Jane K. Dickinson, RN, PhD, CDCES

Diabetes Friends

Posted on May 14, 2012 by janekdickinson

The Diabetes Online Community (DOC) is a network of blogs, websites, social networks and other internet-based resources for, by, and about people with diabetes. Over the last year-plus I have gotten to know the DOC. Once I started blogging more, however, I found I had less time to spend reading blogs.

I do visit other diabetes-related blogs sporadically, though, and I can tell you that there are so many it’s impossible to count. Each one has a unique flavor and purpose. I am participating in the third annual DBlog Week and today’s prompt is to share a “diabetes friend.” It would be impossible to choose a favorite diabetes blog (dblog), so I’m just going to share one that I really like.

Purple Haze is a dblog written by a woman who goes by “Minnesota Nice.” I love her honest and powerful posts that tell the reader how she feels about all different aspects of life in general and life with diabetes (and other health situations). I appreciate dblogs that are more of a hobby than a full-time job – there may not be a post every day, and I can relate to that.

I can’t emphasize enough that there are literally hundreds (thousands??) of diabetes blogs out there, and each one has a different angle and lot of value. If you have all the time in the world, do check them out. Enjoy Dblog Week!

Diabetes Moms

Posted on May 12, 2012 by janekdickinson

Happy Mother’s Day to all the moms out there with diabetes. Raising kids and managing diabetes is a lot to take on. Happy Mother’s Day, also, to moms who are raising or have raised kids with diabetes.

It turns out that my mother is not a fan of anything having to do with blood, needles, etc. Yet I never knew this until 35 years after I was diagnosed. My mom never let me think that diabetes would limit me in any way. She always encouraged me to take care of myself. To this day she doesn’t make diabetes a big deal.

Happy Mother’s Day, also, to those who are taking care of or took care of their mom with diabetes. And a special shout out to anyone who happens to have diabetes, have kids with diabetes, and have a birthday on Mother’s Day.

Enjoy your day, moms!

Posted in diabetes support groups | Tagged diabetes, moms of kids with diabetes, moms with diabetes, Mother's Day | Comments Off

Diabetes Meal Plan – exchange system

Posted on May 11, 2012 by janekdickinson

The “exchange system” diabetes meal plan was introduced in the 1950s. I didn’t come on the diabetes scene until 1975, so I can’t comment on the early exchange days. For the first two decades of my diabetes life; however, we were told to take a certain amount of insulin at a certain time, and then eat certain amounts of food at certain times. Some may (understandably) compare this with prison life.

The Diabetes Control and Complications Trial introduced us to carbohydrate counting, which was closely followed by the introduction of new, fancy types of insulin that work faster or longer than the types we had in the early days. Together, carbohydrate counting and fancy insulin have broken us out of prison, and given us the freedom to eat when we want. In addition, we are not limited to eating the same foods day in and day out.

The downside to carbohydrate counting, however, is that we often focus only on the carbs. This can lead to over (or under) eating protein and fat, overeating carbohydrate, undereating vegetables and weight gain. The nice things about the “exchange system” are 1) it is a great way to introduce someone to the different types of foods and the effect they have on blood glucose levels, 2) it is a good way to learn carbohydrate counting (once you learn what an “exchange” is, it’s easy to transfer that to a “carb serving”), and 3) it is a wonderful reminder to eat foods – in moderation – from all of the food groups.

I was surprised to learn how many people are still being taught to use exchanges in recent years. I truly thought this system had gone the way of the horse and buggy. But knowing it’s still out there, I think the most important thing is to use it to our advantage, and not as a way to frustrate or anger people.

What meal plan were you taught at diagnosis?

Posted in about diabetes, diabetes care | Tagged diabetes, diabetes diet, diabetes exchange system, diabetes meal plan, exchanges, food, nutrition | Comments Off

Check BG before Insulin before Food

Posted on May 9, 2012 by janekdickinson

Don’t you just love when life throws a good lesson in your face? I had that happen last night. I was talking to a patient on Friday about checking blood glucose. He was going on a pump for the first time, and I gave him the usual spiel about not eating without taking insulin and not taking insulin without checking blood glucose.

It’s kind of like driving a car: we don’t drive without gas in the car, and we don’t put gas in the car unless there’s money in the bank/wallet.

At any rate, the point is not to blindly eat or take insulin, because having all that information keeps us safe and healthy. And then last night I took insulin for supper without checking my blood glucose first. I had checked about an hour earlier (too long – my “window” is usually 30 minutes), and so I assumed (we all know that mistake) I was a little on the high side, and I took insulin accordingly.

Long story short, I ended up being low for about two hours. Not a crazy low that I couldn’t deal with, but a huge hassle. And to top it all off, because of miscalculating the treatment for being low, I ended up higher than I like to be this morning. All this because I didn’t check my blood glucose before supper – definitely not worth it. Next time I’ll practice what I preach.

Posted in about diabetes, diabetes care | Tagged blood glucose monitoring, diabetes, high blood glucose, hyperglycemia, hypoglycemia, life lessons, low blood glucose | Comments Off

Diabetes Supplies

Posted on May 7, 2012 by janekdickinson

Once you have diabetes you become a pack mule. I recently got a call from a patient who learned this lesson the hard way. She was 2000-plus miles away from home when her pump stopped working. Another pump was shipped immediately, but she had to get through about 26 hours with no pump.

When we are brand new to diabetes or to insulin pumps, we may closely follow all the instructions/recommendations. But after we settle into our routine, we start to forget the details. This patient had everything she needed for pumping insulin; however, she no longer carried a syringe. She didn’t have her basal rates written down, and so on.

When you wear an insulin pump there are extra things to remember: write down your basal rates and keep them in your wallet (you could also put them in your phone or email them to yourself as back-up to your back-up). Keep a couple syringes with you, in case you have to inject at some point. You might even consider having your health care provider help you figure out how much and what type of insulin you would need should your pump malfunction. Write that information down and keep it with you.

If you take insulin, keep blood glucose monitoring equipment with you. Find a way to carry this stuff when you are hiking, biking, or otherwise away from home. You never know when you’ll need to check in. I was recently hiking up a mountain when I felt I just couldn’t go any further. I had no energy. I checked my blood glucose, and I was low. But I didn’t feel low; we can’t always count on low symptoms. Be prepared.

Posted in diabetes care | Tagged be prepared, diabetes, hypoglycemia, insulin pump, low blood glucose, supplies | Comments Off

Survived!

Posted on May 1, 2012 by janekdickinson

The Health Activist Writers Month Challenge is over. Today we debrief. This was my second time participating in HAWMC, and it was still a challenge. We were allowed two “get out of blog free” passes, and I used them both! It worked out nicely; I only really needed the two.

I learned how to “remove preview” on WEGO’s facebook page around day 26. It was pretty embarrassing that I was the only person who seemed to have a big, obnoxious preview of my blog post every time I posted on their page. I still don’t know how to remove it from my own facebook page, however!

I took a stand and did not join Pinterest. I just can’t handle one more social media outlet right now. More on that in another blog post!

I enjoyed writing a poem and trying out a six-word sentence. Any prompt that involves lists is great for me – I’m a list girl.

I had quite a run on Elliott P. Joslin for a few days. I should learn more about him. I keep saying how much I love him, but it’s all based on the very few things I know about him.

Prompts like the wordle one only serve to remind me how much I still need to learn about using technology. I’m not good with codes, sizing, screen shots, and so on. Thank goodness everything we ever need to know can be found through Google!!

Overall it was a good experience. Like managing diabetes, it was a lot to handle on some days. Other days it was no big deal. Unlike managing diabetes, having prompts made it so much easier to blog daily. Unfortunately, no one is prompting us about diabetes each day (or maybe that’s a good thing. In fact, some people do have those “prompters” in their lives. Another blog post?).

Posted in diabetes blog | Tagged diabetes, Elliott P. Joslin, google, HAWMC, lists, pinterest, prompts, WEGO | Comments Off

Word Cloud

Posted on April 30, 2012 by janekdickinson

I followed the instructions for making this bigger, but failed. So get out your magnifying glass and check out my word cloud. Luckily, it’s the last prompt for Health Activist Writers Month Challenge.

Posted in diabetes blog | Tagged diabetes, HAWMC, word cloud | Comments Off

Hypoglycemia Symptoms in Six

Posted on April 29, 2012 by janekdickinson

Today’s prompt is to write a six sentence story. Since I’m just coming up from a low, I thought hypoglycemia would be a good topic.

Originally I felt shaky when I was low; my parents would say my face got very pale. Over the years my symptoms changed and got more subtle. When I was pregnant, I started yawning as my blood glucose was dropping – this still happens. Now it’s hard to explain my low symptoms. I sometimes see flashy lights (not flashing lights), and other times it’s just this foggy brain feeling. I feel very fortunate, above all, that I always wake up when I’m low during the night.

Well, that was certainly not an exciting six sentence story. The take-home, though, is that symptoms of hypoglycemia change over time, and it’s important to stay in tune with your body. How have your symptoms changed?

Posted in about diabetes, diabetes blog | Tagged diabetes, hypoglycemia, hypoglycemia symptoms, six sentences | Comments Off

The first insulin injection

Posted on April 28, 2012 by janekdickinson

Ok, truth: I don’t really remember my first injection. For the first year after I was diagnosed with type 1 diabetes, my parents (mostly my father) gave me my shots (injections).

I was sent to diabetes camp for two weeks (over the Fourth of July, even) for the sole purpose of learning how to give my own shots. Well, maybe they wanted me to have fun and meet other kids with diabetes too, but that wasn’t the message I got.

Anyway, I was about as homesick as a kid can possibly be (I was 8 years old). I wet the bed, threw up in my sleeping bag, and sucked my thumb. It was pretty horrendous. I remember crying myself to sleep – embarrassed that someone might find out I sucked my thumb, and scared to death of injecting myself.

We woke up every morning and went to the “lab” for “first void.” The “second void” (pee) was checked for sugar. Then we marched up to the infirmary for our shots. The syringes were lined up on trays on the porch table.

As I mentioned, I don’t remember the actual first injection, so it must not have been as big a deal as I had anticipated. I do remember meeting friends (some of whom I’m still in touch with), learning a lot of songs, and having fun (during the day, anyway). So that “first” had its pros and cons. One of the best was being independent in my diabetes care from then on.

Disclaimer: That was a different time – insulin was given once a day in a fixed dose. Now kids need supervision longer because diabetes management is much more complicated. Kids may be able to self-inject at 8 years old, but they still need help with figuring out doses and much more.

Posted in about diabetes, diabetes care | Tagged diabetes, diabetes camp, injection, self-inject | Comments Off