Mark Andrews: A Tight End with Type 1 Diabetes

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

By Katie Doyle

The Baltimore Ravens didn’t choose just any offensive lineup during the 2018 NFL draft – a key part of their strategy is Mark Andrews, a tight end from the University of Oklahoma who has been managing his type 1 diabetes since before he started playing football and into his rookie season.

Beyond Type 1 spoke with Mark about his pre-game rituals, how technology like the Dexcom G6 helps him stay on top of type 1 on long Sunday afternoons, and why it’s important to use his high-profile career to educate and advocate with National Diabetes Awareness month coming up.

How have you managed your diabetes through major life changes, like going away to college, playing a division 1 sport, or going through the NFL draft?

I was diagnosed at 9 years old, and it was the first time I ever saw my dad cry. At that moment, I knew it was serious because it wasn’t something my dad did very often. And since then, my family has been my rock. I was lucky enough to have a dad who was also a doctor and had an understanding of diabetes when I first was diagnosed.

Personally, I wasn’t very nervous. I knew that one day I wanted to move out, play football at a Division 1 level and ultimately play in the NFL. It’s something I was always very diligent about. I wasn’t going to let my nerves or anything else get in the way of that. My mom probably worried most, but my dad was instrumental in instructing my whole family in what to expect and what to know. I rely on them a ton. Using a CGM allows them to be a part of it and know my numbers at all times. It gives them peace of mind to be able to check in on me.

Mark

Image source: Beyond Type 1

How does your family support you from across the country?

My mom will always be my mom, so she still checks on me regularly. Last week, she texted me and said, ‘Hey, I don’t think you have enough complex carbs on board, you’ve been going low and trending low a lot. Just want you to eat something that gives you more complex carbs. I love you, hope you’re having a good week; I’ll talk to you soon!”

It’s awesome to get a text message like that and know my family has my back. After that, I ate a peanut butter and jelly sandwich just to have that background complex carb and went about my day. It’s always good having people look out for you — the more eyes you have on someone with diabetes, the better.

I’ve got a teammate right now named Orlando Brown whose dad had diabetes so he’s incredibly well-informed. He was my college teammate and now he’s my NFL teammate with the Ravens. He’s always wondering what my numbers are, and I actually share my numbers with him from my Dexcom.

When did you feel comfortable enough to talk to your friends and teammates about diabetes?

At first, I remember feeling a little bit reserved and not being totally open about it. I’d go hide in a corner to test. I also remember the first time my friends saw me testing my blood sugar. I was 10 or 11 years old, and they saw blood and thought it was cool. I was kind of in the spotlight because they were so interested in what I was doing.

That opened me up to be more vocal and to share what I’m doing and how I deal with things. After that, I became really comfortable sharing what I deal with having T1D and how I deal with it and sharing with others. I was very open talking to my coaches, and I had my parents to help me out with that, and they still do that to this day. Ever since then, I’ve always wanted to talk about it and shed light on what people with diabetes have to do.

Tell us about your pre-game ritual.

I do something a little bit different: I wear a pump, so I use that for basal (25%) and I use Lantus for my other type of basal (75%) on a normal day. But on a game day, I’ll go 100% Lantus — that allows me to be off the pump for long periods of time but not have to worry.

Knowing your body is key. Knowing what I put in my body and how it will affect me is something that I feel has been instrumental for my health. I’m a big fan of complex carbs; I eat peanut butter and jellies, especially on game days or the day before a game, just allowing myself to have that complex carb to hold me over while I’m exerting a lot of energy.

Having my Dexcom, and the way it allows me to see my blood glucose trends and see what foods react a certain way has been huge for me. There’s a lot that goes into diabetes management, and I think it’s incredible that I can rely on Dexcom and not have to prick my fingers all the time. It really sets me up for success on the field.

Who are your role models?

I didn’t know anyone else with diabetes growing up, but I have my dad, who is extremely knowledgeable and always researching different things. He’s the reason I went to 100% Lantus for game days.

I can remember, at a young age, having diabetes and seeing Jay Cutler in the League, and being able to tell myself that it’s possible. I adopted a mindset that this disease is a part of who I am, but it’s not going to define me and it’s never going to stop me in achieving my dreams. Football is my passion, it’s what I love, but now it’s my job, and diabetes is something I refuse to let affect my job.

You seem like you have a ritual down for games, but how about during the NFL draft? How were you feeling then?

There’s so much work that had been put into that moment, from my mom driving me to soccer practice, to all those hard hours put in on the field, it all lead to that moment of actually playing in the NFL. It was kind of scary to know that that you’re putting your future into someone else’s hands — into 32 organizations’ hands — but this has been my dream for a very, very long time.

Why is it important for young athletes with type 1 to have role models?

To be put on this stage, I’ve always wanted to give back and for me, that’s with diabetes — that hits home for me. Helping kids with diabetes is something that I’ve found has given me the most reward: raising awareness and talking to people about how I use technology and what I do with it, it’s to help people with everyday life and share some of that.

I’m going to work as hard as I can to be the best tight end that I can be, and hopefully one of the premiers tight ends in the League. I want kids to see where I’m at today, like I saw Jay Cutler, and I hope it inspires them to go out there and play sports and be active — to follow their dreams, no matter what they may be. A professional football player? Great! Go out and achieve it. Or if anything else, you know, This guy’s playing football at the highest level, then I can do anything else!

Source: diabetesdaily.com

Home Chef: Meal Kit Delivery That Fits Your Needs

Meal kit delivery services have been gaining popularity in recent years, and it’s no wonder why. It sure is convenient to have all the premeasured ingredients, all ready to prepare the predetermined recipe delivered to you every week, cutting down on both time and food waste.

Recently, I reviewed several meal kits from Home Chef, in particular to assess the more “diabetes-friendly” options. I received two meals at no charge and did not receive any additional compensation for this review. All opinions are my own.

Who They Are

The mission at Home Chef is to “provide everything you need to bring more delicious meals and moments to the table, no matter how busy you are”. Their meal kit delivery service allows you to fully customize your preferences in terms of the types of food, quantities, and cost. You can also choose to skip any weeks when you do not need meal delivery.

Services Offered

When you sign up with the service, you can select from several dietary preferences to get suggestions. Select your preferences, as well as the number of people and meals per week, and you’re almost ready to go!

Photo credit: Home Chef

You will be given suggestions from the current menu, based on your choices. You can still choose to customize all your meal choices within the particular week’s menu options.

Photo credit: Home Chef

Some meals take about 30 minutes to prepare from start to finish, while others boast just a 15-minute prep time. You can also select from the oven-ready or grill-ready collections as well as the classic culinary collection. Finally, there are also entrée salads available for purchase.

The total cost per week will vary, depending on your specific delivery preferences and menu choices. Meals start as low as $6.99 per serving!

My Review

I chose to sample two meals: The Sirloin and Mushroom Demi-Glace for the culinary collection as well as the Pesto Parmesan Chicken with Tuscan Tomato Green Beans from the oven-ready section.

I was impressed with the appearance of the food upon delivery. Everything was appropriately packaged and at the correct temperature. The proteins and produce all looked fresh, and I also appreciated the recyclable packaging materials that were used.

The Sirloin dish was one of the 30-minute meals (*aside: no matter which meal kit I try, it always takes me a bit longer; clearly, this is likely a user issue). The recipe card made the cooking process easy and seamless, as the instructions were very clear, and provided illustrations as well. Most importantly, all the food tasted great! It really delivered a classic and gourmet meal in the comfort of your own kitchen.

The potatoes au gratin with spinach and gorgonzola cheese were particularly a hit with the family. Despite my lower-carb lifestyle, I sampled a small amount these as well, and they certainly delivered on flavor and richness, and were a great accompaniment to the star protein dish – the steak! I used leftover steak and mushrooms for my lunch over a salad the following day and wasn’t disappointed.

Although it was a simpler and plainer dinner, I was absolutely thrilled with the oven-ready chicken and green beans. As a mom of two young kids, working several jobs remotely, it was really a treat to just be able to stick the trays in the oven and have a delicious, nutritious, and carb-conscious option ready to go for everyone to enjoy.

This particular meal was a great option for blood sugar-friendly outcomes for those with diabetes. Can’t go wrong with plenty of lean protein and lots of green veggies covered in a tasty sauce – delicious and healthy for the whole family!

Summary

Overall, the entire family enjoyed both meals that we sampled. I appreciated the produce and protein quality and the clear instructions on how to prepare. Having all the ingredients ready to go, without extra planning or visiting or ordering from a grocery store certainly saves time and effort! Most of all, I really appreciated the multitude of customization options that Home Chef offers, whether by price, food type, dietary restriction, or frequency of delivery, to name a few.

If you’ve never tried a meal delivery kit service before, I would say, you can’t go wrong if you start here!

Source: diabetesdaily.com

Former NFL Player with Type 1 Diabetes Shares His Story

Jake Byrne was diagnosed with type 1 diabetes as a teen, and he didn’t let his condition stop him from pursuing his dreams of playing professional football. He also wrote a book to inspire others with type 1 diabetes to pursue their dreams. We talked to Jake about his journey and the advice he would give to young people recently diagnosed. 

How old were you when you first became interested in football?

Since I was a little kid. My parents are from Wisconsin, and I grew up watching the Green Bay Packers every Sunday. I first started playing football in the 3rd grade.

When were you diagnosed with type 1 diabetes?

I was diagnosed when I was a sophomore in high school; I was 15 years old.

How did your diagnosis affect the trajectory of your football career at the time?

The largest hurdle to overcome was how to manage a new disease with the physical and mental demands the game of football put on someone’s body.

Did you become discouraged about your future?

Yes, the most noticeable change was the sudden weight loss. I lost around 30 lbs. and had to figure out how to adjust to a completely new lifestyle living with T1D.

What worried you the most, and how did you move forward?

How to manage my blood sugar was my biggest worry. Stabilizing my blood sugar to be able to stay in a healthy range for a 2-3 hr. game or practice was such a challenge. There was just not a lot of information or people I knew that could provide helpful insight on how to manage in such an extreme environment. For the most part, it was trial and error that was my method of finding what worked for me.

What was your most memorable football experience?

I have a couple. I never thought I would make it as far as I did in my football career. I always wanted to make it to the NFL, but I set more short-term goals that seemed realistic at the time. The first was after I finally got in a good rhythm with my diabetes and football and was able to play well enough to earn my first scholarship offer from the University of Arkansas. This eventually led to several other offers, which lead to my decision to attend the University of Wisconsin. The second was my Junior year when we beat Ohio State (who was #1 in the country), which lead us to become Big10 Champions earning us an invitation to play in the rose bowl in Pasadena, CA. The third was when I finally got a shot to play in my first NFL game on Sunday for the Huston Texans.

What was the most challenging aspect for you in regard to playing football with type 1 diabetes?

Keeping my blood sugar in a safe range. Lows were always a struggle.

Tell us a little bit about your book. What prompted you to write it? What was the inspiration and motivation behind it?

The inspiration behind the book started when I first received a letter from a young kid who was struggling to convince his parents to let him play football, triggering the feelings around how lost I was when I was first diagnosed. I was looking for some hope and guidance on how to move forward. From that point, I wanted to find a way to share my story to help others that were going through a difficult time overcoming adversity.

*Editor’s note: Jake’s book, “First and Goal: What Football Taught Me About Never Giving Up”, can be purchased on Amazon.

Can you tell us more about how having type 1 diabetes affected your football career experiences and vice versa?

Playing football at a high level is a challenge in itself. Then diabetes adds a level of complexity and discipline on top of that no-one else has to deal with.

Did the training and commitment involved in playing the sport at such a high level translate to more optimal diabetes management?

Absolutely, the amount of physical activity involved in sports like football leaves very little room for error. You can’t take one second off with T1D.

What advice would you give to newly-diagnosed kids and teens who have professional sports aspirations?

Never let diabetes set your limitations. Control your diabetes; don’t let it control you. It all comes down to your willingness to be disciplined in having a proactive approach to their daily routine to match your lifestyle.

Where are you today, and how do you think type 1 diabetes affected your path, overall?

Diabetes taught me very quickly that I had to be very disciplined in everything I do; it ingrained a work ethic and a sense of responsibility that is now part of who I am. That mindset allowed me to chase my dreams to play in the NFL, transition into my career into robotics, and eventually led to an opportunity to work for Locus Robotics as the Director of Customer Success. T1D taught me that through my life that if you work hard and have a thought-out plan, you can accomplish anything you set out to do.

Thank you for taking the time to speak to us, Jake. Your story is sure to be an inspiration to many young athletes with type 1 diabetes. We wish you all the very best in all your future endeavors!

***

Are you a competitive athlete with type 1 diabetes? What challenges have you faced and what advice would you give?

Source: diabetesdaily.com

Diabetes-Friendly Starbucks Drinks

It’s that time of year again, the allure of pumpkin spice and everything nice suddenly takes over your summer vibes. I am not a coffee drinker, but each season I grow more envious of those who are. In the summertime, everyone has their refreshing cold coffee concoctions and each fall I entertain the idea of trying a pumpkin spice latte but never get the guts to follow through.

Most drinks you get at coffee chains like Starbucks come loaded with calories and sugar, making these delicious drinks not the healthiest of choices. There are, however, plenty of low-carb substitutions and creations for you to try. All are low-calorie and low-carb and won’t leave you worrying about your blood sugars or your favorite jeans fitting.

Here are some of the most intriguing diabetes-friendly drinks I found at Starbucks:

  • Sugar-Free Snickerdoodle – This is made by tweaking a Sugar-Free Vanilla Latte by adding one pump of Sugar-Free Cinnamon Dulce syrup. You can add 1-2 Splenda sugar-free sweetener if you need.
  • Skinny Mocha – The regular version contains about 20 g of carbs, but with a few small tweaks you can make it blood sugar friendly. Replace the milk with heavy whipping cream and opt for the sugar-free mocha syrup.
  • Caramel Macchiato – This is a favorite of many but is still loaded with calories and sugar since it contains milk and caramel sauce. Try it cold and swap out the milk for almond milk and hold the sauce. It is still rich with flavor and will get you energized!
  • Cinnamon Dolce Latte – These are delicious and the cinnamon is a great spice to add flavor without adding in any carbs. Ask for an Americano with ½ water and ½ steamed heavy cream and a few pumps of sugar-free cinnamon dolce syrup.
  • Frappuccino – These can be easily transformed into a low-carb drink by avoiding their classic syrup and replacing with sugar-free and 3 shots of heavy cream, blended Frappuccino style.
  • Ombre Pink Drink – The popular drink of the moment is the Ombre Pink Drink which contains their Strawberry Acai Drink, coconut milk and freeze dried strawberries, all of which contain sugar. To lighten up the carbs, opt for whipping cream, passion tango ice tea and four pumps of sugar-free vanilla syrup.

Also, here are some seasonal drinks to consider:

  • Pumpkin Spice Latte – I think people get over their summer blues with just the thought of ordering their first Pumpkin Spice Latte from Starbucks. Just opt for almond milk, hold the whipped cream and ask for one pump of their pre-sweetened pumpkin-flavored syrup.
  • Hot Peppermint Kiss – This is Starbuck’s Peppermint hot tea with 2 pumps of sugar-free vanilla syrup making it a sweet and minty treat.
  • Peppermint Mocha – This creation is a delicious seasonal treat but make sure to order it with almond milk, no whipped cream, and only one pump of their peppermint-flavored syrup to keep this gem blood sugar friendly. I will leave it up to you on whether you add the dark chocolate curls!

If you prefer tea to coffee, there are still plenty of ways to get creative! Many sugar-free options are just waiting to be turned into a low-carb creation, whether it’s Black Tea, Green Tea, White Tea, or Passion Fruit Tea. Here are a few such options:

  • Passion Fruit Tea Drink – This one is very popular in the diabetes community. Be sure to try sugar-free vanilla syrup in Passion Fruit Iced Tea for a refreshing and tasty treat.
  • Low-Carb London Fog – A London fog is typically a combination of Earl Grey tea, steamed milk and vanilla syrup. Replace the milk with whipping cream and use sugar-free vanilla to create this low carb goodness.
  • Unsweetened Peach Citrus White Tea – A refreshing option is to modify it by adding a splash of heavy cream, a few pumps of sugar-free vanilla syrup, no water, and ice.

Living with diabetes makes us more aware of what we are eating and drinking. Thanks to these low-carb tweaks, we can enjoy while not worrying about our blood sugars. I can’t wait to join in on the seasonal fun!

Have you discovered any great low-carb drinks at Starbucks recently? Share and comment below!

Source: diabetesdaily.com

Moving Abroad for Better Diabetes Care

Anyone who lives with diabetes in the United States knows that affording care, and specifically insulin, is becoming more and more difficult as prices on insulin and essential medications continue to rise. A recent Yale study even showed that 1 in 4 people with diabetes have rationed their insulin due to cost, which can quickly lead to serious complications and even premature death. In our recent study , an overwhelming 44% of respondents reported struggling to afford insulin.

Our lack of a strong social safety net is leaving some patients feeling as though they have no other options for affordable care, and some patients have even resorted to crossing the border into Canada and Mexico to buy cheaper insulin, where federal price caps prevent runaway pricing on essential medications and prescription drugs. In light of all this, some people with diabetes have even daydreamed of completely relocating to another country for better care, where health coverage is centralized, universal for all people, and where medications are more affordable. The United States is the only rich country in the world that doesn’t guarantee healthcare for all its citizens.

Meet Liz Donehue, a comedian, writer, and American expat who has lived with type 1 diabetes for the past ten years. She moved abroad a few years ago to find better diabetes coverage, and I chatted with her about her experience moving to the Czech Republic.

What made you want to leave the United States? 

I left the United States for many reasons, but one of them was that the motion to repeal Obamacare passed in the House in 2017. Most of my employers didn’t provide health insurance, so the enactment of Obamacare in 2013 was a life-saving situation. Healthcare and insulin had never been unaffordable to me, but then again I was fortunate enough to have my parents support me in times of need, especially after I aged out of their insurance at age 26. I have never rationed insulin due to cost, only at times when the pharmacy or my endocrinologist made an error during insulin refills.

Why did you choose the Czech Republic? 

Part of the reason I chose the Czech Republic was that their visa process was relatively easy compared to other countries. I also chose the city I’m in, Brno, because of the cost of living. Having moved from Seattle, my cost of living went down by 66%. Other candidates included Poland, Vietnam, and Cambodia, but I had previously been to CZ and they had the most advanced healthcare system out of the four.

What was the deciding factor that made you move?

I had recently been laid off from my job, and I had just gotten out of a relationship. Essentially there was no true reason that kept me in Seattle, so I started to look at other options, especially where there was available socialized healthcare. I did research for about four months before moving, and I was able to secure an apartment online for myself and my cat who I brought with me. I’m living here permanently and my visa is through my current employer.

Will you become a citizen? 

I’m not a Czech citizen and as a “third country national” (non-EU), I will need to have lived in the country for ten years before I can apply. When I first arrived and waited for my freelance visa to process, I had to get private insurance through an international company for my application.

Typically, how expensive is diabetes care and insulin in your new country? 

During this wait, about five months, I was paying out of pocket for appointments and medications. But because it’s CZ, the costs pale in comparison to what they are in the US. A pack of five Humalog pens costs $18 here as opposed to $556 back home without coverage. When I got hired by my current employer, they took over paying for my healthcare costs, about $98 a month. I paid this for myself while I was self-employed, but everything was covered. There are no prior authorizations and the notion of pre-existing conditions doesn’t exist here.

Additionally, monthly insulin supply costs me nothing. I take Humalog and Tresiba daily and my test strips are also free of charge and included with my health insurance costs paid for by my employer. I get new prescriptions every 90 days whether I ask for them or not, so I now have a surplus of insulin and I don’t need to worry about refills.

Do you miss anything about the US healthcare system? 

I think the major thing I miss about the US healthcare system is the access to current technology. The system in CZ, while affordable and readily accessible, doesn’t have the technology to download glucometer readings, for instance. I also need to provide my own samples of urine for quarterly testing instead of having it done in the office. The medical equipment and tools are often metal and sterilized as opposed to plastic and designed for one-time use, which I’ve heard is a practice left over from the communist era.

Are you ever planning on moving back to the US? 

My move to CZ was an act of self-preservation. In the US, for some reason, health insurance is tied to a person’s employment. As long as that system is in place or there is no enactment of a system like Medicare for All, I can’t move back to the US. The pandemic has increased my concerns, and right now, I could go back to the US to visit, but I would not be let back into the Czech Republic just on the basis that I was IN the United States as the situation is worsening by the day. I feel healthier [living here] but I’ve also been taking extreme precautions due to the pandemic since I’m immunocompromised.

Thank you for your time, Liz. We really appreciate you sharing your story with us!

Have you ever considered moving abroad for better health coverage and diabetes care? Why or why would you not move abroad? Share your thoughts below; we would love to hear from you!

Source: diabetesdaily.com

How to Increase Your Life Expectancy

If 2020 has taught us anything, it’s that health is everything. There are simple steps everyone can take to increase their life expectancy, and to give individuals the best chance at living a long, healthy life. Incorporate these simple habits into your daily and weekly routines to increase your life expectancy and improve your health now and into the future.

1. Keep Your HbA1c Low, TiR High

If you live with diabetes, one of the healthiest life-extending habits you can adopt is keeping your HbA1c low and time in range (TiR) high. Tightly managing blood sugar levels can help prevent devastating complications such as blindness, amputation, heart disease, kidney failure and premature death.

In addition, since the HbA1c test is simply an average of one’s high blood sugars and low blood sugars, it’s important to keep your blood sugar consistent and stable, with your time in your target range as high as you can get it. Studies have linked more stable blood sugars (and not gigantic swings between highs and lows) to longer life for those with diabetes. Most people aim for an HbA1c lower than 7%, but check with your doctor for your ideal target.

2. Wear Sunscreen

Wearing sunscreen daily is crucial for preventing the deadliest form of skin cancer, melanoma. Even on cloudy days, your skin will absorb 80% of the sun’s rays, and with it, harmful UV radiation. The American Academy of Dermatology recommends using a broad-spectrum sunscreen of at least 30 SPF every time you go outside. Ample use is crucial: On average, people only use about 20-25% of the amount of sunscreen needed for sufficient protection, so make sure to lather up!

3. Move Your Body

It’s no surprise that exercise is healthy for people, especially people living with chronic conditions like diabetes. Exercise is crucial for heart health, to manage blood sugars, increase lung capacity, and build and tone muscles to prevent future injury. All of the short term benefits of exercise add up to a longer, healthier life. Aim for 30 minutes of moderate exercise most days of the week, more if able! A study showed that people who exercise vigorously for only 3 hours a week had cells that were 9 years younger than nonexercisers.

Photo credit: Adobe Stock

4. Spend Time Outside

Nearly 50% of adults have low vitamin D levels, due to our sedentary lifestyle and the fact that most Americans live and work inside most hours of the day. Vitamin D (which can be absorbed right into the skin when people go outside) is important for proper immune system functioning, healthy teeth and bones, managing depression, and may even help prevent both type 1 and type 2 diabetes! Getting outside for just 15 minutes a day is usually enough to maintain adequate vitamin D levels for most people.

5. Spend More Time with Family & Friends

Blue Zone countries, places around the world that have notoriously long, healthy life expectancies, place a lot of emphasis on socializing with family and friends. Having a social circle can help people get through hard times, reduce daily stress, boost resilience and immune response, and act as a literal shoulder to cry on. This is especially important for people with diabetes who can oftentimes feel isolated and alone with their condition. Connecting with others in our struggle can help extend life expectancy: studies show that maintaining a social circle can help people live up to 50% longer, and having just 3 close social ties can decrease your risk of an early death by 200%. 

6. Eat Whole Foods, Mostly Plants

Consuming a diet rich in fruits and vegetables will be full of vitamins, minerals, and antioxidants that can extend life. Even if you don’t go completely vegetarian or vegan, eating more whole, unprocessed foods is beneficial for a healthy life, and to prevent diabetes complications. Many studies over the years have correlated a plant-forward diet to a lower risk of premature death, as well as protective factors against cancer, heart disease, depression, and dementia. People who eat mostly plants tend to have lower body weight, healthier blood pressure levels, and have significantly lower mortality risk. Bon Appetit!

7. Meditate to Manage Stress

Stress has been correlated with shorter life expectancies, and learning to manage it through meditation and yoga can improve and lengthen your life. Successfully managing stress through meditation can improve the quantity and quality of your sleep, boost your immune response, and improve your relationships, all of which add up to a healthier, longer life. Check out some free meditation apps to get you going!

Photo credit: Adobe Stock

8. See Your Doctor Regularly

Regularly seeing your doctor for screens and tests can catch diseases early (such as cancer), and can ensure an appropriate and timely treatment plan if something is detected. Mammograms, colonoscopies, and pap smears are some of the routine tests and screens scientifically proven to decrease mortality from the diseases they screen for. It may not be fun, but it’s proven, effective, and worth it!

9. Reduce Your Sugar Intake

Sugar is the new tobacco. Dr. Aseem Malhotra, a cardiologist from England, shares, “…added sugar is completely unnecessary. Contrary to what the food industry wants you to believe, the body doesn’t require any carbohydrate energy from added sugar.”

There is evidence linking sugar not only to obesity and higher incidence rates of type 2 diabetes, but also to liver disease, heart disease and tooth decay (which can lead to dementia). If you cut out added sugar from your diet, you are also more likely to gravitate to unpackaged, whole foods, which are chock full of vitamins, minerals, antioxidants, and life-extending properties.

10. Get More Sleep

One in three Americans don’t get enough sleep. Lack of sleep has been linked with a plethora of negative outcomes on many body systems, including cardiovascular, endocrine, immune, and nervous systems. Side effects of not getting enough Zs include obesity, heart disease, hypertension, anxiety, depression, alcohol abuse, stroke and increased risk of developing cancer that can all shorten one’s life. Sleep is when the body replenishes cells, is crucial to proper brain functioning, regulates one’s metabolism, and repairs damage done to the body during the day. Adequate sleep promotes healing of all body systems, and getting enough of it can extend your life. Aim for 7-9 hours per night.

These small, easy changes can add up to many more healthy years. Try to incorporate a few of these strategies into your routine today to increase your life expectancy!

Source: diabetesdaily.com

Book Review: Actually, I Can.: Growing Up with Type 1 Diabetes, A Story of Unexpected Empowerment

Morgan J. Panzirer is 19 years old and is a student at Villanova University, majoring in biology and minoring in Spanish. She was diagnosed with type 1 diabetes at age six and is now working towards her goals of attending medical school and becoming a pediatric endocrinologist.

She recently published a book called “Actually, I Can.: Growing Up with Type 1 Diabetes, A Story of Unexpected Empowerment”. As with all our book reviews, I received a copy of the text at no charge, and I did not receive any additional compensation for my review.

There are many short chapters, as the author walks us through her life with diabetes, highlighting the highs and the lows of her experience in relatable and vivid ways. She shares her positive revelations, as well as frustrations. I think this text is a good read for young people with type 1 diabetes, and especially those who are newly diagnosed. Morgan’s story is really a wonderful example of making lemonade out of lemons, and will sure be inspirational to many.

The title of the book, “Actually, I can” refers to the common assumption that people with diabetes cannot eat sugar. The author explains,

“I can eat anything I want and it doesn’t have to be sugar-free as long as I give myself the proper amount of insulin. There is no special diet I have to follow. I can eat literally anything I want to. Sorry, that sounds super aggressive but I can’t tell you how many times people assume everything I eat has to be sugar-free. It is incredibly frustrating.”

Morgan writes with great candor and a sense of humor, and I can’t imagine her stories wouldn’t be relatable to almost any young person with type 1 diabetes. The author’s upbeat attitude about living with the chronic and challenging health condition comes across throughout the entirety of the text. While she is very honest about the gravity of the disease and the difficulties of living with something so relentless day in and day out, she is also incredibly optimistic.

“The, “Oh my life sucks because I have this disease” attitude is not the one to live by. It is so much more empowering to think about it this way: “Yes this disease sucks, it is such a pain in the ass, and has had such an impact on my everyday life, but look at the kind of person it’s made me.” Make it into a positive. Not everything in your life has to be negative all of the time. This was something I had to learn because I was, like most, only seeing the negative. Just remember: there’s always a positive. No matter how deep it’s buried, I promise you it’s there. There is a reason that you’re in the situation you are right now. Whether it’s to better yourself or educate others, there is reasoning behind it. You may not understand why your life is hell now, but you will later. You have to trust me on that.”

In short, Panzirer’s book is honest and relatable about growing up with type 1 diabetes. It strikes the right balance of acknowledging the gravity and hardships of the condition with a great optimism and empowerment.

What has been your experience with type 1 diabetes? Please share your thoughts below, we love hearing from our readers.

Source: diabetesdaily.com

Study Sheds Light on How High Blood Sugar Can Cause Complications Years Later

People with all types of diabetes are at a higher risk for numerous health complications, in particular for various vascular problems. While it is known that consistently tight glycemic management can greatly minimize these health risks, there are numerous factors which will determine long-term health outcomes.

One interesting concept is that of “metabolic memory,” a phenomenon that suggests high blood glucose levels experienced early on (for instance, before and some time after diagnosis) may still play a role in the development of complications years later, even if blood glucose has been generally well-managed. Several theories have been proposed as to why this may be, and most recently, researchers at the City of Hope conducted a study that may help explain why. The results of the study were recently published in Nature Metabolism.

Researchers selected patients from the DCCT/EDIC trials and compared their DNA to identify differences as they relate to glycemic management histories. The scientists were looking at something called DNA methylation, a process that involves the attachment of chemical groups (methyl groups) to specific regions of DNA.

The addition of certain chemical groups to DNA can change its function. This is one example of epigenetic regulation, a way that gene expression can be altered without a change in the actual DNA sequence (i.e., a mutation). These chemical groups that bind to the DNA can change the way that gene behaves, may affect the function of other genes and alter various physiological events downstream.

In this study, the authors report that they uncovered a connection between the HbA1c levels of patients at the end of the DCCT, their DNA methylation patterns, and the development of complications later in life. They believe that these differences in DNA methylation may promote the development of diabetes-related retinopathy and neuropathy (and likely other complications as well). In fact, many of these changes were occurring in genes that are directly relevant to the development of complications.

Rama Natarajan, PhD, one of the authors of the study, had this to say in a recent press release:

“This comprehensive study has systematically compared the epigenetic states of a large number of type 1 diabetic subjects with their glycemic history and their future development of key diabetic complications over 18 years. While the link between epigenetics and diabetes and related complications has been reported before, this is the first large scale study in type 1 diabetes showing that a prior history of high glucose levels can cause persistent changes in DNA methylation to facilitate metabolic memory and trigger future diabetic complications. This study provides the first evidence in humans supporting the link between DNA methylation in inflammatory and stem cells, a patient’s blood sugar history and development of future complications.”

Having a better understanding of detectable “markers” for complications before they even develop may mean earlier detection (i.e., via blood test) and more timely treatment of diabetes complications in the future. This research group is currently continuing to explore these findings, in collaboration with other research groups. They are planning to evaluate the relationship of DNA methylation and other diabetes-related complications, as well as investigate whether these changes may be a reliable biomarker for early detection. They are also investigating what other epigenetic changes may be relevant in metabolic memory.

Source: diabetesdaily.com

Would You Restrict Carbs to Ease Diabetes Management? (ADA 2020)

Children and adolescents with type 1 diabetes are currently living at a time of a big diabetes technology boom. Continuous glucose monitors (CGMs) and insulin pumps are becoming more popular and offer the promise of better glycemic management and more freedom and peace of mind. As research and clinical trials on automated insulin delivery systems are in full-swing, clinicians from The Joslin Diabetes Center, Yale University, and Harvard University were interested in understanding various patient preferences. In one study, they posed the following question:

Would young people with type 1 diabetes be willing to limit their carbohydrate intake to a maximum of 50 g per meal if this meant they wouldn’t have to administer a manual bolus using an artificial pancreas (AP) system? 

The outcomes of this research were recently presented at the American Diabetes Association (ADA) 80th Scientific Sessions.

To help understand patient perspectives and preferences on this subject,  39 participants (average age 17 +/- 4.7 years) were recruited at two study centers. These patients had an average diabetes duration of 9.4 +/- 4.9 years and an average HbA1c of 8.4 +/- 1.1 %. Interviews were conducted with each participant and parents to gauge their views on the willingness to “limit carb intake to 50 g per meal/snack if this would eliminate the need to manually bolus for food when using the AP system.”

Based on their analysis, the study authors derived the following major insights:

  1. The majority of participants (and their parents) would prefer to have the option of eating more than 50 g per meal/snack and were willing to manually bolus for the excess carbs.
  2. Most believed that 50 g per meal or snack was too restrictive.
  3. Young people generally agreed that automation would “reduce self-care burden.”

The researchers concluded,

“An aversion to food restrictions overpowers the desire for an AP system that can independently manage glucose levels though limited carbohydrate intake. Carbohydrate limitations appear to increase self-care burden more than the time and effort expended on carb counting and bolusing. Future AP systems should consider options that enable users to choose to bolus manually for large meals and to forego bolusing for smaller ones.”

Here are a few notable quotes from the participants, which were highlighted in the poster presentation:

“I think that, if I had to choose between bolusing or limiting my carb intake, I think I would rather bolus, just because nobody really wants to be told what to do.” (25-year-old female)

“Every once in a while she wants to have an ice cream. You know, I think she should be allowed to have these things sometimes when she wants them. I don’t want her to be too restricted.” (Mother of a 16-year-old.)

Sadly, despite continuing advances in technology, the glycemic management for youth with type 1 diabetes has been stagnant or worsening, depending on the age group, for decades. As per the most recent available data, the average HbA1c for young people with type 1 is about 8.7%, similar to what was observed in this cohort. Automated insulin delivery could offer an important solution to so many young people who do not meet the ADA-set glycemic targets (currently, the organization recommends individualizing the A1c goals, from as low as <6.5% all the way up to <8% for some patients).

This study provides an interesting snapshot into what many young people with type 1 diabetes appear to consider very important — the freedom to eat whatever they want and bolus for it. 

There has been a long-standing debate, often in the diabetes online community, and sometimes among healthcare providers, about a low-carbohydrate approach for young people. Many have highlighted the benefits, and exceptional success stories. They are not just anecdotes, either. At least one study has demonstrated exceptional outcomes of carbohydrate lowering for youth with type 1 diabetes, with excellent adherence and reported quality of life, a normal average A1c of ~5.7%, and a very low rate of adverse events.

Nevertheless, some question difficulty of maintaining a lower-carbohydrate diet, and concerns have been cited over the potential for the development of eating disorders as a result of “restricted eating”.

When it comes to developing AP systems, this study suggests that many young patients would prefer more flexibility in the upper threshold of their carbohydrate intake and are willing to put in the work to manually bolus for and accept the outcomes, whatever they may be, of higher carbohydrate eating patterns, in lieu of sticking to a recommended carb limit and not having to manually deliver their insulin dose. Of  course, this is just a small study, and the results may be skewed towards this perspective due to the predominance of teenagers in this cohort. Also, it may be interesting to evaluate a shift in this perspective, if any, following a formal diabetes education program to explain to patients and parents, in detail, the benefits of lowering carbohydrate intake for diabetes management in general, and in the context of AP technology.

What are your thoughts on the subject? We love hearing from our readers.

Source: diabetesdaily.com

Is Healthcare Provider Knowledge of Diabetes Lacking?

People’s experiences with healthcare providers can vary widely. When it comes to living with diabetes, many people expect that their healthcare providers, even if they’re not specialists, will be at least somewhat knowledgeable about their health condition. Many have found however, that while endocrinologists and diabetes education specialists tend to be more attuned to the ins and outs of diabetes management, even their knowledge can be outdated, while the knowledge of other providers, is sometimes starkly lacking.

Meanwhile, two informal polls in two separate diabetes social media groups, highlighted that over 85% of people with diabetes expect any healthcare provider (even if not a diabetes specialist) to have a basic working understanding of diabetes, at the very least the two major types and general treatment options.

Nevertheless, when the asked to share their own experiences, many reported a lot of confusion and uneducated statements about diabetes from various healthcare providers. The consensus during the crowdsourcing research tended to be “while we expect it, we do not routinely see it.”

We asked people to share some of the comments that they received about diabetes from healthcare providers. Here are some surprising responses and stories to ponder:

“When did you have your insulin pump surgery?”

“Type 1 diabetes develops over 2-3 days, not months.”

“He was a big baby so clearly he’s was a diabetic when he came out.”

“You will kill your child with this low carb nonsense… I will not stand by and watch you do that… I’m sure one of the other doctors will call CPS with this.”

“Diabetics like you are only allowed 4 eggs a week. Period.”

“You should eat more carbs, it’ll stabilize your blood sugars.”

“Do not correct under 13 mmol/L [~234 mg/dL].”

“You need to eat a minimum of 45 g carbs per meal.”

“If you don’t like seeing high fasting blood sugar numbers in the morning, don’t test your blood sugar then.”

“You will likely be dead from diabetes by age 30. If by some miracle you are still alive, you will be blind, on kidney dialysis, and in a wheelchair due to amputations.”

“Are you sure you have type 1?”

“It’s probably best if you stop sports and strenuous exercise.”

“If you go low-carb, you’re going to kill yourself.”

“An A1c below 6.5 is dangerous.”

“You don’t have to bolus for corn or peas, they are freebies.”

“Your insides are destroyed from having diabetes so long.”

One woman shared the following story:

“When my daughter was diagnosed at age 2 (I had diagnosed her and had to fight with her pediatrician to test her blood, because her urine test was normal. We already ate low-carb, so I had to feed her a high-carb meal and take her back and storm the pediatrician’s office and force them to give her a test, which came back at around 500, at which point they finally sent us to the ER). After diagnosis, the endo told us she needed at least 100 g carbs for each meal (at age 2!!!), plus 30–50 g snacks in between meals. Insanity! They had her on massive amounts of Lantus, NPH, and Novolog. They told me to feed her lots of ice cream before bed every night to hold her steady at around 200, which was a great night-time number for a kid that age! I swear I still have PTSD from that whole experience! Nightmare! I had to fight with them every step of the way!”

Such stories amassed very quickly, with many nodding their heads at having similar experiences. Is there perhaps a gap in basic diabetes education, in particular for non-specialists?

Image credit: Haidee Merritt. Republished with permission. Please visit her Etsy store for more original work and gifts. 

Almost all will likely agree – while we cannot expect every healthcare provider to be fully attuned to the latest developments in diabetes diagnostics and treatment, an accurate knowledge of the basics should be a requirement – especially with the high number of diabetes diagnoses, and undiagnosed or misdiagnosed patients.

Moreover, ensuring better understanding of diabetes and its management across the board, for all providers, is highly likely to improve patient outcomes in various situations, including recovery from illness and surgery, and more effective prevention of numerous diabetes-associated complications.

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What are your thoughts on this issue? Have you ever had a surprising conversation about diabetes with a healthcare provider?

Source: diabetesdaily.com

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