Archive for March, 2010

Diabetes and Depression

March 21st, 2010

Important reminder at all times: I am not a medical provider.  If you think you or someone you love is clinically depressed or needs professional help, seek out that help immediately.  Don’t even keep reading—ask for help instead.  Now.  You have everything to lose.

People often ask me if I think there is a link between depression and diabetes.  I typically try to sound sophisticated in my reply, but for the sake of brevity here: you betcha I think there is a link!

However, I do not think there is necessarily a genetic link between depression and diabetes.  I think depression in people and in kids living with diabetes is more situational than chemical, at least at the outset.

Think about it from the perspective of a kid living with diabetes, equally applicable to adults:

  1. Welcome to feeling alone.  Your thoughts are necessarily different than those of your friends.  You are likely the only one in your family who has to bleed before you eat.  You’re also probably the only one who, when you look tired, causes family, friends, and teachers to look at you and worriedly start asking you when you last checked your blood glucose.  You are the one who, at the birthday party, has to look at the size of cake with a whole set of questions beyond “is it the corner piece?!” and you know that if you do score that corner piece, more frosting means more carbs and more insulin.
  2. Welcome to worry.  You know how it feels to be different numbers.  You know that numbers carry value judgments, no matter how hard you try to avoid it.  You know you are looking to get those numbers to be in a range that often seems impossible.
  3. Welcome to anxiety.  What you don’t always know is what will happen to your body when your numbers aren’t in that range.  Sometimes you’ll feel sick for a few hours with a high, or sometimes you’ll feel incredibly weak, shaky, and unable to function when your blood glucose is low.  You do know that your diabetes will get in your way sometimes, you won’t always predict it, and you will want to do something but your blood glucose levels won’t permit it right when you want to do it.  Add that to feeling alone and different, and it’s enough to make any kid anxious.
  4. Welcome to feeling powerless.  You probably learned right off the bat how difficult it really is to achieve the blood glucose goals your medical team set out for you.  Diabetes does require recognizing there are times your diabetes has to take center stage or you risk uncomfortable, embarrassing, even dangerous outcomes. 
  5. Welcome to feeling like there was always something you should have done differently.   One of the worst parts of living with diabetes, for me, is that I am always reflecting on what I did and second guessing my actions.  If I go high or low, I feel like there was something I could and should have done to prevent it.  I’m not even sure how realistic it is, but I know that I still search out the reasons behind almost every glucose reading my meter gives me.

I’m kind of amazed at how great kids living with diabetes do with all of it!!  What a testament to their strength.

Bring it on, Mickey!!

March 20th, 2010

I signed up to run the Disneyland Half Marathon over Labor Day weekend today.  I can’t wait!  I also signed up for the Family 5k the day before because –get this—my parents and my husband are coming with me and we’re all going to do the 5k! 

My husband isn’t a runner.  He told me once “I ran when I was a kid.  I don’t need to run anymore.”  My dad can run, but doesn’t do it often—he’s busy at bootcamp and busy golfing his way through retirement.  My mom enjoys sprinting at bootcamp but doesn’t consider herself a distance runner—once around the track is generally enough for her.  So we’ll all work together to get through the five kilometers (about 3.2 miles) in September.  (It can be a bit dicey for me and for my family members if I tell those who don’t run what I think they should do to prepare themselves!  I will wait until they ask.)

But.  Really.  WE WILL BE RUNNING THROUGH DISNEYLAND.  How can one possibly pass up such a great opportunity?!  They even give you a medal when you’re done.

Who doesn’t want a medal?!  FROM DISNEYLAND. 

 (this one is my marathon medal from Disney World)

Because I ran the Walt Disney World marathon in January, when I complete the Disneyland half marathon in September I will have earned the coveted “Coast to Coast” medal, too. 

So, lest you think I run because I always enjoy running, let me again point out key points from above:  A family weekend.  In Disneyland.  A shirt for a half hour’s work.  And a medal.  Seeing my husband, my dad, and my mom each cross the finish line.  And then another shirt, the next day, for two hours’ work.  And two more medals.

Bring it on!

Which came first: high blood glucose levels or diabetes?

March 18th, 2010

First: please let me apologize for asking the kind of question I myself hate to noodle on for any length of time.  My typical response is “why does it matter”?  But, this is a blog; it matters because I’m writing about it.  So there.

I downloaded an app for my iphone the other day called “iDBT: Managing Type 1 Diabetes: A Guide for kids and their families”.  No particular reason I downloaded it, but the fact it was free was very persuasive. 

It basically was a little “game” that pointed out symptoms of IDDM, showed the digestion process, discussed things that affect blood glucose levels, and reminded kids they need to learn about their own bodies and their own diabetes. 

Good stuff; it even used the most memorable term from my first day in the hospital after being diagnosed: “insulin is the key that unlocks the doors to the cells so they can use the glucose in your bloodstream”.  A classic!!


The game kept saying “symptoms” of diabetes.  As in: now that you know you have Type 1 diabetes, be aware of the clues for and symptoms of diabetes.  ???  That doesn’t make sense to me.  You’ve already been diagnosed!

Yes; you need to be aware of the symptoms of high blood glucose.  (Notably, this app did not discuss symptoms of LOW blood glucose, which I consider to be more critical for kids to understand.)  You need to understand what in your body doesn’t work, and how that affects you.  You need to understand what external factors are going to change your blood glucose levels.  You need to understand what to do to make your body keep functioning.   These concepts are essential for every person living with diabetes.

But the app kept mentioning the “symptoms of diabetes”.  Made me wonder: where is the division between a symptom and a diagnosis? 

We all know the symptoms include high blood glucose, ketones, frequent urination, thirst, weight loss, etc.  But the destruction of your pancreas’ beta cells is what actually occurs in type 1 diabetes; the symptoms are merely the manifestations of that destruction. 

So doesn’t that mean that diabetes came first?? 

This kind of thinking gives me a headache…

Today’s Attempt to Combat My Dawn Phenomenon with Exercise

March 17th, 2010

I have a wacky schedule; most mornings I eat a snack before leading bootcamp and have breakfast after that. Then about 2 hours after breakfast, my blood glucose rises steadily through lunch. Frustrating. I have tried a bunch of different insulin options and food options, but none work 100%.

Today’s attempt is not one that I can repeat often, but I figured I’ll give it a shot anyway. I had breakfast an hour ago, my CGM says I’m 130 and on the way up. I haven’t changed any basals and was conservative with my breakfast bolus. My plan is to do an hour of full body weights (Tracey Staehle’s The Parts Series, Bootcamp Premix) and see if that helps keep me within range. The weight workout I have planned is not cardio intensive but is still sure to get my heart rate up, especially since I will be alternating between upper and lower body moves.

Okay; change of plans. I just checked; I’m 96. I have 2.8 units still active for my breakfast, so I am going to do a temporary basal. I’ll just do 30 minutes with that, taking 67% of my typical rate. I’m off!

Good work. I just checked; I’m 94 after my workout. My CGM said I was 129-130 the entire time, so at least my blood glucose levels weren’t swinging. I did eat about 8 jelly beans (maybe 12-15g CHO) about 10 minutes into the workout because I felt my heart rate rise and got nervous about going low.

So, it all seemed to work today. Put a check in the “win” column for today: not only did I get in a fairly good workout, I may have prevented a 250+ later. All good.

What works for you and your dawn phenomenon?

Making An End Run Around Type One Diabetes Complications

March 15th, 2010

Living with a malfunctioning organ (insulin dependent diabetes means my pancreas cannot produce insulin and cannot help to regulate the amount of glucose in my bloodstream) means I will someday encounter any number of physical complications. We all know it and we all know we’re supposed to keep our blood glucose levels “in a healthy range.”

Did you just shift in your chair? Roll your eyes? Take a deep breath?

I do, every time someone who doesn’t live with Type 1 says it. Because it’s HARD. The human body is an amazing complicated and finely tuned machine. With one piece broken—one piece of hundreds—I need to use a lot of brain power, three machines, and count everything I eat and more days than not I still don’t get it “right”.

So, in my attempt to bring my Type-A self to a place I can be okay with that, I looked at what complications I’m likely to meet: heart disease topped the list.

Alright! I can do something with that!

I take care of my heart through cardiovascular exercise. I treat it as best as I can without being fanatical. My eating isn’t great. My stress levels are high. My speed isn’t impressive.

But my endurance can outlast most.

I am very lucky that I enjoy physical activity; I love how it makes me feel and I really love having the confidence to know I can climb over a fence or get out of a window without too much trouble. (I will save a discussion of why I think about these things for another post.) I love going to the grocery store and assuring the checker I need no help out to my car. I love not having to buy Queen-sized underwear.

Most days, it’s the small things in life that make it fun. It’s the big things that make it all worth it. And it’s the strategy to keep going as best as I can that makes it all possible.

Happy 22nd Diabirthday to Me…

March 14th, 2010

I am always introspective on my diabirthday. This year is no different. I can’t help but look back at the tired little girl who didn’t have the energy to keep up with her friends as they ran across the school playground. I didn’t know what it meant when the doctor told me that afternoon 22 years ago that I had a disease called diabetes.

For me, my diagnosis date is the day I do my annual reflection—more so than any other time of the year. My world didn’t change on my birthday, and my world didn’t change on New Year’s Day. It changed on Diagnosis Day. I don’t think about that sick little girl very often, but I think it is right for me to spend a few days around my anniversary and do so.

My diagnosis number was 591. You can see in my diagnosis photo that I was incredibly skinny (58 pounds at a little under five feet tall), about 7/8ths of my hair had fallen out, my skin was very dry, and I was of course eating and drinking anything and everything all the time. There is no gentle way to say it: I was dying.

Not many people get to a point that they have to face such a realization at such a young age. In fact, I feel like each additional year, as I age and my perspective changes, the realization strikes me anew.

Yet, I feel with each diabirthday a stronger and stronger sense of how fortunate I am. Had I been born a generation before, I would have had a much more difficult road. Had I been born three generations before, I would not have seen even age eleven. My firsthand knowledge of the fragility of life has motivated me to achieve much more than I could have without such inspiration.

So yes, I feel fortunate. I have a wide range of tools to help me keep myself in as good physical condition as possible, and in fact, very few things seem impossible.

If that isn’t something to celebrate, I don’t know what is.

Welcome to Diabetes Outside!

March 10th, 2010

Welcome to my blog about life, exercise, and diabetes (not always in that order). I hope that by blogging about my own experiences you can imagine ways to make yourself as fit as you can be, learn tricks and tips for getting there with your diabetes, and most of all, enjoy your life to the fullest.

If you want more information about Diabetes Outside, check out my website at where you can find information about how we can work together to make your life with diabetes work well for you while you are outside the doctor’s office!