Tag Archives: diabetes

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

December 19, 2016 – 9:08 am

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.

By StephenS | Posted in Holidays | Also tagged , | Comments (1)

Underwhelmed.

December 6, 2016 – 10:05 am

It’s back in the news… insulin pricing.

Helped along by a few well-meaning tweets from Senator Bernie Sanders, and maybe a little by the Epipen debacle by Mylan, insulin makers are finally coming to patients and discussing cost in more detail. See the excellent reporting by Mike Hoskins at Diabetes Mine HERE and HERE. It’s good that they’re at least talking about the ever rising cost of this drug. I mean, it’s good, right?

Excuse me while I yawn.

There are countless reasons why insulin costs as much as it does in the United States. One thing is certain: no one wants to break down those reasons for you in any kind of concrete terms. In the case of “pharmacy benefit managers”, they won’t even come to the table to discuss it at all. And in the case of Novo Nordisk, Eli Lilly, and Sanofi, they’re going to talk, but they’re not going to help you understand how much of the cost of insulin goes to them and how much goes to everyone else in this game of legal graft.

This story has really been in the news for some time… I even wrote about it a year and a half ago, after NPR did a story on it. Yet we’ve continued to see the cost of insulin soar higher.

The amount of revenue generated through insulin pricing is in the tens of billions of dollars per year, most of it coming from here in the United States. It’s more than enough for everyone with skin in the game to be rewarded handsomely. Those are just the facts. Like it or not, insulin is a cash cow for drug makers and “pharmacy benefit managers”. Sure, it costs a lot to produce or acquire, but with Type 1 patients especially, they will always have a market for their product. It’s a drug of necessity, not a drug of convenience. I’m not sure there’s any motivation at all for producers or “pharmacy benefit managers” to take action on price.

I hope the discussions that are taking place between the drug manufacturers and patient advocates result in positive steps that will reduce the overwhelming cost of insulin for patients who need it to survive. But I have to be honest: I’m feeling underwhelmed.

Look, discussion is good. It means we’re not forgotten, or worse, ignored. Discussion often leads to things, positive things. I do worry that, as an HIV/AIDS advocate once told a gathering of diabetes advocates, they’re just “checking our box”. Check the box, move on. I don’t think the attendees at the meeting in Washington in November are the type of advocates who will stand for just having their box checked. I hope not.

But for now, I’m in a wait and see mode. Respond to calls for response on insulin pricing issues offered by advocates. Contact my congressman and senators, maybe my state’s insurance commissioner. Spend too much for insulin. Rinse. Repeat.

Underwhelmed.

By StephenS | Posted in Healthcare | Also tagged , | Comments (3)

Thank a diabetes friend this holiday season.

November 29, 2016 – 10:05 am

It seems like there’s a term for nearly every day during the holiday season. Thanksgiving, of course. Then there’s Black Friday, Small Business Saturday, Cyber Monday, and now… Giving Tuesday.

Of all of these, I have the potential to like Giving Tuesday the most. I’m at the point in my life where all of the material things I want are relatively small.

I’m not a big “shop big on the holidays this year” kind of guy anymore. Not because I’m old. Not because I don’t want to open up my wallet this time of year, because I do. For both of us at home, it’s more about spending on others than on ourselves now.

I think the idea of giving of yourself this holiday season is something I can identify with and rally around. That’s where Diabetes Hands Foundation comes in.

Today, DHF will make it easy for you to show your appreciation for those who make our diabetes lives easier, happier, more meaningful. Go to diabeteshandsfoundation.org/thanks and share your message of thanks for those who have touched our lives.

For a five dollar donation to Diabetes Hands Foundation, you’ll be able to get a Thank You card that will be displayed on an online pinboard designed to promote positivity and gratitude during this season of wishes.

Want to find out more? Check out this lovely video:

The season of Thank Yous will continue through the end of the year. So in conclusion:

– Helping Diabetes Hands Foundation enrich the lives of People With Diabetes? CHECK.

– Thanking someone who deserves it? CHECK.

– Making people feel good? Helping to bring the diabetes tribe closer than ever? CHECK and CHECK.

This holiday season, remind someone how important they are to your life with diabetes.

By StephenS | Posted in Holidays | Also tagged , | Comments (1)

Five things I’m thankful for this Thanksgiving.

November 23, 2016 – 9:37 am

It is heavy heart time here in my part of the world, as people all over my country celebrate the Thanksgiving holiday, while wondering what the coming changes in Washington will bring. Before we know it, the holiday shopping season will kick in (if it hasn’t already), and December will be another blur.
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There is a lot to be anxious about this Thanksgiving. There’s no denying that. But there is still much to be thankful for. So, from me to you, here is my list:
 
 
1. I’m thankful for family this year. Not so much the family that voted the way I didn’t, but there’s nothing I can do about it now. If the subject comes up, my plan is to remind them that they were wrong to vote the way they did (I’m not letting that go), and leave it at that. I can argue about it another day. And here’s something to remember if you’re in the same boat this weekend: presidential elections happen once every four years. Family is forever. If you’re lucky enough to have some family near you, count your blessings in addition to giving thanks.

2. I’m more than thankful for my diabetes friends around the world. I have experienced far more kindness from all of you than one man deserves. I will think about you often whenever I think about the things I am most thankful for this year. And every year.

3. I’m thankful for health insurance. And prescription insurance. I’ve been to the doctor more than usual this year. Just about two weeks ago, I went to the eye doctor for a thorough checkup. It seems like whenever I see a healthcare professional these days, I can’t help but think of the people who do not have the level of access to care that I do, and I can’t help but remember that I’m quite fortunate indeed to have the coverage I have, and the ability to pay for it (for now, anyway).

4. While we’re sort of on the subject, how can I not be thankful for the insulin that keeps me alive every day? It is literally a crying shame that all over the world, people still die after a diabetes diagnosis for lack of available insulin. I am so thankful to have a ready supply.

5. I couldn’t be more thankful for the incredible global force of diabetes advocates that exist everywhere. While they may not all know me personally, they care about me and work to secure and ensure access to drugs and devices, education and assistance, and a fair shake among insurance companies and government agencies. Without our vast network of diabetes advocates, our going would be a lot tougher and our path to innovation would be a lot steeper. They deserve our gratitude every single day.
 
 
Wherever you are, whatever your day looks like, whether you live in the USA or elsewhere, I hope you’ll take a moment and reflect on the things that you are truly thankful for. I’ll bet there are more than a few. There will be plenty of time Friday to rant over things that aren’t perfect. This year, I’m going to spend my Thanksgiving expressing my gratitude and enjoying the people closest to me.

I wish you all the best this holiday season. Happy Thanksgiving!

By StephenS | Posted in Holidays | Also tagged , | Comments (3)

Yes… I actually did see the eye doctor.

November 18, 2016 – 9:21 am

That’s the message I can finally give my endocrinologist when she asks me in January. I needed to find a new ophthalmologist since I had reservations about the doctor I had been seeing before. No major complaints, but I felt that he just wasn’t thorough enough in examining my eyes. And when you’re talking about the eyes of someone who has lived 25 years with Type 1 diabetes, thorough is what you want.

So I moved on. I found a new ophthalmologist, in my neighborhood which is a plus, and I went to see him last week.

Verdict? I’m not so excited about the ophthalmologist, though he’s not bad. He doesn’t know the first thing about diabetes beyond asking “how are your numbers?”. Despite that, I think we started on good footing. I felt he was listening to me. And I really like his assistant, who seems to know a lot and has some grasp of diabetes too. She’s one of those assistants who seems to do all the work, then turns it over to the doctor to gild the lily, whatever that means.
eyeglasses
At the end, I wound up with a new prescription, which I hope will help me see stuff on the computer better. And most importantly, after a thorough exam, there were no signs of retinopathy, glaucoma, or cataracts. I’m good for another year.

It’s a good feeling. A good feeling to get good news from the eye doctor, and a good feeling to know that I’m finally taking care of some of that regular maintenance I’ve been putting off for a while. More to come…

I’m not saying this is a brand new me. I am saying that knowing what’s going on with my health beats worrying about what’s going on with my health anytime.

By StephenS | Posted in Healthcare | Also tagged , | Comments (1)