Category Archives: Diabetes

Old School vs. New School

March 29, 2016 – 9:08 am

Fact: I’m not a spring chicken anymore. I’ll be 54 in about two weeks. So you’d think I’d be someone who rejects everything new, clinging to my old habits and my old way of life (pun intended) as long as I possibly can.

If you think that, you’re wrong.

Okay, well, you’re not entirely wrong. I drive a thirteen year old truck (still in great shape), I cling to every last dollar like it’s my last dollar, and I’m not much of a Coldplay fan. But I recognize that Old School definitely loses out to New School when it comes to my diabetes.

Sure, I hung onto my previous insulin pump for nearly six years before getting a new one. But I did get a new one, and it seems to be working fine. I like the new color too (blue). And although I’ve been using the same meter for a few years now, in my opinion, it’s the best for me, so I’ll continue to use it as long as I can afford the strips. Which may not be very long. However, if something better for me comes along, I have no problem choosing that one and leaving my Accu-Chek Nano behind.

I’m always surprised when I come across people at a gathering where they are so excited for the future of technology, but almost in the next breath tell me that they can’t quite bring themselves to consider a new CGM, or a new meter, or even updated, free technology that’s available out there on the interwebz.

The truth is, innovation is only good if we actually put it to use. If we see something out there that might work for us, might help us manage our diabetes better, why not consider it? Where would I be if I hadn’t started on an insulin pump six years ago? Where would I be if I hadn’t learned more about counting carbs and sugar surfing?

The caveat to all this is, of course, that not everything new works for everyone living with diabetes. New things might mean more options; they don’t necessarily mean new requirements. But sometimes new is helpful. Researchers are finding new successes in typically Type 2 medications being used by Type 1s. They’re also finding success when they see some Type 2s start on insulin sooner.

Looking back, it seems like each decade brings different options for dealing with our diabetes. And that’s always good, even if I don’t always adopt every new option right away. Even though I’m a little Old school, I know that thinking New school and looking for the latest in technology and ideas will always benefit me and my diabetes.
 

By StephenS | Tagged , | Comments (3)

Do People With Diabetes obsess too much? Or is it just me?

February 26, 2016 – 9:08 am

I was in the grocery store a few weeks back, in the aisle where the boxed juices sit on the shelf.

As I stood there looking at the flavors (because rule #1 for hypo supplies: taste good), I was also checking out the carb count of every single juice box in the aisle.

“Well, this one looks good, but it’s 22g of carbs per box. This one is 12g… how do I count/bolus for that? Each box of this juice is 15g, which I want. But the flavor is… not my favorite”.

After standing in front of these shelves for over five minutes, I asked myself (out loud—good thing I like to shop early in the morning) whether it really mattered if a juice box had exactly 15 grams of carbohydrates per box. I mean, if I’m in the middle of an overnight low, and I need to treat with a juice box, I don’t think an extra 7 grams is going to make a huge difference. So I wound up picking the juice with the flavor I liked (fruit punch), but 22 grams of carbs.
 
Obsession
This is just my viewpoint on the subject… I completely understand if you are into exact measurements and precise management of your diabetes to get to, and remain in, a good glucose range all the time. In fact, I admire you for that level of dedication.

But you know, I just wonder if years of exchange diets, A1cs, and carb counting has made me obsessive about a gram of carbohydrate here and a couple of BG points there. It was brought into focus for me about a year or so back when I visited my endocrinologist, she relayed my lowest A1c result ever, and in the next breath wondered herself if I had been obsessing too much. Her very words were “You know, it’s not the end of the world if your meter reads 140 mg/dL before dinner once in a while”.

Plus, and I don’t think this happens to everyone, but it happened to me: As I experienced more success with my A1c results, I became more and more of a micromanager about my numbers. I mean, it’s great when you get good results from it, but I don’t think I can keep it up forever. And mostly, I need to remember that I don’t know everything, or even much, about day to day management of my diabetes. You may disagree with that, but there’s no denying that I could stand to learn a lot more.

The other side to this is what happens if something unexpected happens when your numbers are so tight. And something unexpected is bound to happen once in a while. I’m fond of reminding people that the better your numbers are, the closer you are to hypoglycemia all the time. It’s a lot scarier to go from 100 to 50 than it is to go from 200 to 150.

If I’m obsessing over anything right now, it’s probably my basal rates and my insulin to carb ratio. Over the past two years, I’ve also cut down a lot on my daily caloric intake. So if I can get the basal and insulin to carb ratio numbers right, I think I will be in a good place with my diabetes about 80 percent of the time. And if you told me six or seven years ago that I could be on top of my diabetes 80 percent of the time, I wouldn’t have believed you.

How about you? Are you a control freak about your diabetes? Or are you more of a rounded, but nice, edges Person With Diabetes?
 

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Universal truths.

February 22, 2016 – 9:08 am

Truth
I’ve been back on the workout bandwagon for a while now. I’m still finding some time to get on my spin bike at home, and I’ve been getting to the gym so I can run on the track instead of going outside when it’s 20 degrees.

But I’m no different from other People With Diabetes when it comes to working out and fears of hypoglycemia. To combat that, I don’t think of it as managing my diabetes as much as I think of it as managing my insulin. If I can manage my insulin properly, I can avoid the lowest of lows. It seems like I can’t avoid having any lows. I’m not that good at it. But remembering that I might need to tweak basal rates or bolus amounts due to workouts, and doing that properly, is really key. Just about everyone knows that.

Still, working out more often, and the worries of hypoglycemia, coupled with the fact that adding this to my schedule more often, well… it seems like there’s this double-edged sword: Volunteer for something that, in the past, has helped lead to serious hypos; or let the fear create inaction, which is never going to be something that will help me live a good, long life.

Add in knee surgery last year, and worries about how I would come back from that, plus the fact that I really hate how I look right now, and it just seems like a good excuse to either get going or sit right back down and have a drink.

While thinking of all this over the weekend, I came to the realization that there are actually some universal truths that apply to both management of our diabetes and working out. Remembering these truths has helped me embrace working out again, which I have not done for some time due to the reasons stated above.

It’s really hard to get started.
And the older you get, the harder it is to get started. The sooner you get over that, the better you will do. Trust yourself that you will, you can, get started again.

When you’re not on your game on a given day, you feel guilty.
Every day I’m not at the gym, I want to be at the gym. Which means if I don’t go, I feel bad for not going. After every day where I (try to) ignore my diabetes, I feel like I’ve done a disservice to myself and those who care about me. But we live with this disease all the time, right? We need a break (such as it is) once in a while. Which brings me to:

Yesterday is only a benchmark. The future is unwritten.
I’ve written variations of that line a number of times. This past week was when I first realized that it applies to working out as well as living with diabetes. Regardless of what yesterday tells us, there are many chapters left to life, provided we’re still game enough to author them.

Surprises can come at you pretty fast.
Since I started seriously working out again, I’ve had lows in the middle of the night that I didn’t expect, and I’ve had an injury to a toe that I was completely unaware of until my run was over. It helps me to keep in mind that the best planning includes planning for the unexpected. It’s gonna happen.

We are stronger over time than we seem to be an any one moment.
Our lives are not defined by one single day. At least I hope not. With diabetes or with working out, it’s easy to give up when the going gets tough, you’re worn out, and it’s so easy to just say I’m Done. When we don’t do that, well, that’s where champions are made. And People With Diabetes are better at not giving up than any other group of people I’ve ever known.

Maybe the real universal truth is that remaining active is actually part of managing our diabetes. That makes sense, but how often do we think of it that way? I know I don’t… or haven’t… until lately.

Have any other universal truths you’d like to add to the list?
 

By StephenS | Tagged , , | Comments (4)

8 Hidden costs of diabetes.

February 19, 2016 – 9:08 am

Everybody knows diabetes is expensive. We spend a lot of money on insulin, syringes, infusion sets, sensors, and more.
8
But there are a lot of hidden costs in diabetes. I found at least eight things that my doctor never told me about at diagnosis, and they cost me a lot.
 
 
1. Juice, candy, glucose tabs, and other “in case of lows” supplies.
About every other week, I head to the grocery store for some juice. I also need to make sure I don’t have a shortage of candy for those times when my refrigerator isn’t so close. Supplies in the bedroom in case of overnight lows, juice boxes and crackers in my desk drawer at work, hard candy in my truck. I’ve lost track of how much I’ve spent over the years on stuff like that.

2. Extra doctor visits.
Almost all of us visit our endocrinologist every 90 days or so. But what about all of those visits with our primary doc, even if it’s just when we’re “real people sick”? A podiatrist? An ophthalmologist? A dietician? A Certified Diabetes Educator? My insurance plan’s plan year is only a few months old, but I already have a stack of receipts for co-pays to the other healthcare professionals I see throughout the year. And while we’re at it:

3. Time.
Ever consider the time you spend on your diabetes? Just all those HCP visits take up a lot of time we’d like to spend on other pursuits. Add in blood sugar checks, set changes, and the myriad other tasks we perform on a regular basis, and I figure diabetes is gonna owe me a few extra years at the end. It’s a big, giant cost that bothers me more than I can tell you.

4. Education.
A lot of this is of my own doing, but honestly, I want to know more about diabetes, and more about advances in research and development on drugs, devices, and the mental cost of living with this disease. Often, that means spending money so I can get to where the information is being given. Of course, there is much to be learned via the internet, which is what I’m trying to do when I can’t get away to a conference. But a portion of my budget is now permanently earmarked for diabetes travel.

5. More time.
This is the good part of time spent on my diabetes. That includes spending Wednesday nights on Twitter, communing with my D-homies while doing the question and answer thing during #DSMA. When I’m lucky enough to see my diabetes friends in person, I love just being in the moment and soaking up all the goodness. Life ain’t all bad, right? But then there’s:

6. Extra costs for extra conditions.
Many of us living with diabetes get cursed a second or third time over with another condition like Celiac or high blood pressure or, in my case, an annoying skin condition that I’ve been told will also never go away. My extra isn’t anything that anyone needs to worry about, but it still comes with a cost, and even my dermatologist (another HCP cost) says it might be related to a compromised immune system. Thanks diabetes.

7. FItness.
I’m a believer in trying to stay as fit as I can. I don’t look like it, but I still exercise on a regular basis. Because it helps my body use insulin more efficiently, and because I feel better when I exercise. But it doesn’t come cheap. I will say this though: the cost for my road bike, for my spin bike, for workout wear and even my gym membership has been worth Every.Single.Penny.

8. Worries.
This could come under Time, or More Time, but let’s be honest. This deserves its own category. From fears of a future low, and fears of what a previous low has done to our brain cells, to fears of complications that come with years of diabetes unknowns, the cost of this chronic condition goes far beyond anything anyone should consider reasonable.
 
 
This list doesn’t include the money spent supporting my friends and the great causes they work tirelessly for. And it doesn’t count the money I spend on special things for The Great Spousal Unit because she indulges me by letting me write a blog and podcast and go to diabetes events, and oh yeah, she makes it easier sometimes when I’m dealing with a difficult low. No doubt this list could be a lot longer.

There you have it. Next time someone suggests that diabetes is as simple as take insulin and go on with your merry little life, remind them that diabetes comes with a lot of extra costs. And they’re not all covered by insurance.
 

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Something positive.

January 19, 2016 – 9:09 am

After so much death and sadness this past week, it feels good to do something positive.

20160116_093929
This is me, in the middle of donating blood last Saturday. This time, I donated double red blood cells. That bag you see hanging off of the machine in the background (the one that looks like it doesn’t belong) contains my plasma. Behind that was another bag that was just starting to collect my red blood cells.

Basically, the machine you see collects my blood, then separates the red blood cells from the plasma. Once it gathers enough red blood cells, it transfers those to the bag for collection. Then the plasma, along with an anti-coagulant, is pumped back into me through the same IV that took the blood out.

Does that sound creepy? Sorry. It’s actually kinda cool to me.

In case you haven’t read what I’ve written on this subject before, allow me to tell you that, if you live in the USA, and you have diabetes, and your diabetes isn’t old enough to have been treated with bovine or pork-based insulin; and you are, in the words of the American Red Cross, “well controlled on insulin or oral medications”, you may be eligible to donate blood. And I encourage you to consider doing so. You never know when it may be needed.

After this past week that included four high profile deaths due to cancer, the death of the Eagles’ Glenn Frey, and countless other deaths and injuries and infections that could have potentially been helped through a donation of my blood, I do consider it a responsibility to donate. If we’re eligible, it’s one of the easiest, most selfless things we can do.

And after a week like the one we’ve just had, it makes me feel like I’m finally doing something positive to push back against the sadness. I think that qualifies as a win-win. What do you think?
 
 
People living with diabetes may be eligible to donate blood in the United States. CLICK HERE For a full list of eligibility criteria.
 

By StephenS | Also posted in Random Glucose | Tagged , , , | Comments (2)