Success on the (diabetes) journey

Posted on September 30, 2013 by janekdickinson

AirplaneI gave a talk a little over a week ago titled, “Success Along the Diabetes Journey” and it had nothing to do with traveling with diabetes. But today’s blog does!

Usually when I travel I’m either high or low (blood glucose-wise). My theory is that I run high because I’m anxious and I’m sitting a lot and airport food is not ideal. Then when I overcompensate in anticipation of being high, I run low.

Two days ago I flew from Denver to New York City. I drove down to Denver the night before my flight, so basically I was sitting for three hours that night and then for over five hours the next day. But I’m happy to report that I got it right this time! Part of that is due to the fact that I have finally figured out what works at the Hampton Inn breakfast buffet (half an English muffin with PB and a yogurt with blueberries). Then I found a salad at Einstein Bagels in the airport and carried it on.

I’m sharing this experience because it really was one of the first times I have kept my BG in my target range for an entire travel experience. The biggest snafu was that I forgot to get a fork for my salad. Luckily the flight attendant had one in her bag and was willing to give it to me! The salad, by the way (chopped strawberry salad) was amazing – and I’m a pretty big salad snob.

So I’m living proof that it is possible to have success on a (diabetes) journey.

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Pregnancy and Type 1 Diabetes

Posted on September 27, 2013 by janekdickinson

images (1)It’s been a long time since I was pregnant, but it’s an experience we never forget. I have a Facebook friend who is currently pregnant. She posted some questions about pregnancy and type 1 diabetes that I wanted to share here, because it’s likely that other women are wondering about the same things.

Q1- “so it will probably come early right because I heard they don’t let type 1 moms go past 38 weeks.”

My answer: More and more OBs are comfortable having moms with diabetes go to 40 weeks. However, if there are any health issues or even concerns (high blood pressure, large baby, etc.), they will very likely want to induce early, typically at 38 weeks. Many women deliver on their own a little earlier than 40 weeks. I live in a mountain town, three hours away from the nearest major health center, and my OB and I decided to do an amniocentesis at 38 weeks to see if the baby’s lungs were ready. They were, so we decided to go ahead and induce. It’s very important for the OB and the endocrinologist (or other diabetes professional) to be in close communication.

Q2- “I was listening to this talk, this lady made it sound like everyone who has diabetes and had a baby gets eye problems from pregnancy. Has anyone here NOT developed eye problems from pregnancy, I have none right now and I would like to keep it that way.”

My answer: I did not develop eye problems during pregnancy. I had my eyes checked about once a month. I have heard that because women tend to tighten up their blood glucose levels so much and so fast when they are pregnant, that eye changes can occur. This can happen when someone isn’t pregnant as well. There is a chance that these changes can reverse after the baby is born.

Q3 – “Ok, this next question is really hard (upsetting) for me… my doctor says you should be around 135 after a meal and 95 at all other times- is this realistic, were you able to do this, I do not even have insulin resistance yet and I am sure that I have been over 135 every day.”

My answer: During pregnancy it is extra important to keep blood glucose levels in the non-diabetes range, because as soon as Mom’s BG hits about 120 the baby starts making insulin. This can lead to big babies, and can cause the baby to have dangerously low blood glucose when it’s born (because it has all this insulin circulating and the source of glucose – mom – is no longer connected). Moms with diabetes do a lot of work to keep blood glucose levels in or near target, and it’s important not to get too low either (because that can be dangerous). Just as important as working hard to manage the numbers, it’s critical that moms don’t stress themselves out for an occasional blip (high BG). That doesn’t help anything, makes glucose go higher, and will definitely stress out the dad!

So if you are pregnant and have type 1 diabetes, pay attention and take good care of yourself, stay in close touch with your health care providers, be good to yourself, and think positive thoughts about a healthy baby and mom. You’re going to do a great job!!

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Sugar free binges

Posted on September 25, 2013 by janekdickinson

D:DCIM100MEDIAIMG_0047.JPGWhen you drink “sugar free” beverages, do you crave more sweets? Do you go for the “real deal”? The research has gone back and forth on this for years. There was a surge of information a few years back about people who drank “diet” soda eating more calories along with it. But then I heard from nutrition professionals that it wasn’t necessarily true, and other studies showed that people were able to eat/drink fewer calories by sticking to the sugar free stuff.

Now there’s another study that is telling us to watch out for artificially sweetened beverages. This goes back to the theory that our brains get geared up for something sweet, but the artificial sweeteners don’t cut it and we crave more and higher calorie foods/beverages.

For many years I’ve enjoyed one “diet” soda (Fresca, actually) every night after supper. I trained myself to consider that soda my “sweet treat” and I very purposefully did not eat anything while drinking it. Lately, though, I’ve been much more sporadic about drinking my evening Fresca – I’m probably averaging about two or three a month. I can see how drinking a “diet” soda could lead to eating more calories, though, because when I do have one there is a little urge to eat something with it. I imagine that if we aren’t careful (mindful, they call it), we could munch away at high calorie foods – while sipping the artificially sweetened beverage – without giving it much thought.

What is your experience with “sugar free” drinks? And while we’re at it, what’s your sugar free drink of choice? I can’t believe I found a photo of Tab. I used to love Tab. Is it still in stores?? I think I can still sing the theme song for Tab (Tab Cola, what a beautiful treat…).

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Insulin Injection Sites

Posted on September 23, 2013 by janekdickinson

land_icm1101527_4This photo – which I first saw posted on my endocrinologist’s office wall – is disturbing, I admit. It is meant to remind people to rotate injection sites. And I think it’s effective.  It’s a photo of a man who gave his injections in these two sites – over and over for years. I apologize for the graphic photo; now on to a discussion of insulin injection sites.

Things to remember:

  • insulin goes into the fatty, or subcutaneous, tissue. If you inject insulin into muscle it works really fast and erratically. That can be dangerous and we want to avoid it.
  • back in the days of longer insulin needles, we pinched up the fatty tissue to be sure the needle went where we want it to go (not all the way into muscle); now we have short needles and don’t really have to pinch anymore (unless you are using longer needles and you are very thin)
  • rotating sites keeps sites healthy and usable for a long time

Here is a picture of injection sites:

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Many people only use their abdomen (stomach) because it’s easy and most of us have some extra fat there. It’s important to remember to rotate not just between sites (arms, legs, butt, hips, stomach), but also within sites. The abdomen is a large area – you can go up and down and out toward the sides. The hips (“love handles”) are a great site for injections as well.

Give your sites a break: avoid injecting in the same area day after day – move around. Sometimes it helps to make a “site rotation chart.” And all of this is true for those who use insulin pumps too. Pump infusion sets get inserted wherever you can inject insulin.

Healthy sites can mean more effective insulin absorption and more consistent insulin action. For the best outcomes, choose your sites carefully.

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Insulin is our friend

Posted on September 18, 2013 by janekdickinson

insulinThere are many types of insulin out there. And before I go any further, I will share with you my mantra: “Insulin is my friend.” Insulin is everyone’s friend. Many people don’t have to think about insulin, because their bodies take care of it for them. The normally functioning pancreas actually knows when to produce insulin and when to send it out into the bloodstream, based on what the blood glucose is doing.

But for those of us with diabetes, we either think about insulin every day, or we worry about having to think about insulin in the future.

For those with type 1 diabetes, taking insulin keeps us alive because our bodies no longer make it. For those with type 2 diabetes, taking insulin may or may not be necessary. Type 2 is a progressive disease, and many people with type 2 diabetes end up taking insulin at some point. It’s very important to remember that this does not mean they have failed or that they are bad or unworthy.

Here’s a quote from my book:

  • If you struggle with the thought of taking one more medication, try this: Don’t think of insulin as a medication/drug. Think of it as a life-sustaining liquid that your body needs to do its best work. You could even call it the “internal secretion” as they did before insulin was named in 1921!

No matter how you slice it, insulin is truly your friend. If you need it, don’t be afraid or ashamed to take it. If you have fear, frustration, or anger around insulin, consider talking about it with a health professional or some friends who take insulin. There’s a lot of support right here on the internet!

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Cell phones, social media, and health

Posted on September 16, 2013 by janekdickinson

An article on cell phone use and fitness made me think about my own cell phone and computer use. The article says that people who use their cell phones the most are the least fit. They cited statistics about college students who spend up to 7 hours a day on the phone. And get this – only 5 calls! The rest is texting and social media. Yikes!

But it makes sense that being on the phone that much would take away from fitness time. Cell-PhonesThere are so many messages out now about focusing more, doing less multi-tasking, and yet we spend so much time on phones and computers. A few years ago my kids spent some time with their cousins who were teenagers. Their cousins sat around the house talking and texting on their phones – for hours. My son will never live down his distressed quote: “Why are they always talking and texting? Talking and texting – that’s all they do!!” He just wanted to go outside and play! But his cousins were typical teenagers.

Hopefully we can spread the message of healthy lifestyles and the importance of getting off the phone (and computer) and getting outside again. Cell phones are great for convenience and even safety, but they can also contribute to less active lifestyles. I’m working on spending less time on social media and the cell phone. In fact, I’m going to go outside and walk the dog right now!

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Today we remember

Posted on September 11, 2013 by janekdickinson

Today we remember.

We poke fingers and read numbers and take meds and remember.

We exercise and make food choices and remember.

We hug our family and friends.

Today we remember.9114

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diabetes: personal and professional

Posted on September 9, 2013 by janekdickinson

male_patient_with_doctorI have been blogging about diabetes – my experience living with diabetes and helping others live well with diabetes – for over 2 and 1/2 years. During that time I have struggled with figuring out where I fit in.

Before I started blogging I read several blog posts, and made some observations. I discovered that the Diabetes Online Community, while a wonderful place of support and camaraderie, was also a place for venting and complaining. And the topic of those complaints was very often health care professionals. This discovery plagued me because I’m one of those health care professionals! And because I also live with diabetes, I can relate to “both sides” and desperately want to help close the gap that seems to divide us.

I attended the live DSMA meet-up in August, where the topic of “bridging the gap between people with diabetes and health care professionals” was discussed. It was an interesting experience for me, but I didn’t speak up.

So here’s what I would have (maybe should have) said that night: People with diabetes and health care professionals both need to take a moment to recognize the work that the other is doing; our knowledge, experience and expertise; the passion that we both have for this disease; how hard it is to live with/work with diabetes; how busy we all are living our lives/doing our jobs; and that ultimately we all want healthy outcomes. Then we need to build trusting relationships and communicate openly. If one patient/provider relationship isn’t working, we need to seek another. We need to own our disease, and acknowledge that it’s the person’s disease to own.

People with diabetes and their health care providers can work together for successful relationships, which can lead to improved diabetes management and improved health outcomes. So that we can get on with living our lives!!

This post is my September entry in the DSMA Blog Carnival.  If you’d like to participate too, you can get all of the information at http://diabetescaf.org/2013/09/september-dsma-blog-carnival-3/

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A voice for diabetes

Posted on September 6, 2013 by janekdickinson

It has come to my attention that the FDA is holding meetings with people who live with chronic conditions. The purpose of these meetings is to learn about the diseases – hopefully get a better understanding of what it’s like to live with and manage them, and what is needed to improve health outcomes. This is wonderful news!! The bad news, however, is that the FDA has not included people with diabetes on the invitation list. This must change! Please take a look at this link, and if you are so inclined, sign the petition asking that diabetes be included as one of the diseases discussed in these patient meetings.

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New Habits

Posted on September 4, 2013 by janekdickinson

41gVrFNrJAL._SX300_Another tidbit that I read in the book I’m reading is that it takes 66 days to form a new habit. That’s intimidating! Yikes. But I guess if we’re serious about starting a new habit, it’s worth sticking with it for at least 66 days and seeing if it works (becomes permanent). The point in my book is that it’s not about discipline, but rather it’s about forming habits. Maybe it’s a little of both.

And as I’ve mentioned in the past, triggers can help with habits. I am working on a new trigger. I’ve told you in the past that I finish my meals with dark chocolate. Not a lot, but enough to taste good and remind me that I’m finished eating. My new trigger is that after I’ve had my dark chocolate I do two roll-outs with this little wheel thing that my work-out instructor is letting me borrow. Eventually I hope to get up to three and then four and one day ten or fifteen of these roll-outs. In other words, stronger abs!

In the meantime, I posted a quote on facebook yesterday: “A year from now you may wish you had started today” (Karen Lamb). This is one of those quotes that really speaks to me, because I am not one to live in regretville. I hate saying “if only,” or “would’ve,” “could’ve,” etc. So keeping that quote in mind, I can muster the discipline to start some new habits. Starting today.

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