Keys to Long Term Success and Preventing Complications

Contrary to popular belief, you can live a long, healthy life with type 2 diabetes, without developing complications. In its 2010 report, Diabetes UK found that someone with type 2 diabetes is likely to have a reduced life expectancy by up to 10 years, and someone living with type 1 diabetes is likely to have a reduced life expectancy by up to 20 years.

However, with advanced technologies and therapies, people are living longer and healthier than ever. Results from the University of Pittsburgh after a 30-year longitudinal study found that people with type 1 diabetes born after 1965 had a life expectancy of 69 years — longer than any study had ever previously found.

In part four of our four-part series on living well with type 2 diabetes, we will dive into the keys to long term success managing your condition, and how to prevent complications over the long term.

What Causes Complications?

It’s important to know what causes complications in people with type 2 diabetes. Not everyone living with diabetes will develop complications, but the occurrence of chronic hyperglycemia, or high blood sugar, can lead to heart disease, kidney failure, nerve damage, and retinopathy (the most common complications of diabetes). It’s important to keep your blood sugars in range as much as possible to help prevent the onset of these complications.

Keys to Long Term Success

A number of factors have been shown to help slow the progression of (or completely prevent) complications in people with diabetes:

  • Keep HbA1c in range – Studies have shown that keeping your HbA1c lower than 7% can prevent the onset of complications, and closely monitoring your blood sugar (testing regularly) can help tighten your control. Talk with your doctor about the ideal number of times she would like you to test per day, and make sure you always test before and after meals.
  • Take your medications as prescribed – Some people think that insulin is “bad” or they just don’t like the thought of taking a pill every day. You’re prescribed your medicine for a reason, and you should follow all doctors’ orders to take them as prescribed. Rationing or skipping doses can quickly lead to complications or even premature death.
  • Follow a sensible diet – You don’t need to go completely paleo or keto to have better blood sugars, but speaking with your doctor or seeing a nutritionist can help you develop an eating plan that will work for you that you can sustain. Be sure to include plenty of fresh vegetables, protein, and water. Eating similar foods, eating a low carbohydrate lunch (of 20 grams or fewer) and limiting meals at restaurants has also been shown to help improve blood sugar management in people with diabetes.
  • ExerciseExercise is one of the most important things you can do to prevent complications. Not only does it lower blood sugars, but it gets the heart working and the blood pumping, increasing circulation and strengthening your whole cardiovascular system. Exercise boosts your immune system, and increases serotonin in the brain, making you feel good and helping to prevent the onset of depression. According to our Thrivable Insights study, people with type 2 diabetes who have an HbA1c <6.5% are more likely (20% vs 8%) to exercise 4-6 times per week than people living with type 2 diabetes who have an HbA1c of 8% or higher.
  • Surround yourself with support – Diabetes is a marathon, not a sprint, and the journey can be lonely at times. A study from the University Hospital in Denmark found that loneliness may actually cause premature death by damaging the blood vessels of the heart, which can be compounded with a diagnosis of diabetes. Long term success with your diabetes care is much more likely if you surround yourself with supportive family and friends, or if you can find a community who will understand. Sharing your thoughts, worries, and feelings will help lighten your load, and you may just learn a thing or two that you didn’t previously know about diabetes and how to better care for yourself!

Have you had diabetes for a long time, and are thriving without complications? What are some of the best strategies you’ve employed to achieve success? Share this post and comment below!

Source: diabetesdaily.com

Research Trends with Dr. Maria: Cholesterol Benefits & More

Dr. Maria Muccioli holds degrees in Biochemistry and Molecular and Cell Biology and has over 10 years of research experience in the immunology field. She is currently a professor of biology at Stratford University and a science writer at Diabetes Daily. Dr. Maria has been living well with type 1 diabetes since 2008 and is passionate about diabetes research and outreach.

In this recurring article series, Dr. Maria will present some snapshots of recent diabetes research, and especially interesting studies than may fly under the mainstream media radar. Check out our first-ever installment of “Research Trends with Dr. Maria”!

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Allergen in Diabetes Tech Adhesives

Diabetes technologies, like insulin pumps and continuous glucose monitors, are steadily gaining popularity, especially among patients with type 1 diabetes. While the technological advances have shown considerable benefit in improving patient outcomes and quality of life, one common issue is the unfavorable reactions to adhesives. A recent study published in Diabetes Technology & Therapeutics identified that a common culprit of these allergic reactions to adhesives may be a chemical called colophonium, a commonly-used adhesive, which was shown to be an allergen in over 40% of patients in the small study. Read more about the study and the use of this adhesive in medical products here.

Bariatric Surgery May Worsen Retinopathy

Retinopathy (eye disease) is a common complication of diabetes, and can be serious, leading to severe visual impairment and even blindness, especially when left untreated. A recent study published in Acta Ophthalmologica has uncovered a potential link between patients who undergo weight loss surgery and worsening retinopathy. Researchers adjusted for confounding variables, including glycemic control (A1c) and found that those who underwent bariatric surgery experienced worse retinopathy outcomes. Although the sample size was small, the data showed a significant worsening of eye disease in those who underwent surgery as compared to controls. Learn more about the study and outcomes here.

Super Healthy Probiotic Fermented Food Sources

Photo credit: Adobe Stock

Benefits of Probiotics for Type 2 Diabetes

The relevance of the gut microbiome in various health conditions, including diabetes, is gaining more and more attention. A recently published meta-analysis in The Journal of Translational Medicine discusses what we currently know about the effects of probiotic supplementation in patients with type 2 diabetes. Excitingly, probiotics can improve insulin resistance and even lower A1c! Learn more about exactly what the clinical trials have shown here.

Herbal Therapies Gaining Attention

With most modern medicines derived from plant compounds, it is not surprising that more research is being geared toward examining the effects of various herbal remedies on blood glucose levels and insulin sensitivity. A recent review published in The World Journal of Current Medical and Pharmaceutical Research summarizes the effects of some medicinal plants with potential anti-diabetic properties. Learn more about what is known about commons herbs and how they may be beneficial for glycemic control here.

Low HDL Cholesterol Linked to Beta Cell Decline

Research has previously suggested that higher HDL cholesterol levels may be protective of beta-cell function. A longitudinal study recently published in Diabetes Metabolism Research and Reviews indicated that patients with lower levels of HDL cholesterol were more likely to experience beta cell deterioration and develop type 2 diabetes than those with higher HDL cholesterol levels. Learn more about this study here.

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Please share your thoughts with us and stay tuned for more recent research updates!

Source: diabetesdaily.com

Accepting a New Type 2 Diabetes Diagnosis

One of the toughest transitions in life can be a new diagnosis of type 2 diabetes. Either for yourself or a family member, the initial shock of diagnosis is sometimes hard to take and can require some getting used to.

In this first installment of a four-part series on type 2 diabetes, here are five ways to adapt to a new diagnosis in your family and the best ways not only to cope, but to thrive with type 2 diabetes:

There’s No Shame in a Diagnosis

There is nothing to be ashamed of with a type 2 diabetes diagnosis. Type 2 diabetes is simply the body’s response to becoming insulin resistant or the body’s inability to produce enough insulin naturally (more symptoms listed here). There are many risk factors that contribute to a type 2 diabetes diagnosis, but genetics and environmental factors do play a role. You may be discouraged upon diagnosis, but there’s no shame in having diabetes, and there’s no shame in taking charge of your health and taking care of yourself.

Today Is the Perfect Day to Be Healthy – Start Now

Not next week or next month, or even next year. Today is the perfect day to begin. Once you have a diagnosis, make sure you’re prepared with a glucometer, test strips, and a lancet device to start monitoring your blood sugar. You may also have a prescription for metformin or insulin that should be filled. Your doctor probably referred you to a nutritionist to come up with a meal plan, and maybe they’ve recommended regular exercise. Start small. Include more vegetables at your next meal, and aim for a short walk before bed. Taking small steps to improve your health today will lead to lasting health benefits down the road.

Assemble Your Care Team

This includes both professional and community support. Diabetes affects the whole family, and it’s important to have their physical and emotional support. You will need to enlist the expertise of not only your physician, but also an endocrinologist, and perhaps a nutritionist or maybe even a therapist. Caring family members can offer emotional support during this time of transition, and researching local support groups or diabetes advocacy organizations where you can find community will be a tremendous help in the weeks and months to come.

Don’t Operate from a Position of Fear

Make no mistake, type 2 diabetes is a serious disease that can cause devastating complications if left untreated, but it does not necessarily need to incite fear. You can live a long, happy, and healthy life with type 2 diabetes. This is an opportunity to tune into your body and make healthy, positive changes for the road ahead. Healthy lifestyle choices you make now can prevent complications later on in life.

Think of What This Adds to Your Life

A type 2 diabetes diagnosis is not the end of your life. Instead of thinking in terms of deprivation, think of what this adds (and can add!) to your life. More exercise. More opportunities to go outside. More excuses to walk your dog, or play with your children or grandchildren. More vegetables on your plate. More reasons to see your doctor and keep a closer eye on your health. More reasons to be thankful that you have the opportunity to get a firm grasp on your health in the here and now. Think in abundance and be grateful.

A type 2 diabetes diagnosis does not need to bring misery and sadness to your life. It can be an opportunity to connect with yourself, get in tune with your body, and lead you to start or continue to make healthy choices to prevent complications later on in life. And that’s something to cheers to.

Have you recently been diagnosed with type 2 diabetes? How has the diagnosis affected your life so far? Share this post and comment below!

Source: diabetesdaily.com

Diabetic Ketoacidosis (DKA) at 30,000 Feet

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

By PK Hrezo

Twist of Fate?

It’s coincidental, if not oddly poetic, that type 1 diabetes presented itself to my family and me for the first time just two weeks before National Diabetes Awareness Month — a time we won’t soon forget.

Until that night, I thought type 1 diabetes (T1D) was something that kids were born with. I never thought it could be presented at any stage of life. I’d participated in JDRF walks before for friends and charity, so I knew the bare minimum. It had never been suggested to me by medical professionals that T1D was something all parents should keep an eye out for. Perhaps I hadn’t consulted the Parent Handbook regularly enough. But face-to-face with T1D for the first time, it was clear, I was on the brink of full-on parental guilt.

T1D did not run in our family, but that was the first question the ER doctor asked me while my thirteen-year-old daughter Abby was lying on the ER stretcher, nearly comatose, during a severe DKA episode in Halifax, Nova Scotia on October 19th, 2019.

DKA

Image source: Beyond Type 1

I was far from home, away from my husband, family and friends, and I was shell-shocked.

The Backstory

Abby and I had been planning a girl’s weekend to Paris for years, just the two of us, and it was to be the weekend of October 18th. Abby was beyond excited, which now, looking back, is probably what propelled her through the symptoms that we ignored as pre-DKA indicators. But we didn’t know. All we knew was that Abby had been under the weather for about a week – not herself, more tired than usual, and her ear had been bothering her just enough to prompt us to see the family doctor before getting on a plane.

We saw a nurse practitioner who checked Abby’s vitals and said her throat was red, but no ear fluid, and that she’d be okay for travel with some Mucinex. That night, Abby didn’t sleep at all. She woke up and stayed up for most of the night with indigestion. When she looked exhausted the next morning, we chalked it up to a bad night’s sleep.

Once we got to our connection at Chicago O’Hare, Abby seemed to be even more exhausted than before. Looking back, I realize the altitude from the plane ride from Tampa to Chicago had an adverse effect on her already gradual decline into DKA. She was uncomfortable in any position, and very thirsty for sweet, juicy-type drinks. She had an apple juice, a smoothie, a sweet tea with honey – all of these, unbeknownst to me, were contributing to the high sugars that would send her into DKA. I thought I was keeping her hydrated to flush out the virus, but sadly, all I was doing was shoveling more sugars into her bloodstream.

When Abby looked at me during our long layover and said she thought Paris would be a bad idea, I was both glad she’d owned up to it and puzzled by her sudden change. Of course, I wanted to do what was best for her. She mentioned one of our backup destinations — somewhere closer where we could still have our mother-daughter weekend but relax without the hustle and bustle of a busy city. We were already part of the way to another place, so we chose a pleasant B&B in Halifax, where it’d be autumn and beautiful. I made our arrangements and we headed to the next gate.

In Hindsight

If I could redo that day, I wouldn’t have put her on a plane to Canada, but that doesn’t mean I wouldn’t have made a different mistake. I might have booked a room in Chicago, so we could rest and she could sleep it off, which could have been fatal, since I still didn’t know she was in near-DKA.

I called my husband and told him how Abby was behaving, and that we’d changed plans. He was surprised, but agreed she likely just needed rest. That was also about the time doubt squirmed its way into my mind. People were beginning to stare at her. She was stumbling to the bathroom, and she just kept saying she was tired and needed to sleep. I was eager to get out of the airport and settle down somewhere so we could get back to normal. Little did I know, that normal had left us for good.

We pressed on and boarded the aircraft, and after about thirty minutes into the flight, my mommy senses went full-on haywire. What had I done? Something was wrong with Abby — I had no idea what, only that something wasn’t right, and it was too late for us to turn around. Tears welled in my eyes and I stared out the window wondering how I could’ve made such a big mistake.

Completely in the Dark

Abby could hardly hold her cup of ice she’d been munching on. She was dropping everything, and I was getting frustrated, because I’d never seen her that way, and I knew something was happening that she wasn’t telling me. “Talk to me,” I kept saying to her. “I don’t understand what’s going on.”

But Abby didn’t understand what was happening to her either. She complained that her lungs were hurting. Her lungs? I didn’t know if she was exaggerating or if she was having an allergy attack. How did all of those symptoms measure up to exhaustion and a virus? It didn’t make any sense.

Abby got up to use the bathroom again and was gone for quite a while — this is what I now know as T1D’s excessive peeing symptom. I was just about to go check on her, when she returned to our seat and laid over me. Her voice was barely audible when she complained again of her lungs hurting.

“Is there a doctor here?” she asked me in hardly a whisper.

“No,” I told her calmly. “But we’ll find one when we land.”

My nerves spiraled. I was, without a doubt, the worst mom ever. I decided that as soon as we landed, I’d call 911. We were halfway there. I held Abby as she laid over me in the row. And then she began to breathe heavily and rapidly.

I rubbed my hand up and down her arm. The stark difference between my hand temperature and hers was so alarming that I knew I couldn’t put it off any longer.

“Wait here,” I told her, and I beelined for the back of the plane where the two flight attendants stood in the galley.

“Can you see if there is a doctor onboard?” I asked. “I think there’s something wrong with my daughter.”

Team Work

Without hesitation, the flight attendants sprung into action and all the lights on the aircraft came on. While everything was moving in a blur for me, I returned to Abby and a passenger seated behind us, Nick Wasser, popped up as the announcement was made and identified himself as a nurse.

I explained Abby’s symptoms and everything up to that point, and a minute later, two more professionals appeared: Dr. Peter Laureijs and his wife, Beth, also a nurse. The flight attendants had oxygen and medical kits and they moved the passenger from the bulkhead row, so that Abby could be laid there on the floor. The doctor and nurses attended to her with great care, administering oxygen and checking her vitals.

I whispered a prayer and asked God for courage to get through whatever was to come, and that He might save my daughter. I remember very well, the moment when the woman in the adjacent row, Nick’s wife, Johanna, reached her hand over and lay it on mine, with tears in her eyes and said, “If you need anything, I’m right here.” The flight attendants checked on me throughout the remainder of the flight and made sure I was okay. They were in communication with the flight deck, and the pilots opted not to divert, but instead speed up the plane to get us to Halifax sooner, where IWK Health Centre would know how to care for whatever was wrong with Abby.

DKA

Image source: Beyond Type 1

They’d administered an IV by then, and that’s what saved Abby’s life, because unbeknownst to me she was dehydrating by the minute, as her bloodstream was filled with all that sugar that couldn’t be processed.

An ambulance waited on the tarmac when we landed. I could see their flashing lights out the window, and an announcement was made for no one to move until the EMTs had boarded and retrieved Abby. We started moving through the airport and Border Patrol gave me temporary paperwork and told me to call later after we knew what was going on. They wanted to make sure Abby wasn’t contagious, rightfully so, and that we weren’t bringing disease into Canada. At that point, we still had no idea what was happening.

On the ambulance, the EMT said her glucose level was 30 mmol/L (540 mg/DL). That didn’t mean anything to me. I said she’d had a lot of sweet drinks and nothing really to eat, so it was no surprise they were high. I was so naïve to the symptoms of T1D.

Learning the Ropes

The EMTs and ER staff that met us at IWK were all top-notch professionals with such warmth about them, that I never once felt alone, nor judged for my epic mom fail. While Abby was transferred to a bed and hooked up to all kinds of tubes, the ER doctor asked me a ton of questions, one of which was if diabetes was in the family.

“No,” I said informatively.

This is diabetes,” he said. “I can smell the ketones from here.”

“Ketones? What the heck are ketones?”

A word I’d later come to be acquainted with on a much deeper level. T1D had just blindsided me in a T-bone collision. Welcome to your new life. How had I not known? How had the doctor back home not identified it? Did this happen to other kids Abby’s age? Why did it wait so long to show up?

I stepped out and called my husband, and he, too, was in denial at first, insisting she’d probably just had a lot of sugar. Then I mentioned what the doctor said about smelling ketones, and it hit Nate like an anvil.

“Holy cow!” he said. “That’s what I smelled yesterday, remember? I said you need to brush your teeth because your breath smelled, and I thought it was you. I can’t believe I didn’t recognize it!”

Nate is a fire chief in Tarpon Springs and has thirteen years of experience in the EMT/first responder profession, and he has run across T1D patients a number of times.

Abby was admitted to PICU a few hours later where she was tended to by sweet, caring nurses for the next forty-eight hours, and where I would begin googling words and terms I’d never known before, in hopes of learning a lifetime worth of information within a couple of days.

Every time an ICU nurse would come in, I’d fire off questions, one of which being: “Does this type of thing happen very often?” One of the nurses said that in the last three months, they’d had eight cases of pediatric DKA where the parents had no idea that their child was T1D. After ICU, we moved to a room on the children’s ward, where we were introduced to managing T1D on our own. I was trained to use a glucometer and give insulin injections, and how to count carbs.

Making Sense of It All

I posted on Facebook when we finally returned home to Tampa. Sharing the signs of DKA with other parents seemed a priority, in hopes others could learn from my mistake. After my Facebook post went viral, I was contacted by so many other T1D parents and patients who have similar stories. So many of whom were turned away from doctors and ERs who also thought nothing was wrong.

I was an anxious ball of nerves when Abby and I finally received the okay to travel home to Tampa, because I’d be in charge of her insulin doses on my own for the first time. Since I learned dosages and glucose readings in Canadian measurements, I had to retrain my brain to switch over.

DKA

Image source: Beyond Type 1

The IWK nurses stayed in close contact with me throughout our journey home and advised me on what dosage to give after each blood reading. We had a doctor’s appointment the following morning with our new Tampa-based pediatric endocrinologist, and after one delayed flight to Newark, and another delayed flight to Tampa, we muddled through our insulin injections, and were able to get home and begin our new normal.

Together, our family is planning healthier food options with fewer carbs. We are making Abby’s lifestyle change our lifestyle change, we’re all watching our sugar intake. Once at home, I realized how fortunate we were to get help when we needed it, and I realized I didn’t know one of the nurse’s names from the flight. I also wanted to find out the flight crew of UA5596 so I could thank them. I made a Facebook post one morning asking others to help me find them, and I received an overwhelming response.

The post received almost 6K shares from people eager to pass on Abby’s story. The T1D community embraced me in a way I’ll forever be grateful for. Instead of feeling alone with this condition, I feel a part of something so much bigger than a crummy auto-immune disease, and I know a wealth of resources and support are waiting online should I need it.

While Abby and my weekend had not been the one of culture and mother-daughter bonding we’d hoped for, we found something else equally important. We learned that we are both stronger than we think, and that love and faith will get us through anything. We gained a new respect for life and its fragility, and humanity proved it’s still full of compassion. Since that fateful October night, Abby and I have been invited into a community of fellow T1Ds we never knew existed, and we’re reminded that there is strength in numbers, and that people truly are eager to help when given the chance. We are not alone.

Source: diabetesdaily.com

Este Haim on Burnout + Bolusing for Pizza

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

By Todd Boudreaux

Este Haim is the bassist of the pop group Haim, which she formed with her sisters Alana and Danielle in 2007. Este has also been living with type 1 diabetes for nearly 20 years. Last week, Haim announced the release of their new track “Hallelujah,” stating the song is for “anyone struggling with chronic illness.” Beyond Type 1 caught up with Este to ask about the genesis of the track, her life on the road with T1D, and how she faces diabetes burnout with the help of her support system.

A Rough Transition

Freshman year of high school is perhaps the biggest transition in any teenager’s life. For Este Haim, that transition was made all the more difficult by her diagnosis with type 1 diabetes at age 14. Este recalls how difficult it was to fit in given all that she was going through.

“Yeah, it wasn’t a great way to start my first week of high school… I was basically a social pariah for a very long time. You know, I was just the diabetic kid in school that passes out and no one knows why and the diabetic girl that smelled like orange juice all the time.”

Although some of her classmates made life difficult in high school, there are two people Este has always been able to depend on — her sisters Alana and Danielle.

“Not only are they my sisters, I’m also in business with them, so we spend so much time together. We’re on the road together 24 hours a day for weeks on end. So they’ve seen every version of me. They’ve seen me in a good place with diabetes, and in a sh*tty place with diabetes,” Este says.

“I’m lucky that I have Danielle and Alana to be my support and when I am having a bad day, a bad week, a bad month, they’re always the first people to be like, ‘Dude we got you. Whatever you need. We’re going to get through this. Let’s get you a healthy meal. Let’s not have pizza after the show tonight. Let’s go get you something good so that you don’t wake up and your blood sugar is 350.”

Real Talk

“Pizza is such a blessing but it’s also such a curse” — Este’s description of pizza is all too real for anyone who has lived with diabetes.

“After a show, I get so hungry and the only thing that’s available to me is pizza. And we all know that pizza does weird sh*t to blood sugar. It’s this unexplained thing — bread I can bolus for, tomato sauce I can bolus for, cheese I can bolus for, but for some reason when they’re all together it’s this magical thing that I can never get right. It’s insane, what is that? It’s like my favorite food. And of course, it’s the one thing that I really can never get right. It’s hard being on the road and craving food and realizing the only things that are open late are either diners that don’t really have a lot of like salad-y options, or pizza.”

Este’s sisters fully grasp the exhaustion that comes with living with diabetes and have become an amazing support system for her. Their holistic view serves to remind Este that she is more than her diagnosis.

“My sisters have this incredible attitude of, ‘If you’re going to have a bad day, have a bad day, and just live your goddamn life. Tomorrow’s a new day, you get back on the wagon, get back on taking better care of yourself, let’s make some healthier choices. Let’s take a walk around the venue for a little bit, let’s get some exercise.’ And that also takes energy on their part. So I’m thankful that I have them on the road and it’s definitely an integral part of diabetes, is having that support. I’m really lucky.”

Life on the Road

Haim

Image source: Beyond Type 1

Keeping track of blood sugars on a consistent schedule is extremely difficult, and the ups and downs of life on the road can wreak havoc on the ability to maintain glycemic control, of which Este is all too aware.

“It’s being in a different time zone and not being able to sleep and then the stress of that and the cortisol in my blood making my blood sugar rise for no reason. Often, I won’t even know that I’m stressed out, and then I’ll see on my Dexcom that the arrow just goes straight up.”

Having a continuous glucose monitor (CGM) has been a game-changer for Este, not just because it allows her sisters to follow her glucose levels remotely, but also because of what it means to others living with T1D.

“I think awareness is so important and that’s why I wear my Dexcom on my arm now because I have a way of showing people that I am a type 1 diabetic… before I didn’t really have that.”

Diabetes Burnout

Este doesn’t mince words when it comes to the importance of mental health awareness for people living with type 1 diabetes. She is candid about the very real struggles that anyone living with a chronic illness endures over the course of their life.

“I think something that I struggled with, something a lot of people with diabetes struggle with, is perfection. We were taught to look at high blood sugars as a failure. I think that leads to diabetes burnout because you’re constantly trying to be perfect. Mentally, there’s only so much of that you can take without feeling like a failure… And I think that’s been the majority of the reason that I burn out. I’m just like ‘F*ck it, fine, whatever.’”

Haim recently released a new song titled ‘Hallelujah’ and Este posted that her verse in the song was inspired by her struggles living with T1D, specifically calling out the phenomenon of diabetes burnout in her post.

“It’s a lot easier sometimes to just ignore it and not deal with it, but we all know it always catches up with you… I feel like I’ve gone through diabetes burnout — for long periods of time — at least 10 different times in the past 20 years of being a diabetic, and like it’s tough, man. It’s tough to maintain that as a type 1 with chronic illness because there isn’t necessarily a promise that there’s a light at the end of the tunnel, and I said it in my post, it’s like a 24-hour job you can’t clock out of, that you don’t get paid for. Maintaining that mental toughness I think is exhausting for a lot of people.”

Haim

Image source: Beyond Type 1

Looking to the Future

At the end of the day, it all comes back to the support we receive from the people around us. As our discussion wrapped, Este told Beyond Type 1 how important it is to remind those that support us just how appreciated they are.

“The thing that I want to impart to people is to tell our loved ones that support us — that we do appreciate them — and to thank them for being supportive because I don’t know what I would do without my sisters, my parents, my best friends and my boyfriend for that matter… I think it’s really important to find the people that truly love and support you. I know it sounds trite and cliché, but all we can do is look to the future and try and live our best lives and have fun doing it. Enjoy every day as much as you possibly can, and don’t let diabetes get in the way of you doing and achieving everything that you want to do. Truly, that’s all we really can do.”

Source: diabetesdaily.com

100 Things You Can Do This Year for a Better Life with Diabetes

The New Year is here and many of us are hoping to make those resolutions stick. Keep in mind that there are many ways you can influence change, and some steps you can take may seem small but are very effective nonetheless. Please note that anytime you make changes to your diet or exercise routine, it’s also a good idea to check in with your doctor and plan ahead for any necessary medication adjustments.

Without further ado, check out this list of 100 simple things you can try to do this year for a better life with diabetes:

  1. Change your lancet.
  2. Eat lower carb.
  3. Take the stairs.
  4. Join a gym.
  5. See your eye doctor.
  6. Try a new vegetable recipe.
  7. Pack your lunch.
  8. Cut back on alcohol.
  9. Quit smoking.
  10. Invest in comfortable shoes.
  11. Buy a scale to keep accountable.
  12. Check your blood pressure.
  13. Stand while working.
  14. Go for a walk after lunch.
  15. Give gardening a try.
  16. Grocery shop the perimeter.
  17. Stretch.
  18. Keep a blood sugar log.
  19. Try a new diabetes app.
  20. Consider a continuous glucose monitor (CGM).
  21. Check your blood sugar more often.
  22. Don’t reuse your needle/syringe.
  23. Use alcohol swabs for injections and site changes.
  24. Read a book about diabetes.
  25. Join a diabetes support group.
  26. Choose green veggies over starches.
  27. Visit your endocrinologist.
  28. Do basal testing.
  29. Track your cycle.
  30. Count carbohydrates accurately.
  31. Try a half-unit syringe or pen.
  32. Consider trying an insulin pump.
  33. Ride a bike.
  34. Consider getting a pet.
  35. Eat more real food.
  36. Cut back on dessert.
  37. Try a flour substitute.
  38. Try a sugar substitute.
  39. Track your macronutrients.
  40. Track your steps.
  41. Educate about diabetes.
  42. Start a fundraiser.
  43. Attend a diabetes event.
  44. Sign up for our newsletter.
  45. Participate in diabetes surveys.
  46. Treat lows only with glucose.
  47. Eat consistent meals.
  48. Consider intermittent fasting.
  49. Ditch the foods that don’t work well.
  50. Invest in quality proteins.
  51. Eat more plants.
  52. Eat less processed foods.
  53. Ice skate.
  54. Try canoeing.
  55. Go hiking.
  56. Spend more time in nature.
  57. Shovel snow.
  58. Go swimming.
  59. Try ziplining or tree-to-tree.
  60. Get your A1c checked.
  61. Lower the high alert on your CGM.
  62. Eat more probiotics.
  63. Get more fiber.
  64. Swap juice and soda for more water.
  65. Sign up for a “couch to 5k” program.
  66. Jog.
  67. Go rock-climbing.
  68. Rotate your injection sites.
  69. Change your pump-site regularly.
  70. Change your CGM sensor regularly.
  71. Wear your CGM more.
  72. Review your CGM report regularly.
  73. Get a primary care physician.
  74. Get your flu shot.
  75. Figure out if you’re a moderator or abstainer.
  76. Jump rope.
  77. Meditate.
  78. Start a journal.
  79. Keep a food log.
  80. Create a 504 plan for your child.
  81. Speak with your child’s school about non-food related celebrations.
  82. Advocate for yourself or your child better.
  83. Ditch the scale if you’re obsessing.
  84. Take before photos (you will want them!).
  85. Figure out what self-care means to you and practice it daily.
  86. Seek out a friend or therapist if you feel you need help.
  87. Give back to the community by volunteering your time.
  88. Try a sport or activity you never tried before.
  89. Have more grace with yourself.
  90. Surround yourself with positive influences.
  91. Try to see the big picture more often.
  92. Create a healthy work/life balance.
  93. Appreciate the little things.
  94. Don’t be so hard on yourself.
  95. Check in with friends who may need it.
  96. Spend more time with family.
  97. Take the time to thank others and let them know they are appreciated.
  98. Take more deep breaths.
  99. Target things you feel you can change and start with those.
  100. Remember to be grateful for another year around the sun.

Do you want to add anything that has worked well for you? Please share your tips in the comments below.

Source: diabetesdaily.com

A Volleyball Named Wilson and Diabetes Isolation

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

By David Greene

Over 23,000,000 people in the United States have been diagnosed with diabetes. That is almost 1 in every 10 people. The irony is that despite these numbers, many of us feel isolated by our diabetes. This is problematic in that we are undeniably social creatures. Our physical and emotional well-beings are dependent on social connectedness. We need human contact. This is reflected in the ways we use punishment to enforce rules. Effective parenting recommends the use of time outs to correct children’s behaviors. Communities use prisons and prisons use solitary confinement. Religious groups use ex-communication or shunning. And countries use exile. Being isolated from human contact is considered the ultimate sacrifice. Who can forget Tom Hanks’ portrayal of Chuck Noland, a FedEx executive marooned on a small Pacific island in the film Castaway? In order to survive, Noland bonded with “Wilson”, a smudged volleyball that takes on the appearance of a human face. Just a movie you say? Research has shown that people marooned are often found dead even though they had access to all the required food, water, and shelter needed for survival. They died of isolation. They died of loneliness. Our need for human interaction is essential.

Our Own Diabetes Island?

You can’t throw a rock without hitting someone with diabetes. I’m not suggesting this, living with diabetes is tough enough. Just trying to make a point. But we are everywhere. We are in Hollywood, professional sports, beauty pageants, government, and every type of business and industry. We even sit on the United States Supreme Court. Yet research suggests that people with diabetes often feel a sense of personal failure, guilt, shame, distress and embarrassment. Browne and her colleagues called diabetes “the blame and shame disease”. When surveyed, people with diabetes reported feeling rejected, discriminated against, and isolated. To make matters worse, people without diabetes are not aware that people with diabetes have these feelings. For all the same reasons that isolation isn’t good for people without diabetes, it isn’t good for people with diabetes. Add to that, social isolation directly impacts our ability to live with and manage diabetes. It has been correlated with poorer glycemic control, more complications, higher medical costs, increased cognitive impairment, impaired quality of life, and poorer self-care behaviors.

We All Need a Wilson

Some of us are lucky enough to have wonderful “Wilsons” in our lives who support and help us deal with diabetes. Others, not so much. Regardless, research has suggested that educating family, friends, and colleagues about diabetes and encouraging communication about our challenges and needs can increase support and acceptance.

Support groups have long been an effective intervention for the isolating effects of diabetes. In addition to gaining first-hand information about diabetes through other people’s experiences, they provide reciprocal support from others with diabetes, and the opportunity to feel less lonely, isolated or judged. The curative effect of “universality”, knowing that you are not alone and that there are others who are struggling with similar issues, has long been recognized.

Summer camps for people with diabetes represent a unique type of support group. Surrounded by people with similar issues, camps have been found to help people connect with others, gain confidence, reduce anger and anxiety, increase self-esteem, and feel normal again.

And social media is able to provide a wealth of opportunities, connections, and information. For resources on how to get connected to the diabetes online community, click here.

But I preach to the choir. You are reading this on Taking Control of Your Diabetes, a premier diabetes social media platform. I have never met any of the TCOYD folks in person, but I feel connected with them and supported by them.

Back on the Mainland

Ultimately changing the socially isolating nature of diabetes will require societal change. Organizations such as TCOYD, the American Diabetes Association, and the Juvenile Diabetes Research Foundation are making great strides in connecting and organizing people with diabetes. Although the ultimate goal is to cure diabetes, an important side effect is bringing awareness and social acceptance to the disease. These organizations offer a range of opportunities for people to better understand their diabetes and connect with others. They include options such as newsletters, magazines, websites, chat rooms, forums, local chapters, marches, political advocacy, and fundraisers.

Spoiler Alert for the Three People Yet to See Castaway

In one of the more heart-wrenching scenes in Castaway, Noland loses Wilson in rough seas while escaping the island. However, with Wilson’s help, he survived. In the words of Alfred Lord Tennyson, it’s better to have loved and lost, than never to have loved at all. Okay, I admit this analogy of escaping our diabetes isolation is a bit cheesy. But I still believe we are well served by finding our Wilsons, and perhaps even pulling together a quick game of volleyball.

Source: diabetesdaily.com

Review: Genteel Lancing Device

Regularly checking blood glucose levels is an integral part of optimizing diabetes management, and in particular for patients who use insulin. However, frequent finger pricks can be uncomfortable and even painful for some, especially for children, which may be a deterrent to regular blood glucose testing. Genteel is the only currently-available lancing device on the market that is FDA-approved for both finger and alternative site testing and uses a unique technology to minimize the pain of finger pricks for blood sample collection.

Who They Are

Genteel was founded by Dr. Christoher Jacobs, a biomedical engineer. A friend of his was diagnosed with type 2 diabetes and expressed the challenges of the condition, including the pain he experienced from frequent testing. As a result, Dr. Jacobs set out to develop a device that would minimize the pain of obtaining a blood sample, and the Genteel device was born.

What It Is

The Genteel lancing products make use of several ways to minimize the pain of fingersticks. They allow users to select a variable “contact tip” size to minimize the penetration of the lancet under the skin. Also, the products make use of vacuum technology to help draw out a drop of blood for testing automatically, instead of having to squeeze the site.

Image by Genteel

There are two products available — the Genteel Lancing Device and the Genteel Plus Lancing Device. The basic lancing device is only compatible with the provided “butterfly touch” lancets, whereas the upgraded version is compatible with many other lancet types.

Check out the video below that explains exactly how the device works:

My Review

Personally, I found the device to be a bit elaborate and not very practical in terms of ease of use. When the product was first brought to the market, it was reviewed by Ginger Vieira, and I agree with much of her commentary regarding the product size, appearance, and lack of discreteness in use.

However, I can confirm that obtaining a blood sample was not painful for me, whether sampling from the fingertip or from the alternate site (my palm). While I still felt the contact of the lancet, it was definitely not painful and was certainly much more comfortable than many of the fingersticks I have experienced in almost 13 years of testing my blood sugar on a daily basis.

I can see that for some patients, for example, small children, this device may help to eliminate the fear and discomfort of checking blood sugar levels, and hopefully help the user achieve more frequent tests, and as a result, better glycemic control. The stickers included for decorating the lancing device are sure to be a hit with the kids, too.

The products aren’t cheap though! The base model costs $49.99 and the upgraded version $99.99.

Where to Buy

Both the basic and plus models can be purchased directly from the Genteel website. You can read more about each device before making the decision here:

Conclusions

While the Genteel lancing device may not be everyone’s favorite choice, it certainly helps with comfortably and painlessly obtaining a blood sample for testing, which might be a huge consideration for some patients, and in particular, for small children.

Have you tried Genteel products? Please share your thoughts and experiences in the comments.

Source: diabetesdaily.com

The World’s Worst Diabetes Mom: A Book Review

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

By Alexi Melvin

Familiar Face

If you have been an active (or even not so active) follower of the type 1 diabetes (T1D) online community in the past few years, you have likely heard of Stacey Simms. Stacey is a radio host, T1D mom and blogger turned host of the popular podcast Diabetes Connections.

But recently, she’s added a new title to her repertoire: author. Her new book, “The World’s Worst Diabetes Mom,” is currently available for pre-order.

“This isn’t the book I set out to write,” Stacey immediately notes in the introduction. What was initially intended to be a book based on past blog posts turned into something much more unique when measured against other diabetes-related books that came before this one. After an offensive comment made against her parenting skills on social media, Stacey realized that she needed to write a book that acknowledges not just the T1D successes in life, but perhaps moments of pure screw-up that all who deal with diabetes know too well.

This is exactly what Stacey’s book does — and beautifully so. “The World’s Worst Diabetes Mom” does not glamorize the life of a parent of a child with type 1 diabetes or the struggles of a child. The book, in a way, celebrates that the idea of perfection is simply not a “thing” that can be attained while managing type 1 diabetes. Stacey is unapologetic and honest about the lessons she has learned as a T1D parent in a way that makes the reader — whether a parent themselves or a person with type 1 recalling their own early experiences — feel a lot less alone.

Book Review

Image source: Beyond Type 1

Stacey’s charmingly relatable book is organized into chapters based on type 1 milestones in her family’s life and other applicable issues such as: The First Night Home, Pump Start, On-the-Road Adventures, Summer Camp and Social Media Support. The T1D mom takes good care to emphasize that her opinions and experiences are not to be taken as medical advice, and she even includes “Ask your doctor” sections with helpful tips for what to address with your doctor with regard to each preceding chapter.

What Makes It Enjoyable

Although there are many stories and perspectives from people who have been diagnosed with type 1 diabetes available to us today, this book is an important window into the somewhat unexplored life of a T1D caregiver.

Every parent with a child who has type 1 diabetes will undoubtedly remember instances exactly like, or at least very similar to, the ones that Stacey recalls in each of these chapters about learning to manage her son Benny’s T1D, who was diagnosed just before he turned 2. And, even if the reader’s child was diagnosed at a much later age, the emotions that tie into each story – i.e. feelings of inadequacy or failure but ultimately becoming stronger for it – will resonate hugely.

Although the book is written by a T1D parent, people who have type 1 themselves will likely relate to the many moments of confusion and frustration, and will appreciate Stacey’s consistent ability to laugh along the way while always taking the topics seriously.

In this day and age where social media status reigns supreme even in the T1D realm, it is refreshing to read a book that encourages parents, caregivers and T1Ds themselves to resist the pressure to get it right every time. Stacey’s book is hinged on the idea that life is a journey, and that there will be bumps, and that regardless of how many bumps, it is your road to navigate. It’s about the journey.

About the Author:

Stacey Simms hosts the award‐winning podcast “Diabetes Connections,” after having hosted “Charlotte’s Morning News” radio show for many years. She has been named one of Diabetes Forecast’s People to Know, the Charlotte Business Journal’s 40 Under 40, and Mecklenburg Times’ 50 Most Influential Women. She lives near Charlotte, North Carolina, with her husband, two children, and their dog, Freckles.

Source: diabetesdaily.com

Treating Type 1 Diabetes in Bangladesh: Dr. Kaufman and Life for a Child

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

By Francine R. Kaufman, M.D.

Greetings from Dhaka

Traveling over the city by air and then languishing in traffic forever to get to the hotel, I see what now seems typical of a developing country: cars, motorbikes, rickshaws, and people at a standstill jammed up in traffic with horns blaring like a discordant symphony; people living on the streets; old buildings with new structures next to them supported by cranes and rebar trying to reach for the sky.

Yesterday, I was at the main diabetes hospital all day seeing patients. I was with Graham Ogle, who runs Life for a Child and continues to deserve sainthood for his global work in bringing care, education, supplies, and life to close to 21,000 children around the world who likely would perish without his efforts. Graham is so humble and focused; he seemingly knows everyone and everything about the care of children with diabetes in Dhaka, as well as everywhere Life for a Child collaborates with local health care providers in over 40 countries.

Kid

Image source: Beyond Type 1

The diabetes hospital – called BIRDEM – is run by Dr. Bedowra Zabeen, an amazing woman and endocrinologist who is known worldwide for her work throughout Bangladesh. They follow over 7,000 children with diabetes (there are 9,000 total in all of Bangladesh); hundreds come in each day for outpatient care or to be admitted. The Life for a Child program follows 3000 children and young adults (up to age 26) and the Novo Nordisk program helps with another 3000 children. This means few can afford to buy insulin and supplies on their own since there is still insufficient support by the government or insurance programs in this country. From Life for a Child, they can only get regular and NPH insulin and 1-2 blood glucose strips per day. This is how I practiced pediatric diabetes 25-35 years ago. There are a few using newer insulins and even a few with insulin pumps, so if there are resources, families can buy better diabetes care than what is offered by these free charity programs.

Work to Be Done

The patients come through like a torrent. First, a newly-diagnosed child, so emaciated and weak, she could barely stand up. Then 4 children who seemed to be about five-to-six-years old, not adequately treated because they don’t have enough glucose strips, and as a result no chance to appropriately adjust insulin doses. School was a problem for each, either they had to miss a lunch shot or their mother had to come to administer it – most often without first doing a blood test. One was very hyperglycemic because her parents were unable to deny her anything she wanted to eat.

There were also two adorable 17-year-old twin girls, diagnosed within a year of each other, who had just graduated from high school and were waiting to see if they could go on with their education. Despite sleeping late, missing shots, and pretty much de-prioritizing diabetes (the universal story of adolescence and young adulthood), their A1cs were still good, mainly because they had way too many low glucose levels. There were many more routine cases: children taking only two insulin shots per day, having too few blood tests, not having refrigerators to store their insulin (they use clay pots instead), and feeling stigmatized and ostracized.

Then came the really hard cases: a child with severe insulin resistance (likely a gene defect due to too many consanguineous marriages in this country) taking 200-300 units of insulin per day, a child with dermatomyositis (a severe autoimmune disease of the skin and muscles) taking 500 units or more a day and chemotherapy and suffering the crippling joint effects of this rare disease that is most often complicated by diabetes. The fact that her hands were stiff and crippled made it all so much more amazing that she is an artist.

There were a number of pubertal children and even prepubertal children with type 2 diabetes – it’s hard to find someone who is not overweight/obese in Dhaka City, and the children appear to be the most affected. Bangladesh has one of the highest rates of diabetes: 8-10% of the population is affected and it is expected to quickly increase to 13% – and this is mainly Type 2. There are higher rates of kidney complications, but the most difficult aspect of having diabetes in Bangladesh is the stigma, the lack of education concerning its cause (children and their mothers are blamed), and the chance that anyone – particularly a child – can succeed with this disease.

Why We’re Here

Our type 1 diabetes workshop in Dhaka was sponsored by Life for a Child, the Bangladesh Diabetes Association, and ISPAD (the International Society for Pediatric and Adolescent Diabetes), and was organized by Dr. Zabeen. Forty-five physicians and nurses, dietitians, and psychologists from 11 cities and areas across Bangladesh attended our lectures and presentations. Some of the participants flew to Dhaka from the north, took trains for hours, and then battled the Dhaka City traffic to get to the Dhaka Club. It was a parade of brightly colored, sparkling saris since most of the attendees were women; many of the men had red hair and beards from henna staining.

Kid

Image source: Beyond Type 1

Our lectures were intermixed with lectures delivered by Dr. Zabeen, Dr. Azad (who started the field of pediatrics in Bangladesh), and a few other physicians who related the Bangladesh experience in childhood diabetes, pregnancy and diabetes, Ramadan and diabetes, and nutrition and diabetes. They discussed the struggles of managing this difficult disease in an area of our world with unimaginable poverty, very limited access to lab testing, supplies and medications (all with no way to pay for them short of a charity program, like Life for a Child), and in a culture deeply rooted in both prejudice and misunderstanding about diabetes. Schools make no concessions for the children at all, blame is placed on mothers and the children themselves, and they are often denied basic opportunities.

A young, 26-year-old woman who was diagnosed with type 1 diabetes (T1D) at 7 years of age came to speak to the seminar attendees. As a result of having diabetes, she was devalued so her father married her off at age 14. As usual in the villages, she went to live with her husband’s family. Since she arrived 12 years ago, her mother-in-law has not allowed her to have food unless her husband is home – and he works all day. So she fasts all day long, gets frequent and severe hypoglycemia, and often takes no insulin at all. Somehow in the midst of this all, she had a baby 5 years ago, and this little 5-year-old girl was skipping and running around, and adorable.

After our lectures each day, we took selfies with the attendees, and we even danced after my lecture on physical activity. The sway of the saris was mesmerizing and the joy and laughter totally infectious. Amidst it all, their questions and comments revealed how committed they all are to advance diabetes care for children in Bangladesh despite all of the obstacles. It was a struggle to go to the airport, but I somehow sat in the backseat and resigned myself to the stop and go traffic, the veering of cars from one lane to the other, and the constant cacophony of horns. It seemed to fit with my simultaneous feelings of despair and hope – with a great belief in Dr. Zabeen and her teams of amazing health care providers and her patients willing to share their stories.

Source: diabetesdaily.com

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