Diabetes Can Be Controlled But It Is a Constant Struggle!

Philipp was diagnosed with type 2 diabetes right after knee surgery in 2005 and his diagnosis was like a little odyssey. Before jumping into the interview with Philipp, here is what he shared about his diagnosis journey.

mySugr loves to show the many different faces and stories of people with diabetes in the real world. They do their own photoshoots and feature real people living with diabetes instead of using stock photos.

“I was diagnosed with diabetes in 2005, during the evaluation and testing to discover anything that would delay the total left knee replacement surgery.

Nobody mentioned anything about diabetes when I had blood work done the week before surgery.

But upon being admitted hours before my 8am surgery, I was told I was a borderline diabetic. I anxiously asked what does that mean? The technicians at the attending nurse stated that I had a predisposition to having diabetes.

As far as I was concerned, I either had diabetes or I didn’t. I couldn’t grasp the concept of borderline.

After surgery, and in the recovery room when I woke up, I didn’t think anymore about it.

However, once I was delivered to the ward and further tested that evening, I was told that I was now a full-blown person with diabetes. That was a shock, and I began gathering information from the staff. How could I go from borderline diabetes to having diabetes overnight? I wasn’t told what kind of diabetes I had until hours into the second day of my hospital stay. That is when I was diagnosed as type 2.

Upon my third day prior to my release, I was told that I was being prescribed oral diabetes meds and not insulin.

Several weeks later, I was dehydrated and became extremely thirsty and began drinking 32 oz. “slushy” drinks from the 7-11. One every hour.

It became so intense the next day. While my wife was at work, I became so concerned that I drove myself to the VA emergency room. After waiting more than 1 hour I was seen in the ER and after testing my blood sugar level, it was well over 300.

I was blessed for driving to the ER because my vision was super blurry and traffic was almost non-existent. What guided me mostly were the lane dividers that I could hear to guide me, muscle memory for guiding the vehicle and knowing how far away the VA was from our home.

The experiences that are key here are extreme thirst, extreme body temp rise, the extreme need to urinate multiple times in an hour, visual impairment, and potential for bad decision making that can wind up in a very serious situation.

 

1. What was your biggest fears/concerns when you were diagnosed with diabetes?

That it was a mistake. I wasn’t overweight, I exercised regularly and watched what I was eating.

2. What’s the hardest part/biggest struggle for you in living with diabetes day-to-day?

First was the prescription for diabetes medication that the result was not managing my sugar level. Second, not believing this disease couldn’t be eliminated. Third, monitoring my sugar regularly and the levels did not fall below 200.

3. What piece of advice would you give to a person who is newly diagnosed with diabetes?

My advice would be to research as much as possible to get accurate and reliable information regarding diabetes. Do not believe that diabetes can be eliminated. Diabetes can be controlled but it is a constant struggle.

4. Is there a phrase/statement about diabetes that drives you crazy?

Yes! The statement that diabetes can be eliminated by a regulated diet of certain meds drives me crazy.

5. When you think of the word “freedom” in terms of diabetes, what does that mean to you? What would make you feel more free?

Freedom for me would mean that diabetes can be cured in a certain amount of time.

Source: diabetesdaily.com

How Telemedicine Improves Diabetes Care

How Telemedicine Improves Diabetes Care

By Heather Nelson

Rapid advances in telehealth have provided doctors a level of convenience (1) that lends itself to well-rounded patient care. In this article, we will highlight some benefits of telemedicine relating to diabetes management.

Rise of Diabetes Distance Care

Telemedicine is the use of technology in delivering medical care to patients from a distance (2). Once considered necessary for rural or underserved communities, telemedicine has transformed over the past 50 years into a vibrant, integrated service utilized by hospitals and physicians around the globe (3).

Diabetes telemedicine has combined the wonders of technology and the necessity of recurring specialty care to enable providers to be more proactive. One effect of telemedicine on the management of diabetes is that providers are able to help their patients see improved HbA1c levels (4).

As always, in the grand scheme of diabetes therapy solutions, the measuring stick has always been the almighty HbA1c. As technology improves, doctors are seeing the added benefits of reading telehealth data from sensors to measure Time-In-Range as well (TIR) (5).With both of these in mind, a new treatment option can succeed or fail based on the ability to improve HbA1c ranges consistently or provide greater time in optimal blood glucose range. This seems to be no struggle for telemedicine.

The benefits of telemedicine in diabetes distance care are so promising that the CDC (Centers for Disease Control and Prevention) ran a 2-year study in rural Alabama and Georgia (6). The outcome showed decreased hemoglobin A1c as well as average reduced travel time of over 78 minutes per visit. Based on their findings, the CDC declared that “diabetes care delivered via telemedicine was safe and was associated with time savings, cost savings, high appointment adherence rates, and high patient satisfaction.”

Additionally, another study found lower HbA1c levels as well as improved blood pressure and cholesterol levels after just one year of telemedicine (7).

These studies might seem great on paper, but you might be asking yourself…

“How can telemedicine help me manage my diabetes?”

Well, I’m so glad you asked. Welcome to “Telediabetes”!

We all know that diabetes is a chronic disease that requires regular and constant monitoring. Some providers wish to see their patients bi-annually, while others request quarterly or even monthly check-ups. The practical challenges of regular office visits can sometimes prove challenging, and in the gap of in-office care and at-home management, the person with diabetes flounders. This gap is precisely where telemedicine shines.

4 Reasons Why Real-time Feedback No Longer Requires Face-Time Appointments

  • Is the driving distance to your endocrinologist office making those quarterly visits hard to squeeze into your lunch hour? Transmit your health records and let telemedicine connect you for guidance in basal rates adjustments or dosing tweaks with less time off work.
  • Is prohibitive weather keeping you from talking with your mental health practitioner about diabetes challenges? Log into a portal and send a message detailing your snow-day concerns straight away. They can respond via email or video conference to provide real-time support and encouragement.
  • Are school absences piling-up making it hard for your child to miss another half-day for their monthly appointment? Simply log-in, upload the latest chart data you’ve been keeping, and let their doctor analyze the trends and suggest small changes. These tweaks can make a big impact in keeping them at optimal health while keeping them in school and learning (8).
  • Have travel challenges made your food dosing questionable? Send a message to your certified diabetic educator (CDE) and let them guide you to healthier solutions and safer swagging.

Whatever reason you have to miss out on those essential office visits, telemedicine doesn’t judge. Telemedicine understands.

With Great Tech, Comes Great Responsibility

The rapid advances of tracking devices and sensors mean we can readily gather reliable glucose data in a fairly simple manner. But that’s not the full picture your healthcare team will need. We all know that taming the diabetes monster requires a multi-faceted approach. The rise of newer and better diabetes management technology has perfectly poised the diabetic community to benefit from telemedicine and all it has to offer including lifestyle modifications, mental health checks, and more. But we must have solid data to reap those benefits.

The best way to take advantage of all the rewards of telemedicine is to provide good and useful data. The more data you can afford, in a succinct and readable format, the better distance care your provider can give. Utilizing technology means you should be able to provide food records, insulin doses, basal and bolus rates (for our pump-loving friends) as well as activity, health events, and other biometrics like Ketones, HbA1c readings, weight and body measurements.

Beyond the tracking of data itself, presentation also matters. Clearly you can’t courier-pigeon over a stack of origami-worthy paper logs and in this day and age, you shouldn’t have to. Organize your logs into a format that is easily accessible for your healthcare provider. If they need CSV, Excel sheets, or PDFs, provide what they can read.

How mySugr PDF Reports Makes Data Sharing Easy

If you are reading this and genuinely shocked to learn that you need to log things like insulin dosing and food intake, allow us to usher you out from under your rock and into the age of technology by introducing the reporting feature in the mySugr app! Indeed we believe you are the captain of your pancreas. As such, the ability to harness all your well-tracked data into usable information for you and your doctor is a key focus of our app. Using the reports feature you can quickly:

  • View your own data at a glance, anytime, to see trends.
  • Select your own time period to see only the data you wish to discuss. No more information overload or sifting through months of records needlessly.
  • Send preferred data to your doctor via email for quick communication about necessary formula changes. Even select from one of our three output formats for optimal communication.
  • Stay in constant communication and more!

Using the data in these reports, you can truly be the master of your own fate. The reports are meant to empower you as you discuss your treatment decisions with your provider, making the conversation more constructive and putting you back in the driver’s seat of your care.


And for our US friends in the diabetic online community (DOC), we still have our fabulous bundle! mySugr has over 2 million registered users to-date and a 4.6+ rating on the App Store and Google Play. The mySugr Coaching service is second-to-none and utilizing our monthly subscription gets you:

  • Blood glucose meter
  • Lancing device (with a box of refills…so that’ll last you basically forever, amiright)
  • Unlimited test strips (new shipments arrive before you even run out!)
  • The mySugr Pro App (that includes the ability to estimate the HbA1c!)
  • Diabetes coaching (with a pretty top-notch team)
  • Free shipping

And all the tech-support a person could need!

Indeed, we believe telemedicine is here to stay (9) and with good reason!

People living with diabetes can find more freedom and a better quality of life with the rising accessibility of a healthcare team armed and ready to interpret and predetermine the many responses to all the data we track.

As always, mySugr stands on the edge of change ready to help usher in this new age with open arms and glucometers for all Rise up mighty warriors and embrace the freedom of “telediabetes”!


(1) Wicklund E. Leveraging Primary Care Telehealth for Convenience and Quality. https://mhealthintelligence.com/features/leveraging-primary-care-telehealth-for-convenience-and-quality(2) White LA, Krousel-Wood MA, Mather F. Technology meets healthcare: distance learning and telehealth. Jan. 2001. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3116779/

(3) eVisit: The Ultimate Telemedicine Guide | What Is Telemedicine? 2018. https://evisit.com/resources/what-is-telemedicine/

(4) Hompesch M, Kalcher K, Debong F, Morrow L. Significant improvement of blood sugar control in a high risk population of type 1 diabetes using a mobile health app – A retrospective observational study. Poster presentation at ATTD 2017, Paris, France.

(5) Beck R, Bergenstal R, Riddlesworth T, Kollman C, Li Z, Brown A, Close K. Validation of Time in Range as an Outcome Measure for Diabetes Clinical Trials. March 2019.

(6) Xu T, Pujara S, Sutton S, Rhee M. Telemedicine in the Management of Type 1 Diabetes. 2018. http://dx.doi.org/10.5888/pcd15.170168

(7) Steven Shea, MD, Ruth S. Weinstock, MD, PhD, Justin Starren, MD, PhD, Jeanne Teresi, EdD, PhD, Walter Palmas, MD, Lesley Field, RN, MSN, Philip Morin, MS, Robin Goland, MD, Roberto E. Izquierdo, MD, L. Thomas Wolff, MD, Mohammed Ashraf, BA, Charlyn Hilliman, MPA, Stephanie Silver, MPH, Suzanne Meyer, RN, Douglas Holmes, PhD, Eva Petkova, PhD, Linnea Capps, MD, Rafael A. Lantigua, MD, PhD, for the IDEATel Consortium. A Randomized Trial Comparing Telemedicine Case Management with Usual Care in Older, Ethnically Diverse, Medically Underserved Patients with Diabetes Mellitus. Jan-Feb. 2006. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1380195/

(8) Please note that all mySugr products have a minimum age limit of 16 years for the mySugr Logbook and 18 years for the mySugr Bolus Calculator (for more details please read mySugr’s General Terms & Conditions).

(9) Klonoff David C., M.D. Using Telemedicine to Improve Outcomes in Diabetes—An Emerging Technology. July 2009. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2769943/

Source: diabetesdaily.com

Should You Be Afraid of Insulin?

It’s an all-too-common fear for people with diabetes. There is the completely natural fear of needles, but depending on the messages they’ve received from their care providers along with the experiences with insulin from other people in their family or circle, they can feel like insulin is the last resort or that they’ve failed on everything else. We’ll dive into all of that.

Topics

  • What is insulin
  • Why is it prescribed
  • Common messages and fears
  • Should you be afraid of insulin?

Transcript

Scott K. Johnson – Hey, thanks for tuning in to another episode of Coaches Corner. It is great to see you again. Let me know where you’re watching from today. I’d love to hear that. Post it in the comments. One small way that mySugr is giving back is by hosting the short conversations with our diabetes coaches, to talk about staying healthy in body and mind. We really appreciate you sharing some time with us. Now I do have to give the standard disclaimer. We cannot provide medical advice. Please contact your doctor directly for specific questions about your care. Today my sugar coaches Kristen and Maggie, talk about if insulin is something to be afraid of. Let’s take a look. And hi Maggie. Today we are talking about being afraid of insulin which is something that is quite common, especially for those who are new to diabetes, don’t really understand some of how it all works. But maybe we should start with some of the basics. So what is insulin?

Maggie Evans – Yeah, great, great start. So it is always useful to break down the basics. So we hear in the word insulin quite a bit. So I agree kind of, you know, understanding what that is. Insulin is a hormone that’s created by our pancreas or pancreas, it’s kind of right next to our stomach, and insulin is released in response to a meal. So when we eat a meal that’s broken down, and it tends to raise our blood sugar. So when that blood sugar response increases, that’s when insulin is released into the bloodstream. Now, when we explain the mechanism, mechanism of insulin, it’s helpful to use a term of just like a lock in a key. So imagine there’s a bunch of little locked doors on the outside of a cell, and insulin is that key to unlock the door to allow glucose into the cell. So when glucose is allowed in, that helps us create energy and helps us live our lives and do our thing. So thinking of insulin in that way, that it’s just simply a hormone that our bodies already make, I think can kind of help break down that barrier a little bit more too in terms of if it is something that ends up being prescribed.

Scott K. Johnson – Yeah, great point. So let’s from there, ask the question, why is insulin prescribed? If our body is already making it, what leads us to then need it as far as a prescription?

Kristen Bourque – Yeah, so Scott, I think, when we talk a little bit about first the differences between type one and type two, and we’ll talk more about this in our conversation. But essentially, insulin is provided as a treatment for diabetes. So with type one, our pancreas is no longer producing insulin. So there are multiple types of insulin that are provided to help essentially regulate the blood sugar right? With type two, generally what happens over time is the pancreas produces less insulin. So maybe additional insulin might be needed along with the use of oral medications to help regulate blood sugar.

Scott K. Johnson – And it’s, there’s actually quite a few misconceptions about insulin right? Can we dive into some of those? So especially, and I think this is one that’s, that I hear most common is the feeling of, of being a failure, right? Or the doctor saying, all right, let’s try with type two diabetes, as you mentioned, let’s try this this and this, and there’s always this phrase that if that doesn’t work, then we’ll start on insulin right, so it can be a hard step for people to take.

Kristen Bourque – And I think that you bring up such a great point Scott ’cause unfortunately sometimes we hear this kind of being almost used as a maybe a scare tactics sometimes for patients as well. If you don’t follow this and that insulin will be put on your regimen. And so I think there is a lot of unfortunately, negative kind of connotation around insulin. But the important thing to remember is with type two diabetes especially is over time. Again, as I mentioned, the pancreas produces less insulin, it can be up to 75%. So even if we’re doing, you know, diet, exercise, oral medications, we still might not get those numbers that we’re striving for. So yes, it’s very important to kind of wash away those ideas of feeling inadequate or like a failure because what we’re doing and those behavior changes may only sometimes bring us so far. So this is important to remember, is to rely on your healthcare team to find a way of providing you with various options for medications and whatnot to kind of find the best thing for you and ultimately, our goal is right to manage our blood sugar. So insulin may be put on the table, as just another option for you and it does nothing to mean that you did anything wrong in your management of your diabetes at all.

Maggie Evans – I think also emphasizing the fact that just like everybody’s body is different, everybody’s diabetes is different. And that your management of diabetes is going to look different than your neighbor with diabetes or someone else with diabetes. So recognizing that your body’s response to somethings just like what Kristen said, might be different than other people, and you just might well, need insulin. And yet again, breaking down the barrier to that and just recognizing that it is simply that hormone that we already produce, and sometimes we just need a little extra help along the way.

Scott K. Johnson – I love that. There’s a one of my good friends. His name is Bennet. And he has a catchphrase that he says that your diabetes may vary. And it really what it comes down to is right, whatever it takes to manage your blood sugars in a way that works for you. And so you’re able to meet your diabetes management goals, and also your quality of life goals. And it’s different for everybody. So I’m so glad that you mentioned that. What are some other misconceptions around insulin?

Maggie Evans – I think there can tend to be a fear of injections or a fear of needles, fairly common for a lot of people with diabetes. But recognizing that now there’s so many different options and the technology in the diabetes world is just advancing. I feel like every day I hear something new. But there’s other ways around giving yourself insulin injections either every day or with every meal. Now we have pumps that are available. So the pump system uses a little smaller needle that tends to just go right under the skin and barely noticeable. But that can be another way to reduce the amount of injections that you’re given throughout the day or throughout the week. And also knowing that the syringes now, the advancement in the needles is much better, they’re much smaller, they’re thinner, so you can barely feel them. So that makes it much less painful. I’ve even had people tell me that their actual insulin injections are much less painful than just their finger pricks for their, for their glucose checks, so, really interesting to hear that. But just knowing that there are other options and now they’re even coming out with an inhalable insulin, which is very effective as well. So if there is that fear of needles or fear of it being painful, reach out to your providers, reach out to your diabetes care team, let them know these concerns. And there’s always going to be options available. So just as long as you let people know what you’re feeling that can help us and your team kind of direct you in the right direction.

Scott K. Johnson – I’m glad you mentioned that, that open conversation. So if my provider has prescribed insulin, but I’m struggling to take that insulin because of the fear of needles, which, by the way, is completely normal, there is nothing normal about poking yourself with sharp objects, so but like you say, maybe talking with your, your team about the challenges that you are facing in doing what they ask of you, that makes a big difference. So what else are we dealing with?

Kristen Bourque – Oh, when I was going to just add to that kind of what you and Scott, Maggie you mentioned is kind of that fear of the unknown. I think too, with that, with the injection piece of it too. So, like you mentioned, Scott is talking to your healthcare team. But also a lot of times especially when initially prescribed that they’ll do a demonstration with you. So that kind of fear of the unknown, maybe having someone kind of walk it through with you, versus just kind of sending you home on your way, also will, I think help kind of minimize that fear over time too. So yeah, the next thing I would say, of course, is the fear of weight gain, we always kind of get this. And this would also be, the case of certain oral medications as well. But I think that insulin and weight gain are oftentimes associated together. But it’s important to remember that some patients will experience this overall, it helps the body to use food more efficiently. But again, this is going back to is everyone’s different, this isn’t going to be a for sure, side effect that happens. But it is again, going back to talking to your health care team about some of these fears or concerns that you have, in regards to I don’t want to gain weight once I go off, go on insulin. So just kind of let your doctor know, but important to still maintain, healthy diet and activity and all those things as well, to help kind of mitigate that as well, too.

Scott K. Johnson – Great, yeah, that makes a lot of sense. So if we, if we were to kind of wrap this question of should I be afraid of insulin? In a summary, few points, what would that look like?

Kristen Bourque – Of course, no. But just to kind of go off of some other reviews that we’ve mentioned, is that, I think, again, it’s very important to talk with your healthcare team about your concerns about your fears about this. They’re there to get, provide support and be there with you through this journey, but let them know kind of what your thoughts are around it, and see if they can kind of help you to feel more comfortable. But and then kind of just going off of what Maggie had mentioned is there’s so many different options for insulin nowadays, too. So this is another conversation to have with your provider is what you feel more comfortable with. Some people like to use a pump. Some people like to use insulin injections. So again, these are great options that we have that we did not have years ago. So you can ask someone that has had diabetes for quite some time, the differences in the technology and the needles and everything. So, you know, it’s great to know that there’s options available as well, so.

Scott K. Johnson – That’s great, that’s great. And I think that, it’s a very, very useful tool in the diabetes management toolbox. And if you’re struggling to meet your goals on the therapies that you’re using now, and the idea of insulin is there, it might be a way that you finally feel successful in doing what you need to do to get your blood sugars where they need to be. So I think it’s a very powerful tool, and not something to be afraid of. So thank you, thank you for breaking that down a bit.

Kristen Bourque – Yeah, and I think it’s like you said, Scott, it’s, and it’s an important thing to remember that it’s, it will get you closer to your goal. And that’s of course, what we want to focus on, is to manage our diabetes to manage it well. So insulin is just one of those other therapy options that’s available to us. And it’s a great option. So something to be again, a little bit less fearful and more open-minded if it comes up in conversation with your doctor.

Scott K. Johnson – Makes sense, great. Thank you. Well, with that, let’s wrap this session up and we’ll be back again soon. All right, I hope that was helpful. Carol, great to hear that this helps with your expectations, should insulin become a thing for you. Today was actually our last live episode of Coaches Corner. We have really enjoyed our time together. And for those of you who are using the mySugr bundle, I encourage you to continue asking great questions to your coach. They are there for you and happy to support you in your journey of living well with diabetes. If you would like to review any of the information in past episodes, we’ve pulled everything together into a single place, and we’ll put the link here for you. With that stay well, have a great weekend, and I hope to see you again sometime soon.

Source: diabetesdaily.com

Taking the Sting Out of Fingersticks: Lancets, Life Hacks and More

This content originally appeared on diaTribe. Republished with permission.By Marcia Kadanoff with Katie Bowles Tips to reduce the pain and hassle of pricking your finger each time you check your blood sugar levels on a meter When I was first diagnosed with type 2 diabetes two years ago, I struggled quite a bit. I had […]
Source: diabetesdaily.com

Best Apps to Manage Blood Sugar

With everyone going high-tech these days, it seems almost intuitive that our blood sugar management would make its way to a screen (remember the days of pen and paper log books?!). Measuring and tracking your blood sugar is easier than ever with the help of apps, right on your smartphone. Here are our top picks […]
Source: diabetesdaily.com

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