COVID-19: What Your Friends with Pre-Existing Conditions Need You to Know

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

By Lala Jackson

The first few months of 2020 presented a global health crisis not seen in almost a century. When the coronavirus first emerged, wild theories abounded. We didn’t know who was most at risk to get severely ill or die. There was a mind-numbing amount of conflicting information – do we wear masks or not? Is this virus airborne or does it live on surfaces? Am I safe to go outside at all?

For those of us living with chronic diseases like diabetes, this was all exponentially more intense. Living with an invisible illness during a pandemic is a uniquely anxiety-inducing and isolating experience. Each of us has our own level of fear about our risk, but much of our ability to protect ourselves was based on pure gut feelings because no one had enough data from which to make informed decisions.

Now, we know a little bit more. Living with diabetes itself does not appear to increase our risk of contracting coronavirus, but if we do get COVID-19 and end up in the hospital, things could go south quickly. It also seems like many people who do end up in the hospital have other underlying heart or lung conditions or are older in age, so we don’t know what percentage of risk is diabetes-specific. For many of us, memories of poor diabetes care in hospital settings is a major risk to consider – COVID-19 may not kill us but a medical professional who doesn’t listen to or know how to take care of our needs might. And it may not even be their fault – in an overly taxed medical system that does not have the resources to take care of the volume of people who are sick right now, people with often-misunderstood chronic illnesses fall to the wayside.

Existing in the world with a disease like diabetes can already be already dangerous. Existing in a world currently going through a pandemic, with conflicting and limited guidance and leadership, broken healthcare systems, a taxed medical supply chain, and the medication that is our lifeline often too expensive to afford? It’s all still scary, and while we know a little bit more, we’re still flying blind and doing the best we can amidst constantly changing circumstances. Here’s some of what your friends with pre-existing conditions want you to know:

  1. This is still really scary; please give me space and time to figure out what decisions are best for me. Every person living with a pre-existing condition is different. Many of us live with multiple health hurdles we’re juggling, and even within the same disease, we each have to take care of ourselves in different ways. Some of us feel completely safe starting to return to (socially-distanced, while wearing a mask) everyday activities, while some of us feel safer continuing to stay at home. Some of us don’t have a choice — the need to earn a paycheck to support ourselves, our families, or keep our health insurance supersedes our fears. Be kind. Be patient. Don’t assume to know what we need. Ask us how you can support us.
  2. Please stop sending me articles about people with my disease dying from COVID-19. I’ve either already seen it or I’m purposely ignoring it for mental health reasons. I promise I already know all of the risks someone like me faces, and I am doing everything I can to mitigate them. It is my job to pay attention to the level my health requires, and I promise I’ve already done it.
  3. I reserve the right to change my mind at any time for any reason. In a time when we are all making decisions on the fly, there are days we’re agreeing to things because the most recent headline we saw seemed positive, or we’re having a strong mental health day. At any moment, for any reason, that may change. New studies about how COVID-19 affects people are published weekly, with studies that then directly conflict following just a week later. We’re not being flaky; we’re trying to keep ourselves alive in a constantly changing landscape.
  4. “Don’t worry, it only kills people who are old or already sick” is still a really horrible thing to hear. Knowing that there are so many people in the world who care so little about our lives is heavy. For many of us, this is simultaneously compounded by how society views our race, our culture, our social standing, our access to healthcare or a paycheck. We are being told we do not matter from multiple directions, and we are exhausted.
  5. Having a discussion about a COVID-19 vaccine isn’t productive for me. While there are many companies doing clinical trials, there is no current frontrunner. Once there is, there will be conversations about priority vaccinations. No, I don’t know if I will be able to get one. Don’t ask me about how I feel about vaccinations and what I will do once I get one or if I should get one. There are still many unanswered questions about what will happen after a vaccine becomes available and I’m just trying to stay safe until then.
  6. I still love you. But if I say I can’t visit with you yet, please respect that. I miss you immensely. I wish I could see you. Right now, I’m having to weigh the very real thought that if we visit together right now, there’s a chance I won’t be around to know you for the rest of your life. I don’t want to have to make that decision. Please don’t ask me to.
  7. Please stay home while waiting for your COVID-19 test results or if you’re feeling under the weather. This may not feel like a big deal to you. You may not feel like COVID-19 will impact you too harshly or you probably won’t end up interacting with anyone who is high risk when you go outside. But there’s no way to know who’s path you’ll cross and what impact COVID-19 could have on them or someone they are going home to. Many of us who are at higher risk do not have the option of staying inside and away from you. We have to get groceries for our families, we have to earn a paycheck, we have to see our doctor, and many of us don’t look sick. You won’t know when you cross paths with a high-risk person. Please don’t make those choices potentially deadly for us.

To learn more about the precautions everyone impacted by diabetes should take throughout the COVID-19 pandemic, visit coronavirusdiabetes.org.

Source: diabetesdaily.com

Going Virtual: The Future of Diabetes Care

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

By Todd Boudreaux

Ashlyn Mills is a physical therapy assistant in an outpatient setting in Florida, working with people with orthopedic and neurological disabilities. She was diagnosed with type 1 diabetes when she was 19 years old. Ashlyn recently started using DreaMed’s telehealth platform to see an endocrinologist, and spoke with Beyond Type 1 about the shift to virtual care.

Beyond Type 1: To start, can you tell me about your diagnosis, and how you originally managed your diabetes?

Ashlyn Mills: I had a strange diagnosis, it was caught a little bit early. I was already being followed by an endocrinologist for some other issues and we started noticing some higher blood sugars on labs. My A1c wasn’t incredibly high so they put me on a Dexcom and started monitoring my blood sugar so they could see what kind of patterns I was experiencing. My fasting blood sugars crept up higher and higher and they went ahead and added basal insulin at that point. I was insulin dependent about three months after my diagnosis.

They diagnosed me with type 1 from the start. They did say that it looked like a latent onset (LADA), but it was pretty clear that it was type 1 from the get go. I was using insulin pens at that time.

Tell me about your treatment since diagnosis.

I live in a rural area in Florida. There’s not an endocrinologist around here. I had been seeing an endocrinologist at the Mayo Clinic in Jacksonville, which is about a two and a half hour drive for me, and that was just because that’s who came recommended by my primary care physician. I was diagnosed at the Mayo Clinic and followed up with endocrinology there for the first two years after my diagnosis. The nurse practitioner that I was seeing there actually left and came to a clinic that was about an hour and a half from my home, and I had a good rapport with her. I went ahead and followed her.

Her and I had come to the understanding that it was difficult for me to see her every three months, so instead I saw her every six months. It became a little bit of an issue for me being able to talk with someone in between if I had issues, which is how I found DreaMed. I could find somebody to bridge the gap between those six months that I’m going without seeing a doctor in person. Now, I’m able to communicate with someone whenever I want to.

How have you been keeping up with your job as a healthcare worker living with T1D during the pandemic?

Florida did a stay at home order back in March. About mid April my employer decided, “We’re going to send everybody who is high-risk home.” I worked from home for about two months and then the numbers started looking better and they sent me back to work. Now, I’m working in the clinic every day and it is nerve wracking. I’m still working but I’m quarantining from my family right now because I was exposed at work.

I go through phases where I feel like I would be fine if I got it but then I have bad blood sugar days and I’m like, “This is it. If I get COVID I’m doomed because my blood sugar was over 200 mg/dL all day today.” Overall, I think I would be okay but I do worry about being hospitalized. I think that’s my biggest fear with the whole entire thing is ending up in the hospital with no family there to be with me. I pray every day that I stay well but I am working and the numbers in our county are rising quickly

How did you find out about DreaMed and what was that process like getting started?

When I was sent home and started doing telehealth with my patients I realized this is easy, there shouldn’t be any reason why I can’t do this.

At the time my endocrinologist’s office was not offering telehealth appointments, even in the midst of COVID-19. I started doing a little bit of research and found DreaMed. I went on the website and signed up for more information. My experience as a provider doing telemedicine is what led me to push to try to find someone that could do the same with me as a patient.

How does DreaMed work?

They asked me what state I lived in and they connected me with an endocrinologist here in Florida, Dr. Kava. I set a telemedicine appointment with her and she spent about an hour with me on that first call. I think you can view it as a replacement service for your current endocrinologist or just an add-on to your current care.

Was it surprising your appointment lasted for an hour?

Dr. Kava would have spent as long as I wanted her to with me. My normal appointments in the clinic, I drive about two hours to be seen for maybe 10 minutes. Most of the time there’s not too much to discuss at those appointments you just make a few changes, but she asked all about my personal life, including my mental health during the pandemic. She really seemed invested in me as a person, too, not just diabetes.

She nitpicked my data because I told her I’m a little bit of a control freak. She said, “If you want tight control I’ll help you.” She spent a long time combing through all of my graphs and figuring out what we could do to get things even tighter than they already were.

Has any diabetes provider before Dr. Kava asked about your mental health?

That’s the first time I recall that happening. When I was first diagnosed I had a diabetes educator talk with me about mental health and diabetes to prepare me for what may be to come with my mental health. They assume if your control is good you’re doing okay with your mental health, but that’s not always the case. I don’t necessarily quit caring for myself when I feel burned out but that doesn’t mean I’m not struggling mentally with it.

It was Dr. Kava spent a good bit of time talking with me about mental health and diabetes and how my mental health was doing with COVID-19 and all of that so I was very impressed with that.

Were there any other specific suggestions that stuck out to you?

Most adult endocrinologists seem stuck in the stone ages a little bit. Dr. Kava looked at my data and she said, “You’re on a closed loop system. The system is going to suspend you if you’re going to go low. If you want to stay below 140 or if you want to stay below 120 I can help you get your settings there.” That was the first time that I had ever had someone be willing to be that aggressive with my care, but I felt like she was totally game for whatever I wanted her to help me do.

Do you think that you’ll continue using DreaMed?

Yeah, ideally I would like something to bridge the gap right now. Although my endocrinologist has started offering telemedicine I’d like somebody that I can talk with through DreaMed and not feel like I’m bothering. When you’re bothering your endocrinologist a lot of times you’ll get an unexpected bill; it would be nice to pay the monthly fee and have somebody at my fingertips whenever I need them. If my endocrinologist quit offering telemedicine I would love for DreaMed to replace my current endocrinologist. As much as I love her it’d be nice to do telemedicine and not have to drive two hours to be seen by someone.

Do you have any advice for someone living with type 1 who doesn’t currently have access to a local endocrinologist?

I just think if anyone’s trying to figure out what to do in the time of pandemic or just tired of driving to see an endocrinologist as frequently as they do, I would suggest looking into DreaMed. They’re currently offering a three-month trial. I have no dog in the fight, I’m not being compensated to say anything about them. You have nothing to lose. They are very honest and I think it’s worth giving a try.

Source: diabetesdaily.com

A Parent’s Concern: COVID-19 and the School Year

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

By Eugenia Araiza/Mariana Gomez

COVID-19 has brought many challenges and struggles to our daily lives. From the beginning we have adopted new habits in order to adapt to this new normal and this new dynamic and way of life certainly includes our environment and our children.

In the case of children with diabetes, the school environment alone already entails interesting challenges that, although they can be solved through teamwork and diabetes education, are scenarios that require some preparation to face.

The new normal includes concerns the caregivers have about going back to school and, although we look forward to that day, we also analyze the risks that it could represent in a population that a lot of the literature considers “vulnerable”.

In our groups and communities in Latin America, we have a similar opinion and we are pleased to see that the community has gotten to work and has quickly become familiarized with #BigLittleChanges that will help slow the spread of the virus. We know as a fact that social distancing, among other things, is one of the key pillars, but… what will happen when school begins?

We approached members of the type 1 Diabetes Community from Spanish-speaking families to ask their opinion. This is what we found.

About Going Back to School in August

“August seems too soon for in-person classes, it honestly scares me!” Esther shared with us, who thinks the same as Francisco who added “in my opinion, I do not think it can be possible because we are at a very critical point in the pandemic.”

In countries like Mexico, the rules will depend on the school system (public or private) and even on the state and region. In some schools there will be three options for returning to school: in-person, online or hybrid methodology that involves separating the groups to avoid having several children in a classroom alternating the days of in-person and online education.

Viridiana, Zuri’s mother said, “As Zuri’s mother, who lives with type 1 diabetes, I still do not feel it is safe for her to go back to school and I think that many moms are going through the same thing, the uncertainty of not knowing what will happen in the upcoming school year.”

The British Society of Pediatric Endocrinology and Diabetes States:

  1. Clinically extremely vulnerable children are to remain shielded and not to return to school, even if their year group has.
  2. Clinically vulnerable children who are only under the care of primary care are overwhelmingly likely to benefit from returning to school when their year group does.
  3. Clinically vulnerable children, who are under secondary or specialist care for an underlying health condition are, on the balance of probabilities, more likely to benefit from returning to school when their year group does so. These families may need a conversation with their medical teams to balance the potential risks and any anxiety among family members.
  4. All other children should attend school when their year group returns.

The New Normal and School

Among concerned parents, there has been talk about three options for returning to school: in-person, online or hybrid methodology that involves separating the groups to avoid having several children in a classroom alternating the days of in-person and online education.

Marcela told us “we still have not heard anything about when school will begin, personally I am stressed out about my son returning to school and whether they will take the necessary measures to avoid infections, hopefully, some students will attend some days and others online to be incorporated gradually like some people are saying.”

Others like Cloe have been preparing a little ahead of time and have talked with the principals and those in charge of the schools to let them know the family’s concerns regarding their child’s diabetes, the care and risks that it would involve, to which the teacher responded “This is a situation in which many of us agree because the most important thing is the health of our little ones. The authorities have mentioned that we will be able to make exceptions when school starts. Do not worry, when the time comes, we can explore options, you have my full support.”

In Mexico, the Aprende en Casa program used five means for teaching, among them, free textbooks in digital and printed format, which include the basis of all the expected learning and programs disseminated in several digital outlets, including free-to-air and cable television channels, radio and printed and digital materials.

The Parents’ Conditions

When asked about the requirements they have as parents to send their children to school, Yahaira said “I do not have any because at this moment I think that if it is in-person, my child will not go to school” while Mónica said “I would require them to supervise the students so they have no contact with each other, and they should be very clear about social distance”.

Apparently, all this causes great uncertainty because of a lack of assertive communication in many of our countries by the educational authorities and, as Adriana says “I would like to know all the measures that would be taken when school starts, but so far there is nothing clear enough so that parents and also children and teenagers with diabetes can sit, think, and make clear decisions so they can all feel safe and calm.”

Gaby, like many other participants, told us that she would prefer a hybrid system since “personally, I think my daughter would be affected if she stays at home any longer, she is at an age in which she tends to get depressed, and to stay up late talking to friends she has not seen in months. Now she has to start at a new school, it would be good for her not to spend so much time at home and go back to school with the appropriate care.”

The Opinion of Children and Teenagers Living With Diabetes on Going Back to School

Fer tells us that she wants to return and that “she would always have to have her face mask on, carry hand sanitizer, she would not hug her friends and keep her distance”. Ian cannot wait to go back, and it is very difficult for Mónica, his mother, not to send him. The same happens with Damián who wants to go back to school and see his friends. However, Matteo knows for sure that he does not want to return.

Zuri, who is 10 years old, tells us “I am very afraid of catching it and having complications with my diabetes.” 11-year-old Pablo says: “I will not go back until there is a vaccine.” Mali, who is 13 years old, is the one who shows the most concern on the subject and says just the thought of being surrounded by children and teachers scares her.

The Official Positions

Sadly, up to the date this article was published, we have not found any information from school authorities or medical societies for our countries in Latin America.

However, on May 20th the Official Position of the Association of Children’s Diabetes Clinicians (ADC) was published, emphasizing the lack of evidence to suggest that children with diabetes are more vulnerable to get the virus than other children, and parents of children with diabetes are called upon to reinforce safety measures such as hand washing and social distancing.

At the beginning of the statement, it says children with diabetes can return to the school environment as long as protective measures are taken. According to the documents, parents should consider whether the children will be able to keep their distance from their classmates, and if someone at home has a greater risk of contracting the virus. In addition, there are other factors that should be considered. Are parents capable of providing quality education from home? Will this distancing have any negative consequences on their development and emotional well-being?

Here are some safety protocols that will be implemented in different countries that you may be able to discuss with your educational authorities if you are a caregiver to a child with diabetes

  • Placement of students by age group: students will attend school in groups or age groups.
  • Students will not interact with other students outside of their age group.
  • A temperature check will be conducted each day before students enter the premises.
  • All staff will wear face shields.
  • Students will have many opportunities to wash their hands daily.
  • Handwashing stations will be created around the premises.
  • Students will not share supplies and materials.
  • Students will be seated at a safe distance from each other.
  • Teachers will be provided with safe cleaning supplies for students to use throughout the day.

Some Conclusions

Viridiana García, Zuri’s mother, perhaps represented what many of us thought and could not put into words “I think that, at the moment, there is nothing more important than the health of our children, and if we weigh the health of our children against their education, their health seems more important. We should remember that nothing is forever, and these moments of crisis will sooner or later pass and we will have time to recover in all aspects.”

While all this goes through the minds of the parents, a question arises, how long are we going to be able to keep the children out of the new normal?

(We would like to thank Viridiana García, Zuri’s mother, for sharing the protocols of her school with us)

About the Authors

Eugenia Araiza Eugenia has a Degree in Nutrition specialized in Diabetes and she is a Diabetes Educator. She was diagnosed with type 1 diabetes 25 years ago, she is the creator of Healthy Diabetes. She really enjoys studying and helping others in managing their different types of diabetes. She loves studying, managing type 1 diabetes, and nutrition. She especially enjoys writing about the impact diabetes has in her life. She lives surrounded by the love of her family, Luis Felipe, who lives with LADA type diabetes and her teenage son, Indigo.

Mariana Gómez Mariana is a Psychologist and Diabetes Educator. She was diagnosed with type 1 diabetes in the summer of 1985. In 2008, Mariana started a blog where she shares her life experience and topics related to living with diabetes and emotional health with others. Mariana worked with the Mexican Diabetes Federation until 2012 and today she is Director of Emerging Markets for Beyond Type 1. She is the mother of a teenager.

For more information on what you can do to protect yourself and others, visit coronavirusdiabetes.org and share the #BigLittleChanges you are making.

Source: diabetesdaily.com

What It’s Like as a High-Risk Individual Six Months into the COVID-19 Pandemic

Let’s face it: type 1 diabetes has always been a huge annoyance. There’s nothing fun about always living on your toes, and there’s nothing normal about eating in your bed in the middle of the night. But the good news is that type 1 hasn’t stopped me from doing anything in life. I went to college thousands of miles away from home, traveled to numerous countries alone, and have held a successful career at Google for nearly five and a half years now. And even the things I worried about most as a young teen – like how it’d affect friendships and relationships – turned out to be a non-issue. The right people have always been by my side and supportive.

Type 1 has shaped me and even improved my life in such significant ways – and while of course, I’d get rid of it in a second if I could – I’m very appreciative of the personal growth, responsibility, and resilience it’s instigated. I’ve always tried focusing on the positives of type 1 – if I’m “stuck with it,” I might as well own it, control it to the very best of my ability and determine a way to thrive. And for over 12 years with this mentality, I’m fortunate that I have thrived with type 1.

While I naturally have a cautious personality, I’m a firm believer that it’s useless to worry about things out of your control. But what about things that are in your control? When COVID-19 first started earlier this year, it was clear that if I stayed home, stayed away from people, got deliveries versus going shopping myself, etc., I’d have a very low likelihood of contracting COVID-19. I’m very fortunate that I have a job that allows me to work from home, complete control over my home environment, and no responsibilities such as children right now, where their wellbeing would also be a key factor in my decisions. So yes, while I knew I was in control, I didn’t know what great expense that would come at, nor that it would last so long.

Photo credit: Caroline Levens

I’ll admit I had a heightened sense of concern early on in COVID-19. I bought an N95 before COVID-19 was even known to be spreading in the US and was self-quarantined by the first week of March. And up until recently, I felt my COVID-19 experience was probably one collectively shared by nearly everyone – of course, everyone had cabin fever, and COVID had affected their plans, friendships and relationships in unexpected and unfortunate ways.

Then COVID fatigue seemingly blanketed the nation – myself included. The mentality that “well, if this is seemingly going to go on forever, I’ve got to start living my life again. I can’t stay inside forever. The death rate is extremely low anyway. I’d probably be fine. Or whatever I’d experience has got to be better than a year or so cooped up inside.”

And just like that, for the very first time in my life, type 1 felt like it was limiting what I could do. My thoughts and COVID-19 exhaustion was shared with mass America, but I didn’t have the privilege to act on them. And somehow it made it much harder when I felt like the only one still sheltering in place – which, of course, I’m not. There are millions of high-risk individuals – and loved ones of high-risk individuals – experiencing the same thing. But it sure doesn’t help seeing pictures of friends on social media living a life I long for so much right now. I recognize that it is my decision how to respond to COVID-19, but to me, it feels practically synonymous to my immune system declining all invites on my behalf.

To be fair, there are many type 1’s who have largely resumed their normal lives, though many of them are children and have a lower likelihood of experiencing severe complications, or are in lower-risk areas. But at this point in COVID-19 – I personally feel I can’t let up. Health is one of my very top personal priorities, and the truth is, I don’t know what kind of experience I’d have if I were to contract COVID-19, both short term and long term. And to clarify, it’s not just type 1 that has me on my guard – I’m also immunocompromised and have several other autoimmune diseases.

There’s a heavy emotional toll that comes with being part of a high-risk community. Early on in the pandemic, I questioned where type 1 fit in the picture when they said diabetes was a high-risk factor. It was also known that obesity was a huge risk factor, so I was skeptical if it was diabetes in itself that was the risk or intertwined with the risk posed by obesity, which is strongly correlated to type 2. Then came a study out of the UK with thousands of diabetics that showed actually type 1s had significantly higher death rates than type 2s. I personally lost a type 1 friend from my teens, and he was 26, one year younger than me. I’ve read about countless stories that range from minor cold-like symptoms to months of enduring fatigue to permanent lung damage and more.

Riding out sheltering in place is hard – but if I were to have a severe case of COVID-19 that damaged my health, I’d never be able to forgive myself. So I continue doing the best I can. And no doubt it’s come with sacrifices – I couldn’t attend my grandma’s funeral, it put a strain on a relationship I was in, l didn’t get to say a proper goodbye to friends who moved away for good, and even though I’m a total homebody and introvert at heart, I’ve experienced loneliness for the first time.

I know long-term this is just another part of the type 1 journey in life. The level of gratitude I’ll have for the most simple things will be immeasurable post-COVID-19… hugging a grandparent, going grocery shopping, having lunch with a friend. With any luck, I won’t have any future experiences where I feel type 1 is stopping me again, but if I do, I’ll be better equipped to handle it.

So why am I writing this? There’s been so much criticism towards those still staying home, those still wearing masks in outdoor settings, those not sending their children back to school, and it’s really uncalled for and disrespectful in my opinion. You have no idea what someone else is going through, and many of the highest-risk conditions are invisible.

In summary, if you’re not high-risk and are comfortable resuming your normal life, recognize that’s a privilege many aren’t fortunate enough to have. For millions of people at home for one reason or another – be it type 1, older family members, or other medical conditions – we’re still riding out an isolating quarantine, compounded by the stressor of uncertainty and the unknown timeline. So keep in mind that everyone is experiencing COVID-19 differently, and trust that other people know what’s best for them, just as you know what’s best for you. Your pandemic may have “ended,” but others still have to be as on guard as they were months back — all while not knowing if it’s the beginning, middle or end of this wild ride.

Source: diabetesdaily.com

Should My Child with Type 1 Diabetes Go Back to School During COVID-19?

As summer draws to a close, parents and families affected by type 1 diabetes have been plagued with the question of whether or not to send their children back to school during the time of COVID-19.

Earlier this summer, a report from the NHS was released showing that people with diabetes, especially type 1 diabetes, face significantly higher risk for both complications and death from COVID-19. This study sent shockwaves through the diabetes community, and has left many families with many unanswered questions. Should parents send their children to school and risk contracting the virus? Should families keep their children home, and attempt home-school? Is there a middle ground to help mitigate risk and viral transmission, while still enabling our children to learn well? What critical social and psychological developments would a child miss out on, should they stay out of school for a year, or two, or three? What complications would be prevented if they dodged the coronavirus (and the social ridicule of 7th grade) completely?

There is no national consensus: the President wants schools to reopen. Many colleges and universities are either going completely online, or attempting a sort of hybrid (half online, half in-person) schedule. The Centers for Disease Control and Prevention recently changed its guidance, to better adhere to the Administration’s wishes. Throughout the United States, the issue of schools reopening has largely been left up to the school district to decide, and that can be based largely on city and state politics. The decision is further complicated for families with children with diabetes, because although a type 1 patient’s risk may be higher, it’s been previously noted that most children, should they contract COVID-19, have milder cases and many do not even show symptoms. Keeping a child with diabetes home this fall risks to further ostracize and isolate them. So, how can you make the best decision for this upcoming school year?

If anything, the United States has had the benefit of time throughout the pandemic. The origins of the virus came from Wuhan, China, and Americans watched the epidemic play out and spread throughout Asia and Europe from the comfort of their homes for most of the winter. The United States had nearly 3 months to fully prepare, and the same goes for schools reopening. Many schools throughout Asia and Europe have reopened (with safety precautions) with some success and no community spread. However, no country has had as many live and active case counts as the United States when trying to reopen schools.

Although the risk of returning to school is great, sometimes the social and psychological repercussions are greater: many children have reported an increase in anxiety and depression since the pandemic started; being trapped in homes with domestic violence and abuse wreak havoc on mental health and well-being, and many families living close to the poverty line rely on the daily, free breakfast and lunch programs to help feed their family throughout the school year. Shockingly, 114,000 students in the New York City public school system are homeless; they rely on the warmth and shelter of going to school every day to get by.

Photo credit: Adobe Stock

Many families do not have enough (or any) computers at home for remote schooling, and nearly 19 million Americans do not have high speed, broadband internet at home, making remote, teacher-led learning all but impossible. Additionally, having children at home all day often requires a parent to be home, too, and many essential jobs and low-wage workers do not have the option to work from home temporarily or indefinitely. Juggling child care and work has become a critical issue for parents navigating the effects of the pandemic on their families. Furthermore, children need to socialize with other kids their age, and learn to develop social networks for support. Taking that away can and will have lasting detrimental effects.

On the other hand, given the current state of affairs and the rate at which the virus is spreading throughout the United States, children with diabetes face significantly higher risk of exposure and contraction (and complications and even death) should they return to school full-time, for in-person learning. Putting a child at unnecessary risk, in the middle of a pandemic, seems shortsighted and myopic.

Some encouraging research in the midst of turmoil: nearly half of those with type 1 diabetes who contract COVID-19 have managed to treat the virus at home, although hyperglycemia and DKA are common.

Unfortunately, lacking any national guidance for families with children with preexisting conditions like type 1 diabetes, the decision is a personal one. Considerations include your child’s age and ability to self-manage, their mental well-being and ability to cope without friends or in-person learning, your state’s COVID-19 stats and rate of viral decline/increase, and your personal feelings of safety and security with your school’s precautions in regards to COVID-19 risk mitigation. National diabetes organizations have recently released information for returning to school and general COVID-19 guidance, and a town hall was recently held to help parents navigate the decision process.

In closing, any decision you make about your child’s learning needs to be based on your personal circumstances and how comfortable you are with either remote or in-person learning. Reach out to your school’s administrators to see what their plans are for mitigating virus spread this fall: are they limiting class sizes, mandating social distancing, placing hand sanitizers and handwashing stations throughout the school, and requiring masks? Or do you feel your school isn’t doing enough, and you’re willing and able to assist your child in a remote learning situation, where they see other children occasionally for social support? Discuss your concerns and questions with your pediatrician and/or endocrinologist and get their recommendations. Do you have an essential job, where you cannot be home during the day, and you need the school infrastructure for support? Or do you feel overwhelmed with the high risk factor that is type 1 diabetes, and you’re leaning towards homeschooling until there’s a vaccine? There are no perfect decisions here: guilt should not drive your decision. Go with your gut, and what works for your individual situation, and it’ll lead you in the right direction.

Are you navigating back to school (or not!) with your child? What decision has best-suited your family? Share this post and your thoughts below! We love hearing from our readers.

Source: diabetesdaily.com

The Latest on COVID: Staying Safe as The Pandemic Surges

This content originally appeared on diaTribe. Republished with permission.

By Eliza Skoler

As COVID restrictions and recommendations shift, what do we know about staying safe with diabetes? How can we protect others and make careful decisions about risk?

As the pandemic continues to unfold, states and countries are leading their own initiatives to reduce infection rates and keep people safe. This means that people around the world are experiencing different stages of caution, risk, and safety. As we navigate the uncertainty of conflicting messages and daily updates to guidelines and recommendations, everyone – with or without diabetes – can do some things to keep themselves and others as safe as possible. In this article, we’ll look at the latest scientific recommendations to discuss what we know about preventing serious COVID-19 infections.

View our new COVID and diabetes infographic here. Click to read our first COVID reopening article, “COVID Phase 2: Diabetes Care During Reopening,” or check out more of our articles on COVID-19. You can also find the official reopening plan for your US state here.

On July 17, the CDC updated its recommendations for people who are at higher risk for severe coronavirus infection. People with type 2 diabetes have increased risk for severe illness, while people with type 1 diabetes may have increased risk. If you have diabetes, the best thing you can do to prevent severe COVID infection is avoid contact with other people as much as possible.

Click to jump down to a section:

diabetes and COVID

Image source: diaTribe

Stay at home as much as possible to avoid contact with other people

Coronavirus is spread through contact with infected people. This means that by avoiding public spaces and people who do not live with you, you can dramatically reduce your chances of infection. We know that not everyone is able to stay home – if you are an essential worker, thank you for the work you are doing. Please be as careful as possible and see below for information on protecting yourself outside the home.

COVID-19 is primarily spread through the droplets that come out of an infected person’s mouth or nose when they talk, breath, cough, sneeze, laugh, or holler. The virus is carried through these small droplets. Anyone close by can be infected by the virus if the droplets enter their mouth, nose, or eyes.

  • Droplets can also land on surfaces (like door handles or food at the grocery store) and infect someone who touches a contaminated surface and then touches their face.
  • The World Health Organization acknowledged in July that COVID-19 may be spread invisibly through the air. Many scientists agree that tiny droplets can stay in the air for an extended period of time after they are released, which means COVID-19 could be considered an airborne virus, increasing its danger. This provides even more reason to stay home.

Protect yourself if you are outside your home

  • Social distance by staying at least six feet away from other people.
  • Wear a cloth face covering when around other people in public. Your mask should full cover your mouth and nose and fit snugly against your face. See below for more tips on wearing and cleaning your face mask.
  • Wash your hands often with soap and water for at least 20 seconds; use a hand sanitizer with at least 60% alcohol when you don’t have access to soap and water.
  • Avoid touching your eyes, nose, and mouth.
  • Avoid close contact with people who are sick, even in your home.
  • Cover coughs and sneezes. Do not remove your mask to cough, sneeze, or talk to others.
Mask

Image source: CDC

Many people with coronavirus may not show symptoms or know that they are carrying the virus; however, even those without symptoms can still spread it to other people. Cloth face masks are meant to protect people around you if you are already infected (as shown in the image on the right; source: CDC). Studies show that masks are extremely effective: the more people wear masks in public, the less the virus is passed.

Here are some resources on cloth face masks:

As things reopen, make careful decisions

For many people, the hardest part about removing or lessening restrictions is that it can feel “safe” to go back to our pre-pandemic activities. To make the problem even more challenging, even though it’s not completely safe yet, many people are tired of social distancing and staying at home, and the social isolation has taken its toll on many.

According to the CDC, “the more people you interact with, the more closely you interact with them, and the longer that interaction, the higher the risk of COVID-19 spread.” While the pandemic is still raging, here are some ways to be careful if you will be seeing people.

  1. See people outside, rather than inside

Because COVID-19 is spread through the air, it is much easier to spread the virus indoors than outdoors given that wind circulation and open space outside are far greater. This means that closed, small, indoor spaces are the most dangerous places to interact with other people. If you or someone you live with has diabetes, avoid seeing others indoors. Instead, consider seeing people outside, where you have more space to remain distant and the breeze complicates the transmission of droplets.

  • If you must see family or friends indoors, open windows or doors to create air flow. Find an indoor space that is large, so that you can stay far apart.
  • Wear cloth face coverings, even at socially distant gatherings.
  • Wash your hands often (or use hand sanitizer) and don’t touch shared surfaces.
  • Read more about the safety of outdoor gatherings from the New York Times.
  1. Avoid travel

The CDC continues to recommend that people avoid travel, if possible, because traveling exposes you to many other people who may be infected. This is especially important for people with increased risk; if you have diabetes, or you are considering visiting someone with diabetes, travel can pose a high risk for serious coronavirus infection.

  • While traveling in personal vehicles carries the least risk of COVID-19 infection, activities such as road trips can still expose you to the virus at rest stops, gas stations, and other places where you may stop.
  • Learn more about travel considerations from diaTribe and from the CDC.
  • Given the uncertainty of travel restrictions, if you travel you may run the risk of not being allowed to return home.
  1. If you haven’t already, ask your healthcare team if you can try telehealth appointments

Going to a clinic, medical office, or hospital can expose you to people who have COVID-19. Many healthcare teams offer telemedicine appointments so that you can discuss your diabetes management without coming into contact with other people. Ask your healthcare team whether it is safe and important for you to visit the clinic for regular diabetes management.

  1. Stay as healthy as possible

For people with diabetes, it is more important than ever to carefully manage your blood glucose levels. Keeping your blood glucose levels stable will keep your body healthy and ready to fight off an infection.

If you show symptoms or begin to feel unwell, get tested for COVID-19

Symptoms of COVID-19 can appear up to 14 days after you have been infected with the virus. According to the CDC, these are the symptoms to watch out for:

  • Fever or chills
  • Cough
  • Shortness of breath or difficulty breathing
  • Tiredness
  • Muscle ache, headache, or body aches
  • New loss of taste or smell
  • Sore throat
  • Congestion or runny nose
  • Nausea or vomiting
  • Diarrhea

If you have any of these symptoms or are not feeling well, stay away from others, contact your healthcare professional, and get tested for COVID-19. Find free testing sites in your state here. It is important to note that you may experience other symptoms of COVID-19 that are not listed above, or even no symptoms at all.

We know that people with diabetes face more serious outcomes of COVID-19 infection. If you, or someone close to you, has diabetes, it’s even more important to be careful in this pandemic. The best thing you can do to protect yourself and those around you is stay home as much as possible and wear a face mask (appropriately!) when you’re out in public.

Source: diabetesdaily.com

Incorporating a Latinx Lens for Mental Health

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

By Mariana Gomez

As I prepared to write this piece, I had to do my own personal research. My family and I moved from México to the United States in July 2019. We have spent a lot of time trying to learn as much as we can to better understand systemic racism in this new home of ours and learn how to work towards a difference. It is our duty not only to learn as parents, but to teach a thirteen-year-old who is watching, learning and is ready to join in any possible way to help his peers.

What I’ve learned? There is major work to be done in health policies, programs and campaigns that address social determinants of health, health disparities, risk factors, and to build health services for the Hispanic/ Latinx population alongside other ethnicities and races.

Because of a lack of easily accessible or fair health services, the Hispanic and Latinx population in the US will pay a high mental health and emotional well-being price during the COVID-19 pandemic. According to Minority Health, poverty levels among these groups will also have an important impact on emotional health.

“Poor access to care due to low rates of insurance, immigration status, language and cultural barriers in healthcare which can include differences between provider-patient in explanatory models of illness and families as the gatekeepers can limit entry into treatment.” (Cortes et al, 2008) as read in the Handbook of Multicultural Mental Health Assessment and Treatment of Diverse Populations.

Talking about Latinx population includes different sub-groups. Us Latinx are a diverse community. Most of us come from different countries and speak different languages. Yes, Spanish is the official language but some will speak native tongues as well.

I am a Mexican Diabetes Educator who believes that talking about Latinx culture in the diabetes space requires us to work on more topics besides food and language barriers in our practice. Diabetes Education must include programs that recognize our many cultural differences as well.

We need more Latinx researchers, professors and conference speakers guiding these efforts in order to build better, stronger but also culturally appropriate strategies and programs. The work we’ve been able to see so far is indeed amazing, but how about incorporating a “Latinx lens” when talking about us Latinx populations and our health needs? Addressing our emotional health is even more complex as these cultural differences should be included in the different programs designed to help.

I found Salud Latina some years ago in a twitter conversation and felt immediately drawn to their mission “to lead the creation of culturally relevant multimedia research, tools, and stories to fuel people to start and support policy, system, and environmental changes in schools and communities to improve Latino child health, reduce disparities, and promote health equity and a culture of health.”

To explore and learn more about these disparities and the way our mental health is being addressed nowadays, I spoke with Rosalie Aguilar, project coordinator for the Salud America! program at University of Texas Health San Antonio.

During the COVID-19 pandemic, is there a need for culturally and linguistically-oriented mental health care for the Hispanic/Latinx population?

Rosalie: Yes! For Latinos and other people of color, COVID-19 has caused disproportionately higher rates of cases and death, job loss, and other inequitable impacts.

Many are also experiencing more mental health issues than in previous eras, according to Dr. Madeline Aviles-Hernandez, the Outpatient Services Director at the Gándara Center.

“This crisis is making life much more difficult for those [Latinos, African-Americans and other culturally diverse populations] we serve, including those in recovery and people who have yet to be treated for such problems as anxiety and depression,” Áviles-Hernández said in a statement. “Minorities have been—and continue to be—less likely to receive mental health treatment.”

The COVID-19 outbreak has resulted in forced isolation, school and business closure, massive job loss, food insecurity, and a litany of other impacts outside of the illness itself.

These ramifications impact more than just physical health, but mental wellness, too, according to Cathi Tillman, the executive director and founder of La Puerta Abierta — a Philadelphia nonprofit providing mental health support to immigrant and refugee communities.

“People who were supporting themselves on some level now can’t,” Tillman told the Philadelphia Inquirer. “They’ve lost their jobs. They can’t congregate socially, or go to church, which is a big part of the community for many people. They can’t come into the office for therapy. For recent immigrants and refugees, the things that were already difficult are 100% more difficult now.”

How are these needs being addressed so far? What kind of help are these groups receiving and how is your organization and team working to provide support? 

Rosalie: Various nonprofits are stepping in to help fill the gap, but there’s still a huge need for mental health care services and additional social support services. There’s also a need to help address the stigma involved with accessing these services.

Our organization is not involved with providing direct mental health care services. But at the Institute for Health Promotion (IHPR) at UT Health San Antonio, the headquarters of Salud America!, we do have a team of community health workers, promotoras, who provide patient navigation and reach out to patients in the Bexar County area to check up on them, provide social support and to help them connect with their health care providers. These services have been associated with less anxiety and depression among patients and fewer hospital readmissions.

There are other groups out there at the national level like NAMI that can also help connect people to services. We really also appreciate that Informed Immigrant, Immigrants Rising, and FWD.us produced a 10-step guide to help mental health care providers respond to the distress of immigrants whose status is in flux due to ongoing changes to the Deferred Action for Childhood Arrivals (DACA) program, amid coronavirus. We wrote about it here.

Folks can also use findhelp.org or call 211 find support services in their areas. We actually got a chance to speak with the creator of findhelp.org, and tell the story of how he and his team were able to take on the herculean task of digitizing all the social services available in the United States, thus making it easy for people to find and apply for those resources.

How can us Latinx people in the non-profit and health space work and help you? 

I think the important thing right now is to continue to do all we can to prevent the spread of COVID-19 with culturally appropriate messaging and also to continue to push for health equity in Latino communities. If you offer a support service that can be helpful to Latinos let us know, because the word needs to get out.

Also, share our materials on the Impacts of COVID-19 on Latinos and solutions. We have a bilingual infographic, a landing page on “Coronavirus and Latino Health Equity” and a list of actions that could help Latino communities.

What is the biggest campaign you are working on and how can people and our readers join and help?

We are working on several things right now, including culturally aligned messaging to help stop the spread of COVID and also a campaign to help communities get their cities to declare racism a public health issue and commit to action. We know that racism coupled with the impacts of COVID-19 are detrimental to our population. Therefore, we need to do all we can to promote a culture of equity and to reduce bias.

Source: diabetesdaily.com

Summer Is Here: Are You Still Safer at Home?

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

By Julia Flaherty

States and regions across America are slowly reopening, which means social distancing guidelines have become a bit fuzzy. However, the same principles apply to ensure you are best protecting yourself and others. COVID-19 is still a threat and will remain so until we have a widespread vaccine.

It’s important to remember that whether or not you’d like to slowly emerge back into society is your choice. You can absolutely still stay at home if that makes you feel safest and you are able to. But as more businesses and workplaces reopen, you may not have that choice.

It is also completely understandable that, after months inside, you’re ready to begin weighing the risks of certain activities to maintain other physical, mental, and emotional health needs. Both mentalities are okay. But if you plan to re-emerge or have to, there are important guidelines to keep in mind.

Know Your Risks

Public Gatherings

To remain cautious, keep your social circles small. Continue to limit your interactions to the people you live with, and be mindful of any emerging illnesses among your household members. If someone in your household does get sick, the CDC advises quarantining any ill family members in a specific room of your house (if they do not have to be monitored in a medical facility) to keep everyone safe from the spread.

Experts have outlined the risk factors of certain summer activities. While hosting an outdoor barbecue in your backyard with one other household is low to medium risk, going to a beach or pool among strangers is medium to high. Experts also say eating indoors at a restaurant is medium to high risk.

There are still many safety benefits of engaging with friends and family via virtual chats, ordering takeout instead of sitting down at venues (meanwhile supporting your local economy), and enjoying the great outdoors. Experts rate exercising outdoors and camping as low-risk summer activities.

Hygiene

Keep your hands and face (eyes, nose, mouth) clean. The CDC continues to advise washing your hands after treating someone who is sick, eating, preparing food, using the bathroom, tending to a wound or sore, touching pet litter, food, or treats, touching the garbage, interacting with out-of-home surfaces, and so on. Wet your hands with clean running water each time you wash them, and lather your hands, covering all areas of them, for at least 20 seconds. Dry them well using a clean hand towel each time.

Hand sanitizer with at least a 60% alcohol volume is good to use in the interim if you do not have immediate access to soap and water, but the best method is still washing your hands, as hand sanitizer doesn’t eradicate all types of germs. Be mindful of this standard amid all of your summer activities to stay safe.

Regularly launder your clothes and shower. Cough or sneeze into a tissue or your clothing, and then throw away your tissue or change your clothing. When cleaning, use an EPA-approved disinfecting product. Frequently clean high-touch surfaces.

Masks

Though many of us are growing eager to be close to friends and family again, suffering from lockdown burnout and fatigue, it’s still important to remember that masks do not replace the six feet apart social distancing rule. If you are slowly working on re-emerging, keep in mind that not everyone will practice mask safety in a compliant fashion, which puts you at risk.

Some do not know how to wear masks properly, while others still do not have access to compliant masks, and some may choose not to wear a mask at all. To ensure your safety, continue to wear a mask in public settings, such as the grocery store or your workplace if you are returning, and keep staying six feet apart. Experts have commented there are no known grocery store linked cases, indicating that grocery store shopping remains a low risk so long as you follow social distancing guidelines.

Source: diabetesdaily.com

The Benefits of Working from Home with Diabetes

COVID-19 has officially changed the way the world runs. More than ever, people are staying home (whether by choice or mandate), spending more time with their families, avoiding public events, and yes, working from home. Essential employees, such as frontline healthcare workers, grocery store clerks, sanitation crews and workers rendering city services, are still having to report in person, but COVID-19 has made a third of Americans (over 100 million people) switch to home work.

This can be extremely beneficial if you live with a disability or chronic disease, and can be helpful if you live with diabetes. And while Americans still work more than anyone else in the industrialized world, working from home can help balance the stress of diabetes management. Here are some of the benefits of working from home if you live with diabetes.

No Commute

Let’s face it, commuting is not fun. The average American working full-time (8 hours a day, 5 days a week) commutes an average of 4.35 hours a week and over 200 hours (nearly nine days) per year. That is a lot of wasted time. With rising costs of living and stagnant wages, more people live farther and farther from their jobs, and have longer commutes than ever, which can cut into both one’s sleep and time for exercise. “Commuting” from your bedroom to your home-office leaves more time for quality sleep, morning exercise, and a healthy breakfast, which can set your blood sugars up for an excellent day, which can increase work productivity as well.

Not commuting will also save lots of money that would normally be spent on parking, car maintenance, tolls, and gasoline. Even if you normally take public transit to work, metro and bus tickets add up quickly! Working from home is also much better for the environment; transportation accounts for one-third of all greenhouse gases produced in the United States. Staying at home for cleaner air is an easy and simple way to help the planet.

Healthier Meals

Takeaway Chinese food or pizza at lunchtime can be a blood sugar nightmare. Working from home affords people the ability to cook easy, healthy meals in their kitchens, which is not only a healthier option, but saves money, too. It’s easy to cook lentils or beans in a slow cooker, or wash and chop up fruits and veggies for a quick grab and go snack if you get the afternoon munchies. Additionally, check out these easy, low-carb recipes that you can quickly make from the comfort of your own home!

Fewer Sick Days

People who work from home both take fewer sick days and get sick less often (no sharing germs in a communal setting or on the train en route to work!). Also, going into an office with a mild cold or flu can be miserable, but doing some work from home is almost always accessible. Plus, diabetes can mean dawn phenomenon, a kinked pump site midday, or a bad low that would previously require coming in late or leaving early- none of which would be necessary with a work from home schedule. It’s healthier for everyone!

No Judgement

Ever take a correction dose during a meeting, and get the side-eye from a nosey coworker? Ever have someone compare your diabetes to their distant relative who died of horrible complications from diabetes (when you never asked for the story?). Are people always questioning what you’re eating (or not eating), or how much you exercise (or how much you don’t)? Working from home prevents judgement and prodding questions, and you can go about your day and take the best care of yourself without intervention from others.

A Flexible Schedule

This can depend on your organization or company, but many offering work from home will grant their employees some flexibility in their schedules. If you have an endocrinologist appointment in the morning, shifting your work schedule back an hour or two can prevent the need to take personal leave for the entire day. Likewise, a flexible schedule can allow for a lunchtime run, which can counteract high blood sugars in the afternoon. Need to change your pump site or CGM midday? Working from home can let you do all that while still getting you work done. Flexibility is key to excellent diabetes management, and working from home makes it much easier.

Have you been working from home since the COVID-19 pandemic hit? How has it benefited you and your diabetes management? Is there anything that you particularly like or dislike about working from home? Share your story in the comments below; we love hearing from our readers!

Source: diabetesdaily.com

Be Prepared and Know Your Rights: Your Guide to Protesting With Diabetes

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

Editor’s Note: It is an extremely personal decision to protest, and Beyond Type 1 neither endorses nor opposes any person living with diabetes’ participation. This guide is to help those who choose to protest do so as safely as possible.

Protesting is one of many ways to create change and is a right of all Americans under the First Amendment. But if you have diabetes, there are extra things to consider, particularly amidst COVID-19.

Having diabetes – type 1 or type 2 – presents challenges in daily life already; adding a challenging environment with risk of exposure to a virus makes things more complicated. Because of that, you may choose to lend your voice to the things you care about from home, which is also impactful.

However, if you are heading out to protest, here’s what you need to know.

Be Prepared

Step 1: Make sure you are healthy enough and prepared to participate.

Consider the state of your health over the last few days and weeks. The best circumstances under which to attend a protest are when your blood sugars have been stable, you have been eating hearty and nutritious meals, you are well-hydrated, your immune system is strong, and your mental health is fortified.

Step 2: Pack a bag.

In addition to the standard items suggested for all protesters, like extra masks/face coverings, cash, your health insurance card, permanent markers, water, and snacks, there are extra things to consider if you have diabetes. Remember that you may get stuck away from home for a longer period of time than planned.

  • Double down on water. While heavy, staying hydrated can keep your blood sugar levels more manageable and can prevent other health issues. When volunteers or street medics offer more water, accept their offer.
  • Bring a variety of snacks, with a combination of carbohydrates and protein, and glucagon (nasal or injectable kit). It is helpful to have both fast-acting glucose, like glucose tabs or gels, to raise your blood sugar quickly if you experience a low, as well as more substantial snacks to consume periodically to keep your blood sugar stable. Ensure that the people you’re going with know how to use glucagon, including what personal signs of a low blood sugar you experience that they can look out for.
  • Pack extra blood sugar monitoring supplies. Even if you have a continuous glucose monitor (CGM), it is possible for your sensor to fail or become inaccurate due to heat causing your adhesive to loosen or jostling from being in a crowd. With either your CGM or glucose monitor, make sure you are checking your levels often. If you have a closed-loop system and can utilize an ‘exercise’ setting to keep your blood sugar levels slightly higher (typically around 160 mg/dL), do so.
  • Include a back-up insulin delivery method. If you wear an insulin pump, bring insulin pens (with extra pen needles) or vials and syringes. If you utilize injections, make sure you have more supplies than you typically need. Consider packing in a small cooler system/insulated bag to keep your insulin cool.
  • Write down your medical information on index cards kept in the outer pocket of your bag. This should include your medical background information (all medical issues you live with), your medications, and the contact information for your healthcare provider and emergency contact.
  • We are still living in a pandemic, so pack extra face masks, hand sanitizer, and disinfecting wipes. If you accept water or snacks from volunteers, ensure you sanitize surfaces, like the opening of a water bottle. COVID-19 is challenging, but made more challenging by diabetes management. Minimize your risks to stay safe. 

Step 3: Wear protective articles of clothing + a medical alert item. 

Wear a mask or face covering, long pants, comfortable closed-toed shoes, a long sleeve shirt, a hat and/or sunglasses, plus a medical alert item, like a bracelet or necklace.

  • If you do not have a medical alert item, write your alerts on your arm using permanent marker. This could something like “insulin-dependent, type 1 diabetes.” Your alerts should be as clear as possible, helping a person completely unfamiliar with diabetes be more aware of your health background.
  • Protective clothing – long sleeves, sunglasses, hat, etc. – shields you from the sun, and will also provide a barrier for your skin in case tear gas is deployed. A primary component of tear gas is capsaicin, a chemical compound derived from chili peppers. As tear gas (made from fine particles) is absorbed by your skin, it can produce extensive amounts of inflammation. This can lead to health issues in anyone, but can lead to issues with blood sugar, extra pain response, and dehydration for people with diabetes.

Step 4: Have a buddy and communicate.

No one should go to a protest alone if possible, but particularly no one with an underlying health condition. Ensure you attend a protest with someone you trust, who knows you have diabetes, and can help look out for the signs of low or high blood sugar. Ask them to remind you to drink water and eat. Create a plan for where and when to meet if you get separated. Be clear about your limits and make sure you are in agreement about your boundaries. For example, if you are attending with someone who is willing to be arrested and you are not, you will no longer have your buddy system intact, which could lead to a safety issue.

Step 5: Take care of yourself when you get home.

Chances are you just walked a long distance and tensions were high. Hydrate and eat once you get back home or to a safe place. Your blood sugar may drop or rise in unexpected ways due to stress and exertion. Keep an eye on your blood sugar levels as much as possible. If you have a CGM with follow capabilities, ask a friend or family member to make sure their alerts are loud, particularly while you sleep.

Know Your Rights

Attending a protest carries the risk of being detained or arrested. Because of this, ensure you know your rights before you attend. Be aware that while everyone in the US has the same rights theoretically, being undocumented, a person of color, or belonging to any marginalized group – including living with diabetes – alters how you may need to approach interactions with members of law enforcement.

The following is summarized from the American Diabetes Association’s Inappropriate Law Enforcement Response to Individuals with Diabetes.

  1. If you get arrested, clearly and calmly state to the police officer that you have diabetes. If you are concerned about or nearing a medical episode – such as a low or high blood sugar event – while detained, communicate the circumstances to the officer. By law, if an officer has visible cues (such as clear signs of a low or high blood sugar) or has been given notice of a person’s medical condition, they must abide by the resulting rights that provides.
  2. You have a right to be able to take care of your health and receive medical assistance if and as needed. The Fourteenth Amendment grants the right of pretrial detainees (anyone who has been detained, arrested, or jailed) to adequate medical care.
  3. Under the Fourth Amendment, a police officer is not allowed to search or confiscate your belongings without a warrant or without probable cause. If a police officer believes they have probable cause, they must inform you of what they are searching, as well as what they are seizing. Consensual seizures are not prohibited by the Fourth Amendment, so you must state that you do not consent for your belongings to be seized. This all becomes more murky if the police officer can make a case that a severe crime was being committed, an immediate threat is being posed to the officer or public, or if you are resisting or otherwise evading arrest. Stay calm, be clear, and follow directions as much as possible.

Overall, if you are considering or attending a protest, safety comes first. Be prepared. Be careful. Know your rights.

Source: diabetesdaily.com

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