October DSMA Blog Carnival: What’s easy about living with your type?

The October DSMA Blog Carnival topic is easy to answer, but as you can probably guess, the premise of the question goes a lot deeper:
 
 
Type 1, Type 2, LADA, Gestational, diabetes brought on by surgery . . . . the list of types of diabetes goes on. Each type may have differences, but ultimately they are all diabetes. When we think about it, there is a whole lot that all types have in common. However, that doesn’t mean we can’t give credit for some differences too. So let’s look back to our “Breaking down the barriers between types” chat on September 10th and discuss . . . . .

Anything easy about living with your type of diabetes that isn’t easy for another type?
 
 
I remember this question (I moderated this chat, and I still have my notes). The idea behind asking the question was that I wanted to ask people to acknowledge that there may be something that helps them manage their diabetes, that maybe another Person With Diabetes doesn’t have at their disposal.

The easy answer for this Type 1 is that I can take insulin for anything I may eat, at any time of day. That flexibility is something the vast majority of Type 2s, especially, do not have. I’m not going to get into whether Type 1 is easier than Type 2, or easier than any other type of diabetes. The fact is, all diabetes requires a lot of work. But if I acknowledge that some part of diabetes may be slightly easier for my type, I’m recognizing that that’s a part of diabetes that is more difficult for another type. In making this admission, I’m saying to my fellow Type 2s, LADAs, Gestationals, etc… I wish you had it as easy as me.

As I recall, there were one or two Type 2s who mentioned how taking insulin was something that seemed more difficult to them compared to how they manage their day-to-day life with diabetes. Isn’t it interesting how we can think about the same things in different ways?

I also remember asking this question from an educational perspective. I’m intensely curious about nearly everything, and I wanted to see how other people viewed their diabetes versus another type. I wondered how they might consider having to manage their diabetes a different way. Most of the Type 1s participating in the chat that evening answered the same as I did. I found it fascinating that people considered insulin an easy thing for them, even though it meant taking injections or having an insulin pump attached to them 24 hours per day. It’s all in how you look at it, I guess.

In the final analysis, when the word “diabetes” is part of your diagnosis, it doesn’t matter what word (or words) preclude it. You’re dealing with something serious and challenging on a daily basis. The best part was the outpouring of support and understanding for all types during the chat that night. It goes without saying, but I’ll say it anyway: A diabetes diagnosis automatically makes you eligible for as much encouragement and support as the Diabetes Community can muster. As a community, we are stronger and capable of much more when we welcome and support all people, of all types, living with diabetes.
 
 
This post is my October entry in the DSMA Blog Carnival. If you’d like to participate too, you can get all of the information at http://diabetescaf.org/2014/10/october-dsma-blog-carnival-4
 
 
 

8 Questions: Can you guess the answer?

Ready for a guessing game? Let’s see if you can find the answer in 8 questions (or less):
 
 
1. Dexcom users: What is neither red nor yellow?
 
 
2. What can make you smile?
 
 
3. Goldilocks would love this.
 
 
4. For many of us, this eliminates half of the bolus equation.
 
 
5. In some parts of the world, this is worth one dollar. #hundy
 
 
6. According to Joslin Diabetes Center, “People who do not have diabetes typically have fasting plasma blood glucose levels that run under” this.
 
 
7. The square root of this many Maniacs:

 
 
8. For this Type 1 patient, it’s the Happy Medium!
 
 
Answer:
DSC00251
 
 
 

It’s Big Blue Test Time!

Big-Blue-Test
 
 
Today marks the start of one of my favorite parts of the year. It’s Big Blue Test time!

For the next month, every Big Blue Test that is logged will result in a $1.00 (US) donation to non-profit diabetes groups that are working tirelessly to provide education, support, and supplies to people who need them.

Here’s how it works:

1. Test your blood glucose. If you do not have diabetes, you can skip this step.

2. Get active. For 14 to 20 minutes, get up and get moving. You can , walk, run, clean the house, swim, tap dance…whatever!

3. Test again. On average, Big Blue Testers seen their blood glucose level drop 20% after 14-20 minutes of exercise.

4. Share your results. (Answer the questions in the right column of the page at bigbluetest.org). And don’t forget to talk about your experience on social media.

Hashtag-Big-Blue-Test

Tell everyone you know, whether they’re living with diabetes or not. Log those moments of activity throughout your day.
Share this with everyone you know (use the hashtag #bigbluetest).

Have you been looking for a way to help move the needle toward better outcomes for People With Diabetes, but you’re not sure how? This is how.

I’ve already logged my first one! I took the long way walking from the train station to work, and my BG dropped 53 points. I’m going to try to do this every working day (twice per day, of course) for the next month. I’ll bet there’s something similar you can do where you live and work.

Sometimes, diabetes advocacy is both fun and easy. Go to bigbluetest.org to find out more.

Recipe! Flatbread pizza.

Happy Friday!

Cliche alert: Like you, I’m always on the lookout for low-carb options of my favorite foods. Today, I’ll be showing you just how easy it is to make a tasty flatbread pizza. Not only is it low carb, it’s also about three dollars (or less) per pizza. Let’s begin:
 
 
Preheat your oven to 400 degrees fahrenheit. I’m still working on this; you can probably cook these a little lower, say around 350. The idea is to get all the ingredients cooked through while crisping up the flatbread, but not burning it. A little finesse is required. We’ve also done this on the grill, which requires a very low flame so you don’t burn the flatbread. Regardless, watch it like a hawk the first time.

Flatout-Flatbread

I started with flatbread from Flatout Bread. Good size, easy to use, fits on a cookie sheet. 16 grams of carbohydrates per flatbread. They come in a variety of options, including Garden Spinach and Sundried Tomato. I used the Italian Herb. FYI: Their website contains great recipes from other bloggers.

I like to put a very thin layer of olive oil on the bottom of my cookie sheet, along with some garlic powder or celery salt, to give the crust a little zing. Then I went to the refrigerator.

Ingredients

I just looked for anything that might taste good on a pizza. I found turkey deli meat (for Maureen), salami deli meat (for me), green onions, baby portabella mushrooms, and green olives. I also had some cherry tomatoes left from my garden.
 
 
Classico-Pizza-Sauce

We began the pizza build with Classico Fire Roasted Pizza Sauce. The nutrition label says that ¼ cup carries about 6 grams of carbohydrates, and that’s about the amount we used on each pizza. I’m also a big fan of basil on my pizza; we didn’t have fresh basil, but I sprinkled some dried basil flakes on top of the pizza sauce to give it an extra layer of flavor.

Then we just started piling on ingredients! One thing about the tomatoes: A lot of flavor is in the juice of tomatoes, but that extra liquid can really make your pizza soggy if you’re not careful. These cherry tomatoes worked fine, but we made sure to put them on top of the other ingredients. If you’re using something like a Roma tomato, slice it really thin and place each slice on a paper towel first. It won’t drain all of the liquid from the tomato, but keeping the slices thin will keep from weighing everything down, while still giving you that tomato boost. Yes, I’m a fresh tomato addict.

Once we finished with our ingredients, all we needed was a little mozzarella cheese on top. Here’s a look at one pizza before the cheese and one after the cheese. Looks good, right?

Half
 
 
Well, they were even better when we took them out of the oven. Cook your pizza at 400 degrees for 5 to 5 ½ minutes. In our case, thanks to our 50 year old oven (literally), we needed to finish it off for 30 seconds or so under the broiler to brown the top a little bit.

Flatbread-Pizza

From start to finish, these two flatbread pizzas took about 15 minutes. It may not have taken that long to eat them.
 
 
Carbohydrate count: Let’s see… 16g for the flatbread, 6g for the pizza sauce, maybe 3g for anything else. That’s 25 grams of carbohydrates for everything you see in the photos! A regular store bought or pizzeria pizza of the same size would probably be three or four times that amount. Note: You might want to take the fat content of the cheese you use into consideration too.

Carb counts are estimates only. Check with a registered dietician to find out what a healthy carb count is for you.
 
 
Full Disclosure: I’m not getting anything from Flatout Bread or Classico for writing about their products. They are just what I used to make this pizza.
 
 
 

A Pump Vacation? More to it than you might think.

Yeah, about that 3-day pump vacation I had last week: To be honest, it was a little less “Pump Vacation” and a little more “Sudden MDI Freakout”. The reasons for that are ones you can probably think of, but since this was unplanned, I wasn’t really prepared. I was lucky to have done as well as I did, when you consider these factors:

To begin with, I started back on the Lantus for basal insulin. I was still using Novolog for boluses, just like I do in my pump. But it’s been quite a while since I’ve used Lantus, and it scared the crap out of me. Prior to pumping, I had some pretty horrific lows on Lantus, and that’s the first thing I thought of when I did my first basal injection. Here’s the biggie: If I’m injecting for my basal, I need to take exercise and what I’m eating into consideration. Too much (read: ANY) eating without a bolus injection means going high. Exercising without extra carbs or without previously altering the basal injection almost certainly means eating and drinking like a juice-addicted chow hound later on. There’s no such thing as “threshold suspend” when you’re injecting.

Oh, and injections. Part of the flexibility with pumping is the obvious freedom to bolus whenever you need to, without stopping what you’re doing and finding your insulin pen, getting a fresh needle out, and injecting. For everything you put into your mouth. When I had bloused for dinner, eaten, and then Maureen’s family decided to go to Dairy Queen or something for dessert, I had to decide whether I wanted to partake and inject again. I still had to decide whether I wanted to add to my carb count for the day. But part of my decision was based on whether I actually felt like doing another injection.

And the calculations. I’ll admit it… I’m a big user of my pump’s bolus wizard feature. The first time I needed to do a bolus injection, my BG came in at 78 mg/dL. You know what that means, right? Take the 22 mg/dL I was below 100 to figure how much to reduce my bolus so I wouldn’t go low overnight. To my surprise, I found that doing these calculations in my head was like riding a bicycle (in my head). The first calculation took a while, and I practically singed some brain circuitry, but the rest were really no trouble. Good to know I can still do simple math in my head.

But I also had to remember that I was in sunny, HOT Florida. When we went out with my pump on, the air conditioning in the car kept my pump cool, and then we’d quickly go into an air-conditioned building of some sort. But I needed to take the cooler along when I had the insulin pens, or leave them in my pocket the entire time. Which can be tough with a swimsuit on. In retrospect, I should have just kept them in my pocket anyway.

All of this is just a reminder that a pump vacation may seem like a fun idea when you first think of it. But if you don’t do some real planning, you may find yourself in sudden MDI freakout mode, just like me. Make sure you have your calculations down, you’re familiar with what your insulin of choice is capable of, and make sure your meal/carb intake is well planned as much in advance as possible. If you think of these things ahead of time, you can look at even the surprise pump issues with a little less freakout and a little more vacation in mind.
 
 
 

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