Archive for May, 2011

We are such ANIMALS

May 27th, 2011

For all of our things and our systems and our routines and our gadgets and our knowledge and our buildings and cars and concrete and glass and keys and computers and grocery stores and what have you… we are still, at our basic level, animals.

Proof of this can be found in the following research studies of humans.  Turns out, we aren’t much different when it comes to nature than are captive animals in a zoo.

I’m including the entire Science Daily article here; it isn’t that long (considering a three day weekend looms).  Take a gander and then get outside for some fresh air and nature!!

ScienceDaily (Apr. 26, 2011) — Research shows that a walk in the park is more than just a nice way to spend an afternoon. It’s an essential component for good health, according to University of Illinois environment and behavior researcher Frances “Ming” Kuo.

Through the decades, parks advocates, landscape architects, and popular writers have consistently claimed that nature had healing powers,” Kuo said. “But until recently, their claims haven’t undergone rigorous scientific assessment.”

Kuo is also the director of the Landscape and Human Health Laboratory at the U of I and has studied the effect of green space on humans in a number of settings in order to prove or disprove the folklore notions.

“Researchers have studied the effects of nature in many different populations, using many forms of nature,” Kuo said. “They’ve looked at Chicago public housing residents living in high-rises with a tree or two and some grass outside their apartment buildings; college students exposed to slide shows of natural scenes while sitting in a classroom; children with attention deficit disorder playing in a wide range of settings; senior citizens in Tokyo with varying degrees of access to green walkable streets; and middle-class volunteers spending their Saturdays restoring prairie ecosystems, just to name a few.”

Kuo says that although the diversity of the research on this subject is impressive and important, even more important is the rigor with which the work was conducted.

“In any field with enthusiasts, you will find a plethora of well-meaning but flimsy studies purporting to ‘prove’ the benefits of X,” Kuo said. “But in the last decade or so, rigorous work on this question has become more of a rule than an exception. The studies aren’t simply relying on what research participants report to be the benefits of nature. The benefits have been measured objectively using data such as police crime reports, blood pressure, performance on standardized neurocognitive tests, and physiological measures of immune system functioning.”

Kuo said that rather than relying on small, self-selected samples of nature lovers such as park-goers, scientists are increasingly relying on study populations that have no particular relationship to nature. One study examined children who were receiving care from a clinic network targeting low-income populations. Another looked at all United Kingdom residents younger than retirement age listed in national mortality records for the years 2001-2005.

“Scientists are routinely taking into account income and other differences in their studies. So the question is no longer, do people living in greener neighborhoods have better health outcomes? (They do.) Rather, the question has become, do people living in greener neighborhoods have better health outcomes when we take income and other advantages associated with greener neighborhoods into account?” That answer is also, yes, according to Kuo.

After undergoing rigorous scientific scrutiny, Kuo says the benefits of nature still stand.

“We still find these benefits when they are measured objectively, when non-nature lovers are included in our studies, when income and other factors that could explain a nature-health link are taken into account. And the strength, consistency and convergence of the findings are remarkable,” she said.

Kuo drew an analogy to animals. “Just as rats and other laboratory animals housed in unfit environments undergo systematic breakdowns in healthy, positive patterns of social functioning, so do people,” she said.

“In greener settings, we find that people are more generous and more sociable. We find stronger neighborhood social ties and greater sense of community, more mutual trust and willingness to help others.

“In less green environments, we find higher rates of aggression, violence, violent crime, and property crime — even after controlling for income and other differences,” she said. “We also find more evidence of loneliness and more individuals reporting inadequate social support.”

The equation seems too simple to be true.

  • Access to nature and green environments yields better cognitive functioning, more self-discipline and impulse control, and greater mental health overall.
  • Less access to nature is linked to exacerbated attention deficit/hyperactivity disorder symptoms, higher rates of anxiety disorders, and higher rates of clinical depression.

If that isn’t convincing enough, Kuo says the impacts of parks and green environments on human health extend beyond social and psychological health outcomes to include physical health outcomes.

  • Greener environments enhance recovery from surgery, enable and support higher levels of physical activity, improve immune system functioning, help diabetics achieve healthier blood glucose levels, and improve functional health status and independent living skills among older adults.
  • By contrast, environments with less green space are associated with greater rates of childhood obesity; higher rates of 15 out of 24 categories of physician-diagnosed diseases, including cardiovascular diseases; and higher rates of mortality in younger and older adults.

“While it is true that richer people tend to have both greater access to nature and better physical health outcomes, the comparisons here show that even among people of the same socioeconomic status, those who have greater access to nature, have better physical health outcomes. Rarely do the scientific findings on any question align so clearly.”

Because of this strong correlation between nature and health, Kuo encourages city planners to design communities with more public green spaces in mind, not as mere amenities to beautify a neighborhood, but as a vital component that will promote healthier, kinder, smarter, more effective, more resilient people.

Parks and Other Green Environments: Essential Components of a Healthy Human was published in a research series for the National Recreation and Park Association.

Four (4) Days. Four!

May 26th, 2011

Have I ever shared with you how extremely bad I am at packing?  More specifically, packing my supplies?

The air traffic safety people haven’t made the task any easier.

It amazes me how much I can bring “just in case” I need it.  When it comes to supplying myself with potential medical necessities when running a marathon with type one diabetes, it gets even worse!

I am even more amazed by Nat Strand after packing for this short little nothing trip.

I think this time around it was my Mastisol that got me.  I know that anything that may seem “attached” when I start a run will quickly become “not at all attached” once I break a sweat were it not for my Mastisol.

(If you just shuddered, as many do at the thought of Mastisol on their skin, let me assure you: I sweat a lot.  I would not be able to keep anything attached to me without Mastisol.)

And of course Mastisol is crazy expensive so I bought it in the big 2 ounce bottle since I am most often at home when I change sets and sensors and the bigger bottle was cheaper.  But, I have also had a little 15mL bottle of Mastisol spill in my luggage (fortunately for me it was in a Ziploc!) so I’m not interested in bringing or risking the big momma bottle.

But, it’s a marathon.

And, thank you air travel, I cannot wear my sensor in flight.  I’ve tried turning it off in the air and back on on the ground, but that doesn’t work at all.  I’ll need to insert a new one and get it started once I’m on the ground.

All of this means I’ve got to bring my Mastisol with me.  And, of course, I’m realizing this last night and I leave later today.  And I’m not into paying $20 for someone to ship me a small bottle to the hotel and deal with it that way—diabetes is expensive enough.

SO, to fill you in on completely random information that doesn’t really have anything to do with anything, I feel like a genius for what I realized I can do.  I’m going to stick some Tegaderm on my hip with Mastisol before we leave, and then I’ll put in my sensor when we land.  (If I put on my sensor without putting Mastisol and Tegaderm down first, it falls off.  Every time.  I’ve tried more than seven times to do it the way that .)

That way, I’ll accomplish a few things with little hassle. 

The tricks we learn from years of diabetes, years of pumping, years of CGM’ing, and years of running. 

It’s getting better all the time!

It’s A Little Sad We Need the Government for This

May 25th, 2011

It’s a little sad to me that we need the federal government to tell us to get a move on every day.  In an ideal world we wouldn’t need that—we’d be able to live our lives without the stress of an urban or suburban environment relegating us to a life of boxes.  (Lie on a box, eat from a box on a box, get in a box, drive to a box, sit at a box, stare at a box, get back in the box, drive to your box, sit on a box, stare at a box, lie on a box, and repeat!)

However, not only am I unable to change the world just by wishing for a change, I am also not likely to inflict my desires on an entire population.  (If only!)

So despite my sadness I find it somewhat useful to periodically check in on the federal guidelines for physical activity for Americans.  I think they are fairly weak requirements as I’m positive most would benefit more from somewhat higher standards, but I also understand a majority of citizens are very far from achieving even these daily amounts of physical activity… which brings on another wave of sadness!

How do you measure up to these standards?  How does your family measure up?  Your friends?  Are you doing what you can to achieve these recommendations for your body and health?

Children and Adolescents (aged 6–17)

  • Children and adolescents should do 1 hour (60 minutes) or more of physical activity every day.
  • Most of the 1 hour or more a day should be either moderate- or vigorous-intensity aerobic physical activity.
  • As part of their daily physical activity, children and adolescents should do vigorous-intensity activity on at least 3 days per week. They also should do muscle-strengthening and bone-strengthening activity on at least 3 days per week.

Adults (aged 18–64)

  • Adults should do 2 hours and 30 minutes a week of moderate-intensity, or 1 hour and 15 minutes (75 minutes) a week of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate- and vigorous-intensity aerobic physical activity. Aerobic activity should be performed in episodes of at least 10 minutes, preferably spread throughout the week.
  • Additional health benefits are provided by increasing to 5 hours (300 minutes) a week of moderate-intensity aerobic physical activity, or 2 hours and 30 minutes a week of vigorous-intensity physical activity, or an equivalent combination of both.
  • Adults should also do muscle-strengthening activities that involve all major muscle groups performed on 2 or more days per week.

Older Adults (aged 65 and older)

  • Older adults should follow the adult guidelines. If this is not possible due to limiting chronic conditions, older adults should be as physically active as their abilities allow. They should avoid inactivity. Older adults should do exercises that maintain or improve balance if they are at risk of falling.


May 24th, 2011

I hold my morning and afternoon bootcamp classes at a high school campus, which means I’m on a high school campus every day.  The energy radiating off even the buildings has changed through the school year as you can I’m sure imagine. 

Which is to say, SUMMER and GRADUATION is on my mind these days.

I remember graduating from high school: it was, in a word, awesome.  Having had diabetes for seven years at the time and living with giving myself shots in front of everyone at school for the past two years I thought I had it all wrapped up. 

Yeah, at the time my A1c was routinely 12.5-13.4.

(I didn’t say I actually had it all wrapped up; I just thought I did.)

I was concerned about my supplies and prescriptions while at school, but I found where my new pharmacy was close to my college campus, and my doctor was in the same state so there wasn’t any problem with getting my insulin.  (I didn’t go on a pump until mid-way through my freshman year at college so I was still taking shots.)

But you know, I could really have used some actual help learning how to be myself and how to be me with diabetes.

Having had the opportunity last week to chat with a group of teens with diabetes, I heard them echo the same things from my memories.

I admit I felt a little sorry for them; I know that life with diabetes while transitioning from parent-care to self-care is incredibly difficult—especially when as a teen you are trying desperately to not need adults for much of anything!

I don’t want them to have to do it alone.  Ever.  It’s just too much, too complex, and too much is at stake in their lives and in their bodies.

Of course I don’t think there is a lot I can do about some of it: teens are sure nothing will happen to them and far be it from me to ever be the one to shatter that illusion.  Time will take care of that.

But what options can I help out with?  And what can we, as people who have gone through the transition from high school to college and beyond while living with diabetes, offer as help for those walking in our footsteps?

I have a list.  It includes discussing plans for every day regimens, medications and supplies, the financial side of things, dealing with insurance hassles, roommates, and actually leaving for college.

It’s one of the reasons I started Diabetes OutsideI don’t want anyone to feel as scared and alone as I felt, or be in as much denial as I was.  Don’t hesitate to contact me if you want some real help with this transition.

It turns out, it isn’t worth it to try and face life with diabetes on your own.

You’re worth way too much for anyone to let you even attempt it.

Can You Feel THIS, Doc?

May 23rd, 2011

I thought this was an interesting study: researchers followed 891 patients with diabetes for three years and the study involved 29 doctors.

They rated the doctors on how much the doctor understood their patients’ perspectives and how much that understanding factored into the doctors’ desires to help.

The doctors who were rated the highest in this type of empathy had patients who were 16% more likely to have tighter management of their blood sugar levels and 15% more likely to have better cholesterol levels than the patients of the not-as-understanding doctors.

It makes me wonder how many people think about taking care of themselves better in order to please a doctor they like.  In some ways that makes sense, but in other ways it makes me somewhat sad: isn’t taking better care of yourself and your body a big enough motivation?

I guess sometimes it isn’t.

But it also makes sense sometimes when you think about teens with diabetes: they aren’t in it to please ANYONE else, and they may not have the same perspective on their lives as the adults they know. 

And then I think about how much work it must be for a physician to feel the difficulties of daily life with diabetes on behalf of his patients.  Or how often someone cries or yells in front of her in response to a simple “how are you doing” type of question.

I guess it isn’t necessarily easy for any of us.

Unless we turn off our emotions.  Which really doesn’t seem like a good idea for those of us living with diabetes since diabetes can take up so much of our brains!  And from the doctors’ side of things; who would want to get into healthcare in order to stop feeling?

It’s a very interesting thing to think about: does how you feel about your diabetes doctor determine how you care for yourself?

I’m sure it does in some ways.  I just hope we are each smart enough to ensure that in the doctor/patient relationship, WE as PATIENTS get top billing every time.

We deserve it!!

Judgy Judge Judged

May 20th, 2011

When you’re a little kid or trying to raise a little kid into a healthy adult, or when you’re an adult trying to stay as healthy as possible with diabetes, the self-care involved gets really old really fast.  But so many of us are doing such a fantastic job despite the endlessness and micromanagement and frequent feelings of failure of our self-care, I think we don’t stop enough to congratulate ourselves.

It doesn’t help when others don’t seem to understand what all goes into life with diabetes or seem to judge us for our lack of perfect results all of the time.

I had a strange experience today when I was on the phone (for two hours) with my new health insurance company and mail-order pharmacy and doctor’s office (and then the mail order pharmacy and the doctor’s office again).  The mail-order pharmacy would not deal with me until I spoke with someone (I think at the pharmacy) in the Diabetes Program.


Maybe I’m old-fashioned, but I don’t like it when someone other than me or my doctor gets involved in my care.  Or when a pharmacy won’t follow my doctor’s orders until I jump through a hoop.

I’m on the phone and the Diabetes Program lady is asking me all sorts of questions.  Questions like “when were you diagnosed?” that I don’t think have anything to do with anything after 23 years and questions like “do you know your most recent A1c?” and “when is the next time you are going to see your doctor?

I was feeling so completely judged by that point I was glad I was playing solitaire on my computer and could disassociate from the phone conversation.

I don’t understand what on earth she needed to know any of that for, aside from data for the insurance company to compile about the Diabetes Program.  And then they’ll mail me junk mail forever about checking my feet or having my eyes checked.

Oh, joy.

I had to tell her twice I have type one diabetes so I check roughly 12 times a day.  She in turn asked me how often my doctor told me to check my blood sugar.

I tried to not sound like the brat I felt when I replied “she told me to check as often as I feel necessary.”

I wonder if I pulled it off.

I think I at least got through the conversation without calling her any names.  I’m going to feel successful just for that!

What Are Health Insurance Companies Paying For?

May 19th, 2011

The title of this article is great news for trainers and type 2 diabetics alike: Structured Exercise Programs Help Lower Blood Sugar, Study Finds.

This is one of those “study of studies” kinds of studies, which I find fascinating in the research field.  Not having any idea how a regular study with actual people is performed, I think it’s entertaining to learn that you can just study the studies other people have performed and call THAT a study and move on.

But that isn’t my point.  My point is: the people living with type 2 diabetes who were told to exercise and what to do didn’t fare as well when it came to their A1c levels as those who were told to (and did) join a “structured” exercise program.

Makes sense when you think about it.

If you told a kid “brush your teeth” and never showed them how or brushed your teeth at the same time as they were brushing their teeth, it would make sense that eventually the kid would stop brushing.  (If they ever started.)

Adults really aren’t all that different than kids!!

If the study participants were assigned to a structured exercise class that included both aerobic and resistance training, they on average lowered their A1cs by 0.67 percent more than the control group. 

Not bad!

Those who were simply instructed to exercise and given advice on what to do lowered their A1cs by 0.43 percent compared to the control group.

Still not shabby.

My favorite part of the article, though, comes in the editorial by another doctor who pointed out that in one of the studies studied the adults who went to a gym two times or more per week for two years, they incurred $1,252 less in health care costs than their less-active peers.


That doctor went on to advocate for insurance reimbursements for structured physical exercise programs.

I couldn’t agree more.  Exercise is a vital part of our health—diabetes or no diabetes—and given the overwhelming evidence in support of lower health care costs (from this and other studies) it no longer makes sense (if it ever did) for health insurance companies to ignore the importance of exercise. 

What say you, Insurers?  Are YOU ready to help us get healthier through exercise??

A Little Perspective is Always Good

May 18th, 2011

We all know that living with diabetes and trying to manage our blood glucose levels as they fluctuate throughout the day with food, stress, sleep, weather, exercise, wow sometimes it feels they change based on how clean our socks are, is simply a struggle.

It’s hard to micromanage our own bodies every moment of every day.

And because I like to keep things in perspective when I begin feeling overwhelmed with what daily life with diabetes really takes, I thought it would be good to see things in a slightly different light.

That little drop right there you might miss at first glance is a unit of insulin.

If I’m off by a unit every day, it will affect me.  If I have that much more than I need, I’m in need of urgent food intervention and if I don’t get it I’ll need an EMT.

If I’m missing that one unit every day, I will suffer the more traditional long-term complications in the future we’ve all heard about because the glucose in my bloodstream will damage my micro- and macro- vascular systems.

And I take the units through my pump in increments of 0.05 units.  (I didn’t even try to take a picture of that!)

It isn’t very much, is it?

The bigger drop here is 40 units, the average amount of insulin I take every day.

40 units of insulin-- my daily average

It’s amazing how much thought we each put into our lives with diabetes, isn’t it?  Sometimes getting a little perspective and seeing what a massive task we have on our shoulders can help us see that it makes perfect sense we don’t “get it right” all the time.

We’re doing a pretty complex thing here on a fairly minute level.  Most people don’t even realize how much work we are doing in our brains all day every day just to balance our blood sugars with this infinitesimally small tool that is keeping us alive.

I think we’re each kind of amazing just for that—not to even mention our regular lives!!

Yup, we rock.

New Wacky Thing I Did When Checking My BG

May 17th, 2011

I did something yesterday that I’ve thankfully never ever done before when checking my blood sugar.

It was totally weird; almost like when I had that black dot on my finger for what felt like months.

I really hurt my finger!!

Not with the lancet, either.

No, I hurt myself when I was trying to get blood onto the strip!

I guess I squeezed and turned my fingers and hand just so, and I heard something pop, and I felt (omg ewww) gristle or something and it really HURT and now I have a bruise on my knuckle.

 I must have broken a blood vessel of some sort.  Geez.

A person shouldn't be able to do this to herself.

I hit the roof every time I wash my hands and try to dry them off with a towel.  It’s that sort of pressure and twist combination that really does it.  Ouch.

Now, please don’t say it must be because I’m older now after my birthday last week—that just isn’t fair.  I could have done this at any time and at any age.  I just haven’t ever done it before, and it hurt a lot so I’m hoping to never do it again!!

(You can, however, commend me on my massive strength.  Tee hee; that’s what my husband did!)

Of course, it was on one of my favorite fingers that I’ve probably used more than any other in my 23 years with type one. 

And, of course, I was checking in front of someone who had never seen me check my BG before.  So I was acting all brave when what I really wanted to do was hop around and whine like a six year old.

I do have favorite fingers to use to check, and here is probably my MOST favorite and I’m busy breaking it.  Sigh.

It was just so weird.

It’s a good thing I have nine others to use while I wait for it to piece itself back together.

Diabetes is weird.

Almost There!

May 16th, 2011

I ran less than 17 miles yesterday.  Do you know what that means??  It means I’m getting really close to the marathon—it’s TAPER TIME!!!  My longest runs have already been completed and after months of slowly gearing up for the Memorial Day event, now is the time for me to ease back and rest up.  Fun!

However, I did not have a great time out there yesterday.  Sure, I missed out on the rain, which was fantastic, but it was still me running the same routes I’ve been running for the past what seems like eternity.  I let the boredom in and it was almost all over right at that moment.

Training blahs have set in with a vengeance.

I shouldn’t be concerned about the training blahs: I know I’ve been here before, and I know I’ll be there again.

What I CAN do at this point is remember to simply plan better.  It seems I have to keep re-learning the same things as I search for balance between being too rigid with my training and too flexible:

1.       Plan a fun new run.

Sometimes I wonder why I don’t listen to my own advice!  I don’t vary my routes significantly in large part because I don’t like to drive someplace to start running.  That means I’m limited to where my two little legs can carry me, leaving from my front door.  Granted, the farther I run while preparing for a marathon the more sights I can see, but those first few and last few miles are always either on route A or route B.  Yawn.

Yesterday I left my house without a firm route set in my mind.  That wasn’t a great idea, because I let boredom get the better of me!  My “oh, I’ll just see what happens” was really not a good way to plan for 16-18 miles. (I ended up getting in just 16.7)

2.       EAT no matter what my blood glucose levels are.

I think yesterday that was my biggest blunder.  I had eaten oatmeal before I left and didn’t bolus for that, so I knew I had enough glucose in my body to get through the run.  Looking back at it, I see that I did just fine keeping pace for the first 75 minutes before I let myself stop due to boredom and never really got anything back to where it had been.  I kept stopping and starting for a variety of reasons, but I’m betting that if I had taken a little extra insulin and eaten something at mile 4-5 I would have had a much better time of things, and wouldn’t have lost the mental or physical edge. 

3.       REST an additional day if necessary.

This advice I DID take this past weekend.  I have two days I can run in the mornings: Saturdays or Sundays.  (The other mornings are full of bootcamp!) That means that Fridays I generally spend thinking about where I’m going on Saturday (as I really do usually plan a route!) and trying to rest up. 

But the previous weekend I didn’t rest when I should have, and just stuck to my plan of going on Saturday when I probably would have done better had I run on Sunday instead.  This weekend, I knew on Thursday evening I shouldn’t run on Saturday because of the way my legs felt.  So, I saved it all for Sunday instead.  That was smart of me, because at this point, I’m not into getting hurt and not being able to participate in the run!

Like I said, it’s a balancing act to train for a marathon.  Thankfully, I’m almost there.