Imagine Spotlights: Community Manager Tiana Cooks Talks T1D + Pageantry

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

By Beyond Type 1

Imagine Spotlights is a weekly video series produced as part of ADA’s virtual Imagine Camps for kids and teens. Hosted by Rob Howe, this series features conversations with inspirational individuals affected by diabetes and offers a fun learning experience for campers and their families. Watch the first interview with Tiana Cooks below!



*Partial transcript of the conversation below, edited for content + clarity.

You were a senior in high school when you were diagnosed – did you have the typical symptoms?

That’s a great question, and I always think back to that time since I remember it so clearly, and I think it was at least a month before I started feeling a little sick. I don’t know if any of you have bathroom passes, but at my school, they gave us this sheet. And on this sheet, we had about 15 passes to use the entire school year. And if we didn’t use our passes, we received extra lunchtime. I had saved all of my bathroom passes. I had all 15 passes left. And then I remember in one week, I went through the entire sheet of bathroom passes and I was so mad at myself. I remember telling my teacher, “I have to go to the bathroom,” but I was all out of my bathroom passes. So my teacher said, “Tiana, are you okay?” And I said, “That’s a great question.”

I wasn’t feeling great. I was obviously using the restroom a lot. I was very thirsty. I was losing a lot of weight. And then I went to my track coach and said, “Coach, I’ve lost 10 pounds in the first two weeks of the season, what is going on?” And he said, “Well, you probably just lost it because you’ve been running so much.” And then I remember this is when it really hit me. I thought, why is my vision blurry? I remember waking up one morning and I couldn’t see. And so I pulled out my phone and I typed in my symptoms. The first thing that popped up was type 1 diabetes, and I thought, this is it.

Do you ever try to strike up conversations with others you see wearing a pump or continuous glucose monitor (CGM)?

If I see someone else with diabetes, we’re automatically friends. There was one time I was waiting in this line to order food for 15 minutes, and all of a sudden I saw someone with a Dexcom on and I thought, Am I going to stay in line? Am I going to go talk to them? And I chose to go talk to them. I went over and introduced myself to them because I just feel like it’s so rare. They call it seeing a diabetic in the wild. And it’s so rare to see someone that has their equipment on as well.

Can you speak to stigma and stereotypes in the pageant world? How do you battle people’s assumptions about living with diabetes?

People do often stigmatize people with diabetes. They think that just because we’ve got diabetes, we can’t eat certain things or we can’t participate in certain events and that is totally not true. It is present in pageantry as well, people don’t think that we can do pageants because we have diabetes. People don’t think that we can participate in different athletic events because of diabetes. And I think one thing that I’ve learned after participating in various events, whether that be track or softball or basketball or pageantry, there’s always going to be people that have their own opinions. And sometimes those opinions will not be positive, and that’s okay because we just have to educate others about diabetes.

Before I started competing in pageantry, I also had stigmas about people who competed in pageants. Before I had diabetes, I didn’t know what it was. And so until we continue to educate ourselves and others, it will be hard to be fully aware of what people go through. So the more we advocate and the more we continue to tell people and educate them about diabetes, I think the more that stigma is going to go away. I just want to say this, even if people at school say mean things about you because you have diabetes, you just have to know that you’re special and that you have to have that confidence. You have to be confident regardless of what people are saying about you because you know that you’re enough and regardless of what anybody says, you’re capable of doing anything in this life just as good or even better than anybody else.

What advice do you have for people who want to get involved and give back to others living with diabetes?

I would say, if you want to get involved, do what makes sense for you. Just because Tiana is very vocal about her diabetes and just because Tiana loves to talk to other people about it doesn’t mean that you have to. If getting involved for you just means telling people that you meet the warning signs of diabetes, then do that. It might look like being vocal in your community and not online. There’s this huge misconception that in order to be making an impact, you have to be posting or talking about it, and that’s totally false. You can make an impact in your own way. Maybe you write cards to people at your local hospital. That’s how I started, I volunteered at my local hospital.

There are also support groups going on in the community. And we have an online community, our Beyond Type 1 app, and that community is just a great way to meet other people with type 1. There are just so many ways to get involved and it doesn’t look like competing in a beauty pageant all the time. It doesn’t. Or it doesn’t look like having a platform online. I actually helped set up support groups in my community, and those were super fun. Sometimes there would be five people, and other times there would be 50 people at the support groups. It’s just cool to build that community and that support network.

Source: diabetesdaily.com

Be Prepared: Surviving Natural Disasters with Diabetes

This content originally appeared on diaTribe. Republished with permission.

By: Amber Clour

Amber Clour was born and raised in Norman, Oklahoma. Twenty-one days after her eighth birthday, she was rushed to Children’s Hospital where she spent two weeks learning how to live her new life with type 1 diabetes. In 2015 she co-founded DiabetesDailyGrind.com and the Real Life Diabetes Podcast.

It may not be possible to anticipate every emergency, but for those with diabetes, it’s especially important to prepare for the unexpected. Hear how people with diabetes survived natural disasters, what they learned about planning ahead, and the advice they have for others.

Susan Hoagland, 70, who lives with type 1 diabetes, worked up until the day before Hurricane Katrina hit New Orleans in August 2005. Then like most people in the path of the hurricane, she headed out of town.

“In my mind, I was only heading to Austin [Texas] in anticipation of Katrina for a long weekend and didn’t pack all of my medications and supplies,” she said. Hoagland didn’t have a prepared container of supplies, including medications, food, hypo treatments, glucose monitoring devices packed and ready to go – something she would later regret.

***

Dealing with diabetes management every day takes considerable effort, and even when we’re on our A-game, things can at times get overlooked. It’s important to anticipate what might be needed in the case of a natural disaster, so that the fight or flight response due to an adrenaline rush doesn’t get the better or you and your health.

Growing up in Tornado Alley (Oklahoma) means long ago I developed a game plan for emergencies, so that an impending tornado, and the need to leave my home, would not imperil my diabetes management.

I wanted to reach out to others who have been in this situation, and to Carol Atkinson, an expert at the Diabetes Disaster Response Coalition, to hear more about surviving natural disasters and the tips and tricks they have found helpful. The bottom line is that everyone should be prepared to leave their home in case of an emergency with everything they need to make it through the crisis. Being prepared and having everything ready to grab and go means when a natural disaster strikes, you don’t have to face making layers of decisions, delay your departure, or augment your flight or fight response.

To be prepared, think about all the supplies you will need:

  • Medications: Put a supply of all your medications in separate containers to last a week or longer, and think about how to keep insulin at the right temperature, such as an instant cool pack.
  • Injection supplies: syringes, your insulin pens, extra pump supplies
  • Food, a source of glucose, water to stay hydrated: a supply of glucose tabs works really well, some bottles of water, and some food that doesn’t spoil
  • Monitoring supplies – like my CGM, a backup blood glucose meter and strips, and a way to measure ketones
  • Copies of prescriptions
  • An emergency contact list contact in case of an emergency
  • Cellphone charger
  • Batteries, an ID, and cash

***

The morning before Hurricane Katrina hit the banks of New Orleans, Hoagland was in a panic ­– not a good mindset when it comes to making sure she would have everything she would need to survive the catastrophic storm. As she gathered her things in a hurry, she realized she had nowhere to go. She called her son and daughter-in-law, who called friends until they found a place in Austin where she could stay. Despite the fact that it takes eight hours to drive to Austin from New Orleans, she left unprepared.

“I drove straight for two days because you couldn’t stop; there was nowhere to stay,” she recalled. “The rest areas were packed and I had to keep moving. I was fearful for my life and my animals – we had to make it to Austin. It was a nightmare and I wasn’t prepared. In retrospect, I was in survival mode, fueled by adrenaline and weathering high blood sugars.”

One of the many things we might forget as people living with diabetes is how much of an effect adrenaline and stress can have on our blood sugar. It is in our best interest to take the necessary precautions well in advance to lessen the burden on our health when disaster strikes. That includes having the technology you need to test your blood sugar, the medications you need to manage your glucose or other conditions, and back-up emergency supplies like food, batteries, and water.

I reached out to Atkinson, co-chair of the Diabetes Disaster Response Coalition (of which diaTribe is a member) and director of Insulin for Life USA, to find out what advice she has for how to survive the unexpected. She emphasized the importance of preparedness, especially for people living with a chronic illness.

“Always be prepared by building your preparedness kit well before disaster hits and make it customizable to your needs,” Atkinson said. “Be sure to check your kit every quarter to make sure nothing has expired. Other things to consider when packing your preparedness kit ­– a laminated copy of your prescriptions, photo identification, and cash.”

Atkinson suggests leaving the checklist to the experts so you don’t have to worry about making a list yourself. The Diabetes Disaster Resource Coalition makes it easy by providing a downloadable preparedness plan checklist. And you can find even more resources from the coalition here.

Natural disaster

Image source: Cynthia Celt

In 2016, Cynthia Celt and her husband, Mike, set off on an adventure in Costa Rica. After a four hour van ride in the middle of the night in heavy rain, the road was almost a foot deep with mud, and they found themselves stuck in a landslide.

Rescue trucks soon arrived to extract them from the sea of mud. Before Celt knew what was happening, her bag containing all her diabetes supplies was placed into a truck and took off into the dark hills of the unknown country without her. She rode in the back of another truck back to the now powerless resort safely, but without her bag.

“My phone was dead, so I didn’t have my Dexcom readings,” Celt said. “My meter, chargers, and cables were in the back of another truck, which didn’t matter because I had no electricity to charge them. I had little bits of all my diabetes supplies with me, but not nearly enough to sustain me for the entire trip. I was scared to dose as I couldn’t check and had just a candy or two that remained in my purse to treat possible lows.”

Not having access to your diabetes supplies is scary, but Celt said she learned some valuable lessons from this unfortunate experience, including:

  • Always have a blood glucose meter and plenty of strips. “I had somehow failed to bring a meter,” she said. “Lesson learned 100 times over. I now carry a meter and more strips than I will need with me in my purse, even if only headed out for just a few hours!” Make sure that you have all the diabetes supplies you need to manage high or low blood sugar – including your medications and insulin, emergency glucagon, glucose tablets or small snacks, and a blood ketone meter.
  • Having a cell phone battery charger can come in handy. “What saved me when I did get our bags was a 72-hour backup phone charger,” she said. “It allowed me to finally see my blood glucose digits in real time again!” Make sure you have emergency backup batteries and chargers.
  • Research what services will be available to you in the event of an emergency (hospitals, pharmacies, stores to pick up low supplies, etc.). Though this was not her first diabetes travel fumble, being stuck in the dark in a landslide rattled her enough that she now packs back-up diabetes supplies for her back-ups!
  • Don’t be afraid to cause a “fuss” or make a scene if it means having access to the things you need to stay alive. “I should have held onto my bag and helped them understand my life depends on these supplies,” she said. “I was afraid and embarrassed to make an already challenging situation difficult.”

Atkinson stressed that same point, “When evacuating or during any emergency situation,” she said, “define yourself as an insulin dependent person living with diabetes, if you are one. Speak up for yourself.”

In April 2021, Celt was thrown into yet another natural disaster scenario – one that that she had no way to prepare for.

She and her family were camping with friends in the sand dunes not far from their home in Boise, Idaho. They’re fairly seasoned campers, and this was supposed to be just a quick weekend getaway, nothing extreme as far as adventure goes.

She was cruising along in their kayak with her young daughter Madeline and her friend while her husband was in another boat fishing with the others.

“I began to feel the air change and heard sirens from a nearby air base,” Celt recalled. “I saw picnickers scrambling on the shore and then I looked up. What I saw was something I can hardly detail with words. The largest, most sky covering, thunderous sounding wall of sand was charging towards us. It was picking up trees and boats, tossing around bikes and pieces of campers on the land.”

Natural disaster

Image source: Cynthia Celt

Later they learned the storm had overturned semi-trucks and vehicles along the highway. It was what is known as a Haboob, a desert sandstorm common on the Arabian peninsula.

Thankfully before it hit, they were able to make it to shore. Celt grabbed the two small children and slung the dry bag carrying all her diabetes “gear” over her arm.

When out on the water all of her diabetes supplies are always stashed together in a single dry bag. That makes it easy for her to “grab and go”.

“I ran for the hopeful safety of our SUV perched on a shore ridge,” she said. “We piled in and watched as it thundered toward us.”

After several hours they were able to drive to their camper, only to find it ravaged by the storm. The winds did not let up for three days, and they slept in their SUV overnight. However, this time they were a bit more prepared. Celt said, “We always keep an emergency/hidden stash of low supplies, food, and water in the vehicle when camping.”

This scenario was a stark reminder of how quickly disaster can hit. Celt’s words of advice: “It’s impossible to be prepared at all times when living with diabetes. But having your supplies organized, and easy to access and grab on the way out, is incredibly valuable.”

Natural disaster

Image source: Amber Clour

In a different kind of emergency earlier this year, when the pandemic was raging, I packed my bags and relocated to San Antonio, Texas. My casita was the perfect isolation get away, until disaster struck. An unexpected cold front lingered in areas of central Texas where the people and the infrastructure were not equipped to handle below zero temperatures and power outages.

I lost power for days, but fortunately had a gas stove and access to a wood burning fireplace. I also was able to connect with neighbors, and we pooled our resources.

I didn’t fear freezing to death, but I worried my insulin might freeze. However, in the haze of stress I was feeling, I reminded myself the refrigerator wouldn’t get colder than it already was – and the insulation would keep my insulin from freezing. It wasn’t rocket science, but it was clear that my decision fatigue was in full swing. In a situation like this, when freezing your insulin is of great concern, diaTribe’s scientific and medical advisor Dr. Francine Kaufman suggested that you take out a fresh bottle of the insulin you need (basal, prandial, or both) and keep it either in a pocket or a small pack next to your skin. This way you know that you’ll have insulin that won’t freeze.

Stress, both mental and physical, can make diabetes management a nightmare. Keeping my cell phone charged for my CGM data was crucial. Luckily, my Subaru had plenty of gas, so once a day I would sit in the car parked on the street just outside my casita, crank up the heat and charge my phone.

But just when I thought we could get back to normal, our area was notified the water was not safe to drink. I’ve never been in a situation like this and was thankful to have the gas stove to boil water when needed. Not an ideal situation, but I managed.

This entire situation made me think deeply about what’s important when faced with a natural disaster and what things I can realistically do to prepare in advance. Here’s my checklist:

  • HAVE THE EMERGENCY KIT READY TO GO way before an emergency, with a list of all the supplies already in it and what you need to add before you go – like your insulin
  • If you are going to shelter in place, prepare by stocking up on your diabetes supplies and things like non-perishable food, water, batteries, toilet paper, etc., when your budget allows.
  • STAY CALM. It’s okay to be scared and worried, but having your wits about you will make it easier to focus on the items you need to pack.
  • It’s okay to ask for help whether it be for emotional support or supplies. Don’t be embarrassed to contact friends, family, neighbors, local shelters, food pantries, churches, and patient assistance programs. You can also always go to an urgent care facility or hospital if needed. Don’t hesitate in these situations and do what is best for your health and safety.

After some trial and error, I developed a system that makes chaotic situations easier for me to manage. I try to ask myself in these situations, what will I need to survive for at least the next 30 days? Below is a checklist that helps me stay focused.

  1. First, I inventory my supplies so I know what I have and where it is located.
  2. Then I locate a waterproof tub or bag (purchased well in advance) that I can pack my supplies into.
  3. Finally, I start packing my supplies, including:
    • Insulin in a refrigerated case – this is the very last thing I throw in the tub when I am headed to an emergency shelter
    • Syringes for my medication
    • A copy of all my prescriptions
    • Blood glucose meter and plenty of test strips
    • Any CGM supplies I might need including sensors, applicators, and my phone
    • Insulin pump supplies
    • Low blood sugar snacks and glucose tablets
    • Other medications I might need (such as an inhaler, blood pressure pills, glucagon pen, etc.)
    • My driver’s license, passport, cash, and credit cards
    • My diabetes bracelet or disability jewelry
    • Emergency supplies like a flashlight

No one wants to prepare for a natural disaster, but if you take the time now to make sure you have everything you need, you won’t throw your diabetes under the bus when catastrophe strikes.

Below are a few helpful sites to make your natural disaster preparation easy:

And check out some other articles you might want to visit for tips and tricks:

About Amber

Amber Clour was born and raised in Norman, Oklahoma. Twenty-one days after her eighth birthday, she was rushed to Children’s Hospital where she spent two weeks learning how to live her new life with type 1 diabetes.

Since then, her life has been filled pursuing her passion for art, advocacy, non-profit ventures and travel. In 2015 she stepped down as Executive Director for a community artspace and gallery she founded to co-found DiabetesDailyGrind.com and the Real Life Diabetes Podcast. Amber’s – no filter – approach to sharing an honest look into her daily life resonates with many in the diabetes community. She hopes her story and those of podcast guests remind ALL people living diabetes – you are NOT alone.

Source: diabetesdaily.com

Insulin at 100, Part 2: Failed Promises, Bold Breakthroughs

This content originally appeared on diaTribe. Republished with permission.

By James S. Hirsch

Insulin

Image source: diaTribe

The discovery of insulin in 1921 was heralded as the cure for diabetes. The reality was different.

Insulin, to be sure, could temporarily lower blood sugars to near-normal ranges, but it could also cause hypoglycemia – blood sugars that are too low – that could lead to shakiness and confusion or, in extreme cases, seizures, loss of consciousness, or death. Insulin was a daily, self-administered drug, but if used incorrectly, it could kill a patient just as well as it could save a patient. No self-administered therapy, before or since, has quite those same attributes.

What’s more, insulin’s therapeutic powers were overestimated. Yes, insulin lowered blood sugars, but maintaining near-normal levels was still very difficult – and elevated blood glucose over time was still dangerous. As a result, by the middle of the 1930s, patients who were taking insulin began developing serious complications caused by elevated glucose levels, including damage to the eyes, kidneys, nerves, and heart. Insulin hadn’t cured anything but had turned diabetes from a deadly condition into a chronic condition, and a perilous one at that. At the dawn of the insulin age and for many decades thereafter, even those who understood the importance of maintaining near-normal blood sugars did not have the tools to do so. Blood sugar levels were measured by proxy through urine tests, in which samples had to be boiled for three minutes. Simpler methods were developed by the 1940s, but home glucose monitoring was not available until the late 1970s.

Until then, patients – unaware of their blood sugar levels – gave themselves insulin doses flying blind.

But few people outside the diabetes world knew about the daily rigors and risks of the disease – not only because it affected a relatively small percentage of people but also because the insulin narrative was too powerful.

Diabetes, after all, had been cured or at least resolved. That’s what all the pictures showed. That’s what the headlines blared. And that’s what the ads promoted.

Eli Lilly’s ads, for example, initially touted insulin as “An Epoch in the History of Medicine” and later featured a beautiful bride on her wedding day, kissing her beaming father, with the tagline, “Our favorite picture of insulin.”

Even that picture paled in comparison to the astonishing newspaper and magazine stories about insulin, and not just those about Elizabeth Evans Hughes. Insulin was a redemptive tale about science and survival.

Eva and Victor Saxl were Czech immigrants who fled to Shanghai during World War II. There, Eva was diagnosed with diabetes, and when her insulin supplies ran short, Victor, a textile engineer, found a book that described how to make insulin and, using the animal organs from a nearby slaughterhouse, brewed up enough insulin for his wife to survive. After the war, they immigrated to the United States, and when their story was discovered, they soon found themselves on numerous radio and television shows, including Edward R. Murrow’s, and a movie was also produced – about a husband’s devotion to his wife, expressed through the salvation of insulin.

Other life-saving medical breakthroughs occurred – antibiotics in the 1940s, the polio vaccine in the 1950s – and these would treat more people than insulin. But the unique circumstances of insulin’s discovery, with the young, untested scientists finding the potion that would bring children back from the brink of death, was too dramatic to ignore. In 1988, that story was the subject of a television movie on Masterpiece Theater called “Glory Enough for All,” based on Michael Bliss’s definitive book, “The Discovery of Insulin.”

I watched the movie on PBS when it was released, and it featured the brawling Toronto researchers – Banting and Collip literally came to blows over control of the experiments. But ultimately, the movie was about the triumph of medical science in saving dying children, and among the researchers, there was “glory enough for all.”

And then the movie ended.

There was nothing about living with diabetes – about the wildly fluctuating blood sugars, about the relentless demands, about the injections and the doctor visits and the complications, about the dietary restrictions, about the stigma and the isolation and the limitations of insulin.

“Glory Enough for All” was introduced by Alistair Cooke. An American-born Brit with a silver tongue, Cooke was enthralled not only by insulin’s inspirational story but also by the phrase “islets of Langerhans,” used to describe the island of pancreatic cells discovered by Paul Langerhans. “Islets of Langerhans” just rolled off Alistair Cooke’s tongue. To him, insulin was not just a miracle. It was poetry.

The lyrical beauty of insulin was lost on patients. Many of them, in fact, were frustrated that their own stories weren’t being heard. The parents of young patients were frustrated as well.

In 1970, a professional singer in Philadelphia, Lee Ducat, had a 10-year-old boy with type 1 diabetes, and she was miffed by the breezy disregard of his doctor, who told her that “insulin was the cure.” Ducat knew that wasn’t true, so with several other parents, she formed the first chapter of the Juvenile Diabetes Foundation (which is now the JDRF). Other parents soon opened chapters in New York, Washington, New Jersey, and Miami, and their mission was to educate the public about the stark challenges of diabetes in hopes of raising money and finding a cure.

They had no use for the American Diabetes Association, which was founded in 1940 and for many years was little more than a social club and referral service for physicians. As far as the parents were concerned, the ADA was complicit in perpetuating the jaunty insulin narrative that had hurt the cause for decades. Unless the truth about diabetes was known, how could lawmakers, regulators, philanthropists, and journalists – not to mention clinicians – do what had to be done to improve the lives of people with diabetes?

That question was driven home when the JDF chapter in Miami bought a full-page newspaper ad in 1972 to publicize its cause. The ad featured a little boy in a crib holding a glass syringe, and it described the many complications that could arise from diabetes, including blindness and amputations. The headline read, “The Quiet Killer.”

On the day the ad appeared, Marge Kleiman, whose son has type 1, was working in the JDF office, and the phone rang.

“I’m Charles Best,” the caller said, “and I discovered insulin.”

Now retired, Best had become an icon who, after Fred Banting died in 1941, carried the mantle for the Nobel-winning team that had discovered insulin. Best had been praised by the pope, the queen of England, and other heads of state, and he had given the keynote address at the ADA’s first meeting and later served as its president. He happened to be in Miami on the day the JDF ad appeared, and he was outraged.

“What kind of propaganda are you using?” he screamed. “You’re frightening people! This is not the way it is!”

Kleiman knew better. “Dr. Best, what you did was wonderful,” she said. “It allowed people to live longer. But we’re not trying to frighten people. If you tell the truth, maybe they can avoid these complications. Please don’t tell us to keep quiet.”

The JDRF, now a massive international organization focused primarily on type 1,  has continued to tell the truth about diabetes – and fund research – ever since, but changing the insulin narrative was not going to be easy.

Patients could at least take solace that the insulins kept getting better. The first extended-action insulins were introduced in 1936 and continued with widely used NPH insulin (1946) and the Lente insulins (1951). But the real improvement came in the 1970s, spurred by concerns about actual insulin supply. Meat consumption was declining, and slaughterhouses were cutting production, while the number of people with diabetes had been rising steadily (in 1976, there were about 5 million Americans with the disease). At some point, insulin demand could outstrip the animal-based supply.

As described in the book Invisible Frontiers: The Race to Synthesize a Human Gene, by Stephen S. Hall and James D. Watson, the specter of an insulin shortage triggered a race to develop genetically engineered insulin using recombinant DNA technology. Investigators succeeded by inserting the insulin gene into bacteria, which produced insulin that was chemically identical to its naturally produced counterpart.

The first human insulins, Humulin (made by Eli Lilly) and Novolin (made by Novo Nordisk), were introduced in the 1980s. Whether they were superior to animal-based insulins is a matter of debate, but they alleviated fears about an impending global insulin shortage.

Moreover, researchers soon discovered that changing the order of two amino acids in the human insulin molecule created a faster-acting formulation, and that led to the introduction of Humalog (1996) and Novolog (1999). Known as “insulin analogs” because they are more analogous to the body’s natural release of insulin, they were considered clear advancements. Another huge leap came with long-lasting basal insulin analogs, specifically Lantus (by Sanofi in 2000) and Levemir (by Novo Nordisk in 2005). These insulins keep blood sugar levels consistent during periods of fasting and, typically taken once a day, replicate the insulin release of a healthy pancreas. They were immensely popular and also used by many type 2 patients – Lantus was a $5 billion a year drug by 2011.

The improved insulins changed how patients cared for themselves, as the new formulations led to “basal-bolus” therapy – a 24-hour insulin complemented by a mealtime insulin – and that became the standard of care for type 1 diabetes. (Insulin pumps use the same basal-bolus framework.)

A new era of diabetes care, thanks to these insulin breakthroughs, appeared to beckon.

Stay tuned for part three of this riveting story next week!

I want to acknowledge the following people who helped me with this article: Dr. Mark Atkinson, Dr. David Harlan, Dr. Irl Hirsch, Dr. David Nathan, Dr. Jay Skyler, and Dr. Bernard Zinman. Some material in this article came from my book, “Cheating Destiny: Living with Diabetes.”

About James

James S. Hirsch, a former reporter for The New York Times and The Wall Street Journal, is a best-selling author who has written 10 nonfiction books. They include biographies of Willie Mays and Rubin “Hurricane” Carter; an investigation into the Tulsa race riot of 1921; and an examination of our diabetes epidemic. Hirsch has an undergraduate degree from the University of Missouri School of Journalism and a graduate degree from the LBJ School of Public Policy at the University of Texas. He lives in the Boston area with his wife, Sheryl, and they have two children, Amanda and Garrett. Jim has worked as a senior editor and columnist for diaTribe since 2006.

Source: diabetesdaily.com

Mommy Beeps: Parenting with Type 1 Diabetes

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

By Kim Baillieul

A few years ago, I sat at a park while my then two-year-old son played on the playground. A wave of dizziness fell over me right as I felt my continuous glucose monitor (CGM) start beeping. One, two, three – three beeps, confirming the low blood sugar I suspected.

Instinctively, I reached into my purse and grabbed the juice box floating among the loose change and used test strips. Of course, my son’s innate ability to sense whenever I have a sweet treat also kicked in, and next thing I saw were his big, blue eyes fixated on my hand.

“Mommy, can I have your juice box?”

Sure, my sugar had dropped in front of my son before, but this was the first time I had no distraction for him – no alternative snack, no books to read. Most importantly, it was the first time he asked me to share. I shook my head and told him no, but he persisted.

“Mommy, pretty please, can I have your juice box?”

My mind went blank.

How do you explain to a toddler that your juice box is literally keeping you alive?

What I Was Told

For years – even when I was still a child myself – I was cautioned about pregnancy. At 16 years old, my endocrinologist painted daunting pictures of a hypothetical future high-risk pregnancy: weekly doctor’s visits, insanely tight control, constant monitoring. A massive list of things that could go wrong. All of this became my reality over a decade later when I became pregnant with my son.

My high-risk pregnancy with him had overall, gone well, partially thanks to the hard work I put in to maintain a 5.1% average A1C, and partially thanks to luck. I was prepared for the extra scans. I was prepared for the drastic insulin changes. I was prepared for the constant vigilance. I was prepared for what could go wrong.

However, nothing prepared me for how to explain my type 1 diabetes (T1D) to my child. Or why suddenly, at this moment, I couldn’t share a simple juice box. Frankly, I was so dizzy, I couldn’t even get up off the bench.

“I’m sorry sweetheart, I can’t share. This juice box is mommy’s medicine.”

Later, after my sugars were stable, I thought about how to talk to my child about my chronic illness and the scope of what he needed to know. I wanted to achieve a balance – somewhere between knowing enough to be empowered but not so much that he’d become anxious; enough for him to understand what I was doing, but not enough for him to feel responsible for it himself.

All my life I had worked to overcome and ‘beat’ my diabetes, to not let it stop me, you know, upholding the usual mantras of strength. However, as I pondered how to talk to my kids about my type 1, I had to set that all aside. Pride had no place here.

The conversation remained informal, but honest.

Understand that mama’s body doesn’t work the way most other people’s do… I’m not sick, but it can make me feel sick sometimes… This is my insulin pump… This lancet is sharp, please don’t ever touch it.

He had a lot of questions.

Yes, Mommy beeps!… No, you won’t get it when I cough… Yes, even if I forget to cover my mouth… Yes, I can eat most anything as long as I’m careful… Yes, even ketchup… Yes, even ice cream… Yes, even ketchup ice cream – wait, that’s gross!

We both erupted in giggles.

A Universal Struggle

One of the beautiful things about the type 1 community is knowing you’re not alone. As I reflected on this intentional conversation, one of the first ‘growing up’ discussions I had with my son, I realized I’m not likely alone in facing this. Turns out, I wasn’t – the parents with type 1 community was peppered with struggling T1D parents facing the same hurdle. When I looked for resources, I didn’t find anything quite suitable for a type 1 parent.

Throughout my son’s toddlerhood, I captured my efforts in a children’s book I wrote called “Mommy Beeps: A book for children who love a type 1 diabetic.” It was a passion project of mine to provide a resource that didn’t otherwise exist, and hopefully help another family lessen the mental gymnastics of explaining type 1 diabetes to a child who doesn’t have it themselves. Every page is personal – down to the angry T1D on the phone dealing with a denied insurance claim. Because that is reality. Diabetes isn’t just about the finger pricks and injections – the medical and insurance logistics can be just as heavy. Extra doctor’s appointments, tracking of supplies, prescription refills – it all took time away from playing with blocks, giggling on the floor, or reading “Goodnight Moon” for the third time on a given evening.

As for my son, he took to my carefully crafted conversation well – and all of the impromptu ones that followed. Once, after a particularly harrowing high sugar, we planned a library visit to check out some books about the body, so he could find the “piece of Mama that doesn’t work.” We never made it to that page, though, because he was too fascinated by more amusing parts of the body (the toilet humor sure does start young).

A few years later, I braved the high-risk pregnancy world again and came out with a second little boy. The first time my type 1 diabetes interrupted our playing with trains, I talked to him, too. He shrugged it off and kept the train on its way to the station.

Later that night, he leaned into me. Pointing to my stomach, he exclaimed, “Mama’s Dexcom! I kiss it.” Clearly, something stuck in our conversation earlier that day. And I will take any win I can get.

They won’t know any other way, this will be their normal. And really, that’s a beautiful thing, because the T1D community is now just a little bigger.

Find out more about “Mommy Beeps” here.

Source: diabetesdaily.com

Dating with Diabetes

This content originally appeared on diaTribe. Republished with permission.

By Cheryl Alkon

Dating can feel daunting when you live with diabetes. Hear about dating from others with diabetes, and learn what you can do to prepare for dates.

My now-husband David and I met at a friend’s birthday party where there was bowling and a lot of birthday cake.

Knowing I had diabetes, he was surprised by how much cake I ate at the party. I love cake, so I had calculated the carbs and increased my insulin pump dosing accordingly. That night, Dave couldn’t understand how a person with diabetes could be okay eating a lot of cake.

Couple

Image source: diaTribe

He has since learned.

The next day we talked more about what diabetes is, how food and insulin dosing intertwine, and how ongoing diabetes management requires both a daily and a long-term focus. Later on, when things got more serious, Dave asked for, and I found him, a book that covered more detail: Eve Gehling’s The Family & Friends’ Guide to Diabetes. While the book is now outdated and doesn’t cover some current medications and technologies, the focus on support is universal.

Dating with diabetes, like any dating, relies on honest communication. Supportive actions – such as keeping glucagon or sources of sugar readily available, or sympathizing with you, rather than dismissing you, when you vent about a frustrating aspect of living with diabetes – can go a long way. Whether a person with diabetes is just beginning to date, has been at it for a while, or is returning to dating after a hiatus – no matter if they are looking for a serious relationship or not – a thoughtful approach can reduce the challenges of dating with diabetes.

To Tell or Not to Tell

It’s up to you to decide when to tell someone that you have diabetes. You might feel you want to keep it quiet on a first or second date, especially if you don’t know if you’ll see that person again. Or, you may decide to be more open about diabetes from the start – especially before something like an insulin dose or treating low or high glucose levels needs to happen during the date.

It’s important to be comfortable with your diabetes yourself first, because it can be hard to open up and share it with someone else,” said Lexi Rosendahl, 21, who attends nursing school in Green Bay, Wisconsin. Rosendahl, who was diagnosed with type 1 diabetes at age 11, started dating Jordan Paulsen, 24, in October 2020, after meeting him on a dating app. She said she was nervous about disclosing her diabetes.

Couple

Image source: diaTribe

“I was super up front about it, though some people said, ‘Don’t say anything right away,’ but I thought, ‘This is a part of me,’” she said. “If you are talking to someone, and they aren’t accepting or they make you feel bad, drop them. Don’t settle. Someone out there will love you for who you are.” This advice applies to anyone, with or without diabetes.

Rosendahl said Paulsen asked many questions on their first date, when they got ice cream.

“He said, ‘I want to know about this as much as possible,’” she said. “As a nursing student, I do a lot of educating, and I made a little chart he keeps on his fridge about what I look like if I am low. He is also good about throwing a bag of fruit snacks in his pocket in case I go low. I am pretty self-sufficient, but it’s nice to have someone who gets it. It’s really cool; I like to be independent but he is supportive but not smothering me.”

At the same time, many advise not overwhelming a new relationship with too many diabetes details. It’s a balance that can be tricky to strike.

“You don’t have to give a full dissertation on diabetes during your first date,” notes Stephanie Watson in an article for Healthline.com. Also, she writes, “be open about your condition but don’t dwell on it. Try to keep the conversation light. You don’t want to worry your date by talking about [long-term complications], especially if you’ve just met.”

Anyone who would be frightened away or otherwise dismissive of someone’s diabetes doesn’t deserve a moment of your time. If nothing else, someone who has a problem with your diabetes, cites inaccuracies or myths about it and isn’t open to learning why those myths are wrong, is sending indications that spending time with them will likely be more of a burden than bliss. Learning this makes it easier to move on to someone who will be so much better for you.

Ultimately, you already deal with the day-to-day aspects of diabetes. You want to be with someone who supports and promotes you during that journey – not someone who will make it harder.

Dating Logistics

Whether you’re having a date over a meal, an activity like hiking, or something low-key like watching a movie, plan ahead so you have what you need to keep your focus on the date, not on your diabetes.

Like anything else with diabetes, preparation is key.

  • If you are eating at a restaurant, look at the menu ahead of time to figure out what would be a good choice and what the carbohydrate count would be for that meal.
  • If you are drinking alcohol, know how alcohol affects your blood glucose numbers before the date. Sweet drinks will cause increases, while less-sweet drinks can cause your blood sugar to drop, especially if you aren’t eating at the same time.
  • If you take insulin, ensure you have a source of fast-acting carbohydrates on you (in a purse or pocket) so you can treat a low blood sugar early on, rather than needing to rush to find something to treat in the middle of your date.
  • If you’re planning an activity for the date, adjust your insulin if necessary to avoid low blood sugar, and eat a snack either ahead of time or carry one on the date to manage your glucose numbers.
  • If you use a glucose meter, take it with you and make sure you have enough strips, working batteries, and anything else you need to make it work correctly. If you use a continuous glucose monitor (CGM), make sure the sensor is functioning properly.
  • If you wear an insulin pump make sure it is working properly before the date; fill the pump ahead of time if it’s almost time for a site change or the insulin is running low.
  • If you use syringes or insulin pens, make sure you have them handy so you can take your medication easily before a meal or in case the date is going well and continues longer than you anticipated.
  • If you wear an insulin pump and it malfunctions, carrying a syringe and a vial of fast-acting insulin in a glucose meter kit can help you have access to your insulin immediately, instead of needing to end the date.

Finding out a partner is flexible when things happen can be reassuring, said Rosendahl. “We were ice skating when my Dexcom CGM failed,” she said. “We had to run back home so I could change the sensor out, and Jordan said, ‘No judgment, whatever you need,’ It was a nice sign of unconditional love.”

Being diagnosed with type 2 diabetes helped Liz Cambron identify some of the things she valued both in life and in a partner. Cambron, 29, who has a PhD in cellular and molecular biology and manages a research lab in State College, Pennsylvania, described herself as “a partier and drinker who ate a lot of fast food” before she was diagnosed with type 2 diabetes seven years ago. After her diagnosis, she changed her eating patterns, drank far less alcohol, and began working out each day. She now runs in half marathons, lifts weights, and is a partner in an on-demand online exercise program.

“It helped me re-evaluate my priorities and what type of life I wanted to live,” she said. “If I was dating a person who ate a lot of junk food or was a heavy partier, if I took the drinking or the partying away, the relationship didn’t last long and there wasn’t a lot there.”

Couple

Image source: diaTribe

She met her fiancé, James Kopco, four years ago when both attended a group counseling program for graduate students at North Dakota State University. “I would vent about frustrations about having to deal with low blood sugar events in the lab,” she said. As they began dating, they would keep each other accountable by eating healthy meals and exercising together. “Voice what your needs are,” she said. She offered other advice:

  • “Many first dates are going out for a meal or a drink, and if you say you can’t, the person will expect an explanation. There is stigma around type 2 diabetes – that people are overweight – and it can be a challenging first impression. But diabetes is not something to be embarrassed by. You are not a stereotype and don’t be embarrassed to have open communication.”
  • “Be open with your healthcare team about your medications and any side effects. A lot of medications can affect your libido and that can affect your relationship. If that is putting stress on your relationship, don’t feel like you’re stuck on that medication.”

Dating Another with Diabetes

Some people go looking to date another person with diabetes and some just find each other. Shanna Walker, 42, is a recruiter at her local fire department in Spotsylvania, Pennsylvania. She dated someone for about a year; they met through an online dating site and lived about 40 minutes from each other.

“As we were talking, I mentioned I was a diabetic, and he was like, ‘Me too!’” Walker has lived with type 1 diabetes since age 16, while her boyfriend was diagnosed with type 1.5 diabetes (also known as LADA) at age 35, six years ago. “It was very convenient, to be honest. We both had a Dexcom continuous glucose monitor, and we gave each other supplies. We know about highs and lows, so it was nice not to have someone freak out when an alarm went off. We would kid and show each other our numbers to see whose were ‘better.’”

There’s at least one Facebook group devoted to single people with type 1 diabetes: T1der. Launched in 2019, the group exists for people to “Meet other single type 1 diabetics, complain about the struggles of dating as a type 1, post memes and more.”

Couple

Image source: diaTribe

The group was started by Nathan Elmen, 24, who met his girlfriend, Heather Chambers, soon after the group began when she commented on his photo in a group post. Besides diabetes, they share career goals: Elmen is a registered nurse and Chambers is enrolled in the nursing program that he graduated from. The couple lives together in West Melbourne, Florida.

Regardless of diabetes, dating should evolve naturally, Elmen says.

“My advice is to not force yourself into a relationship,” he said. “It can be like winning the Lotto sometimes, and you really just need to bump into the right person – that was how Heather and I met.”

Ultimately, diabetes is just one aspect about you, and when looking for a new relationship, it’s important to focus on all your positive traits. “Just be yourself,” said Walker. “Diabetes doesn’t define you.”

About Cheryl

Cheryl Alkon is a seasoned writer and the author of the book Balancing Pregnancy With Pre-Existing Diabetes: Healthy Mom, Healthy Baby. The book has been called “Hands down, the best book on type 1 diabetes and pregnancy, covering all the major issues that women with type 1 face. It provides excellent tips and secrets for achieving the best management” by Gary Scheiner, the author of Think Like A Pancreas. Since 2010, the book has helped countless women around the world conceive, grow and deliver healthy babies while also dealing with diabetes.

Cheryl covers diabetes and other health and medical topics for various print and online clients. She lives in Massachusetts with her family and holds an undergraduate degree from Brandeis University and a graduate degree from the Columbia University Graduate School of Journalism.

She has lived with type 1 diabetes for more than four decades, since being diagnosed in 1977 at age seven.

Source: diabetesdaily.com

What You Need to Know If You’re Diagnosed with Type 1 Diabetes

This content originally appeared on diaTribe. Republished with permission.

By Dr. Francine Kaufman

If you or your child was recently diagnosed with type 1 diabetes, you probably have many questions about how to manage this new condition. Dr. Fran Kaufman explains glucose levels and glucose targets, types of insulin and insulin doses, the honeymoon phase, and more

Were you recently told that you have, or your child has, type 1 diabetes? If so, you were likely filled with emotions, concerns, doubts, and questions. You were probably informed that there are many concepts you have to learn and many tasks you need to master. Hopefully, you were signed up for diabetes education sessions taught by certified diabetes care and education specialists (CDCES). You may have felt like you were on shaky ground; and despite all this, you knew that the sooner you learned how to manage diabetes, the better you would feel. Attitude matters, and the best attitude to have is a positive one – so hopefully you’re learning the tasks to successfully manage your diabetes.

Diabetes is a life-long condition. It is a marathon, not a sprint; no one day, one glucose level, or one meal makes a difference in the long run. One of the main goals of diabetes management is to balance insulin doses, food, and activity to keep your blood sugar or glucose levels in the desired or target range, as much of the time as possible. To do that, first you must know what the glucose targets are and how glucose levels are measured.  You must also understand what types of insulin are available and how they are combined for your insulin regimen. Finally, don’t forget to focus on your feelings, find support, and look to the future.

Click to jump down to a section:

  1. What are the glucose targets at diagnosis and how do they change over time?

Often when someone is first diagnosed, they are advised to keep their glucose levels between 100-200 mg/dL, to avoid hypoglycemia (low glucose) while they learn how to manage their diabetes. But after a few weeks or so, it may be time to bring glucose into the target range of 70-180 mg/dL, with pre-meal glucose between 70-130 mg/dL and post-meal glucose below 180 mg/dl. Before bed, healthcare professionals often recommend a glucose level above 100 mg/dL to help prevent hypoglycemia.

  1. How are glucose levels measured?

It is crucial that everyone diagnosed with type 1 diabetes learns how to perform fingerstick blood glucose measurements (referred to as BGs, fingersticks, self-monitoring of blood glucose, or SMBGs) and how to use a blood glucose meter (BGM).  When you are first diagnosed, blood glucose tests should preferably be done before each meal, 2-3 hours after each meal, before bed, in the middle of the night, before and after exercise, and before driving.  Here are a few tips for testing your blood glucose:

  • Before testing: Remember to follow the directions on your BGM. Be sure to set the date and time on your meter, have working and backup batteries, and keep all testing supplies away from extreme temperatures.
  • During testing: Make sure your hands are clean and dry. Put a new lancet in the lancing device and put the test strip in the meter. Poke the side (not the middle) of your finger with the lancing device so you maintain more feeling in your finger. Touch the blood droplet to the test strip allowing the BGM to read the glucose value.
  • After testing: Always throw away the lancet into a labeled “sharps container.” Write down the reading to keep a record of your blood sugar trends or review the stored data in the machine or on your computer; this will help you and your healthcare team recognize glucose patterns to more effectively manage your diabetes.

Continuous glucose monitoring devices (CGMs) are a more recent and convenient way to track glucose levels. A sensor that measures glucose (either through the same enzymatic reaction used by the BGM or through a fluorescent technique) is placed in the fatty tissue under the skin in the same place you give insulin shots, or where the insulin pump catheter is placed. Depending on which CGM is used, the sensor lasts either 7 days, 10 days, 14 days, or 90 days. These sensors measure glucose every five minutes and transmit the real-time glucose readings, a trend graph, and alerts to a smartphone or monitoring device. The data is stored in the monitoring device or in the data cloud so that you and your healthcare team can analyze it (if you give your healthcare professional permission to access it). CGM data can also be sent in real time to one or more care partners’ smartphones so they can help with your diabetes management. CGM is a powerful tool that many believe everyone with diabetes should be able to use, including those who are newly diagnosed; however, this technology is still not widely accessible or affordable.

The goal for using any of these devices is to assess the glucose value, and if it is not in your target range, to consider taking some action. If the glucose value is high, it might mean you should take a correction dose of insulin. If the glucose value is low, take oral glucose to bring it back up to the desired range (above 70 mg/dL). Ultimately, you’ll aim to have as many of the glucose measurements in the range of 70-180 mg/dL as possible.  With a CGM – which gets up to 288 glucose measurements a day – the goal is to have 70% of glucose levels in the target range of 70-180 mg/dL (referred to as Time in Range, or TIR). Seventy percent of glucose values is equal to about 16 or 17 hours per day spent in range.

  1. What are the types of insulins and insulin regimens?

It is essential that people with type 1 diabetes take insulin. The insulin can be taken by injection with a pen or syringe, through an insulin pump, or through inhalation. For people with type 1 diabetes, insulin is usually taken multiple times a day. There are many different types of insulin and many different ways to take insulin. Similar to how insulin would work in the body if diabetes wasn’t present, a common way to take insulin is called “basal-bolus insulin.” Basal (long-acting) insulin is considered a “background insulin,” as it is designed for 1-2 daily injections, and it helps the body balance glucose between meals and overnight. Bolus (rapid-acting) insulin acts over a much shorter time period, around 3-4 hours, and should be taken before meals and to correct high glucose levels.

Basal-bolus insulin means you take one or two injections of a basal insulin per day, and you take bolus insulin every time you eat carbohydrates or need a correction dose of insulin for a high glucose level. Some healthcare professionals have people newly diagnosed with diabetes start on a “fixed” insulin regimen – the basal insulin is taken the same way, but you eat a set amount of carbohydrate at each meal with a set dosage of insulin. The advantage of the basal-bolus regimen is flexibility in what you eat and when. The advantage of the fixed regimen is you are usually given a specific meal plan with information on how to substitute one carbohydrate choice for another – you don’t have to be an expert in carbohydrate (“carb”) counting right away, but hopefully you will master it over time. Talk to your healthcare team about which insulin regimen might be best for you and your lifestyle.

  1. How do I take insulin?

To inject insulin, you will use either a pen or a syringe. Make sure to store your insulin in the refrigerator before opening, and at room temperature after opening. Here are some best practices for administering insulin injections:

  • Wash your hands and inspect the pen or syringe. Check that you have the right type of insulin, that it is not expired, and that there are no cracks or unusual qualities to the vial or in the liquid.
  • Label the date that you open your insulin.
  • Rotate the location of injection between the arms, abdomen, legs, hips, and butt, and try not to use the exact same spot in each location. Varying the site of injection will help keep scar tissue and excess fatty tissue from developing.

Insulin pumps are small machines (the size of a deck of cards or smaller) that deliver only rapid-acting insulin; no long-acting insulin is given. The pump delivers insulin directly under your skin without the need for multiple injections each day. There are many types of insulin pumps with various features. Some can be paired with a CGM for automated insulin delivery (AID, also called closed loop or artificial pancreas). Many people are started on insulin pumps weeks or months after diagnosis, but others choose to wait much longer, or to never use an insulin pump at all. If you are interested in an insulin pump, talk with your support network and your healthcare team to determine what type of insulin pump system might be best for you.

  1. How are my basal and bolus doses determined?

In the beginning, you should have frequent contact with your healthcare team to adjust your insulin doses. At first you might need to change your doses almost on a daily basis, but later on, dose adjustment is usually not done unless a pattern lasts at least three days.

  • Basal insulin dose adjustments: Basal doses are in large part determined by your morning glucose levels before breakfast (fasting glucose). The goal of basal insulin is to allow you to wake up with a glucose level between of 80-130 mg/dL, without hypoglycemia (low glucose) or hyperglycemia (high glucose) during the night. Basal insulin also helps maintain glucose levels between meals and if you skip a meal.
  • Bolus insulin dose adjustments:
    • Insulin to Carbohydrate Ratio (ICR): Your ICR is the specific amount of insulin you take for every gram of carbohydrate you eat. In other words, how many grams of glucose are covered by one unit of insulin. You may be told to take your meal insulin at least 15 minutes before you start eating. The American Diabetes Association recommends that your glucose level be less than 180 mg/dL for 1-2 hours after your meal. You should then be back to your premeal value after four hours, without hypoglycemia.
    • Correction bolus insulin: This is taken when the glucose level is higher than the target glucose level of 180 mg/dL. Correction insulin is used to manage high glucose levels before and 3-4 hours after meals, or when hyperglycemia develops during the day or night. For most people, a correction dose of insulin should not be taken for three hours after the last insulin injection. You also need to be careful about correction insulin before exercise or bedtime unless otherwise instructed by your healthcare team.  A correction dose should bring your glucose level back to the target range within three hours, without dipping below 70 mg/dL.

Know that your insulin needs will likely change over time after you are first diagnosed with diabetes. Your basal amount, your insulin to carbohydrate ratio, and the amount you take for correction boluses will all change first with the “honeymoon” or remission phase of diabetes. After that they will change with growth, illness, weight change, aging, or a variety of other factors that can affect how sensitive your body is to insulin.

  1. What is the remission or honeymoon phase of diabetes?

Often after diagnosis and the initiation of insulin therapy, people with type 1 diabetes enter a honeymoon period. This occurs because some insulin-producing cells in the pancreas begin to function again – and make insulin. This means that you’ll be able to decrease the basal and bolus doses of insulin you are taking. Occasionally, someone can get down to a very low dose of insulin each day. It is best not to stop taking insulin altogether, even if it means you only take a very small amount of basal insulin. Unfortunately, the honeymoon period does not last forever, and glucose levels begin to rise again, at which time insulin doses may need to be increased.

There has been a national effort to identify newly diagnosed individuals with type 1 diabetes and tell them about studies designed for people with new onset, including the National Institutes of Health TrialNet study. diaTribe writes about clinical trials here. Please look into research being done and discuss this with your healthcare team if you are interested in being part of the effort to better understand type 1 diabetes and ways to try to preserve insulin-producing cells.

  1. How can I take charge and best support my health? 
  • Focus on how you are feeling – mentally and physically. Identify your challenges, find helpful resources, and get answers to your questions.
  • Put together your team of supporters – your healthcare team, your family and friends, and your co-workers.
  • Think of the overall mission – to successfully manage your diabetes and realize all your life dreams and goals. Master the day-to-day tasks, like how to check your glucose levels, take insulin, balance glucose levels, food, and activity, return to school or work, and stay healthy today and into the future. This is a marathon – give yourself time to adjust, learn, and thrive.

Reach out when you need help, and encourage your support team to do the same – there is a world of resources: doctors, nurses, nutritionists, mental health professionals, coaches, articles, books, videos, websites, associations, and organizations all waiting to help you. diaTribe is one of them.

About Fran

Dr. Fran Kaufman is the Chief Medical Officer of Senseonics, Inc. She is a Distinguished Professor Emerita of Pediatrics and Communications at the Keck School of Medicine and the Annenberg School of Communications at the University of Southern California.

Source: diabetesdaily.com

Interpretation and Management of Hyperglycemia and Exercise

This content originally appeared on Diabetes Motion. Republished with permission.In some circumstances, elevated blood glucose levels can be indicative of medical concerns like insulin deficiency. People with type 1 diabetes are more susceptible to insulin deficiency since they have almost no ability to produce any insulin; therefore, they need to receive instruction on why and […]
Source: diabetesdaily.com

Diabetes, Just Tell Me!

This content originally appeared on Test Guess and Go. Republished with permission.Lately, I have been having days, well actually weeks when I am starting to question how I deal with my diabetes. I have used an insulin pump for 15 years and don’t really want to change back to injections. For me a pump is […]
Source: diabetesdaily.com

Diabetes Care from Parent to Child: Passing the Torch of Care

This content originally appeared on diaTribe. Republished with permission.By Kerri Sparling Transitioning care from parent to child can be a stressful time for families with diabetes – six strategies on how to reduce the burden  Transitioning from my parents being in charge of my diabetes to assuming full care myself didn’t happen overnight. It was a […]
Source: diabetesdaily.com

What Do “Healthy” Blood Glucose Levels Really Look Like?

What is normal blood glucose? In children and adults, ideally, blood sugar levels are tightly-regulated to stay in a narrow range that’s optimal for physiological function. What are these levels, and how much of a glucose excursion is “normal”? Notably, there are some transient exceptions to the accepted “normal range”. In particular, women tend to […]
Source: diabetesdaily.com

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