How to Find a Good Mental Health Provider

If you live with any form of diabetes, you’re far more likely to suffer from depression and anxiety. An estimated 40% of people with type 1 diabetes and 35% of people with type 2 diabetes experience significant levels of “diabetes distress,” which can result in negative mental health repercussions, including diabetes burnout.

A mental health provider can be a crucial part of your medical team. Dr. Mark Heyman, the Founder and Director of the Center for Diabetes and Mental Health (CDMH), explains why:

Diabetes is a self-managed condition. This means that it is the person with diabetes, not their doctor, who is responsible for taking care of him or herself on a daily basis. Diabetes involves making frequent, sometimes life or death decisions under sometimes stressful and physically uncomfortable circumstances.

In addition, diabetes management is constant and can feel overwhelming. If you or someone close to you has diabetes, take a minute and think about all of the steps you take in your diabetes management every day. What to eat, how much insulin to take, when (or whether) to exercise, how to interpret a glucose reading, how many carbs to take to treat a low, the list goes on. Decisions, and resulting behaviors (and their consequences) are critical aspects of diabetes management. However, doing everything necessary to manage diabetes can become overwhelming – and feeling overwhelmed is usually no fun.

There are things you can do to help manage the mental distress of diabetes, including finding a good mental health provider that is especially positioned to help people with diabetes. This article will outline how to find the perfect fit!

Consider What You Want in a Mental Health Provider

Think of your mental health provider (or therapist) as someone you’re trying to develop a long-term relationship with. You want to be comfortable sharing all of your thoughts and feelings with this person, and be vulnerable with them as well.

Mental health providers become very close with their clients, so knowing what will make you uncomfortable is very important and crucial to knowing who you want to look for when searching for a provider. Some things you may want to keep in mind:

  • Gender (do you have a preference to work with only men or only women?)
  • Age (you may feel more comfortable working with someone much older or younger than you, or maybe you’d prefer someone closer to your age)
  • Religion (are you looking to connect spiritually with someone? Perhaps your religion is very important to you, or perhaps you’re looking to keep the interactions completely secular)

When you contact a provider’s office or complete an initial questionnaire for therapy, you’ll usually be asked some questions about basic preferences, such as those described above, to help match you with the best therapist.

You may also be able to research a mental health provider’s bio online to learn more about their areas of expertise before scheduling a visit.

Consider the Issues You Want to Address

There are many different types of mental health providers out there, and knowing that specific issues you want to address can help steer you in the right direction. Perhaps you’re suffering from substance abuse, or maybe you have developed anxiety around food. Maybe you and your spouse are struggling with your child’s new diabetes diagnosis, or you’ve noticed depressive symptoms that you want to tackle early. Different providers can help you manage different issues, so be cognizant of that. Some of the different types of specialists include:

  • LCSW – Licensed Clinical Social Worker
  • LMFT – Licensed Marriage and Family Therapist
  • NCC – National Certified Counselor
  • LCDC – Licensed Chemical Dependency Counselor
  • LPC – Licensed Professional Counselor
  • LMHC – Licensed Mental Health Counselor
  • PsyD – Doctor of Psychology
  • Ph.D. – Doctor of Philosophy
  • MD – Doctor of Medicine

But no matter what a provider’s background credentials entail, what matters most is their area of expertise. Reading up on a provider’s background information and bio can help you familiarize yourself with the areas of mental health they deal with, and can help you decide if they would ultimately make the best fit for you and your needs.

Consider Asking for a Consultation

Consider this an interview for the mental health provider you’re considering “hiring.” Some practices will offer a free, 30-minute consultation, so that you can get to know the provider before deciding to come on as a client. Some important questions to ask if you’re able to, are:

  • Are you a licensed provider? (while every state varies, a licensed provider has passed the minimum competency standards for training within your state)
  • What’s your educational background?
  • What is your treatment orientation? (this refers to the school of thought that the therapist draws from in understanding and treating mental health issues)
  • What is your area of expertise? (and if they say “chronic disease” or “diabetes,” that would be excellent!)
  • Do you accept my insurance?
  • What is the cost per session?
  • Are you a prescribing physician? (some providers may be able to prescribe medication for things like obsessive-compulsive disorder, anxiety, and depression)
  • What is your communication style?
  • Do you prefer short or longer-term therapy? (some providers are very short-term goal-oriented, while others prefer developing a relationship over a long period of time)

These questions are not a complete list, but it’s a good start to finding the perfect fit for you and your care.

Seek out Diabetes Experts

It can be very difficult to find the right mental health provider for you and your needs, and that’s especially true when living with a chronic disease like diabetes.

The American Diabetes Association (ADA) recently teamed up with the American Psychological Association (APA) and created a directory of mental health providers specifically equipped to meet the needs of people with diabetes. All providers in this directory are:

  • Currently licensed as a mental health provider
  • A professional member of the ADA (Associate, Medicine & Science, Health Care & Education)
  • Have demonstrated competence in treating the mental health needs of people with diabetes

Currently, the directory has about 60 providers, 40 of which provide pediatric services, and the list is rapidly growing. The tool is simple to use: enter your zip code and whether you’re looking for adult or pediatric services. The directory will then pull up diabetes-trained mental health providers near you. The directory also lets you access what types of insurance a chosen provider accepts, their office location, phone number, and more.

Finding an appropriate mental health provider can be a difficult but worthwhile challenge. Investing your time, money, and energy to improving your mental health as someone living with diabetes is absolutely worth it, and it is crucial that you find a mental health provider that is going to work best for you in getting your needs and goals met. Hopefully these tools will make it a little easier to get there!

Source: diabetesdaily.com

Community Table: Nutrition, Health + Wellness in the Black Diabetes Community

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

By JDRF-Beyond Type 1 Alliance

During our second Community Table discussion, Beyond Type 1 sat down with a group of experts and community members to discuss nutrition, health, and wellness in the Black diabetes community, and share helpful resources and perspectives. Watch the discussion in full!



Speakers included:

  • T’ara Smith, who served as the moderator for this event, was originally diagnosed with type 2 diabetes in 2017 but was re-diagnosed with LADA diabetes in 2019 and is Senior Manager of Beyond Type 2.
  • Keith Crear, who has lived with type 2 diabetes since 2017, is a sports photographer and multimedia specialist.
  • Alexis Newman, who has had type 1 diabetes for 37 years and is a registered dietician.
  • Dex Geralds, who has had type 2 diabetes since 2016 and works as a personal trainer and CrossFit coach.
  • Joy Ashby Cornthwaite, a dietitian and a certifies diabetes care and education specialist.

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

What does wellness mean or look like for you, and has your diagnosis changed the way that you live?

Dex: It’s balance. I know a lot of times when I’m with people who don’t typically know about diabetes, there’s a lot of things surrounding food that they believe I cannot have at all. Once you find the balance, you’re able to still eat some of the things that you’re eating before your diagnosis, maybe not at the same amount that you were eating before. Just finding balance with the way you eat, balance in the way you exercise. Whether it’s like myself who exercise maybe two hours a day or just going out for a 15-minute brisk walk. Just finding balance in what comes with that. The last thing in balance is just your mental health and making sure you check in with yourself and your feelings and your emotions and figure out what brings you happiness and joy.

Keith: It is a balance. It’s knowing what to eat, what not to eat, what to consume, when to consume it. Exercise is very, very important.

Alexis: For me, what it looks like is making sure that I am well, not only with how I’m eating, but also exercise. Making sure I’m honest and checking in with my friends and family, my support system, too. Also, the spiritual aspect of it. I’m a Christian, so making sure I’m connected in the sources that I feel encouraged in. When one of those are kind of out of whack, I don’t feel well.

Joy: I think of health on a continuum, and I encourage that in every day. In my family life, in my personal life, but also for those who I help to balance their journey with diabetes because everyone has their own journey and their whole complete individual. When someone comes to a session with me, I find out where on the continuum you are and what can we work on today? It has to come from you. It has to be what you want and not necessarily what I want. But I’m going to use my skills to get you to where you need to be.

What misconceptions have you encountered pertaining specifically to Black people with diabetes when it comes to fitness? What is some of the ways that you’ve helped your Black clients move past those stigmas and misconceptions?

Dex: The biggest thing is support in our community and in the world in general. If you’re overweight you get looked down upon and that can add to depression and lead to worse things. I know a big term going on right now is “unlearning” and taking everything, looking at it through a different scope, and then figuring out what brought you to this point and then what can I do to change this. It’s not just a one-stop shop kind of thing. It’s going to take a while for you to start to see changes for the most part. You have to create these better habits and getting through that way.

Learning to love yourself is vital, and when you learn to love yourself you want to do the things that’s right for you and you’re going to quiet that outside noise and put your blinders on and work for yourself and not think about the negative things that you might be getting from someone else. My family has a history of diabetes and obesity. My oldest sister, she’s lost 150 pounds now, but still just over 400 pounds. I remember things people would say to her growing up. Now that I support her and my family’s supporting her, she’s been on this incredible journey and losing weight because now she feels confident enough to do the things that once scared her or felt ashamed about. Being able to conversate and talk to my sister, or just clients in general, I’ve been able to learn what’s going on and been able to apply that to them in their journey in fitness.

Alexis: The kind of things that I’ve seen is that they believe that people think they’re lazy so they don’t want to push through that because they’re afraid of what people are going to think. I’ve also seen the fear of not knowing what to do overtake them in my discussions with my patients. Another idea is that they have this perceived idea of what exercise looks like, so really breaking it down into bite-sized pieces of like, “Look, as long as you’re like being consistent with the movement, whatever you choose to do, you can add on time, you can add on intensity. But, as long as you’re out there trying to move.” Those are the things that I have conversations with my patients about in terms of fitness.

Another thing too, is that an ideal weight of someone who’s African American may not be similar to another culture or race. We need to keep that in mind as we are discussing food, nutrition, health, and weight that the ideal weight that a doctor may have for you may not be appropriate. I think that needs to be said and also needs to be addressed when we’re talking to these patients about weight and health and glucose numbers and things like that.

Joy: When it comes to fitness, one of the great disservices, especially for the Black community, is to tell people that they need to lose weight if they’re moving. For many people who are living with diabetes, movement doesn’t always equate to weight loss. It also doesn’t always equate to better blood glucose values.

There’s a lot of things that go into thinking about exercise. When you’re telling someone that it’s going to make them better to exercise and they’re saying that their blood glucose is either crashing or going up way too high with exercise there’s a disconnect. You haven’t heard what they’re saying to you. You need to find out what people are experiencing in their exercise journey and then address those things and say, “Look, you may not lose weight, but let’s check your blood glucose before and after.” Celebrate the win over either the hyperglycemia that you have been feeling or the hypoglycemia that you were feeling if you didn’t pre-exercise meal or whatever reason. Celebrate the win that is more than weight.

How can we celebrate our culture or different types of Black cultures throughout the year, not just during Black History Month?

Joy: Support each other. I know for years I felt like I was the sole person saying, “Black people aren’t making ourselves sick with diabetes.” We need help. We need medications. We need diabetes health care and management. We need to know how to take care of ourselves and we don’t have to do that alone. Whatever we need to do we need to support each other and do it together and then we’re louder.

Dex: Our culture is so vast and rich, and it needs to be shared every day and whatever way possible. Whether it’s through social media or just through conversation or the way you dress, the way you wear your hair. It just needs to be expressed and be out there for people to see and enjoy and learn. I love my culture so much.

Alexis: Buy Black. There are so many amazing Black companies, I’ve been focusing on and amplifying those businesses on social media and telling my friends. I’m in a friend group and we’re talking about face care. I’m like, “All right, I’m using this” and they’re using this Black company. We’re just sharing information of these amazing Black companies that are out there. If we can’t do that, then no one else is going to. It’s really important to invest in Black businesses because they’re everywhere.

T’ara: Yes, please support Black businesses that you see, especially in the diabetes community. There’s so many Black people in the diabetes community who have businesses and organizations who could use amplifying on your social platforms. That social sharing could do a whole lot because you never know who can see their products, so please amplify it.

Keith: Constant delivery of content from Black creators. Constantly delivering things from Black history that could be done every day. The way you wear your hair, the clothes. Just something that constantly keeps it in the public eye so it’s not condensed down to just one month. There are a lot of people out there that are doing it and it’s always great to see that. If more of us continue to do that it’ll shift the narrative and it will shift the visual aspect of how we’re seen in society as a whole.

Source: diabetesdaily.com

My Type 2 Diabetes Is Forcing Me to Find a New Reason to Live

By Abby Hanna

April 21st, 2021 was when it finally happened. It was around 1:00 am and I was dozing off in bed. With the melatonin in my system and a good day behind me, I had no reason to be up any longer. My nights were usually long and painful due to my anxiety and lively thoughts, but that morning I had a good enough day to let me sleep peacefully. An exceptional day even. I had gotten my blood work from the day before back, and it looked like everything was stellar. My doctor emailed me that afternoon- “Hello Ms. Hanna, your labs look good overall.” I had carelessly overlooked the note she left about my low cholesterol (I’ll just eat more avocado toast or something) and went on with my day proud of how my body was taking care of itself without me ever having to intervene.

And then came that night. That was supposed to be a peaceful night. Me dozing off in bed. Melatonin in my system. And something told me to check my email. I decided why not, noone ever sends anything important at 1:00 am, it’ll be a quick scroll and then right to bed. I noticed another email from my doctor, more blood work results from the other day. I clicked on the message that revealed the results, and it was as if someone had replaced that sleepy pill in my system with Adderall. I’ve never sobered up so fast. I actually had a little bit of research to do from the information that she gave me. What I was looking at wasn’t an email explaining my labs, but the actual labs themselves. With a bit of research and decoding, I had confirmed what I thought was true. A cold chill ran through me as I stared at my labs. I rubbed my eyes to make sure I wasn’t dreaming. No, those labs are correct Abby. You have type 2 diabetes.

It was like finding out that your deepest fears were true. Like looking under the bed and seeing that the boogie man actually was there, or feeling the pain of pinching yourself when you thought that you were dreaming. Or looking behind you and realizing that someone is indeed following you, or getting a test back with a big fat F that you couldn’t afford to fail, or opening your bedroom blinds to reveal a dark figure is watching you, or hearing the sputtering of your car breaking down in the middle of nowhere, or reading your lab results in the middle of the night that say: You. Have. Diabetes. It was the end of my world. My body purged itself of any reason to sleep and immediately filled itself with anxiety and anguish. I did eventually end up going to sleep hours later, after learning every single thing on earth about diabetes.

I actually entered a state of bliss for the next few days. I had found out that my A1c (the number that tracks your blood sugar and how much excess sugar you have in your body) was relatively low when it came to the diabetic range. If your A1c is 6.5 or higher, you have diabetes, and mine was 6.6. I felt great about that, and although I aggressively changed my diet the next couple of days, I held dearly to my truth, which was that I wasn’t that much of a diabetic, only a little diabetic. A diet diabetic, if you will!

I knew that when I had a phone call with my doctor she would reassure me that everyone else’s diabetes was bad and that mine was just fine and that with a couple of smoothies, I’d be diabetes-free and back to normal like everyone else. So I waited a couple of days for my appointment. I set up MyFitnessPal. Ate a couple more vegetables, just for kicks, because I knew that when you have diabetes lite like me, you just have to add an order of apples to your McDonald’s meal instead of throwing it out all together.

Monday came around and we finally had the conversation. She told me everything I already knew about diabetes due to my extensive research days before. I told her that my worst habit is eating once a day. She sent a couple of informational videos about living with diabetes and told me that a nutritionist would be calling me soon. And then I posed the question. “So this is like a short-term thing, right? My A1c is pretty low for diabetes, so I just need to get it even lower and then I won’t have diabetes anymore, right?” And then she told me that this diagnosis was forever.

I started sobbing. And I sobbed through the rest of my conversation with her. I sobbed while telling my mom. I sobbed while on my walk. I sobbed in the grocery store while I picked up the “5 best foods to combat high blood sugar”. I sobbed while sitting in the car thinking about how I couldn’t flip this to be something that it’s not. I realized that this was the first thing that I couldn’t run from. I had successfully coped with everything in my life with the help of food. Food was my sidekick, my refuge, my safe space. And with this, I couldn’t run to food. I actually had to do the opposite. I had to run away from food because if I ran to it, it would be the very thing that kills me one day. It made me think about my relationship with myself and my body on a whole new level.

For as long as I can remember, food has been my safety blanket. It was my hobby. I had always loved cooking and wouldn’t mind taking the extra 20 minutes to turn top ramen into fine cuisine, or slow cooking something in the oven to make the taste richer. I loved the crinkly sounds of a takeout order, the squishy packets of soy sauce and ketchup, the red Thank You’s staring at me with gratitude as I opened the bag to reveal what treasure I ordered for that day. I loved the sizzling sound of a raw egg hitting a hot pan. The bubbling boil of a ripe stew slowly melding its flavors over a low fire. Everything about food was special to me, it was an experience, and I unabashedly leaned into it. Eating was my favorite thing to do and I would eat if I felt sad, if I was happy, to celebrate, to commemorate, to combat boredom. Everyone is supposed to eat, obviously, but I wouldn’t shy away from giving myself my favorite foods whenever I wanted them. These tendencies got a lot worse during the pandemic. I was already fighting my depression with cheeseburgers and my anxiety with brownies. The addition of a global catastrophe was scary, but it was no match for pad thai, mac and cheese, and crab rangoon. I felt justified giving myself whatever I wanted whenever I wanted. And why should I feel bad? I hate my life so I’m gonna enjoy my meals because it’s the only thing keeping me from killing myself!

Oops. Did I just say that?

The thought came tumbling to the forefront of my brain as I sat in the car thinking about this new life I would have to live with diabetes. I realized that the only thing keeping me alive was food. Literally. I hated everything else, my depression had taken everything from me but the sweet taste of lemonade or the spicy kick of kimchi. I realized that I hated my body and thus didn’t care what went into it. Growing up with body dysmorphia has made me distance myself from myself as much as physically possible. And mental illness has made me work towards quieting my brain and running from my problems in any way that I can. So, I don’t do my hair, I wear big chunky outfits to hide my body, I let the root of my fears hide in the crevices of my brain, and I revisit my good pal Caviar because it’s the only thing keeping me from ending it all. And now I am forced to take care of my body.

Learning about all the things that can contribute to high blood sugar was probably one of the wildest parts of the diagnosis. Anxiety, bad sleep habits, and stress are three things that I am too familiar with, and three things that also can raise blood sugar. Not eating enough and not getting enough exercise are also three things that can increase your blood sugar, or put it at alarmingly low rates.

Being diabetic means being confronted with my body’s health and well-being for the first time. It doesn’t just mean having more smoothies but it means sleeping at an appropriate time and making sure that I’m not stressing about all the worries of life. It means drinking enough water because my body deserves water, and it means going on a walk because my body deserves to feel the warmth of the sun and the coolness of the wind. This is hard for me. Because I want to sleep all day and I want to stress eat. I want my first time of the day leaving the house to be when I pick up my Ono Hawaiian from the delivery driver. I don’t want to have to think about loving myself and what that really means. But I have to. I have to make the decision to prioritize myself even though indulgence has felt like prioritizing me this whole time. It clearly wasn’t. Because this is where it got me. I don’t know what self-love is and I’m scared to find out, but I know that my security blanket has been ripped from me, and although it’s cold and painful, I hope there is something worth it on the other side.

 

Editor’s note: If you are struggling with mental health issues and diabetes, we urge you to seek professional help. The American Diabetes Association maintains a registry of mental health providers that have specially trained on caring for patients with diabetes.

Source: diabetesdaily.com

Quiz: How Engaged Are You With Your Diabetes?

Everyone manages their diabetes differently. As long as you’re thriving physically, mentally, and emotionally, each person needs to find a management style and level of engagement that will work for them and that they can stick to consistently. Take this quiz to better identify if you’re as engaged with your diabetes management as you think you are, along with tips for how to improve your diabetes management:

What time do you typically check your blood sugar in the morning? 

A. You’re supposed to test in the morning?
B. Whenever I remember, but definitely before my first meal of the day
C. As soon as I wake up, of course
D. I have a CGM, so I always know my blood sugar
E. My diabetes doesn’t require regular blood sugar testing

If your blood sugar is over 250 mg/dL, what do you typically do? 

A.Wait and see approach. It’ll come down eventually
B. Take some insulin (if applicable), but I don’t stress over it too much
C. I take insulin (if applicable), drink some water, and get some movement in
D. I take insulin (if applicable), test for ketones, drink tons of water and exercise for 20 minutes to bring myself down. No snacks until I’m in my goal range, either

When I’m at a birthday party, I: 

A. Always have the cake! And probably more than one slice; life is too short
B. I’ll have some cake if I’m craving it
C. Have the cake, but make sure to sneak a peek at the label for carb counts
D. Pretend I’m having the cake while finding a surreptitious way of sneaking it into the garbage. Vegetables are easier to bolus for anyway.

How often do you go to the Endocrinologist? 

A. What’s an Endocrinologist?
B. Usually, every year, if I can remember to schedule an appointment
C. Every 6 months or so
D. Every 3 months, right on the dot. I never miss a visit

My favorite low snack is:

A. Everything in sight. I usually overeat for my lows and need to then treat high blood sugars!
B. Candy!
C. Anything that’s within 15-20 grams of carbohydrates
D. Low snacks are not supposed to be fun. They’re measured out glucose to assist in a low blood sugar incident. I’ll eat a few glucose tablets and move on with my day

How often do you change your lancet? 

A. They’re…changeable?
B. Um….not often enough
C. Honestly? Every few years
D. After every time I lance my finger, duh!

When my blood sugar is stubbornly high, I: 

A. No stress, man! I didn’t ask for this disease
B. Feel pretty guilty, but it usually passes
C. Take a correction dose but realize that blood sugars aren’t good or bad, they’re just information to take into account, telling me what to do to better manage my diabetes
D. Berate myself mercilessly. I always feel guilty when I let my blood sugar go high. It’s all my fault

How do you clean an insulin pump or CGM site? 

A.You…have to clean sites?
B. I don’t do anything different, but I know I should
C. I usually change my sites after I shower, so nothing, but I’m clean enough
D. I always use an alcohol swab. You must take the risk of infection seriously!
E. I’m not on insulin or I don’t use an insulin pump and/or CGM

Do you take “rest” days? 

A. From what?
B. Yes, but I don’t have a strict exercise routine, either
C. I take a few rest days per week
D. I exercise 7 days a week and never take a rest day. Diabetes doesn’t take a break, so neither can I

How do you give yourself a break from diabetes?

A. I usually just ignore my diabetes
B. Diabetes just fits into my life. It’s mostly running in the background, honestly
C. I get regular massages and enjoy wine on the weekends
D. I never get a break from diabetes

Answer Key

If your answers are mostly As:

You are more hands-off with your diabetes, often neglecting your care and suffering as a result. You don’t often take the time to count carbohydrates, exercise, or test your blood sugar. This can be due to diabetes burnout, depression/anxiety, or denial of your condition.

Schedule an appointment with your care team or Endocrinologist right away to seek the help you need to get back on track with your diabetes. You may also need better support from family and friends, and even seeking professional counseling or therapy may help.

If your answers are mostly Bs:

You are permissive/indulgent with your diabetes. You don’t let diabetes stand in your way of having a normal life, but you’re not taking the best care of yourself, either. You are aware that you need to treat yourself better, but you’re not the best at prioritizing self-care or your diabetes management. Reach out to family, friends, and your medical team to get back on track and re-motivate yourself to get on the top of your diabetes game!

If your answers are mostly Cs:

You are doing a great job taking care of your diabetes with this more hands-on, authoritative management style. This style of management is characterized by high responsiveness and high demands. You realize the gravity of your condition and you work hard to take great care of yourself, without becoming obsessive or having diabetes completely rule your life. Great job and keep up the excellent work!

If your answers are mostly Ds:

You fall under the authoritarian/disciplinarian style of diabetes management, ruling your diabetes with an iron fist. You never give yourself a break, demand absolute perfection from yourself and your blood sugars, berate yourself if you make mistakes or act human, and can never relax about exercise, diet, or your life with diabetes.

You’ve got to give yourself a break, or you’ll face diabetes burnout and you’ll suffer more in the long run. Talk with your doctor, counselor, or therapist on implementing strategies that will allow you to give yourself some grace and make space for the humanness of diabetes.

How much thought do you put into your diabetes care? What level of engagement has worked best for you now or in the past? Has learning more about how you approach your diabetes care helped you handle your diabetes better? Share this quiz and comment on your experience below!

Source: diabetesdaily.com

Most Important Vitamins People with Diabetes Need

People with diabetes have special dietary requirements, but unfortunately, lots of important vitamins and minerals are lacking in the standard American diet. That’s where vitamins can play a crucial role in supplementing one’s health. This article will outline the most important vitamins that people with diabetes need to live their healthiest life.

Vitamin B12

People with diabetes with nerve damage in their hands and feet may see their symptoms worsen if they have a vitamin B12 deficiency. Vitamin B12 helps improve the health of red blood cells and boosts brain function.

Studies show that long-term use of the diabetes drug Metformin can lead to a vitamin B12 deficiency, and strong sources of the vitamin can be found in fish, dairy milk, meat products, and eggs. There are also vegan and vegetarian forms of Vitamin B12 that can be taken orally in pill form.

Vitamin D

Vitamin D deficiencies are common in people with both type 1 and type 2 diabetes, and a recent study out of Denmark has shown that people with diabetes who have a Vitamin D deficiency are at an increased risk of diabetes complications and premature death. Solving for this vitamin is cheap and easy: sitting in the sun for 15-20 minutes per day without sunscreen will restore most deficiencies, or Vitamin D can be found in fish, dairy products, or egg yolks.

Vitamin C

Increasing one’s intake of Vitamin C helps control the levels of sorbitol in the blood, which can be harmful at high levels and may contribute to retinopathy and kidney damage, which are common complications of diabetes. Vitamin C can also increase insulin sensitivity, reduce insulin resistance, and help people improve their HbA1c levels.

Vitamin C is found in many fruits (and juices) such as lemons, oranges, tomatoes, guava, watermelon, and strawberries, and is also readily available in supplement form. It is also abundant in vegetables like cauliflower, Brussels sprouts, broccoli, and peppers.

Chromium

Studies show that chromium, found in brewer’s yeast, improves insulin sensitivity and tolerance in people with type 2 diabetes. Chromium helps maintain healthy skin, hair, and eyes. It is effective at supporting the nervous system and enhancing immune system function. Chromium can be found only in trace amounts in foods like meat, spices, and grains, so people with diabetes should take chromium supplements.

Curcumin

A 2013 meta-analysis shows that curcumin (the active ingredient in turmeric) lowers blood glucose levels, increases insulin sensitivity, and stabilizes blood sugar levels, helping to decrease the likelihood of complications in people with diabetes. Researchers also found that curcumin may play a role in diabetes prevention.

Turmeric and curcumin also help improve mood, which is important for people with diabetes as depression and anxiety are found at much higher rates in this population, aid in digestion, and even improve immune system health.

This extract can be found in over-the-counter supplements and can be added to foods in its natural form (Turmeric), found in the spice aisle of any grocery store. Make sure to consume turmeric with black pepper, as the spice enhances curcumin absorption in the body by up to 2,000%, maximizing its benefits.

Always work with your doctor and/or registered dietitian to determine which vitamins you should incorporate into your daily routine. Your doctor will most likely order a blood test or urine sample to determine what’s needed, but supplementing your diet with more vitamins and minerals can be helpful to achieve better blood sugars and lower HbA1c levels in the short term, and may even prevent long-term diabetes complications and premature death.

Source: diabetesdaily.com

MoreThan a Diabetic: Eritrea Mussa Khan

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

By Makaila Heifner

Eritrea Mussa Khan is 28 years old and has had type 1 diabetes for 18 years. She lives in Dallas, Texas with her husband where she works full-time in application development training for a large school district.

Recently, Eritrea joined the team at Diabetics Doing Things as a Content Creator and is a co-host on the podcast. Their new 4-part series “More Than a Diabetic,” features 15 members of the diabetes community who are all people of color. This series focuses on important topics like medical racism, representation in the diabetes community, and how we can collectively as a community do better to support Black and other people of color with diabetes.

Eritrea recently sat down with Beyond Type 1 to discuss the podcast, identity, and diabetes.

BT1: Do you remember what it was like when you were diagnosed? Had you had any prior knowledge of type 1?

Eritrea: No, I didn’t know anything about diabetes at all. I was eight, so I was pretty small. I remember that I sent my parents home when I got diagnosed because I was more worried about my siblings than myself and being like, “Hey, my mom has to get up early tomorrow and take my brothers to school. She has to go home and get some rest.” I took charge of a lot of my own care, but also my parents were foreigners to the country. Their understanding was limited because of language barriers so it was easier for me to take charge and be the translator, not just for them, but for myself so that I could understand everything firsthand. If I needed to take care of myself, I could do that. I was very much a little adult about it.

How did you become involved in the diabetes world and activism?

I started going to diabetes camps when I was really young. I was diagnosed in 2002, and I went to my first diabetes camp that same winter. The next summer I started to go to Camp New Horizons here in Texas with my brothers because it was offered to diabetics and their siblings. At 13, you can become a counselor in training (CIT), and so I became a CIT and then my brothers all grew up going to camp as well so then they became CITs. It kind of became a family thing. When I turned 18, I became a counselor and then I started volunteering every summer. I have a lot of friends with diabetes. I went to a lot of camps so it makes sense that I made a lot of long-lasting relationships. As I got older, I just tried to volunteer my time here and there. Last year in 2020 I met Rob Howe at a Diabetes Meetup in Dallas (pre-pandemic) and later got really lucky to be offered an opportunity to create content over at Diabetics Doing Things.

Do you ever feel burned out while working in diabetes?

I’m lucky enough that I don’t work in the diabetes space full time, and I don’t want to say never but I just feel it would be so hard. I know some people who work full-time in diabetes and seriously huge “Kudos,” because I feel like we already work full time in diabetes. There’s no vacation from this thing! I do definitely go through some burnout. I have a therapist. This is not a humblebrag. I am not okay all of the time, it’s hard out here. But somehow, I manage. I try to go for walks a lot so that I can really just look around the earth and realize that it’s so much bigger than just me and my experience and what I’m going through in my moment. I try to eat good food and enjoy as many small things as I can. It’s the small stuff that makes up the big stuff.

How did you come to create “more than a diabetic” and why did you feel like the space was so necessary for the community?

When Rob and I started talking about me working at Diabetics Doing Things, the conversation was really around doing things differently. There is a type of aesthetic or type of face of diabetes. That face is very common within the online community and I see it all the time, or even faces that look like mine, which is the very consumable Black girl: light skin, curly hair, very cute, blah, blah, blah. And I hate it. It’s ridiculous, Black people and people of color exist in all shades, shapes, sizes, types of diabetes. And their experiences should be talked about, represented appropriately. I wanted to create a space where people were going to have real conversations without mincing words to spare feelings. I thought that it was important for us to be honest, to be clear, and to have these conversations out in the open instead of continuing to talk about having these conversations. Something that’s always really bothered me about how systems of oppression are created is that the conversations about changing them are always being had by the same people who created the problem. It really felt like it was time for these conversations to be centered around the people who are impacted by the societal impact of erasing BIPOC experiences. So, that’s what we did.

When do you feel most empowered and who in your life contributes to that?

I always feel supported at home. I have the best husband ever who lets me go on hour-long rants about things and tells me, “Hell yeah.” Having the space and sometimes the bravery to say things that might make some people uncomfortable is crucial. I also work somewhere really great, and Rob is a really great person to work for. I always feel like Diabetics Doing Things is here to tell the truth, even if those truths may be a little bit uncomfortable sometimes.

Do you have a message for anyone that’s struggling with discrimination or racism?

I think we’re all struggling. I think every single person is struggling. But maybe something we could all think about more is just being intentionally kind. There’s a difference between being nice and being kind. We all need to be a little bit kinder and think more about the other person’s human experience. We need to be a little bit more intentional with that kindness. If we are being asked to speak somewhere, questions need to be asked. Who else is speaking? Am I taking up space that could be for someone else? Are all groups being represented here appropriately? Are we making this accessible for everyone?

It’s about being kind, being intentional, opening up doors for other people other than just ourselves. I know that we all want to get ahead, I know we all want to do well. That’s not what I’m arguing. I’m just saying that we can’t all do well when we’re ignoring the needs of other people in our community. You cant be an advocate for diabetes and then ignore BIPOC with diabetes or LGBTQ people with diabetes or type 2 diabetics. We all have diabetes. We all need to help each other.

What’s next for you? The podcast?

Diabetics Doing Things is still doing takeovers on Mondays. We do about two takeovers a month. It’s called “Doing Things Day,” and we hand over our account to somebody somewhere and they take us through a day in their life with type 1 diabetes. We’ve gone to places like Palestine, Lebanon, London, Georgia, Tennessee. We get to see a sliver of a moment in someone’s life, just a day. I really enjoy these takeovers because they allow us to go all over the world. It’s going to be really awesome. We’re covering some really cool new people in March.

For now, I know I am doing some more producing at Diabetics Doing Things, and I’m not really going anywhere. I’ll be here working on stuff, brainstorming what my next thing is.

I’m also working on a project that I’m really excited about. I’m looking for diabetics in the media. I love projects like these because I so enjoy going down a rabbit hole. Catching up on Steel Magnolias and Scrubs has been a treat. I’m really excited for what 2021 will bring to Diabetics Doing Things and what season two of More Than A Diabetic will look like.

Any last thoughts?

For anybody listening to any of these episodes, please just listen. That’s it, have an open mind. If you find yourself feeling something while listening, I invite you to lean into that feeling and explore it. This is not about just one singular person. What the ultimate goal of More than a diabetic was is to shed a spotlight on an issue that impacts all of us. It’s about a shared community experience that so many people who look like me, and who don’t look like me, have gone through.

Source: diabetesdaily.com

Realistic Goal-Setting and Avoiding Stigma: One Mom’s Perspective

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

By Bonnie O’Neil

The title of the article arrests my attention, compelling me to read further. The Numbers of Shame and Blame: How Stigma Affects Patients and Diabetes Management. I shudder as I read the results of a study by the diaTribe Foundation. “Diabetes stigma affects 76% of people living with type 1 diabetes (T1D) and 83% of parents raising a child with T1D.” The statistics are so high.

Stigma. The word itself sounds uncomfortable on my lips. Diabetes stigma means carrying a sense of disgrace or shame because of having T1D, an unpreventable auto-immune disease.

I continue reading. “The majority of respondents who believe T1D is associated with social stigma identified the top three drivers of diabetes stigma — a perception of failure of personal responsibility, a perception of being a burden on society, and a perception of having a character flaw.”

I cringe as I read these findings. Does my son feel like he’s a failure when his blood sugars don’t cooperate and do what he wants them to do? Maybe he does. I know as his parent and caregiver I feel like a failure when his A1c isn’t what I had hoped it would be. Does he feel like he’s a burden on society? On his school? On his family? Oh, I hope not. I can hardly even reread that last driver of stigma on the list. Does he feel like he has a character flaw simply because he has T1D? My heart rises up to my throat.

How can I help my son navigate living with T1D in such a way that he doesn’t fall prey to the shame and failure associated with disease stigma? Rereading the statistics, I pause and ask myself another question. How do I as his parent carry disease stigma? The survey tells me 83 percent of us parents raising a child with T1D are affected by it. Am I a part of that 83 percent? When his physician suggests we make some changes to achieve better outcomes, do my reactions model for my son my own feelings of failure, guilt, or shame?

Whether overtly stated or simply implied, we all have goals in mind for our child’s T1D management. While I never announced my goals as clearly as I would my New Year’s resolutions, my son and I both knew what they were.

  • A1c at 7.0 or below
  • Blood sugars between 80-150
  • Not too many juice boxes in a day

Setting goals is important; it’s what keeps us moving forward as humans. During certain times of the year we’re especially focused on goal setting. Whether it’s January’s hopes for the new year, September’s back-to-school focus, or our birth month marking one more circuit around the sun, we can’t escape the human drive to set goals.

But in our best efforts to keep our child healthy and safe, how can we set reasonable goals that serve more as guard rails than leave us feeling stigmatized if the goals are left unmet?

Set Realistic Goals

It’s easy to slip from the hope and optimism of setting a new goal to feeling shame if those goals aren’t attained. Start small when setting new goals. Remember your child lives with this disease 24/7. Your eagerness to try a new approach to glucose management might feel like the addition of one more heavy weight placed on top of what your child is already carrying. Check in with your child. How does he feel about your goals? There’s a fine line between maintaining glucose control and contributing to diabetes burnout.

Hold Your Goals Loosely

Beware of the trap of stigma when we don’t hit our goals. Commit to living in the no-shame zone. The statistics reveal that 83% of parents raising a child with T1D struggle with stigma, meaning we parents struggle more with shame than even our children with T1D do. The next time you find yourself stressing over an unmet goal you have for your child’s care, recognize that the 83% is you. And it’s me. Let’s break the power of stigma in our own lives so we don’t model it and pass it along to our children. Offer grace to yourself and your child if the goals go out the window for a period of time. You can always get back on track once this season is over, so don’t buy into the failure narrative. Be good to yourself and to your child.

Be Aware of What You Reward

When my son was young, I would often take him to buy a small toy or gift after his appointments with his endocrinologist. It was a few years before I realized that I only bought him a treat when his A1c was at a level that met or surpassed the goal I had in mind. What message was I sending to my son? That I only reward what makes me proud? That my pride in him was linked to his A1c? Even well-intentioned gestures can leave our children feeling shame when they don’t reach our goals. Instead of rewarding only those times when the numbers match our goals, why not celebrate our child’s hard work and the joy of sharing life together after every appointment?

Watch Your Words

Goals like “Let’s do better with blood sugar control next year” imply a judgment that the past year was less than stellar. Your child (or you) may receive this message as a judgment that they (or you) were less than stellar last year. Words like better, good, and bad, which we use all too frequently when talking about blood sugars, are qualitative and can leave our child feeling stigmatized. Blood sugars and A1c’s are just numbers that provide us valuable information from which to make future decisions. Being careful with our language can help protect our child from carrying a sense of stigma.

Remember above all, our goal isn’t really about reaching blood sugar goals. Our goal is to build a healthy lifelong relationship with our child based on respect, encouragement, and love.

Source: diabetesdaily.com

The Importance of Sleep Health for Diabetes

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

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

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

Why Is Sleep Important?

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

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

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

Americans Are Not Getting Enough Sleep

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

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

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

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

People With Diabetes Need to Prioritize Sleep!

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

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

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

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

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

how to get enough sleep

Photo credit: iStock

Strategies to Improve Sleep Health

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

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

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

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

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

Source: diabetesdaily.com

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

This content originally appeared on diaTribe. Republished with permission.

By Julia Kenney

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

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

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

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

Dog

Image source: diaTribe

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

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

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

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

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

How can diabetes service dogs help their owners?

Dog

Image source: diaTribe

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

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

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

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

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

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

Could a diabetes service dog be right for me? 

Dog

Image source: diaTribe

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

There are a few more important things to think about:

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

Want to learn more about diabetes service dogs?

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

Source: diabetesdaily.com

Diabetes Complications: How They Affected My Body

I have a list of excuses as to why my diabetes was never really properly controlled. At 24 years old, I was diagnosed, but I was treated as a type 2. My doctor based it on my age. For 2 years that I was treated as a type 2, my sugars were never coming down, and my doctor kept upping my dosages until I was taking over 20 pills a day. I had tried a couple of different doctors through my insurance, but with no result. Finally, I went to see a highly rated endocrinologist, whom I had to pay out of pocket. At 26, I didn’t exactly have the funds to do so. I was properly diagnosed by this doctor, but unfortunately, couldn’t keep seeing him at such a high cost.

Recently, through type 1 (T1) meetup groups and social media, I see many young women, men too, who’ve been diagnosed in their twenties. There really isn’t any time in someone’s life that’s a great time to be diagnosed, but for me, and I’m assuming many others, your twenties can be difficult for so many reasons. You’re suddenly on your own health insurance. Your parents are no longer in control of it, and I’m sure, like me, you don’t want them to be! In your twenties, you’re invincible! Your life is yours, your decisions are yours, you feel like everything is yours.

Suddenly the doctors are telling you, “You can’t do this, you can’t have that,” and that diabetes will affect other aspects of your life, your health. But I wasn’t told specifically, all the things. For me, it started to feel like the doctors were in some conspiracy to take all (and more) of the money I made. I couldn’t afford diabetes.

Go to the dentist for a cleaning, I’m told I should be going every 3 months. I didn’t have dental insurance, and I always had great teeth. Never had a cavity, why do I need to worry now?

Quickly I became frustrated. Another endo, who had come highly recommended, did accept my insurance, so I vowed to take better care of myself. And then he started selling me bars and shakes, thought I needed to lose weight (I weighed 138 lbs., I’m 5’7” – not exactly overweight). I tried for a while but realized it was a lifestyle I could never keep up with, and he obviously had ulterior motives.

I felt that if the people who were “supposed” to be helping and supporting me didn’t care, why should I? Well now I wish I did, I wish I had understood all of the “little” complications, some of which are discussed, and some that aren’t as much.

I see young women on social media, who have changed their ways (and I applaud them), but I know there are many who suffer from diabulimia. You’re young, you’ve lost all this weight, you suddenly can wear anything you want, it seems like there’s at least one benefit of this illness. And there are those who have fallen into a depression, have lost hope, and just don’t care for themselves properly.

My sugars were always a little high, but I never (knowingly) missed a shot. My A1c typically ran in the 9% range. Definitely not near where it should be, but I see people who’ve run 13-14%, just to remain slim.

Gums and Teeth

First, it started with my gums. While I was still in my twenties,  I sliced them, just on a potato chip. Crazy! Usually, if that happened, it would heal, almost immediately. Not this time. This time, I got an infection. Gum disease isn’t pretty, especially when your mouth is constantly infected. Infections can raise glucose levels, and raised glucose levels can exacerbate infections. Round and round it goes. And this doesn’t happen overnight.

Nothing really ever went wrong until I hit 40. Even though through my thirties, I had surgeries and saw a periodontist every three months; eventually my gums just weren’t strong enough to keep my teeth in place. But at 20-something, who thinks they’re going to lose their teeth? I was someone who was always known for smiling. I have one of the biggest, cheesiest grins. But suddenly, I lost it, five teeth, and a lot of bone to go with it. Dental implants? Well, aside from being expensive, I need sinus lifts just to ensure the implants take hold.

Frozen Shoulder

What almost seemed out of the blue, I suddenly could not move my shoulder. It didn’t happen overnight, so at first, I thought maybe I was just sleeping funny. But then, I couldn’t raise my arm, even a little. Of course, it was my left shoulder, as I’m left hand dominant (Murphy’s law, right?). I hadn’t heard of this, but it was debilitating. When you can’t move your shoulder, raise your arm – showering, getting dressed, every basic thing becomes nearly impossible to do. I went for an MRI, physical therapy…and this went on for months. It finally subsided, but for months, I couldn’t get dressed, or undressed, without help. For someone who has always been active, lifted weights, this was frustrating, depressing, completely debilitating.

Diabetic Gastroparesis

My sugars definitely got a little out of control when I took a second job. I was working constantly, my part-time job was at a catering hall, so getting fed properly, and at proper times, became nearly impossible. Checking my sugar? Well, that was out the window too. That’s on me for taking that job, but when you need money, you do what you have to. Until you can’t. I’d be feeling fine, I’d finally eat, and almost immediately, I was nauseous, vomiting, feeling like I was going to die. At first, I just assumed I had a stomach flu. Nothing can really be done, you just have to let those run their course. But then, it was happening every week, two times, then three, until I was driving home from work, less than a 15-minute commute, and I couldn’t even pull my car over, I was just opening my car door and vomiting right out the door, several times.

I couldn’t get an appointment with the doctor, so I was told I could see a nurse. As soon as she took my vitals, she told me I needed to see the doctor, and she immediately set me up for an EKG. Fortunately, my heart is fine. But I do suffer from diabetic gastroparesis. Now that I’m aware, I can properly handle, and though every now and again I have a bout with it, overall, it’s basically under control.

Diabetic Mastopathy

I’m 43 years old, and I finally went for my first mammogram. Yes, I’ve been putting it off, because I’ve been in fear of finding something else wrong with me. I loved my teeth, I’ve lost them. I loved my hair, lost a lot around the time I was diagnosed, and though it did get better, it never was the same. I’ve dealt. But I’ve always felt that whatever else could happen to me, I would never let anyone cut into my breast(s), so the less I knew… I know, irresponsible, and ignorant.

Well, I finally went, and just to my luck, they found a lump. I had to be scheduled for a biopsy right away. To say this was nerve-wracking (even though I know women go through this every day, I’m sure they’re not calm about it either), was an understatement. (The stress also seemed to elevate my blood sugars like I’ve never known) I went for my biopsy, and metal markers were inserted, should I need surgery. I waited, very impatiently, for my results. Fortunately, my doctor called me immediately following the weekend (I went on a Thursday).

Now funny, you would think the doctor would know my medical history, but he didn’t! Thankfully, first, he did say it was benign. I can’t tell you what relief I felt, but then he followed with, “Are you an insulin-dependent diabetic?” What? What does that have to do with anything? Well, apparently, diabetic mastopathy happens to more of than not type 1s, but even types 2s, who are insulin-dependent, and whose glucose levels run higher.

Fortunately, this is not life-threatening. None of what I’ve gone through has been. But I promise you, I would’ve preferred to not have had to endure any of it. Managing diabetes alone can be difficult. There’s no need to add anxiety, fear, cost, insecurity, to an already consuming illness. What I wouldn’t give to have my teeth, the hours spent clinging to the toilet or garbage can, thinking I might die, or the lost months of movement in my shoulder/arm back. I would’ve preferred to never have dealt with the anxiety of knowing metal clips were being inserted. Granted, anything in life can happen to us, whether or not we’re diabetic. People lose teeth, suffer from gastroparesis, lose mobility, or get biopsies, who aren’t diabetic. But if we can help to not exacerbate or trigger the situation by managing our blood sugar levels properly, why wouldn’t we? No matter how skinny you might feel you need to be, if you have no teeth to show your smile, no mobility in your shoulder, how good can you really feel about yourself? At 43, my will to be healthy, to live healthy, is stronger than it ever was.

Source: diabetesdaily.com

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