Tag Archives: 8 things

8 Questions… just because.

It’s been kind of a whirlwind week, in the middle of two or three whirlwind weeks in a row. Lots of things going on, some important news, and a few really sad stories outside of the Diabetes Community.

Since we’re busy and we’ve had a lot of dark clouds hanging over our collective heads lately, I think we all could use a break. So, without further ado, here are eight interesting diabetes questions based on, well, nothing really. Feel free to leave your answers in the comments. Here we go:

1. Insulin pump or MDI (multiple daily injections)? Or neither? We know that some people who live with Type 2 diabetes don’t take insulin at all, and some insulin users are using inhalable insulin. I’m still working with my Animas Vibe pump, even though Animas has decided to go out of business. Whatever you do to help manage your diabetes, if it’s working, you’re doing the right thing. Isn’t it great to have choices? When we’re allowed to have choices?

2. Dexcom or Libre? With U.S. FDA approval of Abbott’s Freestyle Libre continuous glucose monitor, I suspect this will be a question asked more and more in doctor’s offices and at diabetes conferences nationwide. These aren’t the only CGMs available, but they’re the only ones available as standalone devices (not required to be paired with an insulin pump). Again, it’s great to have choices, when we’re allowed to have choices.

3. Have you heard of The Affordable Insulin Project? This is another of DPAC’s efforts on an issue that affects millions of Americans. Check out the website and see how you can help spread the word and help make access to the life-saving drug that many cannot live without more affordable. To find out more, go to AffordableInsulinProject.org.

4. Have you donated insulin or supplies to victims of Hurricane Maria in Puerto Rico? Insulin for Life USA is helping to coordinate efforts to send much-needed insulin and test strips to those impacted by hurricane Maria, and also hurricanes Harvey and Irma. Find out how you can help pay it forward by going to ifl-usa.org.

5. Are you donating blood? All of us were shaken this week by the news that hundreds were gunned down at a concert in Las Vegas. In response, many have donated blood via the American Red Cross. Did you know that many People With Diabetes in the USA can donate blood? Whether it helps victims in Vegas, or those closer to your home, every pint is necessary and so appreciated. I can state unequivocally that donating blood has been one of the most fulfilling experiences of my life. Consider donating too, then go to RedCrossBlood.org.

6. Did you watch the Sammies this year? Maybe you missed them because you were concentrating on the Emmys. The Sammies, or Service to America medals, are known as the Oscars of government service. They’re given each year to federal employees who are recognized as “breaking down barriers, overcoming huge challenges and getting results”. That’s especially true of Courtney Lias and Stayce Beck of the U.S. Food and Drug Administration, who have been instrumental in helping artificial pancreas research move from the “maybe, someday” stage to patient’s hands. I cannot say enough good things about them. Read about their incredible work HERE. Congratulations Stayce and Courtney!

7. Will I see you this weekend? Friends for Life comes to the Washington, D.C. area this weekend in Falls Church, Virginia. If you’re coming, I hope to see you as I advocate at the DPAC table in the exhibit area. Look for a brief recap in this space shortly.

8. Will I see you next weekend? When it rains, it pours, and diabetes events will be pouring over Northern Virginia like monsoon season in Myanmar this October, as the Diabetes UnConference and Diabetes Sisters’ Weekend for Women co-locate in Alexandria October 13-15. I will once again be a facilitator at the UnConference, and I am very much looking forward to getting together for peer-to-peer support, encouragement, and all the feels. I’ll let you know how it goes later in the month.
 
 
Those are my questions of the moment… have any answers, or questions of your own? Let me see yours in the comments below.

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Getting Acquainted.

Now that I’m officially several weeks into my life on Dexcom, I just wanted to scribble down some notes for the purpose of keeping a record on how it’s been going so far.
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This is mostly stream of consciousness, but as usual, my stream of consciousness still contains several words. Hopefully, they are ones you’ll want to read. Here are eight observations on the early going with Dexcom.

1. I know that I have FDA approval to bolus based on my Dexcom G5 readings, but I haven’t done it yet. Okay, I may have pushed a one unit correction bolus through once or twice without doing a fingerstick, but that’s all. I’m not blousing for a meal based on my display. I’m confident in my Dexcom– I’m just not confident that it will be perfect 100 percent of the time, every single day. I would hate to over- or under-bolus based on the one time it’s off by a bit. I hate to think of the result of doing that. So, no dice to the bolus-off-Dex so far.

2. I’ve got to remember to order some Skin Tac or Opsite Flexfix or something to hold down my sensor, and soon. The peeling is real, folks.

3. At the Diabetes UnConference, I checked in with a couple of people to get their pointers on doing an upper arm insertion. I also looked at Daniele Hargenrader’s recent video showing her doing this. Then I did it. Then I loved it. It’s mostly out of the way, and the sensor works pretty good there. And the accuracy has been fantastic. Win-win-win.

4. I’m not interested in using my thigh or forearm for sensor placement. I use my thigh a lot for insulin pump infusion sites, and I’m guessing that using my forearm would be painful. This outlook is subject to change, as I should be from time to time. Also, I may be going back to using my midsection for a while anyway. More about that at another time.

5. Based on what I’m seeing up to now, it looks like the basal rate settings on my insulin pump are, frankly, stellar. Whether I’m high or low (you’re welcome Janelle Monae), once the peaks level out, if I don’t touch my pump, the line on my graph is pretty flat. I’m a little shocked, but happy that my endocrinologist and I were able to work this out without the benefit of a CGM to guide us.
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6. I have avoided the newbie temptation to check my CGM graph every two minutes. I think that’s because of my Dexcom experience during clinical trials. Of course, not checking the receiver all the time means I’ve made the mistake of putting it on the table and walking out of the room every so often. I never said I was perfect.

7. That said, can I just say how much I really hate the fact that I still have to look at a pager-sized display to get my readings? I’m not buying the “We’re working on an Android solution” anymore. You’re not… just admit it. If I’m wrong about that, I’ll be the happiest guy around who ever had to eat his own words, and I will gladly eat those words in this very space.

8. Like anything, when things go well, you tend to see something in a very positive light. That’s where I am now. At the beginning, I had a failed transmitter which also cost me a few sensors, and that was extremely frustrating. I realize that how I use my CGM, and how I react to various things affecting my use of my CGM, may very well change over time. But I hope things remain positive. Because for the last couple of weeks, it hasn’t been a big problem to deal with, and that’s the only way I’m going to buy into the notion of wearing my Dexcom every single day.

Those are my initial observations. I wonder how I will feel about my CGM in a year? Only time will tell. The goal is to make it to another year and find out.

8 things to help you manage your blood sugar (and your life) over the holidays.

With another holiday season upon us, we have more chances than usual for our blood sugar to get out of whack. There are several reasons for this, and if you will permit me, I’m going to list eight of them here.

Why? Because I’ve made plenty of mistakes in my diabetes management over the holidays. So you can consider these a sort of “don’t make the same mistakes I’ve made” list.
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1. Be careful what, how, and when you drink. Others have written about alcohol and diabetes far better than I ever will. See HERE and HERE and HERE. Of course there are more chances to imbibe in December, and being careful does not always mean you have to say No. It just means it’s important to be aware of how alcohol affects your blood sugar. Hint: it’s not how you might think.

2. What about those parties? There’s no question there are more social situations right now than there are earlier in the year. Some of the questions I ask myself are: Is a party taking the place of a meal? Is it between meals, or later in the evening? It’s important for me to know, because it will help me determine whether I need to set a temporary basal on my pump (either higher or lower).

3. Keep up on the BG checks. If I know I’m going to a party that starts around 6:00 p.m. (around when I usually eat dinner), I can do a check before I leave the house and when I get to the party, so I have a good starting point before I decide to eat something. Of course, if you’re wearing a CGM, you’re going to be looking at that a little more often through the night, and that’s great. If the party includes some finger food but it’s not an actual meal, I’ll probably just bolus a little after I see what’s there to eat and guess what my carb intake might be. The point is to stay on top of my BGs in situations like this because it’s easy for me to have numbers that are not normal, for various reasons.

4. Do not over bolus. As someone who makes this mistake from time to time, let me say it again: Do not over bolus. Your diabetes numbers do not have to be perfect in December, and it’s probably best that you don’t set yourself up for disaster by trying too hard to get to 100 mg/dL. If you’re checking your numbers a lot anyway, you’re obviously doing what you can to mitigate super high numbers. Don’t make it worse by rage blousing and winding up with a hypoglycemic EMT or ER visit at the holidays. I’ve been there. If I can help it, I won’t make this mistake again.

5. That said, Yes, you can eat that. Hey, don’t look to me for validation for eating that cupcake with the red and green sprinkles. But if you do it, don’t complain about a high BG number later. Most of us are adults. We’re capable of making our own decisions, while usually recognizing where the line is, even if we do cross it once in a while. Ignore that crummy “sugar free” [insert dessert name here]. Often, the carb count isn’t any less than the real thing. It just doesn’t taste as good, and sometimes it’s laced with sorbitol, which means if you do eat it, you might be spending more time than usual in the bathroom, rather than with your friends and family.

6. Go with the flow. Like I said in the last paragraph, your numbers are not always going to be perfect. Do you want to concentrate on diabetes perfection, or do you want to enjoy special times with family and friends? We’re meant to celebrate the holidays, not obsess over our next A1c.

7. Have a diabuddy? When spending time in places and among people where your diabetes isn’t well known, it’s especially helpful if someone else in attendance “gets it”. If your spouse, or a friend who knows you and/or your diabetes well can attend with you, you’ll have the added feeling that no matter what happens, someone will be there who understands you and can help you when you need it. Who doesn’t like to have a wingman? Bonus tip: a bracelet or necklace announcing your status as a Person With Diabetes is almost as good.

8. Enjoy, enjoy, enjoy. Be grateful. Be nice. It’s okay to talk diabetes (it’s kind of hard for me not to talk about diabetes), but it’s a festive time too. Ask someone else how they’re doing. Tell someone how happy you are to see them. Wish them all the best this holiday season.
 
 
So remember to check often. Be careful while imbibing. Don’t be too hard on yourself. And have a happy and fun time this December.

8 Things about my diabetes.

This blog is a place for me to write about diabetes, but it’s also a place for me to write about my diabetes. So today, I’m telling you eight things you might not know about what’s going on in my life, diabetes-wise:
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1. Diabetes By The Numbers is not going away. As seems to happen with all things audio in my life, technology has let me down. I had been recording my podcast interviews through my ten year old laptop, and frankly, it’s just running out of juice. It was having trouble recording my interviews without garbling up important parts of what people were saying. If I’m going to do this podcasting thing, I want to have as good a sound as I can get. So I’ve invested in a new laptop (prices have really come down– this has more computing power for about a thousand bucks less than a decade ago). So look for new episodes of Diabetes By The Numbers soon. I don’t know about you, but I miss it.
 
 
2. I’m finally seeing doctors again. After writing about letting my appointments with various doctors slide for a while, I made a couple of phone calls. I have an appointment with my endocrinologist this afternoon, which, actually, I’m looking forward to. It’s been about 4 1/2 months since my last visit, and we have lots to discuss. I’ll let you know if there are any great nuggets that come out of this appointment. There usually are.

I’m also seeing a new ophthalmologist in a few weeks. Fingers crossed that this one is a little more detailed than the last one. Plus, I need a new prescription.
 
 
3. I’m training for a 5K run. This is my local neighborhood run, that takes place about five minutes away from my house. I had run this race every year for about ten years until I had knee surgery last June. This is my comeback run, my first athletic event in two years. I’ve lost weight in the past year, but I’m still not in great shape, so I don’t expect to do well. I don’t care. Simply put, this event is very important to me, and I will participate, even if I have to crawl my way to the finish line.

Then it’s back to the bike for a while.
 
 
4. I will be in Orlando in July. Actually, I should say I hope to be in Orlando in July, provided I can get the okay from my job to take off that week. I plan to be onsite during the Friends for Life conference, but I’m not necessarily going as an attendee. The plan is to go to MasterLab (sponsored by Diabetes Hands Foundation, which is letting me attend for free) on July 6, and then I’ll be working in the exhibit hall on the 6th, 7th, and 8th. If you’re going to be there, please come by and see me… there’s something I want you to do, and it will help all of us living with and affected by diabetes. I mean it.
 
 
5. It won’t be long before September is here. And September means… the Diabetes UnConference Atlantic City, September 9-11! In case you’re wondering, yes, this is the weekend of the Miss America pageant, which is held there each year, and while those festivities are occurring, scores of adults living with diabetes and the people who love us will be getting together for the only peer-to-peer conference of its kind. We’ll be talking about all the psychosocial aspects of living with diabetes 24/7/365. There will also be fun get-togethers, new friends made, lots of acceptance and support, and probably some hugs too when the UnConference makes its way to the U.S. east coast for the first time. Check out the super team of facilitators. I’ll bet you can recognize one or two.

More to come as deadlines near. I don’t want you to miss out on anything! To find out more, CLICK HERE. In case you haven’t figured it out yet, I will be one of the facilitators in Atlantic City this September, and I can’t wait.
 
 
6. I will be hosting DSMA next week. I’ve been keeping to about a once-per-month schedule moderating the fastest hour of the week, the DSMA Twitter Chat, which happens every Wednesday at 9:00 p.m.(US). The other moderators are (of course) Cherise Shockley, Kelly Kunik, and Chelcie Rice. The DSMA chat is great fun, and it’s a great way to meet others from the diabetes community, all while answering prompts from the moderator. It’s been a great honor to help lead the community discussion on both important and fun topics, and that honor continues next week.

If you’d like to participate, it’s easy. First: get a Twitter account. Second: follow the @DiabetesSocMed Twitter handle and/or the #DSMA hashtag to participate. Come and join the conversation!
 
 
7. Still going on the Animas Vibe pump. I’ve been on the Vibe for about six months now, with a short break in April (I ran out of supplies– I’ll get that worked out with my endo today). Overall, the pump has been durable and delivers insulin like nobody’s business, but there are definitely things I don’t like about it. No use complaining anymore… I’m stuck with this one for another 3 1/2 years. Boo on the local trainer who was going to get together with me to show me some of the more intricate features of the pump. I got sick just before we were scheduled to meet, so I had to cancel. After that, repeated phone messages have been met with only silence. Maybe I can hit up the people working at the Animas booth in Florida for a quick tips and tricks session.
 
 
8. My diabetes circle is getting bigger. I work in a building with about 500 or 600 other people. Lawyers, admin assistants, architects, financial wizards. Just a couple of years ago I didn’t know anyone there who was living with diabetes. As far as I knew (though I knew it wasn’t true), I was the only one. Well, now I know three, two Type 2s, and a Type 1 who is wearing the same insulin pump that I wear. He got his first. It’s a double edged sword, really… I’m happy to know there are a few others around who get it, but I’m not happy that they have to live with this stupid condition too.
 
 
Okay… so that’s what’s happening in my world lately. What’s new with you?
 

8 Hidden costs of diabetes.

Everybody knows diabetes is expensive. We spend a lot of money on insulin, syringes, infusion sets, sensors, and more.
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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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