Has President Biden Just Canceled Affordable Insulin?

President Biden, a long-time champion of both expanded access to healthcare and affordable prescription drugs, just froze a move made by the Trump administration late in his term aimed at reducing the cost of insulin. This has some advocates fearing that Biden essentially “canceled” affordable insulin in his first week in office. So, what’s going on?

In fact, President Biden did indeed freeze a plan that was promoted by the Trump administration to lower the cost of insulin. But it’s not what you think.

Last week, the Biden administration announced a regulatory freeze pending review on all new regulations and Executive Orders (EOs) signed by President Trump during the final days of his term, including new regulations that had not yet gone into effect. The freeze will last 60 days until the Biden team can review them more thoroughly.

President Trump had signed an EO last year claiming to make insulin more affordable, that would force community health centers, including Federally Qualified Health Centers (FQHCs) to pass along 340B Program federal discounts on insulin to patients who qualify under the program. The rule was finalized in December 2020.

This would have essentially made insulin-free for low-income patients who qualify, instead of between $1-5 dollars per vial that they have traditionally paid at these health centers for their insulin. The rule was supposed to go into effect on January 22 but has now been delayed until March 22nd.

President Trump claimed that the rule change would make insulin more affordable for the 28 million Americans who frequent FQHCs for their health care, but a Health and Human Services statement admitted that “the economic impact is expected to be minimal” because the majority of patients who get insulin from these 340B participating health centers already get discounted insulin. In some cases, patients receive a 30-day supply of insulin for just $7, according to the report published in the Federal Register.

There is some speculation that enacting President Trump’s Executive Order would cause some Federally Qualified Health Centers to go out of business, which would be truly detrimental to the populations they serve during a pandemic, and the Biden administration just wants time to review all EOs and assess their potential consequences before taking further action.

In short, the 60-day regulatory freeze is not causing the price of insulin to increase, and it is not preventing action in the future to make sure that insulin is available and affordable for all Americans who need it. Additionally, there is no evidence that the Executive Order would have actually lowered insulin costs in a substantial way for the majority of people who require the hormone to live.

While President Trump’s Executive Order may have caused a media firestorm last year, it in no way paved the way for more affordable insulin for the 7.4 million Americans who rely on daily insulin injections to live, and President Biden freezing Trump’s EO in no way raises the cost of insulin, either.

Only time will tell what steps will be taken at the federal level to assure more affordable insulin for all Americans who need it to survive. Time is of the essence, and we’re running out of it.

What steps do you think the new Biden administration needs to take to address the rising cost of insulin in the United States? Share your ideas below!

Source: diabetesdaily.com

New Target A1C Recommended for Youth with Type 1 Diabetes

This content originally appeared on diaTribe. Republished with permission.

By Matthew Garza and Lydia Davis

The American Diabetes Association has lowered the A1C target for children to less than 7.0%, aiming to improve long-term health outcomes without increasing hypoglycemic events.

The American Diabetes Association (ADA) recently issued a new recommendation on A1C targets for children: youth with type 1 diabetes should aim for an A1C below 7.0%, rather than the previously recommended target of 7.5%. The ADA also emphasized that although this is a target for the general population of children with type 1 diabetes, it is important that each child’s A1C goal be personalized, taking into account hypoglycemia awareness, baseline A1C, and other health issues.

In 2018, the American Diabetes Association (ADA) reiterated its long-held recommendation that children with type 1 diabetes should aim to have an A1C of less than 7.5%. This target was designed to help prevent severe hypoglycemia (low blood sugar) in children. The ADA has revised that position in light of a recent review paper, which showed that elevated blood glucose levels can lead to significant complications during child development, including abnormal brain development, an increase in heart problems, retinopathy, and neuropathy. The review also showed that newer diabetes therapies and technology have resulted in a lower risk for severe hypoglycemia.

However, for certain groups of at-risk children, this new recommendation may not apply, and it may be safer to target an A1C of 7.5% or higher. Children with low hypoglycemia awareness, those who cannot alert others to symptoms of hypoglycemia, those without access to helpful diabetes technology (such as continuous glucose monitoring), and those who cannot test their blood glucose levels regularly should continue to aim for an A1C of less than 7.5%. Children with a history of severe hypoglycemia should aim for an A1C of less than 8.0%.

In contrast, children who are not at risk for hypoglycemia (for example during the often-experienced “honeymoon” period) should aim for an A1C as low as 6.5%.

The lower A1C goal of 7.0% will hopefully lead to a reduction in diabetes complications during childhood and throughout the lives of people with type 1 diabetes, without increasing their risk of severe hypoglycemia while they are young.

Source: diabetesdaily.com

5-Course Meal for Valentine’s Day

They say that the most romantic meal is the one you cook at home. So for this Valentine’s Day, we put together this 5-course meal for you and your partner. If you stick with one serving from each of these recipes, you’d only consume about 20g of net carbs for the entire meal. And yes, that includes dessert!

broccoli cheese soup

Photo credit: Jo Harding | Brenda Bennett

Soup: Low-Carb Broccoli Cheese

This pureed broccoli with cheddar cheese is hearty, creamy, and delicious even for carnivores. The additional ingredients — celery, carrots, and onion — make this recipe savory, and but if you want to add some protein, you can top it off with bacon strips.

Total carbs: 9g | Net carbs: 6g per serving

stuffed peppers

Photo credit: Sarah Severance

Appetizer: Garlic Cream Cheese & Spinach Roasted Mini Sweet Peppers

There are endless variations on what you can stuff in pepper bowls, but for this recipe, you’ll be using cream cheese and chopped spinach, two ingredients that are both diabetes-friendly. Add spices if you want to get more creative.

Carbs: 1.5g for each pepper half

chickpea salad

Photo credit: Laura Miner

Salad: Greek Chickpea, Avocado, & Cucumber

Apart from chickpeas, all the other ingredients you need for this salad are either household staples or easy to find in grocery stores. Just chop or dice the vegetables, mix them with the Greek vinaigrette, and you’re ready to enjoy some rainbow on your plate.

Total carbs: 7g | Net carbs: 4g

Main Course: Keto Braised Short Ribs & Mashed Cauliflower

short ribs

Photo credit: Lisa Marcaurele

Keto Braised Short Ribs

You can prepare your main course ahead of time using an oven, slow cooker, or instant pot. Each method has its advantages, but whichever method you choose, you can expect the meat to be fall-off-the-bone tender and infused with flavors of red wine, bacon, and herbs.

Total carbs: 4g | Net carbs: 3g

Mashed Cauliflower

Photo credit: Jennifer Shun

Mashed Cauliflower

The vegetable salad may be enough to go with the ribs, but this mashed cauliflower is a perfect alternative (or addition to your meal). It’s fluffy, creamy, and with subtle undertones from its other ingredients. This recipe uses a food processor. The longer you process, the fluffier the texture of this side dish.

Total carbs: 5g | Net carbs: 3g

Crustless Cheesecake

Photo credit: Caroline Levens

Dessert: Crustless Cheesecake

This recipe doesn’t use coconut or almond flour, which is a plus point if you have a tree nut allergy. If it looks too plain for you, you can garnish it with low-carb melted chocolate, crushed cookies, or whipped cream.

Total carbs excluding the topping: 2g

You can also check out these fruity mocktails if you need a drink to go with your meal.

Enjoy your meal, lovebirds, and always remember that the secret ingredient is always love (and fewer carbs).

Source: diabetesdaily.com

Diabetes and Hangovers: What You Need to Know

Anyone who lives with diabetes knows that a hangover can wreak havoc not only on productivity and sense of well-being but also on your blood sugars, leaving them unpredictable for hours and even days. When you’ve had too much to drink and you’re feeling hungover, what can you do?

This article will touch upon the best course of action to take to help your diabetes management when you are hungover, the best food and beverages to help treat a hangover, and how you can prevent a hangover in the future.

What Exactly Is a Hangover?

A hangover, quite simply, is the culmination of unpleasant symptoms that develop several hours after drinking too much alcohol. Common signs of a hangover include:

  • Headache
  • Nausea, vomiting, or stomach pain
  • Light and sound sensitivity
  • Fatigue
  • Thirst
  • Dizziness
  • Poor sleep quality
  • Decreased ability to concentrate

More severe symptoms of a hangover include:

  • Shallow breathing
  • Low body temperature
  • Excessive vomiting (not able to hold down water)
  • Confusion
  • Seizures
  • Blue-tinged skin
  • Loss of consciousness

If someone you know is experiencing severe symptoms of a hangover, seek emergency medical treatment immediately, or call 911.

So You’re Hungover; What Should You Do?

A hangover’s nemesis is time and hydration. Most hangovers disappear within 24 hours, although some can last for days. It can be excruciating, but sometimes you simply must wait it out.

While you’re waiting, the next best thing you can do is hydrate with water (about 15.5 cups, or 3.7 liters, of fluids a day for men and about 11.5 cups, or 2.7 liters, of fluids a day for women), and make sure to get plenty of electrolytes from sources such as coconut water and sports drinks (although make sure to count carbohydrates and dose insulin appropriately, if needed).

The caffeine in coffee can also energize you and can be beneficial for headaches and sleepiness after a night of drinking. Staying adequately hydrated will also make blood sugar management easier.

It is also extremely important to keep a close watch on your blood sugars and watch for any signs or symptoms of developing diabetic ketoacidosis (DKA), which can be life-threatening. Check your blood sugar every few hours or wear a continuous glucose monitor (CGM) to make sure you’re staying in range, as recommended by your doctor.

If you notice your blood sugar remaining stubbornly high (at or above 250 mg/dL) for several hours or more and you have moderate to high ketones, contact your doctor right away and seek medical attention to prevent developing DKA. You may need IV fluids administered at a hospital to hydrate and an intravenous insulin drip, which can bring blood sugars down more aggressively than subcutaneous injections at home.

Some people experience low blood sugars after a night of drinking because the liver is busy processing the alcohol content from drinks consumed, leaving one to fend for themselves because glycogen (glucose) will not be released if one’s blood sugar starts to drop. The more one drinks, the greater the likelihood of low blood sugar, which can be dangerous.

glucose tabs

Tip: Carry glucose tabs when you’re drinking with friends. | Photo credit: iStock

People with diabetes should always carry glucose tabs or gel with them in case of an emergency low and should check their blood sugar regularly both during and after drinking. It’s also important to remember that some diabetes medications may not work as well if too much alcohol is consumed, especially type 2 diabetes medications.

If your blood sugars are staying within range and you don’t feel too nauseous, make sure to eat a good meal, which helps combat hangovers and stabilizes blood sugar. Aim for a balance of carbohydrates, fat, and protein. Some recommended foods include:

  • Bananas
  • Oranges
  • Eggs
  • Avocados
  • Rice
  • Oatmeal
  • Toast
  • Crackers
  • Clear broth soup

Getting plenty of sleep also helps remedy a hangover; alcohol notoriously disturbs sleep patterns, so if you didn’t get a good night’s rest after drinking, taking a nap the next day can help you bounce back quicker.

Some people take over-the-counter pain relievers, such as aspirin or ibuprofen, to manage symptoms. If you’re unsure what to take or are worried about the side effects of any over-the-counter medication, talk with your doctor about what will work best for you.

Finally, even though you may not feel well, getting outside for a quick, 20-minute walk can help revitalize you, get some fresh air into your lungs, and help you feel better faster. While vigorous exercise is not recommended while hungover, some light exercise can boost not only your mental health but will charge the cardiovascular system and speed up recovery.

How to Prevent a Hangover

The surest way to prevent a hangover is by abstaining from alcohol or only drinking in moderation. Some other tactics to help prevent hangovers include:

  • Drink alcohol only with food and never on an empty stomach
  • Drink slowly
  • Make sure you stay hydrated with water while drinking (a good rule of thumb is drinking one glass of water for every alcoholic beverage)
  • Keep a close watch on your blood sugar (sugary alcoholic beverages can make your blood sugars spike, while the alcohol itself can make you crash. Be wary of both consequences and check your blood sugar often).
  • Avoid sugary mixed drinks and sweet wines, which are not only bad for blood sugars but may also make hangovers much worse. Instead, mix liquor with water, seltzer water, or diet drinks.
  • Know your limits, and stick to them
  • Stick with friends or family who will watch (and potentially limit) your alcohol intake
  • Avoid alcohol that contains higher amounts of congeners: congeners give many types of alcoholic beverages their flavor. They are found in larger amounts primarily in dark liquors (like brandy and bourbon) and contribute to worse hangovers. Instead, choose lighter beverages such as vodka, white wine, or gin
  • Eat something (like a banana) and drink water before going to bed after a night of drinking

Hangovers are an unpleasant side-effect of drinking alcohol, and having a hangover with diabetes makes them all the more complicated. But with these strategies, you can help prevent hangovers in the future, while still imbibing from time to time.

If you think you have a problem with drinking or develop signs of alcohol addiction, get help immediately.

Source: diabetesdaily.com

3-Ingredient Hot Chocolate: Mmmm

This content originally appeared on TCOYD: Taking Control of Your Diabetes. Republished with permission.

Did you know that a regular coffee shop hot chocolate can easily have 400 calories, 40 grams of carbs and 40 grams of sugar? Delicious, but yowza! Be your own barista and give this one a try – it’s under 200 calories, has 10 net carbs and only 1g of sugar.

Here’s what we used:

Photo credit: Sarah Severance (TCOYD)

3-ingredient hot chocolate


3-Ingredient Hot Chocolate: Mmmm

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Treat yourself to a simply sweet homemade hot chocolate. Made with real chocolate and coconut whipped cream, it’s like a hug in a mug.
Course Drinks
Cuisine American
Keyword Chocolate
Servings 1 mug
Calories 170kcal


  • 1 cup unsweetened vanilla almond milk
  • 1/3 Lily’s low sugar chocolate bar
  • 2 tbsp coconut whipped cream


  • Heat the almond milk and the chocolate bar in a small saucepan over low heat. Stir occasionally to mix the chocolate as it melts. Do not bring it to a boil, only simmer until melted/warm.
  • Pour into your favorite mug and top with whipped cream. You can also add a shot of espresso or a shot of something stronger.


Net carbs: 10g


Calories: 170kcal | Carbohydrates: 20g | Protein: 3g | Fat: 13g | Fiber: 10g | Sugar: 1g

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.

3-Ingredient Hot Chocolate_ Mmmm Recipe

Source: diabetesdaily.com

My Decision to Get Screened for Type 1 Diabetes

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

By Jorge A. Aguilar

My mom lives with type 1 diabetes. Do you wonder what that is? Well, type 1 diabetes is a life condition in which you have to be careful in what you eat, your exercise, and you have to have good control of your blood sugar levels and make a balance with the insulin you need. This is because your body destroys the cells that make insulin and then stops making it.

When I Was Little

Since I was born my mom taught me how to help her change her insulin pump and refill it, I would pass her the things she needed and we pretended that I was a health professional. I learned quickly how to inject insulin and she also taught me how to help her in an emergency.

I remember one morning I wanted to show her something in a video game, to which she said, “Yes, I’m coming.” That’s completely normal except for the fact that she sounded weird in some way. I called my dad and it turned out that my mom had hypoglycemia and I had to help her. Fortunately, I acted in time and she sure doesn’t even remember.

Type 1 Diabetes Is Interesting and Sometimes Worrisome

I find it interesting that it is normal for people with diabetes to inject insulin and endure pain from time to time. Even vaccines scare me, they scare the hell out of me.

It is sometimes scary to think that she could have hypoglycemia while sleeping and might not wake up. It’s also scary to be extra careful with what you eat and to avoid eating certain types of food if you want to have everything under a perfect balance. It seems that living with type 1 diabetes is a lot of work.

Know My Risks

I know there is some genetic risk. I understand that this means that at some point in my life I could develop type 1 diabetes although I also understand, from what I read and my mother has told me, that this risk is small. I think whatever it is I would like to know if I have that risk or not to be prepared later in my life.

I think that if I knew if I had antibodies that would one day attack the cells in my body that produce insulin, I could be calm but also very prepared because I would let my parents know if I had any symptoms like the ones my mother usually talks about at work: thirst, really wanting to go to the bathroom, feeling very hungry, and feeling very tired, among others.

Know Your Risks

My mom helped me ask Indigo for his opinion. Indigo’s mother also lives with type 1 diabetes and he told us that he would definitely have this test done because “knowing the risk, he could take action.” He told us that getting tested would help him get ready by asking his mother lots of questions. He confessed that he would pay more attention to the things his mom does and says and that it would definitely not cause him stress because he has seen her taking good care of herself and succeeding. He does not consider this as something complicated as he spends a lot of time watching his mother do all this and other stuff in life.

I think that if it were possible for everyone to take the test they should do it because, on the one hand, it does not affect you at all to take a test, on the other you contribute to science and finally, it is a good way to prepare yourself mentally for what comes in your lifetime. If it comes.

You should take a diabetes antibody test because you may learn that you are likely to develop type 1 diabetes and you may learn to take better care of yourself with or without risk.

Source: diabetesdaily.com

The Importance of Sleep Health for Diabetes

Everyone who lives with diabetes knows that the cornerstones of successful management include insulin therapy, strict monitoring of one’s diet, exercise, and managing stress. But another, lesser-known key element to good diabetes management is sleep health.

According to the Centers for Disease Control and Prevention (CDC), nearly 1 in 3 Americans don’t get enough sleep. The National Sleep Foundation recommends that adults between 18 and 60 sleep at least 7 hours every night. Sleeping less than that is associated with an increased risk of developing chronic conditions such as obesity, type 2 diabetes, hypertension, heart disease, and even stroke.

Sleep health is especially important for people with diabetes. This article will outline the reasons why sleep health is so important and how you can improve your sleep health to improve your diabetes management.

Why Is Sleep Important?

Sleep is important for everyone. Sleep plays an important role not only in physical health but in mental health maintenance as well. During sleep, the body heals and repairs cells damaged during the day (like muscles worked and stretched during exercise), and even restores and clears out both heart and blood vessels, reducing inflammation throughout the body.

Sleep brings much-needed balance back to hormone levels, such as cortisol, serotonin, leptin, ghrelin, melatonin, and adrenaline, working to restore mental and emotional health. Restoration of these key hormones helps the body control stress, combat depression, achieve satiety, and manage hunger levels throughout the day.

Most importantly, sleep helps protect immune function. One study monitored the development of the common cold after giving people nasal drops with the virus to a group of people. The researchers discovered that those who sleep fewer than 7 hours for two weeks were nearly 3 times more likely to develop a cold than those in the study who slept 8 or more hours each night for the duration of the study.

Americans Are Not Getting Enough Sleep

This is all great, except Americans are simply not getting enough sleep. City-dwellers are more likely than those living in rural areas to suffer from sleep deprivation, and the CDC shows that the northeastern and Appalachian mountain parts of the country are the most affected. Nearly 11 percent of Americans are only getting 6 or fewer hours of sleep per night!

There are many reasons why people aren’t getting enough sleep: 24/7 technology, ever-increasing workloads, light and noise pollution in cities, the but most stunning reason, from the National Sleep Foundation, is that Americans simply don’t prioritize sleep.

In a survey, when Americans were asked which of five activities were most important to them, just 10% of people said sleep, the lowest by far out of exercise, nutrition, work, and other hobbies.

As a nation we are not getting enough sleep,” said Dr. Wayne Giles, director of CDC’s Division of Population Health. “Lifestyle changes such as going to bed at the same time each night; rising at the same time each morning; and turning off or removing televisions, computers, mobile devices from the bedroom, can help people get the healthy sleep they need.”

People With Diabetes Need to Prioritize Sleep!

Even though sleep is often disrupted because of diabetes due to CGM alarms, insulin pumps beeping, low and high blood sugars, and the 24/7 nature of the disease, sleep is crucial for good diabetes management.

“Getting inadequate amounts of sleep can negatively impact blood sugar levels short and long term,” says Dr. Gregg Faiman, an endocrinologist at University Hospitals Cleveland Medical Center. “In fact, sleep is as essential to your health as nutrition and exercise,” he says.

Not having enough of it can cause insulin resistance and insatiable hunger due to out of balance hormones, fatigue that makes exercising more difficult, and brain fog that makes carbohydrate counting and the self-control to properly manage food and diet harder.

Sleep affects all other elements of diabetes management: when you don’t have enough sleep, you need more insulin (due to insulin resistance from spiked cortisol levels) to control blood sugars, your body is hungrier when your hormonal leptin levels are off balance, which makes eating and balancing carbohydrates more complex, you’re more tired which makes exercise all the more difficult, and your body is naturally stressed out, wreaking havoc on diabetes management.

Plus, if you nap during the day to try and make up for a bad night’s rest, you may not be tired at bedtime, and one sleepless night can lead to two, which can then turn into a chronic problem, which sets the stage for harder to control blood sugars, higher HbA1c, and possibly even complications later on in life.

how to get enough sleep

Photo credit: iStock

Strategies to Improve Sleep Health

Creating good sleep habits can take time, but the following recommendations can help you improve your sleep, which will positively affect not only your diabetes management but your overall health as well:

  • Exercise daily so you are tired at bedtime
  • Avoid all caffeine after 12 p.m.
  • Go to sleep and wake up at the same time every day
  • Do not nap during the day
  • Use the bathroom right before bed, so you don’t wake up in the middle of the night to go
  • Limit fluids before bed
  • Make sure your blood sugar isn’t too high or low at bedtime
  • Turn your thermostat down at bedtime for more peaceful sleep
  • Take a relaxing bath before bed
  • Eat foods that contain natural melatonin at night: cherries, pomegranate, grapes, walnuts, peanuts, or sunflower seeds work well
  • Do some gentle yoga, meditation, or breathing exercises to calm you down before bed
  • Do not allow screens in the bedroom; opt for journaling or reading in bed instead (except, of course, your continuous glucose monitor and insulin pump)
  • Close all curtains and make your room as dark as possible
  • Keep pets outside of the bedroom, and especially off the bed (except diabetes alert dogs, of course).

Managing sleep can be complex and challenging, but making sure to get at least 7 hours of quality sleep per night will make diabetes management easier and better blood sugars more achievable.

Try out these tactics for several weeks, and see if any make a meaningful difference in the amount of quality sleep you’re getting each night, and if it has any positive effects on blood sugar levels the next day.

While an underrated component of diabetes health, sleep is crucial for better blood sugar management, one night at a time. Do you struggle with getting an adequate amount of quality sleep each night? What tactics have helped you improve your sleep health? Share this post and comment below!

Source: diabetesdaily.com

Diabetes is Ruff: Diving into the World of Diabetes Service Dogs

This content originally appeared on diaTribe. Republished with permission.

By Julia Kenney

When you think of tools to help you manage diabetes, you likely think of therapies and devices – but what about dogs? We spoke with Mark Ruefenacht, who trained the first diabetes service dog in the world, to learn how these special animals can support people with diabetes.

There are many reasons to love dogs. Because they are cute, because they are smart, because they are the furry best friends you didn’t know you needed, and they love you unconditionally. But did you know that some dogs can also save your life and help you manage diabetes? Just one more thing to add to the list.

In diabetes, severe cases of high or low blood sugar (hyperglycemia and hypoglycemia, respectively) are dangerous and can lead to serious long and short-term health complications. Diabetes service dogs are trained to help, specifically when the owner’s blood sugar is too low or too high.

There are two kinds of diabetes service dogs, Medical Response Dogs and Diabetic Alert Dogs. Medical Response Dogs are trained to respond to the symptoms of severe low blood sugar such as fatigue, loss of consciousness, and seizure-like behavior to help notify you and others of hypoglycemic events. Medical Response Dogs can also retrieve “low” supplies such as food, drinks, or an emergency kit. Diabetic Alert Dogs, also referred to as DADs, are trained to smell the compounds that are released from someone’s body when blood sugar is high or low. Because of this, Diabetic Alert Dogs are able to alert their owners of dangerous levels of blood sugar before they become symptomatic. A variety of breeds can be trained to be diabetes service dogs, including golden retrievers, Labrador retrievers, mixed-sporting breeds, and poodles.


Image source: diaTribe

Nobody knows more about these dogs than Mark Ruefenacht, founder of Dogs4Diabetics (D4D), one of the leading diabetes service dog training organizations in the world. Ruefenacht  has lived with diabetes for over 30 years and got involved with service dogs for the blind due to his family history of diabetes-related eye disease (retinopathy). After an incident of severe hypoglycemia, Ruefenacht started training Armstrong, the world’s first diabetes service dog, to recognize and respond to the scent of hypoglycemia in his sweat and breath. Through training and testing, Ruefenacht found that there might be a scent associated with hypoglycemia that is common among people with diabetes and could be taught to other dogs. Since then, he has helped train hundreds more dogs with D4D. In our interview, Ruefanacht shared his insights on the benefits of Diabetic Alert Dogs and how to know if they are right for you.

How are Diabetic Alert Dogs trained? Who are they trained for?

Diabetic Alert Dogs are typically trained for people with type 1 diabetes or insulin-dependent type 2 diabetes. This is for two reasons. As Ruefenacht describes, people with type 2 diabetes who are not dependent on insulin typically do not have life-threatening low blood sugars. Because of this, Diabetic Alert Dogs are most helpful for people who are insulin-dependent. Furthermore, under the Americans with Disabilities Act, service dogs can only be given to people with a recognized disability, which could cause barriers to getting a service dog, especially for people with type 2 diabetes who are not insulin dependent. There are additional requirements and limitations for public service dogs under the Americans with Disabilities Act, so diabetes service dog organizations also train dogs in various support skills to help people with diabetes at home (and not in public). Dogs4Diabetics refers to these dogs as “Diabetes Buddy Dogs.” If you are wondering whether you could qualify for a service dog, talk to a service dog organization.

As for the training these dogs receive, the programs typically focus on scent discrimination. This means that the dogs are taught to detect smells in the air associated with blood sugar changes and to ignore smells associated with normal, safe bodily functions. Ruefenacht said, “The big myth is that dogs are smelling blood sugar. But the dogs are actually sensing the compounds that come out of the liver when the blood sugar is either dropping rapidly or is low.” Though humans can’t detect these smells, dogs likely can. Scientists are not sure what exactly the dogs identify, but research suggests that it’s ketones (for high blood sugar) and may be a natural chemical called isoprene (for low blood sugar). Ruefenacht uses low and high blood sugar breath samples to train the dogs; after about six months of intensive training, they can distinguish these scents in people.

Can diabetes service dogs reliably alert their owners to changes in glucose levels? It depends on the dog and it’s training – but research shows that diabetes service dogs can often be effective, and that quality of life and diabetes management tends to improve in owners. According to Kim Denton, who works for Dogs4Diabetics and has had type 1 diabetes with hypoglycemia unawareness for over 40 years, having a Diabetic Alert Dog “changed my life for the better by helping me keep my blood glucose in a much tighter range, which means fewer health complications and I feel much better both physically and mentally.”

How can diabetes service dogs help their owners?


Image source: diaTribe

Denton says that her dog, Troy, “has saved my life so many times by alerting me before my glucose dropped to a life-threatening level, that I can’t keep track anymore. Troy tells me long before my CGM detects a rapid drop or rise in my glucose levels, and he does it without that annoying beeping! If my sugar starts dropping while I am sleeping, Troy jumps on me to wake me up and will continue licking my face if I start to fade off.” In addition to alerting owners to early changes in blood sugar so that they can act to stabilize glucose levels, there are other skills that diabetes service dogs can learn. Here are some examples, though every organization has different training programs:

  • Alert the owner to audio signals from insulin pumps, continuous glucose monitors (CGM), and other devices. This is especially helpful for people with impaired hearing, for children, and for diabetes management while sleeping.
  • Alert people nearby to help the owner in cases of severe blood sugar changes, or retrieve a cell phone.
  • Retrieve medications and other necessary supplies in an emergency.
  • Provide emotional support.

It is important to know that diabetes service dogs are an additive tool to help people manage their diabetes. A service dog should never replace CGM, self-monitoring blood glucose with fingersticks, hypoglycemia prevention methods, or healthy lifestyle efforts; a diabetes service dog can be an additional form of support for people with diabetes.

How do service dogs provide emotional support? Why is this important?

The majority of diabetes service dogs are also trained with emotional support and wellness skills. This means that in addition to helping people manage their blood sugar, these dogs can also help improve their owner’s mental and emotional wellbeing. This is especially important for people with diabetes because of the stress that often comes with long-term management of a chronic condition – learn about diabetes distress and how to reduce it here. People with diabetes are also two to three times more likely to experience symptoms of depression than the general population, according to the CDC.

Ruefenacht is keenly aware of the relationship between diabetes and mental health, and he has worked to address this through his diabetes service dog training programs. Ruefenacht says his clients appreciate the diabetes management component of the service dog training, “but they value the companionship and emotional support more.” Like most other dogs, diabetes service dogs are companions and become part of the owner’s family. Many owners appreciate the stress-relieving experience of walking, playing, or just being with a dog, which can be incredibly helpful for people with diabetes. Denton says “Troy understands not only my need to have normal glucose levels but also my need for comfort and companionship when my diabetes gets me down.” Dogs can also be trained to cater to specific mental health conditions such as depression and anxiety.

Could a diabetes service dog be right for me? 


Image source: diaTribe

Diabetes service dogs are a great option for some people, but not for everyone. There are several ways that people can get support in managing their diabetes, and it is important to think about what works best for you – for example, Diabetic Alert Dogs are trained to sense blood sugar changes in their owners, but for many, this can be accomplished using a CGM. Diabetes service dogs can be a helpful option for people who frequently experience episodes of hypoglycemia, experience hypoglycemia unawareness, need help regulating their blood sugar at night, or need additional support. According to Taylor Johnson, who has type 1 diabetes and a Diabetic Alert Dog named Claire, “Having a service dog is the best decision I’ve ever made regarding my diabetes management. I love gadgets and tech but they are not foolproof, and Claire is the additional piece of mind I need to sleep at night.” Talk with your healthcare professional to assess your need for a diabetes service dog if it is something that you are considering – and remember, a diabetes service dog will not replace the need for careful glucose monitoring and hypoglycemia prevention efforts.

There are a few more important things to think about:

  • Cost: The process of getting and training diabetes service dogs and their owners can be expensive. There are some organizations that provide training services for free or for a reduced cost for those who qualify. Other organizations offer financial assistance or payment plans for those who qualify. For example, as a 501(c)(3) nonprofit that relies on charitable donations, D4D does not charge its clients for the dogs or other program services which significantly reduces the costs of owning a diabetes service dog.
  • Time: Owners also need to put a significant amount of time into training and maintaining the skills of their diabetes service dog outside of the formal training the dogs receive. This includes participation in some of the initial training of the dog, giving the dog time to acclimate to your specific needs as a person with diabetes, and follow-up training throughout the dog’s lifetime.

Want to learn more about diabetes service dogs?

  • Check out some different diabetes service dog organizations to get a sense of the application process, service dog training programs, and service dog community

Source: diabetesdaily.com

5 Ways to Make Time for Exercise

Prioritizing yourself isn’t easy. Whether your busy taking care of kids, an elderly parent, hustling at your job, or just life in general, it is sometimes hard to remember to take of yourself. This means getting adequate sleep, checking your blood sugar regularly, eating a proper diet and getting in physical activity. All of which can also help you better manage your diabetes and overall health. But finding the time is not an easy feat.

Here are 5 ways you can make the time for exercise:

Make an Appointment

Just like you schedule meetings, lunch dates, and family functions, your hour of exercise deserves a daily slot too. Once it is on your schedule, you can plan other commitments accordingly, and prioritize your health.

Meal Prep

Many people spend a great deal of time preparing meals for themselves and their families. This can really eat up a good chunk of your free time. Think ahead and meal prep. You can easily prepare an entire week’s worth of meals in just a few hours, freeing up enough time each day to get yourself moving!

Work Within Your Confinements

Making time is easier said than done. And many people work long hours, two jobs, and have other responsibilities that do not afford a lot of free time. Get creative. There are things you can do, some like calisthenics throughout the day to keep your blood flowing. You can also look to invest in a desk bike or an under the desk elliptical. These gems are a worthy investment if you are unable to find time to go to a gym. It will allow you to work and work out at the same time!

Find a Workout Buddy

Staying accountable is a key to success, so having someone there to push you can only help you to achieve your goals. You would be more likely to take a long stroll at 6 am with some good conversation rather than go at it alone. Reach out to friends and see if they’d be interested, I bet you’d be surprised at the response!

Think Big Picture

We are often thinking of others before ourselves, which shows we care. We mustn’t forget the importance of making our health a priority, so we can be around for our loved ones for a long time to come. If you are bogged down with work or consumed with other things, remember health is wealth, and that must come first!

Putting ourselves first isn’t something we easily do, but it is important for our long-term health. A little bit of physical activity can go a long way in managing your diabetes and your overall health!

Have you found time for exercise despite being too busy? What motivates you on a day-to-day basis?

Source: diabetesdaily.com

Gobble Review: Make Tasty Meals Without the Hassle

As many of us continue to stay at home more than usual, finding new ways to make creative, easy and healthy dinners is a priority for many. Recently, I tried out a meal kit delivery service from Gobble and thought I would share my thoughts as a mom of two living with type 1 diabetes.

I received the products at no charge and all opinions are my own.

Who They Are

Gobble is a meal kit delivery service that aims to make delicious, home-cooked meals fast and easy to prepare. Everything you need is sent out perfectly portioned, and each meal takes about 15 minutes to make. They offer a great variety of dinner menus and incorporate a lot of classic dishes that can please all kinds of palates, including kids’!

Services Offered

You can select from the traditional Gobble box dinner plan that features classic dishes, or opt for the Lean and Clean version, which features “lean proteins, healthy fats, and under 600 calories per serving” while still delivering the “and convenience and flavors of Gobble’s 15-minute dinner kits.”

For each option, you can select to have dinner delivered for either two or four people, either three or four days per week. You can customize your choices, and request accommodations for dairy-, nut-, and gluten-free items. Meals start as low as $11.99 per serving, and you can skip deliveries or cancel your subscription hassle-free.

My Review

I tried out three different meals from Gobble and was impressed with all of them:

Pan-Roasted Chicken with Green Bean Casserole & Mashed Potatoes: This one was a classic and rustic choice. We all enjoyed it, and I just skipped the mashed potatoes, to make life easier for blood sugar management. The green bean casserole was delicious and the skin on the chicken came out super crispy! My husband and four-year-old daughter loved it, too!

Miso-Glazed Salmon with (Soba) Noodles & Snow Peas: I am the fish-eater in the family, so I was thrilled to receive a well-portioned a fresh-looking piece of skin-on Salmon. Again, preparation was easy-to-follow, and quick, and the meal came out great! One caveat: I substituted my own edamame noodles in place of the Soba noodles to keep the carb count down. Delicious!

Citrus Chicken & Broccoli Stir Fry: This meal was an option from the “Lean and Clean” plan, and it was super quick to make! Most of the dinners I eat are basically some protein and non-starchy vegetables, so this was right up my alley. The sauce was a bit sweet, but I used it sparingly and was able to enjoy this filling and delicious meal without a blood sugar spike, which is always a win!


The two big factors that make the Gobble meal kit delivery service a winner in my book are:

  • They do not skimp on the protein!
  • The meals are really quick and easy to make (and most importantly, taste great, of course!)

Do you use a meal kit delivery service? Have you tried Gobble? How has your experience been? Please share your thoughts in the comments; we love hearing from our readers!

Source: diabetesdaily.com

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