Also, READ EVERYTHING. Science changes monthly. Keep reading, keep joining groups, keep reaching out. Forget what you hear on the news and from politicians, you are the advocate for your child. Go against the grain, and be a trendsetter. Those are the people that make a difference.

Vera, thank you so much for sharing both you and your son’s experience. We wish Aaron nothing but health and happiness and we will continue to follow his journey!

What are your thoughts on this kind of experimental treatment? Is this something you would consider? Share and comment below!


Watch Type 1 Diabetes on Netflix

This content originally appeared on Beyond Type 1. Republished with permission.

By Alexi Melvin

If you’ve browsed Netflix in the last couple of weeks – as I’m sure the majority of us have throughout shelter in place – you may have stumbled on a few representations of type 1 diabetes in major Netflix shows.

The double-whammy of type 1 diabetes (T1D) related content is thanks to Netflix having released both “The Baby-Sitters Club” and “Say I Do” only two days apart from each other.

Usually, when we know diabetes has been represented in a show or movie, the collective “oh no, what did they say about it this time?” sinks in. However, these shows did a pretty decent job. In “Say I Do,” a wedding reality show, the groom with T1D was able to tell his own diabetes story in a way we’ve not often seen done. It was refreshing. In “The Baby-Sitters Club,” the beloved character with diabetes from the book series has an entire episode dedicated to her experience. It’s not a perfect representation, but it is more screen-time for diabetes than we normally see.

The Baby-Sitters Club

This Netflix reboot – released on July 3rd – of the beloved book series, turned TV series, turned 1995 film of the same name is a more modern take, but for the most part stays true to the original characters. One of these familiar characters is Stacey, a new member of the BSC and New York City transplant.

In episode 3 of the season, “The Truth About Stacey,” Stacey’s “secret” is finally revealed. She has type 1 diabetes.

Not to go too deep into spoilers, but let’s just say that Stacey (and her mother, in part) has felt a lot of shame in the past about her T1D and is hesitant to reveal it to her new group of friends. Her competency and safety as a babysitter is questioned as a result of the revelation, but luckily it’s not a spoiler to say this matter is resolved, since The Baby-Sitters Club wouldn’t be what it is without Stacey.

The show gets a few things wrong but don’t worry – it all wraps up with a bedazzled insulin pump in full view.

Say I Do

Released on July 1st, “Say I Do” has already made a name for itself as a super sweet guilty pleasure for reality show enthusiasts. Episode 1 introduces us to Marcus LaCour and his wife, Tiffany, whose first wedding years prior was an epic disaster. Now, they’re given a chance at doing it over again, having the real wedding they always hoped for.

Marcus is immediately transparent with the show’s three hosts that he has type 1 diabetes, having been diagnosed at age 15. During a conversation about food for the wedding’s reception, Marcus goes into detail about his diagnosis and T1D management today. He shares details like temporarily losing his sight on the way to the hospital, how losing his health insurance at one point led to tough decisions for the family, and that he maintains lower-carbohydrate eating habits that help him manage his blood sugar levels.

What Was Done Well

The overarching theme within Stacey’s T1D struggles in The Baby-Sitters Club is that she has found a new support system that accepts her for everything that she is – so, why shouldn’t she accept herself too? To see a young girl dealing with a new diagnosis have such a strong team of friends that truly have her back is refreshing, and something that every person impacted by diabetes deserves.

Growing up in the 90s, the 1995 The Baby-Sitters Club film was a favorite of mine. After I was diagnosed with T1D at age 14, one of the very first things that flashed through my head was this movie’s scene when Stacey fell down in the middle of a hike because she was low. It was the only portrayal of someone having type 1 diabetes that I was even remotely familiar with.

The ’95 film version of BSC left us with way more questions than answers when it comes to what type 1 diabetes is. We knew that Stacey had something called “diabetes.” We know that her mother was very insistent that she “eat something” before her hike. And we knew that she fell down because she didn’t eat. But any further detail about insulin injections, blood sugar management, differentiation between the types of diabetes and what causes type 1 diabetes was entirely lacking.

In the Netflix reboot of BSC, we get a clearer picture of what T1D looks like. The story has been modernized, so we get an updated look at how T1D is managed with the insulin pump hooked to the front of Stacey’s waistband. We also see Stacey dive much deeper into the inner turmoil that goes along with a T1D diagnosis. Type 1 diabetes is much more visible here than we’ve seen it before in past film and TV attempts.

In “Say I Do,” Marcus takes enormous care to share his story, and the producers took equal care in spending time on his story. From Marcus, we learn what a type 1 diagnosis can mean for a family, and what it means to him personally.

Is There Still Room for Improvement?

Absolutely. There needs to be even more transparency and accuracy within our portrayals of diabetes in pop culture. There are unclear moments in episode 3 of The Baby-Sitters Club, such as Stacey’s “episode,” which appeared to be a seizure from a severe hypoglycemic event. However, it was also presented as possibly coinciding with her diabetes diagnosis, which would have meant high blood sugar and possibly diabetic ketoacidosis (DKA), as opposed to a low.

The lens with which we are meant to view a type 1 diabetes diagnosis could also have been a little less dark. I question whether Stacey’s T1D storyline perpetuates the idea that having type 1 is means for bullying or shame. Nevertheless, it ultimately morphs into a more optimistic tone.

When it comes to reality television like “Say I Do,” we need more Marcus LaCours! And we need more show showrunners and producers who take care with telling these stories well. When we think about documentary style TV, not a lot of examples come to mind of people we’ve seen that live with T1D. If they do, not a lot of time is spent on clarity around what diabetes is and means for the person living with it.

The more we all choose to use our platforms to educate others about type 1 diabetes, like Marcus did in “Say I Do”, the more stories will emerge, and the more our experience of diabetes will be normalized, better understood, and seen as just one part of a complex person or character, not just a plot device or the butt of a joke.


What is the Gut Microbiome and How Does it Relate to Diabetes?

This content originally appeared on diaTribe. Republished with permission.

By Matthew Garza

The microbiome is an exciting area of research for diabetes management. What do we know and what questions do we still have about the microbiome?

Interest in the microbiome, and how much it may affect our bodies, has been on the rise. People often talk about the microbiome as it relates to the immune system, the digestive system, chronic diseases, and more. But what exactly is the microbiome and how does it relate to diabetes?

What is the microbiome?

The human body is made up of tiny cells. However, we also have trillions of microorganisms (called microbiota or microbes) that are found in and on our bodies. These microorganisms include bacteria, fungi, parasites, and viruses.

While “microbiome” is defined as all the genes and DNA that these microorganisms contain, people often use the word to describe the entire population of microorganisms themselves. Even more specifically, the most common use of the word microbiome is to refer to the population of microbes that live in your gut (including your stomach and digestive tract) where the largest concentration of these microbiota can be found. While most of the microbes in the body are symbiotic (which means that both the human and the microbes benefit from the relationship), some are pathogenic, meaning that they promote diseases. In healthy individuals there is a balance between the microbes and the human host cells. If there is a major disturbance – for example, an infectious disease, the introduction of a bacteria-destroying medicine like antibiotics, or even a new diet – it can lead to the system becoming unbalanced.

Your microbiome is entirely unique to you and is determined by a number of factors including:

  • Your DNA
  • Your diet
  • Your level of activity (exercise)
  • Environmental factors – a person’s microbiome can change based on exposure (for example, to new foods or medications).

How do the microbes that make up the microbiome affect the body?

The human body needs a healthy and diverse microbiome to properly function. Our microbiomes are essential for human development, work closely with the immune system, are vital for nutrition, and even regulate how sensitive we are to insulin.

The microbiome interacts with the immune system frequently. The immune system includes all of the cells and processes in our body that fight and protect us from harmful bacteria, viruses, and disease. When germs enter the body through food or drinks, the gut microbiome plays a role in making sure we do not get sick. The microbiome also helps make vitamins and molecules that our body needs, such as B vitamins including thiamine and riboflavin, and vitamin K, among others. Microbes help break down harmful food molecules and complex carbohydrates so that the body can use the products for nutrition, muscle function, and the prevention of certain chronic diseases.

Humans share about 99.9% of their DNA (genetic material) with other humans. However, most human microbiomes are 80-90% different from person-to-person. This means that differences within the microbiome may be used for personal medicine. People respond to treatments differently for a variety of reasons, and personal medicine is a new concept for treating diabetes. If doctors know more information about the genetic makeup, or in this case the unique microbiome, of a person with diabetes, they may be able to use specific strategies for preventing, detecting, treating, or monitoring that individual’s diabetes.

How does the microbiome relate to diabetes?

Knowledge of the microbiome is limited given its relatively recent discovery. We are learning new things about the microbiome and how it relates to specific diseases, such as diabetes, every day. However, here are some of the discoveries and hypotheses being made related to the microbiome and diabetes.

For type 1 diabetes (T1D), the relationship between diabetes diagnosis and changes in the microbiome is not yet fully understood. Two studies (found here and here) highlight some of the key findings in this research:

  • People with T1D have less variety in the types of microorganisms in their microbiome.
  • Certain types of bacteria are more prevalent in people with T1D than those without – usually this means there is a smaller population of beneficial microorganisms.
  • Drastic changes in the gut microbiome could lead to a greater chance of inflammation in people with T1D. T1D is partially caused by inflammation of the cells in the pancreas where insulin is produced. Inflammation occurs when something damages your body’s cells and the immune system releases chemicals that increase blood flow and support to that area.

Similar to T1D, for type 2 diabetes (T2D) there is a lot of new research in the field, but much is still unknown. This paper summarizes many major findings:

  • Certain species of gut bacteria such as A. muciniphila can affect gut permeability, and increased gut permeability is often observed in people with T2D. Some bacteria could help decrease leaks in the gut by creating more tight junctions in our cells or by stopping the destruction of the mucin layer, a thin layer which lies on top of the inner lining of the gut. Tight junctions are small proteins between cells in the gut which prevent particles from leaking in or out.
  • Some microbes can influence blood glucose levels and control the digestion of sugars, e.g. bacteria which produce butyrate from the digestion of dietary fiber. Butyrate is a fatty acid that plays a role in homeostasis and metabolism.
  • Some microbes may affect the production and release of gut hormones, which is also highly influenced by butyrate. It has been shown that insulin sensitivity may be influenced by particular microbes.

What can you do to support the health of your microbiome?

There are a number of things you can do which have been shown to support the health of the microbiome. Here are some proactive steps you can take:

  • eating fiber (digestible and nondigestible carbs, like asparagus, onions, garlic, and chicory)
  • reducing the amount of sugars and artificial sweeteners you eat
  • avoiding taking antibiotics when not medically necessary, since this can damage your gut bacteria
  • eating plenty of fruits and vegetables

Other strategies for staying healthy also strengthen the microbiome and the immune system. These include:

  • reducing stress
  • exercising
  • getting good, quality sleep
  • not smoking at all

There are countless groups doing valuable research on the microbiome and its relationship to diabetes; however, so much is still unknown. We look forward to learning more about how to strengthen our microbiomes to keep them healthy and properly functioning.


Would You Restrict Carbs to Ease Diabetes Management? (ADA 2020)

Children and adolescents with type 1 diabetes are currently living at a time of a big diabetes technology boom. Continuous glucose monitors (CGMs) and insulin pumps are becoming more popular and offer the promise of better glycemic management and more freedom and peace of mind. As research and clinical trials on automated insulin delivery systems are in full-swing, clinicians from The Joslin Diabetes Center, Yale University, and Harvard University were interested in understanding various patient preferences. In one study, they posed the following question:

Would young people with type 1 diabetes be willing to limit their carbohydrate intake to a maximum of 50 g per meal if this meant they wouldn’t have to administer a manual bolus using an artificial pancreas (AP) system? 

The outcomes of this research were recently presented at the American Diabetes Association (ADA) 80th Scientific Sessions.

To help understand patient perspectives and preferences on this subject,  39 participants (average age 17 +/- 4.7 years) were recruited at two study centers. These patients had an average diabetes duration of 9.4 +/- 4.9 years and an average HbA1c of 8.4 +/- 1.1 %. Interviews were conducted with each participant and parents to gauge their views on the willingness to “limit carb intake to 50 g per meal/snack if this would eliminate the need to manually bolus for food when using the AP system.”

Based on their analysis, the study authors derived the following major insights:

  1. The majority of participants (and their parents) would prefer to have the option of eating more than 50 g per meal/snack and were willing to manually bolus for the excess carbs.
  2. Most believed that 50 g per meal or snack was too restrictive.
  3. Young people generally agreed that automation would “reduce self-care burden.”

The researchers concluded,

“An aversion to food restrictions overpowers the desire for an AP system that can independently manage glucose levels though limited carbohydrate intake. Carbohydrate limitations appear to increase self-care burden more than the time and effort expended on carb counting and bolusing. Future AP systems should consider options that enable users to choose to bolus manually for large meals and to forego bolusing for smaller ones.”

Here are a few notable quotes from the participants, which were highlighted in the poster presentation:

“I think that, if I had to choose between bolusing or limiting my carb intake, I think I would rather bolus, just because nobody really wants to be told what to do.” (25-year-old female)

“Every once in a while she wants to have an ice cream. You know, I think she should be allowed to have these things sometimes when she wants them. I don’t want her to be too restricted.” (Mother of a 16-year-old.)

Sadly, despite continuing advances in technology, the glycemic management for youth with type 1 diabetes has been stagnant or worsening, depending on the age group, for decades. As per the most recent available data, the average HbA1c for young people with type 1 is about 8.7%, similar to what was observed in this cohort. Automated insulin delivery could offer an important solution to so many young people who do not meet the ADA-set glycemic targets (currently, the organization recommends individualizing the A1c goals, from as low as <6.5% all the way up to <8% for some patients).

This study provides an interesting snapshot into what many young people with type 1 diabetes appear to consider very important — the freedom to eat whatever they want and bolus for it. 

There has been a long-standing debate, often in the diabetes online community, and sometimes among healthcare providers, about a low-carbohydrate approach for young people. Many have highlighted the benefits, and exceptional success stories. They are not just anecdotes, either. At least one study has demonstrated exceptional outcomes of carbohydrate lowering for youth with type 1 diabetes, with excellent adherence and reported quality of life, a normal average A1c of ~5.7%, and a very low rate of adverse events.

Nevertheless, some question difficulty of maintaining a lower-carbohydrate diet, and concerns have been cited over the potential for the development of eating disorders as a result of “restricted eating”.

When it comes to developing AP systems, this study suggests that many young patients would prefer more flexibility in the upper threshold of their carbohydrate intake and are willing to put in the work to manually bolus for and accept the outcomes, whatever they may be, of higher carbohydrate eating patterns, in lieu of sticking to a recommended carb limit and not having to manually deliver their insulin dose. Of  course, this is just a small study, and the results may be skewed towards this perspective due to the predominance of teenagers in this cohort. Also, it may be interesting to evaluate a shift in this perspective, if any, following a formal diabetes education program to explain to patients and parents, in detail, the benefits of lowering carbohydrate intake for diabetes management in general, and in the context of AP technology.

What are your thoughts on the subject? We love hearing from our readers.


Insulin Pump Therapy for Those Living with Type 2 Diabetes: Doris’s Story


My name is Doris, and I am a wife, small business owner, volunteer and an Assistant Director at a non-profit agency. I’m always busy, which is why some are surprised that I also live with type 2 diabetes. Managing my diabetes hasn’t always been easy. In reading my story, I hope you can take away some of the lessons that it took me years to learn.

20 years ago, I noticed that I was feeling sick each morning and it was a struggle to get myself together. One morning, I arrived at work and was extremely tired and nauseous. A co-worker took me to the emergency room where I was diagnosed with type 2 diabetes. I was in my thirties then. At the time, I was dealing with other health challenges as well. Adding this serious disease to an already full plate was overwhelming to say the least. I knew very little about type 2 diabetes. I thought that diabetes was common and I could handle it, so I wasn’t really too worried. In my naivety, I thought if I just took the medication prescribed for me and avoided sugar, I would be just fine. Boy was I wrong! I learned very quickly that I needed to educate myself about the disease, causes, symptoms, treatments, and find a specialist.

I have been living with type 2 diabetes for over twenty years now. I have had so many changes in my drug therapy regimen, I can’t count. No matter what combination of medications and insulin I took, or changes I made to my diet or exercise, my A1C levels would not stay consistently at or below 7. I have been hospitalized twice due to elevated blood sugar levels. I even sought help from diabetes specialists, but I still wasn’t able to get control of my blood sugar the way I wanted. Throughout the years, I really struggled with always being tired and listless. Some days I couldn’t even make it out of bed. It was a struggle being able to do activities. My family and friends thought I was being lazy or anti-social because I would pass on so many events. They did not understand how I was being affected.

About 4 years ago, I had to change my primary doctor because of insurance coverage. The process of having to find a new doctor was always exasperating to me because I wanted to find someone that was truly solutions-based and took time with their patients. I ended up finding a family practice doctor near my home. I liked the fact that she was always very candid with me about my out of control blood sugar levels, high A1C, and the other medical complications I was dealing with due to type 2 diabetes. She was increasingly concerned as the test results showed that I was heading toward serious complications with my kidneys. One day, I visited her office to review my test results, and we had a serious discussion on what my prognosis looked like. She felt it was important to discuss my options. I began crying because I felt so defeated and helpless. She spoke to me about insulin pump therapy. I knew very little about it. I thought it was only offered to patients that have type 1 diabetes. She gave me some literature and told me to think about it and let her know if I wanted to pursue it further. I went home and discussed it with my husband and other family members. I was depressed about the situation because the quality of my life looked bleak. I did some research on insulin pump therapy but couldn’t find much information about it or how it was used with type 2 diabetes patients.  I called my doctor and asked her to give me some more details of what the therapy consisted of. My level of apprehension was pretty high at this point, so she scheduled some time for me to meet with a nurse who specialized in insulin pump therapy.

I spoke to Shelly, a nurse from Medtronic, who was able to give me better insight into what the therapy would involve and how I could benefit from it. Her knowledge about the therapy, the disease, and her willingness to answer what felt like a million of my questions gave me some hope. After that conversation and further research, I knew that I had to try insulin pump therapy. I put my initial skepticism away and without further hesitation, I told my doctor to sign me up.

When my MiniMedTM 630G pump arrived, I met with Shelly for my product training. I initially thought it was complicated. There were too many parts and too many steps for me to get this right! I became nervous, but I knew how important it was for me. I took a deep breath, concentrated, and with Shelly’s guidance, was able to successfully start insulin pump therapy. I still had a lot of questions concerning the pump. Shelly’s number was on speed dial for a while. The more I used the pump, the more my confidence with handling the pump grew. I was so amazed at this technology and how the device could adapt to my changing needs.

After a month of using the pump, my blood tests results came back and I was ecstatic. My A1C level had dropped and I was seeing much better blood sugar levels. I do the happy dance every time I get a blood sugar level under 100.

I have been using the pump for over 3 years, and have had such a positive experience using the pump. I can’t believe the difference it has made in my live. Most notable to me is more energy— I don’t feel tired and sluggish anymore. I’m able to be more active and participate more in daily activities. When it comes to my blood sugar levels, they are more stable now and my A1C level is at 7.1! I could have never imagined that happening before.

I am no longer a home body either. I am always busy, on the go, and wanting to do more. I look at my life 3 years ago and I was facing a totally different scenario. Things that I had put on hold, I am now pursuing. Using the pump has changed my life drastically. I no longer see just dark days ahead of me— I see the chance to live my best life. I get so emotional when I speak about my experience with the pump. It’s motivated me to figure out what I could be doing to help others. I believe in the product so much that I signed up to be an Ambassador for Medtronic, so I can share my journey with others.

As I reflect on my experiences researching and ultimately using the pump, one of my major takeaways is that you must be committed and dedicated to the process. Although I have certainly grown accustomed to using the pump, it was a bit of a struggle for the first few months. Even now, I have to always remember small things like having additional batteries and pump supplies on hand. In addition, I plan my schedule to ensure that I can continuously use the therapy, even when I travel.

Another takeaway is that it’s important to talk with someone that’s living with type 2 diabetes and using insulin pump therapy. Although I received excellent information form the nurse, nothing beats speaking to someone who has firsthand knowledge.

Finally, be proactive and learn about the coverage that your medical insurance provides when it comes to the cost of the pump and the supplies.

Overall, my experience using insulin pump therapy as a diabetes management tool has definitely benefitted me and what I do in my life. Things don’t always happen the way you plan them, but when you have the right information and know where to go to find answers, your possibilities keep growing and for that I am thankful!


The testimonial above relates an account of an individual’s experience with a Medtronic device. The account is genuine, typical and documented. However, this individual’s experience does not provide any indication, guide, warranty or guarantee as to the response or experience other people may have using the device. The experience other individuals have with the device could be different. Experiences can and do vary. Please talk to your doctor about your condition and the risks and benefits of Medtronic devices.

Important Safety Information: MiniMed 630G System with SmartGuard Technology

Indicated for the continuous delivery of insulin, at set and variable rates, for the management of diabetes mellitus. MiniMed™ 630G system is approved for ages 14 years or older with Guardian™ Sensor 3 and MiniMed™ 630G system is approved for ages 16 years or older with Enlite™ sensor. Both systems require a prescription. Insulin infusion pumps and associated components of insulin infusion systems are limited to sale by or on the order of a physician and should only be used under the direction of a healthcare professional familiar with the risks of insulin pump therapy. Pump therapy is not recommended for people who are unwilling or unable to perform a minimum of four blood glucose tests per day. Pump therapy is not recommended for people who are unwilling or unable to maintain contact with their healthcare professional. Pump therapy is not recommended for people whose vision or hearing does not allow recognition of pump signals and alarms. Insulin pumps use rapid-acting insulin. If your insulin delivery is interrupted for any reason, you must be prepared to replace the missed insulin immediately. Replace the infusion set every 48–72 hours, or more frequently per your healthcare professional’s instructions. Insertion of a glucose sensor may cause bleeding or irritation at the insertion site. Consult a physician immediately if you experience significant pain or if you suspect that the site is infected. The information provided by CGM systems is intended to supplement, not replace, blood glucose information obtained using a blood glucose meter. A confirmatory fingerstick using a CONTOUR®NEXT LINK 2.4 meter is required prior to making adjustments to diabetes therapy. Always check the pump display when using a CONTOUR®NEXT LINK 2.4 meter, to ensure the glucose result shown agrees with the glucose results shown on the meter. Do not calibrate your CGM device or calculate a bolus using a result taken from an Alternative Site (palm) or a result from a control solution test. If a control solution test is out of range, please note that the result may be transmitted to your pump when in the “Always” send mode. It is not recommended to calibrate your CGM device when sensor or blood glucose values are changing rapidly, e.g., following a meal or physical exercise. The MiniMed™ 630G system is not intended to be used directly for preventing or treating hypoglycemia but to suspend insulin delivery when the user is unable to respond to the Suspend on low alarm and take measures to prevent or treat hypoglycemia themselves. Therapy to prevent or treat hypoglycemia should be administered according to the recommendations of the user’s healthcare provider.

WARNING: The SmartGuard™ Suspend on low feature will cause the pump to temporarily suspend insulin delivery for two hours when the sensor glucose reaches a set threshold. Under some conditions of use the pump can suspend again, resulting in very limited insulin delivery. Prolonged suspension can increase the risk of serious hyperglycemia, ketosis, and ketoacidosis. Before using the SmartGuard™ feature, it is important to read the SmartGuard™ feature information in the User Guide and discuss proper use of the feature with your healthcare provider.

See and the appropriate user guides for additional important details.


Should You Be Afraid of Insulin?

It’s an all-too-common fear for people with diabetes. There is the completely natural fear of needles, but depending on the messages they’ve received from their care providers along with the experiences with insulin from other people in their family or circle, they can feel like insulin is the last resort or that they’ve failed on everything else. We’ll dive into all of that.


  • What is insulin
  • Why is it prescribed
  • Common messages and fears
  • Should you be afraid of insulin?


Scott K. Johnson – Hey, thanks for tuning in to another episode of Coaches Corner. It is great to see you again. Let me know where you’re watching from today. I’d love to hear that. Post it in the comments. One small way that mySugr is giving back is by hosting the short conversations with our diabetes coaches, to talk about staying healthy in body and mind. We really appreciate you sharing some time with us. Now I do have to give the standard disclaimer. We cannot provide medical advice. Please contact your doctor directly for specific questions about your care. Today my sugar coaches Kristen and Maggie, talk about if insulin is something to be afraid of. Let’s take a look. And hi Maggie. Today we are talking about being afraid of insulin which is something that is quite common, especially for those who are new to diabetes, don’t really understand some of how it all works. But maybe we should start with some of the basics. So what is insulin?

Maggie Evans – Yeah, great, great start. So it is always useful to break down the basics. So we hear in the word insulin quite a bit. So I agree kind of, you know, understanding what that is. Insulin is a hormone that’s created by our pancreas or pancreas, it’s kind of right next to our stomach, and insulin is released in response to a meal. So when we eat a meal that’s broken down, and it tends to raise our blood sugar. So when that blood sugar response increases, that’s when insulin is released into the bloodstream. Now, when we explain the mechanism, mechanism of insulin, it’s helpful to use a term of just like a lock in a key. So imagine there’s a bunch of little locked doors on the outside of a cell, and insulin is that key to unlock the door to allow glucose into the cell. So when glucose is allowed in, that helps us create energy and helps us live our lives and do our thing. So thinking of insulin in that way, that it’s just simply a hormone that our bodies already make, I think can kind of help break down that barrier a little bit more too in terms of if it is something that ends up being prescribed.

Scott K. Johnson – Yeah, great point. So let’s from there, ask the question, why is insulin prescribed? If our body is already making it, what leads us to then need it as far as a prescription?

Kristen Bourque – Yeah, so Scott, I think, when we talk a little bit about first the differences between type one and type two, and we’ll talk more about this in our conversation. But essentially, insulin is provided as a treatment for diabetes. So with type one, our pancreas is no longer producing insulin. So there are multiple types of insulin that are provided to help essentially regulate the blood sugar right? With type two, generally what happens over time is the pancreas produces less insulin. So maybe additional insulin might be needed along with the use of oral medications to help regulate blood sugar.

Scott K. Johnson – And it’s, there’s actually quite a few misconceptions about insulin right? Can we dive into some of those? So especially, and I think this is one that’s, that I hear most common is the feeling of, of being a failure, right? Or the doctor saying, all right, let’s try with type two diabetes, as you mentioned, let’s try this this and this, and there’s always this phrase that if that doesn’t work, then we’ll start on insulin right, so it can be a hard step for people to take.

Kristen Bourque – And I think that you bring up such a great point Scott ’cause unfortunately sometimes we hear this kind of being almost used as a maybe a scare tactics sometimes for patients as well. If you don’t follow this and that insulin will be put on your regimen. And so I think there is a lot of unfortunately, negative kind of connotation around insulin. But the important thing to remember is with type two diabetes especially is over time. Again, as I mentioned, the pancreas produces less insulin, it can be up to 75%. So even if we’re doing, you know, diet, exercise, oral medications, we still might not get those numbers that we’re striving for. So yes, it’s very important to kind of wash away those ideas of feeling inadequate or like a failure because what we’re doing and those behavior changes may only sometimes bring us so far. So this is important to remember, is to rely on your healthcare team to find a way of providing you with various options for medications and whatnot to kind of find the best thing for you and ultimately, our goal is right to manage our blood sugar. So insulin may be put on the table, as just another option for you and it does nothing to mean that you did anything wrong in your management of your diabetes at all.

Maggie Evans – I think also emphasizing the fact that just like everybody’s body is different, everybody’s diabetes is different. And that your management of diabetes is going to look different than your neighbor with diabetes or someone else with diabetes. So recognizing that your body’s response to somethings just like what Kristen said, might be different than other people, and you just might well, need insulin. And yet again, breaking down the barrier to that and just recognizing that it is simply that hormone that we already produce, and sometimes we just need a little extra help along the way.

Scott K. Johnson – I love that. There’s a one of my good friends. His name is Bennet. And he has a catchphrase that he says that your diabetes may vary. And it really what it comes down to is right, whatever it takes to manage your blood sugars in a way that works for you. And so you’re able to meet your diabetes management goals, and also your quality of life goals. And it’s different for everybody. So I’m so glad that you mentioned that. What are some other misconceptions around insulin?

Maggie Evans – I think there can tend to be a fear of injections or a fear of needles, fairly common for a lot of people with diabetes. But recognizing that now there’s so many different options and the technology in the diabetes world is just advancing. I feel like every day I hear something new. But there’s other ways around giving yourself insulin injections either every day or with every meal. Now we have pumps that are available. So the pump system uses a little smaller needle that tends to just go right under the skin and barely noticeable. But that can be another way to reduce the amount of injections that you’re given throughout the day or throughout the week. And also knowing that the syringes now, the advancement in the needles is much better, they’re much smaller, they’re thinner, so you can barely feel them. So that makes it much less painful. I’ve even had people tell me that their actual insulin injections are much less painful than just their finger pricks for their, for their glucose checks, so, really interesting to hear that. But just knowing that there are other options and now they’re even coming out with an inhalable insulin, which is very effective as well. So if there is that fear of needles or fear of it being painful, reach out to your providers, reach out to your diabetes care team, let them know these concerns. And there’s always going to be options available. So just as long as you let people know what you’re feeling that can help us and your team kind of direct you in the right direction.

Scott K. Johnson – I’m glad you mentioned that, that open conversation. So if my provider has prescribed insulin, but I’m struggling to take that insulin because of the fear of needles, which, by the way, is completely normal, there is nothing normal about poking yourself with sharp objects, so but like you say, maybe talking with your, your team about the challenges that you are facing in doing what they ask of you, that makes a big difference. So what else are we dealing with?

Kristen Bourque – Oh, when I was going to just add to that kind of what you and Scott, Maggie you mentioned is kind of that fear of the unknown. I think too, with that, with the injection piece of it too. So, like you mentioned, Scott is talking to your healthcare team. But also a lot of times especially when initially prescribed that they’ll do a demonstration with you. So that kind of fear of the unknown, maybe having someone kind of walk it through with you, versus just kind of sending you home on your way, also will, I think help kind of minimize that fear over time too. So yeah, the next thing I would say, of course, is the fear of weight gain, we always kind of get this. And this would also be, the case of certain oral medications as well. But I think that insulin and weight gain are oftentimes associated together. But it’s important to remember that some patients will experience this overall, it helps the body to use food more efficiently. But again, this is going back to is everyone’s different, this isn’t going to be a for sure, side effect that happens. But it is again, going back to talking to your health care team about some of these fears or concerns that you have, in regards to I don’t want to gain weight once I go off, go on insulin. So just kind of let your doctor know, but important to still maintain, healthy diet and activity and all those things as well, to help kind of mitigate that as well, too.

Scott K. Johnson – Great, yeah, that makes a lot of sense. So if we, if we were to kind of wrap this question of should I be afraid of insulin? In a summary, few points, what would that look like?

Kristen Bourque – Of course, no. But just to kind of go off of some other reviews that we’ve mentioned, is that, I think, again, it’s very important to talk with your healthcare team about your concerns about your fears about this. They’re there to get, provide support and be there with you through this journey, but let them know kind of what your thoughts are around it, and see if they can kind of help you to feel more comfortable. But and then kind of just going off of what Maggie had mentioned is there’s so many different options for insulin nowadays, too. So this is another conversation to have with your provider is what you feel more comfortable with. Some people like to use a pump. Some people like to use insulin injections. So again, these are great options that we have that we did not have years ago. So you can ask someone that has had diabetes for quite some time, the differences in the technology and the needles and everything. So, you know, it’s great to know that there’s options available as well, so.

Scott K. Johnson – That’s great, that’s great. And I think that, it’s a very, very useful tool in the diabetes management toolbox. And if you’re struggling to meet your goals on the therapies that you’re using now, and the idea of insulin is there, it might be a way that you finally feel successful in doing what you need to do to get your blood sugars where they need to be. So I think it’s a very powerful tool, and not something to be afraid of. So thank you, thank you for breaking that down a bit.

Kristen Bourque – Yeah, and I think it’s like you said, Scott, it’s, and it’s an important thing to remember that it’s, it will get you closer to your goal. And that’s of course, what we want to focus on, is to manage our diabetes to manage it well. So insulin is just one of those other therapy options that’s available to us. And it’s a great option. So something to be again, a little bit less fearful and more open-minded if it comes up in conversation with your doctor.

Scott K. Johnson – Makes sense, great. Thank you. Well, with that, let’s wrap this session up and we’ll be back again soon. All right, I hope that was helpful. Carol, great to hear that this helps with your expectations, should insulin become a thing for you. Today was actually our last live episode of Coaches Corner. We have really enjoyed our time together. And for those of you who are using the mySugr bundle, I encourage you to continue asking great questions to your coach. They are there for you and happy to support you in your journey of living well with diabetes. If you would like to review any of the information in past episodes, we’ve pulled everything together into a single place, and we’ll put the link here for you. With that stay well, have a great weekend, and I hope to see you again sometime soon.


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