Archive for August, 2010

I Didn’t Know That!

August 17th, 2010

I see that the NovoPen is celebrating a birthday this year—it turns 25! 

I had no idea.  Should I have gotten a card?  Shoot.  I must have been distracted by the fact that TODAY IS MY MOM’S BIRTHDAY.  Happy Birthday Mom!  But I digress.

The pen was first introduced in 1985, which makes me feel really old because I remember 1985.  Dang.  But anyway, it makes me really wonder why I never used a pen to take my insulin.

Well, I guess one reason would be that I was taking way too much insulin when I was younger—more than three times what I take now.  Slightly frightening.  I saw a new doctor once who told me to simply cut my dosage in half.  Scary, but wouldn’t you know it; my blood sugars didn’t change.  Talk about a lot of extra insulin.

(Alright; now I’m afraid that someone is going to try this because I told you I did it.  DON’T CHANGE YOUR INSULIN BECAUSE I SAID SOMETHING.  Go ahead and ask your doctor, but don’t think I did anything smart back then when it came to diabetes—I didn’t.)

But back to the pen.  I used it two years ago when I tried going off my pump for a week or so.  It was okay but not what I’m used to—I’m used to the vial and knocking the air bubbles out as I flick my fingers against the syringe.  But the pen was nice and it was convenient!

I remember—when I was a new type one and desperate for anything that didn’t involve a needle—seeing an ad for a device that looked like the pen but was needleless.  It essentially blew the insulin through someone’s skin and misted into the body.  Geez I wanted that thing almost as much as I wanted a puppy.

I never got it, though; eventually after I saw it enough I figured there was NO WAY that thing worked like the picture said it would. 

But I never got the pen, either, and now I wonder why.  Was it not as prevalent then as it is now?  I mean, I took shots for years and no one ever asked me if I wanted to try the pen.  I would have used it, I think.  I took shots at school every day and could have really used something less bulky than my little bright blue cooler thing (which really was a pretty good gadget, insulated somehow with spaces for vials and spaces for syringes all in a checkbook-sized container). 

I bet there are thousands of type ones who never learned how to draw up a syringe.  They don’t need to know because there are pens everywhere.  Wacky!  And here it was, thinking everyone with type one had to know how to do.  I guess not—at least since 1985.

So better late than never: Happy birthday, insulin pen!

I’m Ready!

August 16th, 2010

I promise I’ll get off my numerous soapboxes.  (After today, I mean.)  And this one I suspect is a little bit preaching to the choir, yet my fingers are itching to write this again:

I want a different name.

I’m trying to figure out how to explain this desire.  I wonder if natural blondes feel similarly when a bottle- bleached platinum blonde stands next to them and whines about blondes not getting any respect?

Or something.  I don’t know.

I just know I want a different name.

I don’t want to ever hear someone ask me if I eat cinnamon because cinnamon is supposed to cure diabetes.  Or blueberries or the latest wack-a-fruit found in the Amazon.  I want to never see that question on someone’s face that starts with “but you aren’t overweight.”  I want my inbox to never contain email about preventing diabetes.  Or prediabetes.

Just give me a new name.  Please.

Is it because I never had the chance to prevent my diabetes?  Or is it because I spend quite a bit of time explaining my disease to others who think it’s the other kind of diabetes?  Do I feel like some sort of victim of the media’s mass marketing of the solitary word “diabetes” to mean something that does not apply to me?  Or is it that I’m offended by the condescension I read into messages from the American Diabetes Association, who I would have thought understood me?  Or am I sad my body destroyed a portion of itself decades ago and can’t believe anyone could be so complacent to knowingly let a similar thing happen in their own body?  Am I bitter that I don’t ever have the chance to reverse or improve my diabetes?

Probably a little bit of all of those.  I don’t know.

I just know I want a new name.

Not a new type.  Not a new term.  Not a new prefix or suffix.  No anagrams.  No new rhyming jingle that works on a bracelet or bumper sticker.  Nope, I don’t need any of those.

I just want a new name, and I think I deserve it.

Out of all of the things about living with type one diabetes I deal with every day as I sleep, wake, eat, breathe, work, dream, move, cry, laugh, and think, THIS is the one I think I really would like one hundred percent.  No conditions, no complications, no pills, no lab work, no trials.  Just a new name.

I’m ready.

Are you?

Take Care of Your Heart

August 13th, 2010

I want to highlight this one again and repeat the information as often as possible: take care of your heart.  Take care of it by using it and working your heart to encourage it to grow stronger and healthier every day.


The risk of dying from cardiovascular disease prior to age 40 is nearly twentyfold in persons with type one diabetes compared to non-diabetics.  You need to take care of that ticker!  How?


Children and teens with type one diabetes will deal with their disease better when the entire family faces management as a team.  One of the ways to help and support a loved one with type one is to model acceptance and adoption of exercise in the lives of each individual family member.  It isn’t just your heart you need to care for; it’s for your loved ones as well. 


Adolescents and adults who exercise have a greater perception and positive view of their own health.  How can one living with a chronic disease like type one diabetes improve their own outlook and know they are helping their body stay healthy?


Adolescents have a demonstrated tendency for poor glycemic control through years of turbulent hormonal and social and physical changes.  How can you cope with the stress of these difficult blood sugar fluctuations?


For parents and people with type one diabetes, sometimes you need to look past the fear of going low during exercise.  Sometimes you need to look at long term complications and be afraid enough of those to change what you do NOW

Given the fantastic tools we now have compared to the tools available 60 years ago for managing type one diabetes, we don’t need to be as afraid of kidney or eye problems associated with microvascular damage.  We’ve moved to macrovascular concerns: heart disease and strokeA diagnosis of type one diabetes is the warning sign for these catastrophic events.  However, we have the tools to deal with those complications and we can use them NOW.

Exercise.   Protect your heart, your body, and your life.

Get out there.

Exercise Is Medicine—I love it!!

August 12th, 2010

I’ve been writing for a while about how much I use exercise as a tool to help me stay healthy with type one diabetes.  The American College of Sports Medicine (ACSM) has launched a campaigned called “Exercise is Medicine” with various tools to help those with all sorts of health issues think about how to exercise to improve their health.

 I of course zoomed over to the Type 2 Diabetes page to see what ACSM has to say.  Yup; pretty simple from my perspective.  The page just outlines what many of us already know about our diabetes and physical activity, in terms of increased insulin sensitivity and a resulting increased need for carbohydrates.  We are lucky in that we don’t have any physical limitations our disease created and (absent any complications) our mobility is not compromised.  We can do what anyone else can do.  We just need to think about it a little bit more.

Speaking of thinking about exercise in our lives, I invite everyone to check out another tool at the ACSM’s Exercise is Medicine page.  It’s a way to think about exercise in our lives.  I know I posted yesterday about my questions why someone might not exercise and I think the grid on the ACSM’s Decisional Balance page is a fairly good reflection of reality.  (Including my questions why someone would chose the “inactive” side of things.)

So spend a little time at the Exercise is Medicine website and see if there are any tools you can use to re-think exercise in your life.  Keep thinking, start doing, and let me know if you need some help. 

You’ll thank yourself.

Wow. That’s a lot of people!

August 11th, 2010

The government reported earlier this month that more than 26.7% of the entire US population is obese. 

That’s more than 72 MILLION PEOPLE.  And those numbers don’t even include anyone “overweight.” 

Get this:  the numbers are from a SURVEY, so people were self-reporting their own data. 


Now, I’m not saying those 400,000 people who did the survey lied. 

I’m just saying my own driver’s license isn’t right.

It makes me sad and frustrated all at the same time.  I wonder what our ancestors would think of us now: we have all sorts of medicines and procedures and knowledge that can help us live a long life and so many of us are throwing it away because we eat too much chemical food and don’t move around so much or exercise at all.  I wonder what those people who had to grow their own food and work their own land and walk miles to school or to a neighbor would think of us now.

Don’t forget: I’ve been there.  I don’t think I was morbidly obese yet, but I was pretty close.  I understand that it is easy to eat and not exercise.  I watch my husband schedule time to work out on the treadmill at work have to work so late he can’t fit in the treadmill time.  I watch coworkers join gyms and never go to those gyms.

I understand how hectic our lives are and how often caring for a child or parent or spouse or job or career or any number of circumstance can make us think exercise should fall off the list.

What I don’t understand is how many people don’t even question why, or think about working to change their habits to include exercise higher on their priority list.  Don’t they know they will be better able to care for another if they take care of themselves first?  Don’t they pay attention to the flight attendants explaining the oxygen instructions??

We have all kinds of information about what we need to do to keep ourselves healthy.  We know it’s a matter of calories in, calories out.  We know it’s about moving more and sitting less. 

 So what are we missing?

Tools of the Trade: My CGM

August 10th, 2010

So I was driving home last night and realized for like the fourth or fifth time in the past few days I was really happy to not be wearing my CGM.* 

I know a lot of people aren’t big fans of the CGM for various reasons, and I’ve heard from my doctor that not many people wear it for more than 2-3 years.  I still find mine useful, and I think I’m coming up on two and a half years.

This is the kind of thing I wonder about when I drive.

Why, when I think it’s useful and relatively helpful, does it make me so happy to NOT wear it?

First of all, let me assure you that this CGM has significant issues.  The delay factor and margin of error is just ridiculous—not to mention the sensors being rather let’s say fickle.  The CGM doesn’t work for me when I run, which is unfortunate, and that thing has caused me to lose more sleep than anything ever in my life.  (I’m a rock-hard sleeper so if something wakes me up, it’s news in my world and this thing gets to vibrating my pump under the covers and I nearly jump out of my skin every time.  My cats chewed my pump cord once when they were kittens so now my pump sleeps under the covers every night.)

In addition to the untrustworthy readings I get from the CGM, it also is actually painful for me.  I wear it most often on my hip and butt, so any time I sit down I run the risk of knocking it or hitting it or just moving in a way the little stick of metal doesn’t enjoy and it simply hurts.  I ran with it in my arm a few weeks ago and I guess my arm was sweaty so the thing fell out as I ran—that hurt.

All of this said, I still wear the thing.  Why?  Because it reminds me to check my blood sugar more often, and it yells at me when I’m high.  I think both of these things are good ideas for me.  So I put up with the CGM, and I defend it to my type one friends and doctors who look at me like I’m crazy because I still wear it.

But I do love taking a break from the CGM.

And I decided last night I know why.

It’s because I CAN take a break from wearing it.  It’s the only diabetes tool I have in my arsenal that I don’t NEED.  I could throw it off a bridge some day and never get sick as a result.  I probably wouldn’t even know it was gone for a number of days.

I can’t really do that with my pump;  if I go off my pump my life changes because I’m looking at the clock, taking shots and counting and doing math and figuring more than I do now.  If I stop my CGM my life doesn’t change at all.  It’s just gone.

I can’t take a break from my blood sugar meter, either.  Yes, I go to the grocery store sometimes without my meter and don’t miss it.  But have you ever run out of strips when you got to work and realized you can’t check again until you’re back at home?  Weird feeling, to say the least.

And I can’t take a break from being high, or being low.  I can’t take a break from much of my disease.

But being without my CGM?  Kind of feels like a vacation in some ways.  And that makes me happy.

*CGM= continuous glucose monitor

Exercise and Hunger

August 9th, 2010

Do you feel more hungry after you exercise, or less hungry?  Is that hunger real, or is it just you telling yourself “it’s okay to eat” because you just worked out? 

I am probably not the best person to discuss hunger.  I don’t have the best sense of real hunger after so many years of eating when I’m not hungry because I’m low, not eating when I think I’m hungry because I was trying to lose weight, stopping when I’m full versus stopping when I’ve eaten enough carbohydrates to cover the insulin I took 15 minutes ago—always trying to eat enough but not too much gets fairly difficult while trying to simultaneously manage the nutrients my body needs to perform and all of the social aspects of eating.

It gets difficult. 

Which is why I find it so curious that after a long run, I’m rarely hungry.  (Long run = 90+ minutes)  I would have thought that I’d come home and be starving!  But that just doesn’t happen.  I don’t get “hungry” for a couple of hours after a long run. 

I also know that the old trick of taking a walk around the block when you think you’re hungry can really work when you’re faced with a clock that is slowly turning from 3:30 to 4:00 and dinner isn’t until 6:30 or 7:00… a lot of damage can be done in that hour if you haven’t had a good breakfast and lunch!

So I thought this study evaluating the hunger levels of 11 male university students over three 8-hour sessions was worth a blog post.

The participants ran for 60 minutes on the treadmill for one session, did 90 minutes of resistance training for another session, and did no exercise for the third session.  The researchers studied two key appetite hormones in the subjects’ bodies: ghrelin and peptide YY.  (No worries: no quiz at the end of this!)  Ghrelin is the only hormone known to stimulate appetite, while peptide YY suppresses appetite.  The study participants also answered questions about their hunger after each session.

The researchers found that during the treadmill session, when the participants were performing aerobic exercise, ghrelin levels dropped and peptide YY levels increased—the hormones were suppressing appetite.  In the resistance session, the ghrelin levels dropped but the peptide YY levels didn’t change. 

According to the participants, though, both aerobic and resistance exercise suppressed hunger, but the aerobic exercise did so to a greater degree. 

This would explain my long run phenomenon.

So next time you’re feeling ravenous and can’t quite figure out why, maybe it’s just that your ghrelin is out of whack. 

No Wonder We All Love Saturdays!

August 6th, 2010

This one just strikes my funny bone for some reason.   I love that somebody was able to convince someone this needed scientific study!  And these results are a crack-up!

It turns out; we eat more on Saturdays than the rest of the days of the week.

Researchers published the 2008 study in Obesity research journal and describe that they followed 48 non-obese adults between ages 50 and 60 for one year.  Some were assigned to change nothing, some assigned to reduce calorie intake by 20%, and the remainder were assigned to increase activity by 20%. 

At the end of the year, the researchers found consistent results across the board: weight loss slowed dramatically over weekends throughout the year—not just during the holidays—and Saturdays were the day for mass calorie consumption.  The calorie reduction folks stopped losing weight but the exercisers gained weight on weekends!

So this means we can now relax, as it isn’t “just me” here.  We all love to eat more on Saturdays!

I assume we eat more on Saturdays because we have a change in our routines on the weekends and because I think we tend also to be more social.  More social activity and less structure usually means more wacky blood sugars for me and more food eaten on the run.  Both are in line with what these researchers found.

But I do want to point out a couple things with these results:

(1) they still lost weight and

(2) even when you are active you still need to watch what you eat.

When I did Weight Watchers I used the point system new at the time and was able to put extra points in the bank for the week.  I always used my points for nachos.  I’d dream about those nachos all week long!  They were so tasty.

After reading about this study, I betcha I ate them on Saturdays.

My August Adventure: August 4, 2010

August 5th, 2010

I wanted to spend some QT in the outdoors yesterday, after work.  I wanted to have more than six minutes of nice outdoor time.  And, I wanted to get a run in too.

Usually when I run I am so busy huffing and puffing that I don’t always look around and enjoy my surroundings.   (This is designed to keep me fall-free and twisted-ankle-free as well.)  I don’t think that is a bad thing, but I got myself thinking with the August Adventure post the other day and I thought about running in nice places that would make me happy and relaxed.

I was hoping to get in 7 or 8 miles, but I also wanted to run them on the slow side and keep my heart rate nice and low while I ran.  It’s a good idea for me to run some nice ones every now and then, just as it is a good idea to run some hard ones too.

Of course, as I was changing out of work clothes and into running clothes I checked and was 138.  Not terrible, but there was some active insulin left too so I ate some food and hoped for the best.

I left from work, and ran over onto Stanford campus.  Usually I run a 4 mile loop, but last night I wanted more.  I thought of running the loop twice, but it isn’t really a pretty loop and that wouldn’t really get me the “nice outdoor time” I was going for. 

So I started and didn’t think too much about the route.  I went where I wanted, when I got there

It was so fun! 

I did stop at mile four because that fourth mile felt just as hard as the first three, but was nearly a minute slower.  Problem.  When that happens, I know I need to stop and check.  Not part of my plan, but my workout last night wasn’t about a plan. 

And of course, 63.  Bummer.  I stood right there on the corner and had a gu.  I stood there for 7 minutes and checked again; 103.  Yay!  I guess the sport beans I ate at mile 3.5 had started working, and I knew the gu wasn’t far behind.  But I also used the low as a reminder to keep my effort level in check and just relax as I ran; speed wasn’t the point last night.

The second half of my run was simply lovely.  In fact, I named the run a Lovely Stanford Random Run.  I ran through neighborhoods I’ve not run through and in fact discovered a street ran all the way through that I would never have guessed from the other side.  I ran past some really cute houses with beautiful flowers and ran past some gorgeous estates whose photographs belong in magazines.

And I ended with a blood sugar of 84.  Tired, and energized at the same time.  What more could I ask of the great outdoors?

I Admit It

August 4th, 2010

I admit it—I don’t understand what point all the anger is supposed to serve for people living and dealing with diabetes.

I’m not at all saying that I don’t get or have never been angry about having diabetes—that would be a lie—I just don’t spend much time in that mental space quite simply because being there exhausts me and it rarely gives me anything in return.

Sadness, sure.  Frustration, sure.  Confusion, sure.  But anger, just not that much. 

I read an old blog post from Parenting Diabetic Kids this morning where they listed the Top Ten Things the parents hate to hear.  Mainly it was what you might expect from a loved one forced to give a little one a shot or finger stick, and who is concerned with lows and highs. 

It was the unadulterated anger when faced with comments from others about sugar, what the kids can eat, how they got the disease, unknowing comments and related assumptions there is only one type of diabetes that concern me.  One of the comments in response to someone learning a child has diabetes that topped the list was “at least it’s not cancer.”  The response from many parents to this comment alone was less than gracious.

It was rather startling and I wonder how they make it through the day with all that anger inside and leaking out when they have to also deal with diabetes.

I’m not saying I don’t understand these frustrations.  What I don’t understand is the repeated messages I see online and have seen over the years in “support groups” for people with diabetes.  I don’t understand how so many can “live” so long in such an angry space.

And of course it isn’t just the parents or caregivers I’m talking about.  I meet many people with diabetes who were diagnosed forty years ago and still live with pure anger about it every day.

I think diabetes is a really hard thing to live with.  I think type one diabetes is crazy hard to balance, and I can’t imagine how it is to deal with the rather limited tools and restrictions imposed on people with type two.  I understand that these difficulties can be opportunities to spur more research and education about ways to remove the harmful eventualities of the disease progression and new methods and new medications.  I’m all for that.

Maybe I just get confused because I wonder what guarantees anyone thought were waiting for them in life?  I look around and see so many terrible things happening in the world and I look down at my digital pump and its sterile infusion set and my fancy insulin and get my blood sugar result in 5 seconds and I just wonder: what does all the anger do for anyone?

I do want to applaud one comment I read from someone who has two family members with type one.  I think she gets what it is like, even if her own pancreas works, to live with the constant checks.

My husband and daughter are both diabetic and we always get these comments. But I have to say I agree with the “at least it’s not cancer”. There were kids in hospital when [my daughter] was diagnosed at age 2 last year, who were dying – of cancer or other diseases. Those parents were losing their kids. My husband’s colleague had a 2-year-old boy diagnosed with MD a few years ago. That family watched their child die and there was NOTHING they could do about it. At least [my daughter] has a pump and a blood meter! I’m not going to lose my kid. OK she’ll face physical problems and many emotional issues but with the help and support of her family and friends she can get through them and lead a normal life. My friend’s little girl is highly allergic to a number of foods and can actually eat less at parties than [my daughter] can. If she eats the wrong thing she might die immediately. I think I’d be far more scared about that! We’ve all got challenges to deal with in life, and our job is to get on with them and help our kids lead as normal a life as possible. And who knows, dealing with diabetes might just make them stronger, healthier adults. I have certainly learned a lot and grown up a lot in the last 15 months since [my daughter’s] diagnosis, even though my husband has been Type 1 for nearly 10 years now. He has learned a lot too. Hang in there, keep smiling and keep raising awareness!