Archive for November, 2010

It is going to be SO FUN

November 30th, 2010

I really do try and not preach at you in my blog.  It’s one of my rules: I don’t want to be someone I wouldn’t want to hang out with… and I don’t ever feel like being preached at so I try to avoid preaching… I really do.

But.

Maybe today will sound like I’m preaching.  I just really like this idea, and have had nothing but positive responses to the idea in practice.  I think it would be a great thing for you to try, too.

It’s a holiday lights walk.  (Or a holiday lights run, whichever floats your boat.)

I set an arbitrary day (December 15) and an arbitrary time (5:30pm…it’s dark out but it is early enough to get home in time for dinner but not so late as to interfere with dinner by too much) and an arbitrary place to meet (for me, at a neighborhood park).  I am inviting everyone I know and everyone I meet.

I asked them to show up at the park wearing light and reflective clothing, a Santa hat if they want, and bring a flashlight.  I’m going to hand out jingle bells on safety pins so they can attach the bells to their shoelaces.

IT IS GOING TO BE SO FUN.  I am so looking forward to it!!  ITISGOINGTOBESOFUNSOFUNSOFUN.

I know some streets that have awesome light displays and I mapped out a route using gmaps pedometer that would take us through some of the best streets.  For the walk, I mapped out a little less than 3 miles.  For the run, I mapped out a little less than 6 miles.  Most groups can do this mileage in an hour.

Last night, I pre-ran the route to double check that it was as safe as a nighttime run can be: I looked at the condition of the sidewalk, the traffic, where the stop signs are, all that jazz.  I was really surprised at how fun the route felt, even by myself.  I don’t know how it happened, but it felt like the entire way was a little bit downhill.  (And there are two hills I know I travelled, so I’m even more confused!)

I’ve been safety pinning the jingle bells while I watch TV. 

Did I mention I’m excited about this?

Here is where I may start to preach: this was really REALLY easy to plan.  You can absolutely plan the same exact thing in your neighborhood, and I think you should. 

I know a lot of people won’t be able to make it.  I figure even if one other person can come, we’ll have fun.  So grab your friend.  Grab your coworkers.  Grab people you know from church or book club.  Set the time, be clear about where to meet and what to wear and bring, and then get out there and enjoy the holiday sights!

And if you’re in my neck of the woods, come join us!!

Sharing Wisdom

November 29th, 2010

Can’t believe it has been four whole days without a blog from me, can you. 

I have an online diary/ tracker that tells me what I’ve done each day for exercise.  I think I started it in late 2008 or maybe it was late 2007.  Anyway, it tells me what is going on.  I like it.

Looking at my tracker helps me know what I’m missing, and keeps me on track to keep me fit and healthy, and if I’m lucky it helps me stay injury free.  (Injuries suck and I want to avoid them.)

Since I try here to share wisdom I’ve either gathered for myself or I’ve tried to learn from others, I’m happy to have seen a Runner’s World article from March (yes I know that was 8 months ago; I save all of my RWs!) 2010 about how to stay active and healthy.  Many of the items are running-specific, but some of them apply to any and all activities.  I’ve edited the list and added my own take:

  1. Know your limits.

I can’t work out every day at the same intensity.  No one can.

  1. Listen to your body.

Your body, as you know, has something to say 100% of the time.  Sometimes it’s just a steady hum, sometimes it’s a gentle prod, sometimes it is an ice pick in the shin with each step.  Whatever your body is telling you, you need to listen.

  1. Nix negative thoughts.

If you can figure out how to stop the “can’t” and the “wah” and the “won’t” and the “bad” and the “gross” or the “weak” or whatever it is and substitute in a “now” and a “try” and a “go” and a “work” and a “yay” and a “phew” and a “yes” and a “push” and a “good” you will be so much better off in every area of your life.  Try it.  Please.

  1. Find an outlet. 

Seek out what boosts your spirits and perform those activities rather than something that drags you down.  Nobody who knows anything wants you to do something that drains you emotionally without finding something that will regenerate your emotional wellbeing.  (Ha!  Not that we know what “well-being” means…) Exercise spurs endorphins for you… if you find the right thing for YOU.  It’s worth finding what that is.

  1. Seek out support.

Find friends who exercise and use them.  Use them for cheers and for venting.  If you want support, you need to seek some out.  Have you ever tried complaining to a non-exerciser about not being able to make it to the gym yesterday?  That blank look is just as bad as the “you’re crazy” response.  Find others who can relate to your goals and support you reaching them.  You are worth it.

Reviewing the list, I think it could apply to nearly every area of our lives and not just exercise.  Cool.

More About Food (isn’t it always about food)

November 23rd, 2010

I am not a medical professional.  I cannot give nutritional advice or guidance.  I am able only to share basic information: if you have more specific questions I advise you to seek a professional trained to give nutritional and dietetic advice.

But.

Food labels.

More specifically, CLAIMS on food labels.

See, diabetes is complicated and I personally do not appreciate (read: Do. Not. Appreciate.) marketers messing with me and my efforts to do my best.

I came across notes from a presentation I was at a number of years ago; I had forgotten some of the points and thought you might be interested in them.  I took a look at the FDA website and they don’t look like they have changed.

Fact: THE FDA DOES NOT EVALUATE NOR REGULATE TERMS PLACED ON LABELS OUTSIDE THE NUTRITION FACTS LABEL (the box with the calories, carbohydrate, serving size, etc)

If you’ve ever done carb counting you know what you look for in that Nutrition Facts box:

  • Single serving size
  • Number of servings in container
  • Number of carbohydrates in serving size

(I often take it another step beyond this and calculate how many carbohydrates are in the entire package, then, and divide that by how much of the container I think I’m going to eat.  It’s somehow easier for me.  It’s what I did with Weight Watcher points, too.)

And then there began the entire “Carb Craze” a number of years ago that messed with labeling even more:

*Net Carbs         *Non Impact Carbs         *Impact Carbs

These carbohydrate whizbang mathematics mean nothing: they have no legal or scientific definition.  If you subtract fiber when you count your carbs because your doctor or CDE told you to, keep doing whatever you were taught.  Don’t pay attention to this hocus pocus.  You know what impacts your blood sugar far, far better than any food marketer!!

And what is a sugar alcohol, anyway?  It is a carbohydrate with a chemical structure similar to sugar and alcohol, sure, but they are not completely absorbed the way that sugar is.  So not only will they mess with your digestive system, they will also mess with your carbohydrate counts.  I mean, how does one reliably calculate for “incomplete absorption”??  I will always vote against “sugar free candy” because they are concocted using a lot of sugar alcohols.  Crazy, disruptive, and not even very tasty!! 

More words they use to make “food” sound like you want to buy it but actually have zero meaning and are unverified by any reputable agency: natural, nontoxic, sensitivity tested, no chemical, no hormones, ozone-friendly.

I’m just saying: if you are buying “food” because it is ozone friendly, you need to see a registered dietitian.  Stat.

Yes, diabetes is the thinking person’s disease.  We have to think all the time.  But more than that, we have to be critical when it comes to our food choices.  We have to know all of this stuff on the labels and what it means for us and our bodies.  You’ve always got to be learning and taking mental notes since our bodies change over time and without warning.

It’s complicated. 

So stop messing with me, food marketers!! 

If you need me, I’ll be in the produce section.  I feel safer over there…

Do You Have a Plan for Thanksgiving?

November 22nd, 2010

I know I’ve said before that I come from a family of Planners.  Big time Planners.  When I was growing up, we planned what was for dinner.  We planned what was for breakfast two weeks from that day.  We planned what roads we were going to take to get to the next week’s doctor visit.  We planned nearly everything.

Which should tell you, I’m used to making plans.

But it occurred to me that maybe not everyone plans like I was taught to plan.  In some ways that is a good thing, and in some ways my planning reflex has served me well.

Which is to say, I’m already planning how to make it through the eating this week. 

I know I’m going to feel a need to overeat on Thursday.  I think I’ve already been overeating for the past few weeks!  And I know there is a month of more eating ahead of me.

So how am I going to manage all of those calories?

How am I going to manage the insulin that cookies, pies, cakes, mashed potatoes, sweet potatoes, coffee cakes, cranberry sauce, gravy, appetizers, salad with dried cranberries, and nearly every other food imaginable will require?

Overwhelming to list them all.

I learned a number of years ago that I’m just not great at scaling back on the actual food I put on my plate or, most importantly, in my mouth. 

That’d be an easy way to do it, sure, but for me it simply isn’t realistic.

When I get overwhelmed, I make a plan.  A plan!  Da plan, Boss, da plan!!

I’ve increased my cardio this week, and plan for at least an hour of moderate to high intensity every day this week.  I’m going to lighten up on my breakfast carbs, because I need much more insulin at breakfast than I do later in the day and I want to keep my daily insulin needs roughly the same.  I’ve increased the weight of the weights I’m lifting.  I’m doing an extra leg workout this week because the bigger muscles (like my legs) use more energy and continue to burn when I challenge them with heavy weights.

I am very fortunate to be enjoying Thanksgiving dinner at my friend’s house; she lives 2 miles away from me.  I’m planning to walk to her house and more importantly to walk home.   I think that walk home will help me with my post-feast blood sugars.

I’m going to try to keep my week to an unusual Thursday only; I want to treat the other days like normal food days and only give Thursday the special eating treatment. 

We shall see what happens with my plan.  I feel much better going into the week knowing that I have retained some control and have a plan to fall back on.

Think about what your plan is right now, and see if you can tweak it to make it even better for you, your health, your sanity, and your enjoyment of the holiday.  If you have ideas others could use, post them here or on the Diabetes Outside Facebook page!

The Diabetes Monologue

November 19th, 2010

I was listening to John Madden on the radio this morning (love him) and he mentioned, probably without realizing it, a play someone ran in a game last year. 

It made me think.

I know a lot of things, and I pay attention to a lot of things, and I go a lot of places and I perform a lot of tasks and play a lot of different roles every day of my life.  But a play from a year ago and most of the 13,007 cases I had to read in law school and I think who actually done it in nearly every mystery I’ve ever read no longer exists in my brain.

I don’t think there is any room inside there; I don’t even know if there ever was!

I really don’t think it’s age related.  I think I have less room in my brain than the Average Jane has for storing information on TV shows, cartoon plot lines, or what have you. 

I think I have a considerable chunk up there reserved for my diabetes information

If you don’t have diabetes, have you ever thought about how much goes into trying to function for one organ?!  I am constantly amazed, and I have been doing it for more than 20 years! 

what I had for breakfast and what that’s going to do to my blood sugar by lunch and what my number was and what day of the month it is and what basal rate am I at and did I go on a temporary basal this morning and did I do extra exercise with the bootcampers and why didn’t I eat a snack and did I bring candy with me and what am I planning to do after work and how many miles is that and is it unusually hot or cold outside and how long will the aftereffects of the marathon impact my metabolism and my basal rate and how is my basal rate do I need to run tests on that again I hate those and am I going to go do a heavy weight workout after work or am I going to run and if I run how long am I running for and how fast and will it be fast enough to change the insulin/food I need and what am I going to do to prevent a swing if I run and if I am going to do heavy weight work how heavy and when was the last time I did that and the time before when I hadn’t done heavy weight work and then I did it what happened to my blood sugar and how likely is that to happen again and am I going low right now in fact what is my blood sugar right now I should check and when was the last time I checked and did I bolus and where is my meter and when is the next meal and what am I going to eat and how much insulin is that going to take and how much insulin is left in my pump do I need to change my site when was the last time I changed my site and

So, yes: I’ll say it:  My brain is not like the brain of a person without diabetes.  My brain does all the same things their brains do, and it does that diabetes monologue.  And I have to store a lot of that information for future reference, too.

It’s kind of a shame, really.  I could use some of that extra space. 

There are a lot of football games and cartoons and mysteries out there.

A Different Set of Numbers to Know

November 18th, 2010

I read an article this morning about wellness versus well-being and what each might mean to everyone.  I thought it was pretty interesting and will take a few days thinking about how to re-orient my mind with the new ideas.

One person said that an important part of wellness (whatever that means to her) is knowing your “core numbers.”  I thought probably we diabetics would have a different list. 

Her list includes knowing your:

  • Blood pressure
  • Pulse
  • Height/weight
  • Cholesterol (HDL and LDL)
  • Body Mass Index (BMI)
  • Number of hours of sleep
  • Daily caloric intake
  • Target Heart Rate
  • Bone Density

So what would you include on a list of your “core numbers”?  I’m sure most of us would include Hg A1c and maybe average total daily insulin and most recent blood sugar. 

I’d also want to know minutes spent per week exercising at moderate to vigorous intensity. 

In the military, you’d want to know your PT score! 

For the Army, the timed push up test, the timed sit-up test and the 2 mile run are three separate scores that are added together for a final score.  Basic training soldiers are required to score 180 or more to fulfill the physical requirements.

Check it out!  They have charts with minimum and maximum requirements for each age and gender!

I’m a 33 year old female, so I’d need to perform: 45 pushups, 76 sit ups, and run 2 miles in 15:54 in order to score the highest possible 300 points.  Yowza; I’ve got some work to do!

Then again, I could do 15 pushups, 42 sit ups, and run the 2 miles in 21:42 and pass.  I *know* I can do that right now; I wouldn’t even need to adjust my basals.  Sweet!

Now I’m thinking now about giving myself a military PT test later just to see how I score.  Anyone care to join me?

The Wee Hours

November 17th, 2010

A couple years ago I had an eye doctor tell me that each fall he gets a load of patients complaining of worsening vision; it happens each year right around Daylight Savings Time.

I’ve noticed since the time changed that when I’m driving I can’t see people walking their dogs or jogging as well as I could when it was brighter.  (Duh.)

Makes me think of a running rule I know: If you have to ask: does this driver see me? The answer is no.

Since I’m all about getting you outside and getting you exercising (your dog should pay me a commission) I need to also be all about you doing so as safely as possible.  YOU ARE AT THE MERCY OF THE DRIVER’S EYESIGHT anytime you are within 100 yards of them.  Let’s review some bad ideas and move towards a safer way to move out there.

Very Bad Idea #1: going out there in dark pants and a dark shirt.  Drivers won’t see you from afar and may not see you at all until they are dangerously close (30-40 feet or less!!).  BE SMARTER THAN THIS.

Still A Very Bad Idea #2: going out in dark pants and a light shirt.  Better than #1, but the difference is negligible from the driver’s side.  They won’t be able to see you until they are at best 50 feet away.  Not enough.  BE SMARTER STILL.

Not Great But Better Idea #3: going out in clothes and shoes with reflective details.  The reflective details help the driver see you, if the driver has headlights on and is paying attention within 100 yards.  The more reflective details, the better.  BRIGHTEN UP.

Getting Even Better Idea #4: going out with a brightly colored jacket or top can help the sleepy drivers out there see you sooner as you move.  Reflective panels on the sleeves help the drivers detect your motion as far as 150 yards away.  BRIGHTER + LIGHTER = BETTER.

This Is A Good Idea #5: get outside in the dim dark dreary morning or evening wearing a reflective vest or blinking red light.  As long as the reflective material covers at least half of the vest and the light is an LED caution hazard pay attention driver blinking red, you’ll put the drivers in a better position to avoid you from nearly a quarter of a mile away… which is precisely what you want.   BRIGHTER + LIGHTER + BLINKING = FANTASTIC.

Let’s All Do This One Great Idea #6: get out there and wear a headlamp or handheld light with an LED whitish beam that moves as you move.  The motion will signal to all drivers from nearly a half mile away that you are a human being (or a dog: don’t forget lighting your dogs!!) and they should not drive into you.  This one takes the cake for the smartest thing you can do to protect yourself and warn those drivers.  BRIGHTER + LIGHTER + BLINKING + MOVING = SAFEST AND SMARTEST.

I took these ideas from a great article in Runners World (January 2010).  Thanks, RW!!

Don’t Underestimate Yourself!!

November 16th, 2010

Do you know how much weight you can actually lift?  Have you ever tried to see how much you are actually able to do?

I’d guess it isn’t something you think of while you go throughout your average day.

However, if you’re hoping to really use the body you’ve got, you need to challenge it.

Why?

Because MUSCLE RESPONDS TO RESISTANCE.

If you underestimate the weight you can lift, and perform a squat with, say, 3 pound dumbbells in each hand, then the “challenge” you are giving your thighs is much less of a challenge than you give them when you carry your groceries into your house.  When you are working out, you want the workout to be challenging—more of a challenge than you face in your normal routine.

I can’t say I think that carrying groceries into my house is routinely a “good workout”.

Runner’s World published the “lift less weight with more reps to get toned” myth as its #4 biggest myth last spring.  Take a look:

A study at Georgia Southern University determined lifting 85 per cent of your maximum ability for eight reps burns about twice as many calories in the two hours post-workout, compared with 15 reps at 45 per cent max. And don’t worry: lifting heftier iron won’t transform you into an Arnold Schwarzenegger-alike. Achieving that look requires eating a high-calorie diet and a longterm power-lifting regime – which you won’t be doing. “If you’re creating a calorie deficit, you simply won’t bulk up like a bodybuilder,” says New York-based running coach Monica Vazquez.

So the next time you’re at the gym and looking at the dumbbells in front of you, or the plates on the machines, ramp it up a little.  (The benefits will last much longer than you’re used to, so watch out for lows after the workout!  Check at 2, 4, and 6 hours after you’re done to catch any oncoming lows.)

Try it: you might like it!

You Never Know What You’ll Find in Your Inbox

November 15th, 2010

I sat down at my computer to blog this morning and opened my email.  In my inbox sat a message from a former employer, marked as !!high priority!!.  (I am not sure why they still send me email, as I haven’t worked for them in a few months, but okay.)

The subject line: SAFETY TOPIC: Diabetic Incident (DRILL)

Oooh. 

I’m reading the message about the “diabetic incident” and realize that even the two basic concepts they discuss must be incredibly confusing for the layperson.

Diabetics are subject to two very different types of emergencies:

 

1. Insulin Shock (or Insulin Reaction) aka hypoglycemia

 

This condition occurs when there is TOO MUCH INSULIN in the body. This condition rapidly reduces the level of sugar in the blood and brain cells suffer.

 

Insulin reaction can be caused by taking too much medication, by failing to eat, by heavy exercise and by emotional factors.

 

SIGNS & SYMPTOMS: Fast breathing, fast pulse, dizziness, weakness, change in the level of consciousness, vision difficulties, sweating, headache, numb hands or feet, hand tremors, hunger, and disorientation/confusion

 

 

2. Diabetic Coma aka Hyperglycemia

 

This condition occurs when there is TOO MUCH SUGAR and too little INSULIN in the blood and body cells do not get enough nourishment.

 

Diabetic coma can be caused by eating too much sugar, by not taking prescribed medications, by stress and by infection.

 

SIGNS AND SYMPTOMS: Diabetic coma develops more slowly than Insulin shock, sometimes over a period of days. Signs and symptoms include drowsiness, confusion, deep and fast breathing, thirst, dehydration, fever, nausea, vomiting, a change in the level of consciousness and a peculiar sweet or fruity-smelling breath.

 

Sugar is required in the body for nourishment. Insulin is a hormone that helps the body cells use the sugar. When the body does not produce enough Insulin, body cells do not get the needed nourishment and diabetes results.  People with this condition take Insulin to keep their diabetes under control. 

 

See what I mean??  Confusing!!  No sentence in here is necessarily wrong, but I’m confused anyway… and I know the differences!!

And then the drill part is kind of confusing, too, I think.  Again, not wrong, but really confusing.

Follow the procedures outlined below for Insulin Shock

First Aid for Insulin Shock

Distinguishing between the two types of diabetic emergencies can be difficult.  Of the two conditions, insulin shock is a true emergency which requires prompt action.  Looking for the signs and symptoms listed above will help to distinguish the two diabetic emergencies. (Always look for an identifying bracelet which may reveal a person’s condition).  In addition, if the patient is conscious, you can ask two very important questions which will help determine the nature of the problem:

1.       ASK “HAVE YOU EATEN TODAY?”

Someone who has eaten, but has not taken prescribed medication may be in a diabetic coma.

2.       ASK “HAVE YOU TAKEN YOUR MEDICATION TODAY?”

Someone who has not eaten, but did take their medication, may be having an Insulin reaction.

·         If victim is conscious, administer 10-30 g carbohydrate (orange juice, sports drink, regular soda) follow with protein (energy bar or protein bar, etc). Activate EMS and monitor victim.

·         If unconscious, activate EMS and monitor victim.

First Aid for Diabetic Coma

·         If victim is conscious, administer fluids (water, non caffeine drinks, sugar free but not diet drinks) follow with protein (energy bar or protein bar, etc). Activate EMS and monitor victim.  Turn head to side if vomiting

·         If unconscious, turn head to side in case of vomiting.

A PERSON IN INSULIN SHOCK NEEDS SUGAR QUICKLY! IF THE PERSON IS CONSCIOUS, GIVE SUGAR IN ANY FORM: CANDY, FRUIT JUICE OR A SOFT DRINK! DO NOT GIVE THE PERSON CHOCOLATE OR DIET DRINKS.

SUGAR GIVEN TO A PERSON IN INSULIN SHOCK CAN BE LIFE-SAVING! IF THE PERSON IS SUFFERING FROM DIABETIC COMA, THE SUGAR IS NOT REQUIRED BUT WILL NOT CAUSE THEM FURTHER HARM.

I admit, I’m totally not clear what the protein bar is going to do in this situation.  And “do not give the person chocolate” seems pretty harsh.  (But that’s probably just me: I never want someone to not give me chocolate!  Not that chocolate is the quickest or best low food, but I just mean as a general rule.)

Anyway, I think that since we are in the middle of Nation Diabetes Month it may be a good chance for all of us to take the 2 minutes to explain in person to a coworker or two (or three or five or twenty) what YOU need when YOU start acting funny. 

Well, funnier than usual.

November is National Diabetes Month– Wahoo? Hmm.

November 12th, 2010

I’m not sure who made November National Diabetes Month.  I went to the Centers for Disease Control and Prevention since I figured they’d know. 

I found the page that started with a let’s be nice and say “off-putting” sentence:

You have the power to prevent and control diabetes.

It didn’t necessarily get better as I continued to read:

If you already have diabetes, managing the disease can lower your risk of complications such as kidney failure, heart disease and stroke, blindness, and amputations of legs and feet.

So maybe I shouldn’t be looking to the government health agency for much help.

I went to the American Diabetes Association’s website since I figured maybe they could be more of a help. 

Ah.  They want a donation from me. 

Moving on, I did a search on the site for what to say about November.  More information

American Diabetes Month®

November is American Diabetes Month, a time to communicate the seriousness of diabetes and the importance of diabetes prevention and control. For years, the American Diabetes Association has used this month as an opportunity to raise awareness of the disease and its serious complications.

Still not quite happy with this.  I try to communicate something about my disease every day… so a full month dedicated to doing precisely that seems… simultaneously superfluous and unnecessary.  (And I’m rather confused why the ADA felt a need to trademark the term “American Diabetes Month”.)

So off I went next to the JDRF website.  (Maybe they won’t tell me to prevent and control my diabetes.)  Oh wait: still a plug for money and self-serving laudations for what JDRF is doing when it comes to research.  Well, I guess it’s closer. 

Renewal of U.S. Government Special Diabetes Program Will Ensure Progress toward Better Treatments and a Cure for Type 1 Diabetes

NEW YORK, Nov. 5, 2010 – Thanks to significant research advances in recent years, people living with type 1 diabetes have received better treatments and therapies. Scientists have made headway in uncovering the possible cause of type 1 diabetes, and in their efforts to find ways to prevent, treat, or reverse the autoimmune disease and its complications. Despite this progress, we still have a long road ahead of us to identify a cure that will eliminate type 1 diabetes once and for all.

Alright.  I’m done with my search.  I am still not finding what I want on three of the biggest national resources I expect should be supporting ME and MY DISEASE. 

I don’t need a month each year to wear blue, or gray, or whatever.  I don’t need to send money to organizations so that they can design holiday cards and mail me a catalog about the holiday cards. 

Nope.  That isn’t what the month is to me.  To me, November being Diabetes Month is about what every other month, day, hour, and minute is about: keeping myself healthy, emotionally and physically, and living my life. 

My diabetes comes first some days, and my life comes first some days.  It’s hard to explain to a lot of people how constant the diabetes thinking really is.  It’s hard to explain being at a restaurant or at someone’s house and wondering if I should bolus before I’ve seen the food (preferable to time the insulin to meet the carbohydrates entering my system to keep my blood sugar levels more even), or after (safer in that I can visually guess the carbohydrate counts and don’t risk my insulin hitting my system before the food has left the kitchen on its way to me).  It’s hard to explain how I don’t even realize I’m checking my blood sugar at work until I see a coworker get nervous and stop talking to me because he’s busy watching me check.  Or, for that matter, how that coworker’s response FEELS to me.

I wonder if November being Diabetes Month really does increase awareness of my type one diabetes.  I suspect it doesn’t.  Given the fact that the American Diabetes Association still seems concerned about me losing a foot, I am not sure they understand my type one.

Good thing November holds other special events for me in my life: if it were a special month just because it is Diabetes Month I might be disappointed!