Getting a start on New Year’s Resolutioners

Since we’re a little less than two weeks away from Halloween here in the USA, I guess we can start talking about the holiday season.

That’s not because I consider Halloween to be part of the holiday season. To be honest, I don’t really like Halloween that much.

Most of my adult life, I’ve followed kind of a baseball schedule of fitness and nutrition: start working out a little in January, work out a lot in February, get into decent shape by April, keep up the activity until October. Once October hits, rest and allow myself some leeway when it comes to fitness and nutrition, something that lasts a little later than New Year’s Day (leftovers).

That brings me to October. The beginning of October, I’m still doing pretty well. But we always throw a party on the day our neighborhood hosts its Halloween trick or treating (on the Sunday before Halloween). I make what has now become the traditional Cincinnati Chili recipe, which isn’t always the healthiest thing in the world. Especially if it goes on a hot dog. Throw in a few snack here and there, and before you know it, I’ve started a bad annual habit.

Generally, I work hard all year to stay in shape and keep my weight from ballooning. But inevitably, beginning with Halloween and ending after New Year’s Day, I let myself down.

It doesn’t matter what I’m loading up on, or whether this behavior might have potentially dangerous consequences in the future. It’s simply something I’ve made an effort to curb going forward.

I’m not trying to say No to everything now. I’m just trying to moderate, and this year, I’ll be trying to moderate even more than before. Thanks to increased insulin resistance and lower metabolism (Hello, aging), this becomes more critical for me each year.

The good news is, I’m at a point in my life where I’m not motivated by food in general. Most of the time. But not all the time.

I don’t have a strategy that I employ. I just try to eat less, drink less, and eat less and drink less of the things that make it harder to stay in shape and maintain my weight. I also try to remain active, or increase activity, like walking more or doing more yard work, especially in December. It makes me feel like I’m getting a head start on all the New Year’s Resolutioners (Resolutionists?) out there.

Whatever you want to call it, this will be my second year of doing it. Last year, I really dreaded the idea. Now, I’m not so afraid of it.

It’s not about denial… it’s about adding years onto my life, instead of pounds onto my waistline. Is that a bad way to think about it?

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Like these links.

Happy Friday, everyone. I hope you’re wearing blue today to recognize and support everyone living with and affected by diabetes. So in that vein, let me say Happy #BlueFridays!

Now, on to today’s links for your perusal:
 
 
Every so often, I go to this site to read what people write. I may have also written something there once. Sometimes, it’s a real help to have a place to unload, and to read and know you’re not alone. Thanks to Christopher Snider for creating
MyDiabetesSecret.com
 
 
Do you ever find yourself straining to understand or explain terms like average glucose, standard deviation, and coefficient of variation? Want to know more about what you’re looking at in those CGM or meter downloads? Then you’re going to want to keep this article from Adam Brown and Divya Gopisetty at diaTribe handy. Spoiler alert: it includes examples too!
Understanding Average Glucose, Standard Deviation, CV, and Blood Sugar Variability
 
 
I don’t quite know how to explain this story, but it involves sunscreen, moisturizers, pump and CGM placement, and it’s not porn. But, as Kelly Kunik will tell you, the struggle is real.
Diabetes Hardware & The Moisturizer/Sunscreen Chess Game
 
 
I’m always jealous of Renza Scibilia, because she gets to travel to amazing conferences where things like #DOCDay happen, like at the annual EASD conference in Berlin recently. Her mention of the new Diatravellers initiative caught my eye too.
#DOCDAY at EASD2018
 
 
Read anything fun, inspiring, or interesting lately? Please share! In the meantime, enjoy your weekend, and I’ll catch up with you next week.

Wordless Wednesday: New Orleans

This is a diabetes blog… but it’s also a personal blog.

I spent time with friends last weekend in New Orleans, Louisiana. Yes, my friends were living with diabetes, or they were important people in the lives of those living with diabetes. It was not a conference. This was all personal. And wonderful.

But I did take some photos! Here are a dozen ways I saw New Orleans last weekend.











Advocating with DPAC Champions

It’s been another incredibly busy week, in the middle of an incredibly busy year. I’m through talking about it, but I just thought I would mention that as the reason why I’ve been silent here this week.

But last weekend… last weekend was full and eventful. I was fortunate enough to have been able to go to Washington, D.C. for the very first DPAC Policy Training Meeting.

Disclosure: DPAC paid for my hotel and parking for this event. All opinions are owned entirely by me.

Diabetes Patient Advocacy Coalition (DPAC) held this training meeting to help about 30 of us advocates learn about important issues that many of us have been discussing, and to learn how to more effectively advocate our positions before lawmakers. Saturday and Sunday were about learning, and Monday was about going to Capitol Hill and putting what we learned into action before Congressional staffers.

Saturday and Sunday were spent learning the ins and outs of why the price of insulin is getting higher and higher. We also learned about two measures before the United States Congress right now: House Resolution 5768 and Senate Bill 3366 – Expanding Access to Diabetes Self-Management Training Act of 2018.

Let’s take a look at each of these, one at a time.

Access to affordable insulin

It’s no secret that the price of insulin is skyrocketing. In fact, the cost of insulin has tripled in the past 15 years. That is not sustainable.

However, the Congressional Diabetes Caucus has requested information from a number of end points in the insulin supply chain (fancy talk for patients, medical professionals, pharma, pharmacy benefit managers). They’ve received information back, and they’ve been compiling their findings in a report, which is due to be released soon… hopefully, within the next month.

At the moment, there is no legislation before Congress which will address the price of insulin. But if we’re going to get there, we need to know where the pain points are. We’re hoping this report will shed some light on that, and that’s why we asked lawmakers to share that report the moment they get it, with their constituents and with DPAC, because there’s nothing better than transparency when it comes to something like this.

Diabetes Self-Management Training Act

Sponsored in the House by Representative Tom Reid (R-NY) and co-sponsored in the Senate by Jeanne Shaheen (D-NH) and Susan Collins (R-ME), These companion bills aim to increase access to diabetes self-management training for senior citizens who are on Medicare. This is incredibly important for a number of reasons.

Imagine living on Medicare for 10 years after retirement. We know how much diabetes technology and treatment can change in just a decade. Sometimes it’s like drinking from a fire hose. But imagine not having diabetes self-management training (or DSMT) paid for by Medicare when you need it then. Today, Medicare pays for 10 hours of training in the first year, and just 2 hours after that. This bill would change that.

Did you know that Medicare recipients can’t receive Medical Nutrition Therapy (MNT) and DSMT on the same day? So, if you’re 75, and it’s already an effort to get to the hospital where the training is conducted, but you have to go one day for MNT and another day for DSMT. Doesn’t make sense, does it? This bill would change that.

The bill would also allow for DSMT to be delivered outside of a medical professional setting… think local library or fire department meeting hall. There’s also a provision to look into expanding virtual training via telehealth or online. Both of these could be game-changers for people in rural communities like Dorchester County, Maryland, which has the highest prevalence of diabetes of any county in my state, but where many people live 30 or more miles away from a hospital.

We know that since we’re nearing the end of the 115th Congress, there’s virtually no chance of these measures passing before the end of the year. But we went and asked lawmakers to sign on as co-sponsors of the legislation so that when this comes up (as it undoubtedly will) in the 116th Congress, it will be much easier for these Congressmen and Senators to say yes.

For more on this important legislation, click HERE.

The best part of the long weekend? Going to the U.S. Capitol with my fellow DPAC Champions to advocate before Congressional staffers. My meetings with staff from the offices of Rep. John Sarbanes (D-MD), Senator Chris Van Hollen (D-MD), Senator Ben Cardin (D-MD), and Senator Patty Murray (D-WA) were productive and helpful. We didn’t get a single No on anything. A huge success.

Before I wrap up, a few Thank Yous:

Thanks to Christel Marchand Aprigliano and Leyla Mansour-Cole from DPAC for organizing the weekend and doing the cat herding so the DPAC Champions would be in the best position possible to fulfill our mission.

Thanks to Logan Hoover, Legislative Assistant for Representative Tom Reid (R-NY), who is Chair of the Congressional Diabetes Caucus. He spent time with us on Sunday to give us valuable information on how to share our stories and make an impact with the people we met on Monday.

Thank you to Jasmine Gonzalvo for being an amazing supporter and educator over the weekend, on the importance of both of these initiatives. And to Stewart Perry and George Huntley for doing an amazing job of explaining how “market forces” (my quotation marks), rather than patient empathy, have impacted the price of insulin in the USA.

Finally, thanks to our friends at the Endocrine Society and Lions Club International for partnering with us in this effort. It takes a village, and I’m glad to have these people on my block.
 
 
It’s easy to think of this event as a culmination of lots of effort on the part of DPAC, its Board of Directors, its Patient Advisory Board, and DPAC Champions. I tend to think of this as a beginning.

There was a construction site across from our hotel this weekend, with a big wall surrounding it, and messages on the wall. When I saw two of the messages, I knew what this weekend meant for me.
It took all of us from a “What if?”…

…to a “Why not?”

Whatever the message, I’m confident that the progress we’re making will help to yield positive results for People With Diabetes in the United States.

Your Government at Work (Part 2). Let’s build a community!

This is a fairly short post (for me, anyway).

If you didn’t see my post on Facebook about this earlier, I invite you to check it out now. It’s from the Center for Devices and Radiological Health (CDRH) at the U.S. Food and Drug Administration (FDA).

CLICK HERE TO FIND OUT MORE

CDRH is the group that looks at things like insulin pumps, CGMs, and artificial pancreas systems. I think the focus of this initiative is to help foster collaboration when it comes to design and improvement of devices that help us manage our diabetes (and other conditions, but since this is a diabetes blog, that’s where my focus is).

I don’t think that CDRH and FDA are saying that they’re building a community… I thiink they’re saying they’re interested in helping communities build themselves, and listening to those communities when it comes to device development, submission, and approval. How great is that?

The best part is, you can be involved. I wish I had a dollar for every time someone said to me, “I’d like to be in on something like that, but I never get the chance”.

Well, here’s your chance.

Here’s the first paragraph of the notice from CDRH, which says a lot:

One of the Center for Devices and Radiological Health’s (CDRH’s) strategic priorities for 2018-2020 is the creation of collaborative communities to bring together medical device stakeholders to achieve common outcomes, solve shared challenges, and leverage collective opportunities. CDRH believes collaborative communities can contribute to improvements in areas affecting U.S. patients and healthcare. We encourage interested stakeholders to learn more about collaborative communities and review the toolkit, which provides a collection of helpful ideas to foster strong collaborative communities that are well-prepared to take on healthcare challenges.

CLICK HERE – GET INVOLVED

If you read here often, you understand how much I believe in community-based approaches to challenges everywhere. And how much I believe in all of us being involved in said communities.

So let me ask you… why not you?

Enjoy the rest of your week.

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