Real Talk with Dave: Sick Days

One of the things I hate the most about Diabetes are the sick days that come with the disease. They don’t happen everyday, and they may not happen very often, however, when they do show up at random, it can be one of the things that make us Diabetics feel like we are incapable of doing what we want to do.

I’m talking about the days in which we may wake up with a super high or low blood sugar that just drains us physically.

These sick days may not even start at the beginning of your day. It can happen at pretty much any part of the day and for some reason, that high or low that you may be experiencing is that like no other. They are not like the typical, daily highs and lows. For some reason, these bad blood sugars “hurt” in a sense and make us feel so horrible, that we practically have to put the day on hold.

This issue has been something that I have been dealing with lately and some non-Diabetics may not understand truly just how difficult these days are.

I struggle very often with waking up from a high (weather it be from over treating a low during the night, to simply having my pump site needing a change), and for some weird reason, waking up from a high physically hurts more than a high appearing throughout the day. Once I am awake and conscious of the fact that I am high, I get the worst headaches and nausea I can ever experience.

For some, waking up high has become normal and their bodies may have even gotten used to that fact, but for others, when all seems right and their numbers may be on track daily, having these unexpected bad blood sugars can ultimately determine their day. Don’t get me wrong, I know we all try our very best every moment to have good numbers, but over the years, I have met and heard of other Diabetics say how they feel “safer” in knowing that their numbers are a bit high at night, as they don’t feel lows and don’t want to not wake up in the middle of the night if needed to treat a low. I completely understand that view, however, making sure you don’t go too high is also a factor to keep in mind.

Symptoms that are a result of these “sick days” include headaches, dizziness, dry mouth, nausea, tiredness, lethargy, and the list goes on.

Each person is different and may experience their own unique symptoms, however, finding a way to cope with your own unique challenges and feelings is necessary to establish ahead of time so you can be prepared when you are surprised by a sick day. At times, you may feel the need to push through these bad days and try to make it through the day, all while hurting inside from how your Diabetes is making you feel that day, but it is necessary and simply okay to take a step back and put things off for a bit until you are back to normal. The people you encounter daily should be understanding and supportive, making it easier on you to take the day off, essentially, and restore your health until you’re up and running again. You may have to skip school, work, or even an outing with your friends, but that is just fine as you won’t be you if you’re not feeling good and you may not even enjoy it.

The days in which you experience these sick days, you may feel ashamed, down, and depressed. Don’t be, though! It is not your fault.

No one is at fault, actually, because you didn’t choose to have Diabetes and you certainly are doing whatever it takes to control your Diabetes daily and that in itself is amazing. We all make our own types of sacrifices over the years to better manage our Diabetes, so don’t sweat it. Yeah, you may feel down at the moment, but remember to get back on your feet and try again.

So if you are feeling sick one day due to any Diabetic complications, take it easy. You work hard at your Diabetes, that every now and then, a break to rest and recover is necessary.

Live well,

Dave

Oh No, I’m low!

Being a Type 1 Diabetic for almost eight years now, it’s second nature. Nothing phases me anymore, not even ignorant comments or grueling routine blood draws. As anyone reading this post who either has T1D, or is close to a T1D, knows, there becomes a point where it just becomes a part of you.

I no longer have diabetes; I am a diabetic.

This feeling of figuring I know the way the disease will manifest itself in my day to day life, can quickly shatter as soon as diabetes makes me feel weak.

Being low is never a great feeling, not before or after you down two juice boxes and half a tub of peanut butter without realizing it. Lows as a collegiate athlete are much worse. Learning to combat the shame I feel when I have a 40 mg/dl blood sugar reading half way through a two hour tennis practice, and have to sit out for twenty minutes is an uphill battle. This shame is not induced by anyone but myself, though. The feeling of sitting out when the rest of my team is out practicing, is one of the few times I feel disabled.

I often sit there, repeating thoughts in my head, such as, “You are an idiot for taking insulin before practice”, or “You are pathetic; buck up and get out there”.

However, I am not pathetic. I am not an idiot. In fact, I am someone without a full-functioning pancreas.

I am a someone who has to alter their daily life significantly because of an illness that I did not cause. On top of all of that, I do all of the other things my teammates do, and succeed as a collegiate student athlete.

So where does this shame stem? As a seasoned T1D, I put unnecessary pressure on myself to be perfect, and to get angry with myself for the lows and highs. Having many other T1D friends, I know I am not the only one who does this. These feelings of shame creep up often  during a low on an important test, or during a tennis match, where I am representing my team and university.

While I cannot say the “shameful lows” are completely gone, as I head into my final year of school and as an athlete, I can say, they have substantially lessened in my four years in college. Instead of getting angry at myself for the low blood sugar, I shifted the internal conversations to question why I’d gone low and how I could better prepare for next time I was in a similar situation.

In shifting this focus, I now see lows and highs as a learning and growth opportunity. For highs (which are usually due to adrenaline) during matches, I think of diabetes as a mental game with myself, and laugh off mistakes instead of letting the anger get to me or my blood sugar. For lows, I have tailored my diet and eating times substantially to set me up for success in the classroom and on the court.

Shifting my focus from negatively viewing the disease’s impact on my physical and mental health, to seeing T1D as a way to better understand my body, has helped my mind and my a1c.

Real Talk With Dave: Battling Blood Sugars

Over the last few weeks, I have been struggling with managing my blood sugars and I have been finding it to be very difficult and frustrating to find peace with my numbers. Having moments in your life where your Diabetes isn’t exactly where you would like it to be can have a negative effect on your blood sugars and make you realize just how much we need to push for a cure on T1D. We all have different lives that we live, making T1D somewhat of a big annoyance if one cannot handle their Diabetes effectively. Just know, it’s not your fault and time will pass where you overcome these bad moments with your numbers or whatever else T1D has to throw at you and good things will come, making you feel confident and empowered in handling your Diabetes the way you are used to.

            Every now and then, there comes a time in the lives of those living with T1D where changes come, such as numbers reacting a different way than they used to when you would eat or do something you always did, finding that you need to alter your doses or planning a bit, just to get the numbers back to the way they were.

Some may find that certain brands of Insulin don’t work the way they used to anymore, causing you to search for another brand that is just as effective as your previous Insulin before the change happened. These are just some examples that, like it or not, do happen with Diabetes, making life more stressful and overwhelming at times.

This past week, as I was driving to class, I noticed my Insulin pump site had ripped out while in the car. I had only 5 minutes to get to class and change my site out for a new one. You can only imagine the amount of stress and pressure that was on me at that time. I got to my school and parked, grabbed my emergency kit in my car, and changed my site out in about 2 minutes. Though I got to class just in time, my numbers were going sky high prior to the sight ripping out, even though I took my Insulin.

Then, on my break, I quickly checked my BG and found my blood sugar at 426 mg/dL.

My new site apparently hadn’t gone in properly and effectively, resulting in my numbers to go that high. I then tried just about anything to get some fresh insulin flowing inside of me as I still had another hour of class that afternoon. Unfortunately, my numbers continued going up pretty fast and halfway through that hour, I had to leave class early and rush home to get access to some fresh new Insulin and an all new site, which by then, my number had reached 490 mg/dL. I was alarmed, felt very sick, and was ultimately drained as I hadn’t been that high in a while.

Rest assured, all is well now, however, through that experience, I came to a point where I was feeling very unhappy with my numbers and how I was feeling most of the time, that I decided to make a change in my doses. Though I changed them, I have still been dealing with some high numbers here and there. These are the struggles we go through on a day to day basis that sometimes go unnoticed.

Diabetics are warriors that face these challenges regularly, but as we battle with our numbers and overall well being of T1D, we are here to make a difference and inspire others.

We are more than capable of turning Type One into Type None. Due to many days of feeling weak, sick, and unstable, it can be hard to enjoy life as we are in a constant battle with our numbers. It can be a constant struggle and challenge in one’s life, BUT as some like to say, we are blood sugar warriors. With constant support and encouragement from one another, as well as hard work and effort in our health, we are capable of change and well being. It just takes time (and lots of it), but at some point or another, things DO get better.

Enjoy the good times, learn from the bad, and strive to make a difference as a Diabetic as we patiently wait and push for a cure!

Live well,

Dave

Real Talk with Dave: It’s a Spooky Time for Spooky Blood Sugars!

It’s finally fall and most people are especially excited that October is here, which means Halloween time is present! Everywhere you go, there are Halloween themed decorations and pumpkin spice latte creations, making everyone excited for the holidays and the exciting festivities that come with them. Many people get into the spirit of Halloween, the costumes, the candy, and the fun times with friends, however, being a Type 1 Diabetic comes with just a few extra things to plan and prepare for.

I think it’s safe to say that us Diabetics work hard each day, so the one night where candy is the star of the show, I believe it is okay to enjoy some Halloween treats in moderation.

Planning ahead is key as you begin to make arrangements for Halloween.

I get it, Diabetes is not fun, it can be scary and have it’s ups and downs, however, it shouldn’t stop you from celebrating a fun holiday! For example, most Diabetics try and avoid unnecessary sugar throughout their day and watch out for things that can complicate their lives in terms of their blood sugar levels, BUT, if you plan on walking from door to door on the night of Halloween, you will be getting in some exercise, which may potentially drop your blood glucose levels, so go ahead and enjoy a piece of candy or two (and some insulin, of course). Don’t over do it though, because you don’t want to come back home that night or shorten your trick-or-treat experience due to severe high sugar levels and a stomach ache. That’s why, in moderation, eating a few pieces of candy throughout the night and finishing the rest of it over the course of the next few days is a better alternative in managing your numbers. Halloween is a fun-filled holiday where people go out dressed as their favorite characters and hang out with friends, eating candy all night, and T1D should not limit that, just be responsible in your choices as you decide how much candy to eat and when.

As you go from door to door, it wouldn’t hurt to have a backpack or purse with you that has all your emergency medical supplies, your blood glucometer, and some extra insulin, because you never know what could happen and not being at home with access to these supplies can be dangerous, so always prepare for the worst, just like you would at school, work, or on a vacation. Also, make sure you are walking with a group of people who know of your Diabetes and limitations, as in certain situations, them knowing can potentially save your life, say if you were to go severely low or high that night.

Always surround yourself with a trusted group or people (or at least one person) who is willing to help you out in any way possible if needed.

As for carb counting and sugar contents, most Halloween candies are familiar and of common brand names, so just be sure to check the nutrition facts on the back of the wrapper or do a quick google search on your phone for nutrition facts on the candy of your choice, this way, you can effectively and safely give yourself the right dose of Insulin needed for what you choose to eat!

In terms of costumes (that’s right, I’m discussing costumes), if you are unsure of where you may place your Insulin pump or carry your Continuous Glucose Monitor (CGM) if your costume is a little out of the ordinary and has no waistline or belt clip, you can always wear a strap, band, or garter underneath your costume, which provides a place to clip and secure your devices, and don’t be afraid to show off that beautiful site of yours! You can even decorate your sites for the occasion or to match your costume if you’d like!

            So don’t stress the holidays, take part in all the activities your heart desires (within reason, of course), and enjoy this life you were given! T1D has nothing on you.

Enjoy some Halloween candy responsibly, because yes, even Diabetics CAN eat candy! With smart choices and planning ahead, you can do the holidays, life, and just about anything you would have done had you not had T1D!

Live well,

Dave

A day in the life of a type-1 diabetic

It’s already been established that Diabetes is a disease that we, who have it, cannot run away from. We have to deal with it and we have to maintain control non-stop. There is no taking a break from it.

I am 24 and have been diabetic since I was 11. I have been alive with diabetes longer than without, and yet, in my head, the “normal” life is the one I had before.

I am currently treating my diabetes with insulin pump therapy (the pump is a little machine that never leaves me – it constantly injects tiny little doses, known as basal, as well as some extra insulin when needed, for meals for example, known as bolus). I use a blood glucose monitor called FreeStyle Libre, which tests my blood via a sensor on my upper arm. With this machine, I do not need to prick my fingers to draw blood (although I still often do, as the sensor readings are often less accurate than the finger-pricking ones, unfortunately), and I can check the trend of the last eight hours, which is very helpful to understand where I am going and prevent a high or a low.

My diabetes and I have a love/hate relationship. I “love” it because it taught me how to be strong, independent and proud. But I hate it because as much as it gave me strength, it gave me weakness too.

As much independence it gave, it brought me on my knees countless times, forcing me to seek support from my family. And no matter how proud I am of who I am today, it sometimes happens that I let my diabetes catch-up with me and I feel raw, deep shame. Shame for my own lack of control, or judgement, leading to a hypo or a hyper. Shame for my scars. Shame for my sensors adorning my body constantly.

But despite this hate, I try to live my life with my diabetes, not against it. I try to wear it as a badge of honour, even if my will sometimes falter. And then come the darkest times. No one is my friend and no one can understand. What a selfish way of seeing it… I have to snap out of it and remind myself that I am not a burden. We all have our battles to fight, it just so happens that mine is diabetes. But the support and love I get from my family and friends, I give back to them in their own battles (I hope so, at least).

Let me just give you an incentive of a normal day for me. I am about to write my Saturday as I lived it, but as some of you may not be familiar with some technical terms, here is a couple of numbers that might help you. When I talk about BG, I mean blood glucose or blood sugar. A low BG, or hypoglycaemia, is anything below 4.3mmol/L. Anything over 9mmol/L is a hyperglycaemia, or a high. As a diabetic, my blood glucose can go as low as 1.2mmol/L (personal lowest) and as high as 33mmol/L (again, not proud, but personal highest). When I talk about inject insulin, I write U, for units.

8am – I wake up, just minutes before my alarm. I usually like waking up before my alarm. It gives me a sense of pride – a proof that my subconscious knows my routine, that I don’t need a machine to help me wake up, that I have slept the right amount of time. But today I do not feel pride. I cannot see clearly, everything is blurry and my eyes do not adapt to the sunlight as they should. Even before feeling anything else, I know what that means: I woke up with low sugars. And true enough, when I test my sugars, the little monitor makes an unhappy sound. It blinks my number: 2.8mmol/L and it displays the pattern of my last 8 hours of sleep. I have been down for 2 hours. And I have not felt it until now. That is worrying. I’ll have to mention it to my endocrinologist during our next appointment. But I shrug it off.

The main focus right now is to treat the hypo. I reach for the candy beans I keep close to my bed, in case of emergency. While I wait for the sugar to reach my bloodstream, I mumble and grunt. This is no way to start a day. I feel weak, shaky, dizzy, my muscles ache, and I am irritable.

8;15am – Time for a check-up. But I am feeling somewhat better so I know I am going up. Beep-beep: 3.4mmol/L. Still low but I have to start moving. Work doesn’t wait. I gobble another couple  of beans and start to freshen up and dress up. I usually shower at night, because I am not a morning person and I know I’d hit the snooze button way past shower time. It works out fine today as I just lost 15 minutes lying in bed waiting to feel a tiny bit better, let alone, go into a shower where I could slip.

8:25am – It’s not been 15 minutes yet but I can’t wait. I hate running late. Beep-beep: 4.2mmol/L. That’s good enough. Like very often, I am not hungry in the morning, but this time I cannot skip breakfast. I take a slice of chocolate chip brioche out of the bag, quickly pour and drink a glass of orange juice, and leave the house, brioche in hand.

9:40am – I am at work, with time to spare. I did not miss my bus, nor my train, and it takes me only 12 min to arrive at work from the station. I ate my slice of brioche in the train, read a couple of chapters and even surfed my Facebook. I finally sit down at the back of the store, in which I work full-time. I have some 20 min to prepare for the day. I check my glucose again. I do not want to have a hypo in the middle of my shift, in front of my co-worker and customers, and I do not want to have a hyper either. I have not yet injected for the piece of brioche. I am not even sure I will need to. All depends on my sugars now. Hence the third check of the day. If I’m around 8 and it looks like I’m going high, I will need to have a bolus. But if not, then the brioche’s carbs will have helped me get out of the hypo. Beep-beep: 6.7mmol/L. Finally, a good number. Despite the bad beginning, I am now feeling relieved and ready to tackle my day.

10am – The doors are open, I let the customers in, and I note half-jokingly to myself that I should write about a day in a retail worker’s life too. We witness the weirdest things. That’d make a pretty funny article.

11:40am – I am so hungry. But I try and ignore my stomach, as well as my lovely co-worker who just brought some snacks from the store next door.

It’s ok to give in and have a snack, but if I do, I have to figure out how much carbs I’m ingesting, and really, who wants to do maths before stuffing honey- roasted cashews down one’s throat?

I’ll avoid the counter area until lunch time, meanwhile there’s plenty of stuff to do on the floor.

12:05pm – That’s it? Not even 30min have passed since I realised I was hungry… Today I will be the second one to go on break… With the breaks starting at 12:30pm and lasting 45 min, I’ll have mine at 1:15pm. Nope. I can’t wait that long. I disappear for a minute and go in the staff break-room. I reach into my bag and take my diabetes pouch out. I take the monitor to my arm and wait for the expected “beep-beep”. But not this time. This time it’s a “Beep-beep-beep” that’s ringing… It’s an alarm to remind me to change my sensor in 3 days. Great… Another $90 to cough up… I press ok, and the screen displays my glucose. 9.1mmol/L. I look into my Calorie King App to estimate the intake of carbs. [Serving size: 10 whole nuts – Total Carbs: 6g / serving]. Let’s assume I’ll eat about a hand-full, seems to me that’s about 25 nuts, makes 25g of carbs. I enter my blood glucose and my carbs intake in my pump and it does the rest of the work for me. It’s injecting 2.65U. 1.45U for the carbs and 1.2U to correct my BG, according to my own personal settings. Bless the genius minds of the scientists and medical engineers who have concocted this little gem of a machine. I press ok and feel the insulin being pushed under my skin in my belly. I hurry back on the floor. I don’t want the girls to think I’m giving myself a break at the back. That took about 5 min and even though they never complain or even seem to notice my little disappearances, I try minimising them as much as possible because I feel it’s unfair for them. I am back, and can now enjoy those hard-earned cashews.

1:15pm – My co-worker has come back from her break and it is now my turn. I hurry to the break- room, wave my machine to my arm, check the number (7.3mmol/L – perfect), take my wallet and go buy a nice, warm lunch in the food court. I opt on the spicy pumpkin soup with toast that’s smelling so good from their counter. When I bring my own lunch, that I cooked myself, I know the estimate number of carbs. Or when I buy ready-to-eat meals (yes, I do eat those too, I am not perfect), I just need to look at the nutrition info label. But today, I ask the girl who serves me if she knows what the carbs count is. She stares at me with blank eyes, then shrugs. A couple of years ago, I would feel the urge to explain my odd question. But now, I don’t care what she thinks. I take my phone out and look the information up onto the same App as before. 1 cup of soup is 16g of carbs. The soup is a big portion, I’d say 2 cups, that makes 32g. 1 slice of white bread (is my bread white or wheat? Does that make a difference? I wave it off, if there is a difference, surely it won’t be a big one) is 10g of carbs. That makes a meal of 42g of carbs. Again, I enter all this information into my pump and I’m all set. I sit down at a table and starts eating my lunch, while enjoying my book. After I am done with my meal, I set off to the break-room and look at the remaining time for my break. About 15 minutes. Good. I can relax and continue reading.

1:56pm – My break is almost over, I want to check my blood again. Yes, I know, again.

Normally when I started a day with a hypo, you can be sure a hyper will follow, as a bouncing effect.

This morning it hasn’t happened, so I’m cautious. And, you see, I am weary of hypos and hypers, especially in the workplace. I don’t know if it is just me, but I want to prove that my diabetes does not affect my abilities, and so I am very vigilant. And also, it is not really pleasant to experience. Beep-beep: 8.7mmol/L. Nothing wrong going on here. I am ready to head back to work.

4pm – The store has been quite busy for the past few hours. Late Father’s Day shoppers is my guess. While most of the time, the customers are happy to wander in the aisles, browsing, today, we do not even have time to ask them if they need assistance, they go straight to us, with a very specific book in mind. A book that we then have to find out the location of, if it is even in stock. As soon as I am done with one customer, another jumps in. I have been thirsty, so I fetch my bottle, and even though I would like to check my blood again, I hear a bell at the counter, which means I am needed there. I hurry back, sipping my water while making my way to the front of the store. My sugars will have to wait.

6:12pm – It is closing time. Finally. The girls and I are exhausted. The customers sometimes seem like leeches. They are in hurry, very demanding and feel entitled to pristine customer service, and the want it now. The day has been long and draining. I close up the store and head off to the station. I have a dinner with friends outside of town and I don’t want to be the last one arriving. While walking, I reach for my monitor and check my glucose:14.6mmol/L. Uh-oh… that piece of bread did seem quite large and it was soaking in butter… Plus the stress of the day, I guess. But all that is guess-work. So uncertain. In defeat, I enter my blood glucose level into my pump and it tells me to inject, which I do.

The train ride is about an hour, I will have gone down by then, hopefully.

7:20pm – I’ve arrived and first thing I do after kissing hello to my friends and offering my help, is to check again: 10.2mmol/L. Gowing down, good. If it hadn’t, then I would have had to check my insulin line, maybe even change it… Not what you want to do during a friend’s dinner party. I enjoy the appetizers, wine and conversation, keeping track of what I put in my mouth. I will need to remember everything for the meal bolus, when the rest of the guests have arrived and the food done cooking. I play with their son, a 4-year-old bundle of joy. As we play, he notices my line, and tries tugging on it. “What’s that?” I try and explain to him that I am sick and this is my medication. He looks at me, dubious. “No you’re not!” Again, I try to explain that I am sick inside of my tummy, and I show him where the line goes in. I want him to know that there is nothing to fear about me. Kids are very observant and they are smarter than we give them credit for. If I explain to him, He will get it, even if not in details. But if I try to hide my tummy, and change the subject, he will remember. Very delicately, I let him touch the pump and the cannula site. And then I let him wave my monitor to my arm to test my blood. “I am your doctor!” He exclaims happily. The incident is past. The mum is proud of her son’s reaction. I am proud of mine.

9pm – I start feeling weak… The food has just been taken out of the oven. We are a bunch of Europeans and Brazilians, we eat late. Which would have been fine, if I had not assumed they would want to eat early to accommodate their boy’s schedule. But I did, and I pressed OK for the bolus to correct my previous hyper. I wanted to take a proactive approach and think ahead, but it backfired on me. Now, I test my blood: 3.4 mmol/L. I have to drink sugar and water, while my friend looks on, worried and apologetic. I don’t want her to feel bad, so I smile and try as best as I can to reassure her. “I’m Ok” I mouth to her from across the table. I know that the next few moments are going to be critical, if I want to avoid doing what I call the yoyo effect, which is bouncing up and down (my blood sugars, not actually me) for the next, I don’t know… 12 hours? So I refill on sugar, and start eating my meal hoping it’ll make my glucose steadily go up, until it is safe for me to inject for the meal. The meal itself is pretty lean. Probably about 40g all in all, counting the puff pastry crust, the gravy and side of pasta. But after 10 minutes, I am still feeling tired. I check my sugars and they are actually getting lower 3.0mmol/L. That’s when I get frustrated and worried. Why can’t I enjoy a nice dinner with friends?

I almost want to just let myself stay on high next time. Wouldn’t that be easier? I don’t really feel the high until it is too high…

But deep down, I know that is a very dangerous road, and I do not want to venture down it ever again. I drink my sugary water. I know I look pale and I am very quiet, and my eye socket are grey and I look like a ghost of myself only a few minutes ago. But I do not want to deal with the stares right now. I ignore the stares. After a few more minutes, I feel better. Even if my body hasn’t moved from that chair, it feels like I am sitting down at the table after vanishing somewhere. I join the conversation again, laugh at jokes (weakly at first but then with my usual gusto), and happily sip my wine. All is forgotten. All is good.

12:30pm – Most of the guests have gone home. My brother has had some wine too and doesn’t want to drive home. He will be sleeping over. I try to decide if I should too. I don’t drive and I usually don’t mind the train… But it is Saturday night and I don’t want to spend an hour to get home, in a train smelling of alcohol and sweat. Our friends have a spare bedroom for me too, so I decide I’ll sleep over too, even if I was craving my own bed tonight. Tonight, was not a wild night but I did have some wine and the alcohol does bring my sugars down. So, guess what, I test myself again. Beep-beep: 11.3mmol/L. That is probably the after-effect of my dinner hypo. I decide not to inject, because I fear to go down again because of the wine. I’m hoping by tomorrow, I’ll have come down by myself (and of course thanks to my pump injecting my basal overnight). I am tired and a bit frustrated too. I don’t want to spend one more minute of my night thinking about my diabetes. Obviously, I make mistakes whether I over-think it or not. I keep my bag close to the bed. In there I have my phone, my monitor and a pack of candy beans – in case of an unwelcome overnight hypo. It’s sleep time now. We will see. Tomorrow is another day…

http://mydiabadasslife.simplesite.com/

Real Talk With Dave: I’m Sorry For What I Said When I Was Low…

Lows do things to us that we have no control over. I’m pretty sure any Diabetic can agree with that. When we have low blood sugars, we become, what some may consider, a monster in which we are hit with so many symptoms, such as uncontrollable shaking, fast heartbeat, and anxiety. In reality, going through a low can really bring us down and make us regret saying and doing certain things. I guess you could say that lows can brin out the worst in us.

I can remember countless times in which I went severely low and reacted in ways in which I wish I never had before.

I would become this uncontrollable monster in which I would be angry and very aggressive as I tried to get my hands on anything that could bring my blood sugars back up immediately. Sweat dripping down my face and agitated by what was going on inside of me, I would snap at people trying to help me in those difficult times (sorry Mom!), having absolutely no control over my emotions and actions. There have been several times in which I would wake up in the middle of the night, practically covered in sweat, as I found myself severely low and in need of some fast acting sugars, running downstairs to completely demolish the kitchen. Now I know those are some pretty heavy visuals of what lows are like, but hey, that’s the truth of what they actually consist of and I believe it is important to share these real life experiences to show that we’re not alone in this horrible fight against T1D.

At times, going low can make you anxious and scared, which then gets in your head and almost forces you to snap at just about anybody. You may not want to talk to people or be near anybody as you go through a low as you feel that aggression building up inside of you. That’s okay though, because eventually, you will come out of that low and be better and stronger than ever! I get it, lows are the worst!

I’ve had my share of bad lows and each time, I feel as though I learn a little something.

I learn how to cope, how to relax, and most importantly, how to treat my low in the safest way possible. Planning is key in eliminating the amount of lows you may have. At one point in my life, I used to go low about 4-6 times a day which drained me both physically and emotionally. After talking to my Doctor and gaining control over my Diabetes, I have successfully dropped the amount of lows I have everyday significantly. Some days I might not go low at all! It’s different for everyone, as some people may struggle from highs more than lows, but just know, help is available.

Lows can be some of the scariest things you can encounter as they can happen at literally any moment of the day and be as aggressive and intense as they decide to be. Though lows are one of the hardest things to deal with as a Diabetic, it takes a few bad moments in which we learn how to deal with them as we become more prepared for lows in the future. Most of the time, we as Diabetics can handle and treat a low like a boss, it’s only in severe cases in which we need some immediate medical attention, but it is up to us to decide how we are going to handle the situation we are given. For example, talking to yourself in a positive sense, whether out loud or in your head, can help you get out of that horrible low and into a good mood. Try telling yourself when you go low how you have always made it out of a low and ended up feeling just fine.

So don’t stress low blood sugars! Lows will come and go, but YOU, a strong and brave Diabetic, are here to stay as we patiently wait for a cure together.

Live well,

Dave


Follow Dave on Instagram: @type1livabetic

Real Talk With Dave: Loving Your Numbers!

As a Type 1 Diabetic of 9 years, I have had certain time frames in which my numbers were wonderful, and times in which I just could not gain control over them.

Most Type 1 Diabetics are diagnosed at a very young age, which makes it a bit more difficult to gain control over their blood sugars as they are, in reality, kids who just want to be kids. This disease takes a certain part away from you, and most T1D patients hardly remember a childhood without Diabetes. Wanting to go out with friends, sports teams, or on field trips make it hard to stick to a day to day regimen and diet, which then causes blood sugars to spike up and crash from time to time. At some point (and we each discover that point in our lives at a different rate), we need to find a common ground between living and loving our numbers. It can be tough, time consuming, and overwhelming to have to figure out what works out for each individual person and the way their body reacts to certain things, but at one point in time, your numbers will cooperate if you set your mind to healthy living.

What it takes is self-discipline.

Just a few weeks of training your mind to carefully watch your numbers as they change throughout the day (maybe by monitoring them on a continuous glucose monitor (CGM)), sticking to a healthy diet consisting of different nutrients that are beneficial to a person with T1D, and figuring out what truly works best for you can be all you will need in finding happiness with your numbers. I’m not saying you have to give up your favorite dessert or be on a strict health plan in order to work towards those better numbers. What I am saying is that in moderation, anything can be done. I for one can not give up my favorite food (sushi), which can be very high in carbs and tricky to calculate how many carbs I am eating, so that is what I may call a “cheat meal” in which I accept that fact that my numbers may go a bit higher than usual, actually much higher than usual, but I am able to let it slide.

Us Diabetics work hard each day just to stay alive, so every now and then, it’s okay to have a day where we eat what we want and however much we want

…just as long as you do get back in the zone of those great numbers.

I can remember countless times in which I would have a determined mindset which allowed me to gain the numbers I wanted, but then there were also times in which I simply did not care about my numbers, diet, or exercise plan, but you know what? That is absolutely okay. We all go through a burn-out period and it does get in our minds and makes us think we are failing on our bodies, but we just need to find out what inspires us to pick ourselves back up and start over again.

Something that helps me is that if one day is really tough and I just cannot seem to get one good blood sugar reading that day, I tell myself how it’s okay to continue the rest of the day with not so good blood sugars, as safely as possible, just as long as the next day, I start fresh and new and treat it as a blank page in a notebook, allowing me to make better choices and plan ahead for the day and what I want it to look like. Highs and lows come from a number of different causes, such as different foods, exercise, stress, and sickness, etc. That is why as much as we try to gain the control we need, some days just get the best of us and don’t allow us to truly live. But we are human. We get sick. We get stressed out. We are active. So as hard as we try, it may not work out the way we intended it to work out, but again, that is absolutely OKAY.

Nobody is perfect.

There are no Diabetics out there who have mastered T1D completely as this disease is aggressive and doesn’t care how long you’ve had Diabetes for.

It is not an easy thing to get right away, but eventually, accumulating as many “good” days as possible makes it easier to overlook the bad days. Days will pass in which you may feel like giving up, but you have to remember who you are here on earth for: your parents, friends, family, and ultimately, yourself. The better the numbers, the better (and longer) the life you will be able to live.

So go ahead, work towards those amazing blood sugars that you are capable of!

Live well,

Dave

Break the fast if you have hypoglycemic symptoms, experts advise diabetic patients

Break the fast if you have hypoglycemic symptoms, experts advise diabetic patients
Islamabad

Fasting is generally very challenging for people living with diabetes, particularly insulin-dependent patients with Type 1 diabetes. Diabetic patients who wish to fast must diligently plan for a safe Ramazan. It is important to individualize each patient’s management plan, depending on their diet and lifestyle, medications, risk of hypoglycemia, and glycemic control, and to minimize complications associated with fasting. Generally, the risk of hypoglycemia and hyperglycemia in patients with Type 2 diabetes is not overly common, and has less severe consequences.

Consultant endocrinologist at Shifa International Hospital (SIH) Dr. Sheraz Khan shared this information at a seminar on ‘Roza aur Sehat,’ organized to create awareness in diabetic patients who intend to fast without harming their
blood glucose level. A large number of patients, doctors and people from various walks of life attended the seminar.

The approximate number of Muslims with diabetes is around 4.6%; an estimated 50 million Muslims with diabetes around the world observe fasting during the month of Ramazan each year, Dr. Sheraz shared. Islam exempts people from the duty of fasting if they are sick, or if fasting affects their health, as fasting for patients with diabetes carries a risk of an assortment of complications including hypoglycemia, postprandial hyperglycemia, and metabolic complications associated with dehydration.

Nevertheless, a large number of people with diabetes still choose to fast during Ramazan despite the advice of their doctor and permission from religious authorities, thus creating medical challenges for themselves and their healthcare providers. It is thus important for such patients to make necessary preparations to engage in fasting as safely as possible, Dr. Sheraz underlined.

Consultant endocrinologist at SIH Dr. Tayyab Badshah said, patients may be reluctant to self-monitor…

Suicide by insulin a risk in people with diabetes

Experts warn that insulin can be abused by people with diabetes istockphoto

Insulin typically saves the lives of those with diabetes, but it can also be a way for some people to kill themselves, a new review warns.

People with the blood sugar disease tend to suffer higher rates of depression, the researchers explained. And suicide or suicide attempts using insulin or other diabetes medications that lower blood sugar levels may not always be an easy-to-spot attempt at self-harm, they added.

“Some suicides with insulin are likely missed in people with diabetes, just as [suicide may be missed] in people without diabetes using other medications or after a car accident. Could a suicide using insulin be missed? Absolutely,” said Alicia McAuliffe-Fogarty, vice president of lifestyle management at the American Diabetes Association.

Insulin is a natural hormone produced by the body. Its job is to help usher the sugar from foods into the body’s cells to provide fuel for those cells. But insulin is also a complex medication.

People with type 1 diabetes no longer make enough insulin and must give themselves insulin to stay alive. People with type 2 diabetes don’t use insulin efficiently — this is called insulin resistance — and eventually don’t make enough insulin to keep up with the body’s demands. At this point, people with type 2 diabetes also need to take insulin.

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Insulin can be given by multiple injections every day or via an insulin pump. Insulin pumps deliver insulin through a small tube that’s inserted under the skin. The site of the insulin pump must be changed every few days. But once the tube is in, someone who uses an insulin pump only needs to push a few buttons to deliver a dose of insulin.

However, getting the right amount of insulin is no easy task. Many factors affect the body’s need for insulin. Exercise decreases the need. Foods that are higher in carbohydrates increase the need. Stress and other moods can affect the need for insulin, as can illness or hormonal shifts, such as those that occur with menstruation.

People with diabetes often have to make adjustments to their insulin doses. If they make a mistake and take too much, an extremely low blood sugar level (hypoglycemia) can occur. If they give themselves too little insulin, their blood sugar levels rise (hyperglycemia). Either condition can be very dangerous.

According to Dr. Alyson Myers, director of inpatient diabetes at North Shore University Hospital, in Manhasset, N.Y., “If someone comes in with hypoglycemia, you think, ‘Oh, they overdid it.’ And, sometimes when people come in with hyperglycemia or DKA (a complication of hyperglycemia), the intention to self-harm can be missed.”

Myers is also the lead author of the review, published recently in the journal Current Diabetes Reviews.

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It’s not clear exactly how high the rates of suicide are in people with diabetes, though Myers said the rates are higher than in the general population.

Plus, an attempt at suicide using insulin or other blood sugar-lowering medications may ultimately fail. “The body is a resilient thing,” Myers said, explaining that the body has ways to protect itself, such as releasing a natural form of sugar from the liver.

Instead of automatically assuming there was an error in care, Myers recommended that physicians consider the possibility of a suicide attempt or self-harm through the use of insulin and other medications.

She suggested that doctors follow the guidelines from the diabetes association on psychosocial care for people with diabetes that includes a multi-disciplinary team, including a behavioral health specialist.

McAuliffe-Fogarty agreed that when doctors see patients — whether it’s in the hospital or for an office visit — they should screen for psychosocial concerns.

If a doctor identifies a potential concern, “refer to a mental health care provider so people can get the help they need to live a full and happy life,” she said.

Given that 20 percent to 25 percent of people with diabetes screen positive for depressive symptoms at some point, people may need help sometimes.

“If you see signs of depression, changes in people’s sleep patterns or eating behaviors, a loss of interest in things they once enjoyed; if they say things like, ‘when I’m not here things will be better,’ or express an intention to self-harm, make an appointment with a mental health-care provider. People often need some help coping and figuring out how to deal with things,” McAuliffe-Fogarty said.

“If you’re very nervous that they might harm themselves, call their doctor or bring them to the hospital. Or call 911 if you think they’re in immediate trouble,” she advised.

If you’re concerned that a loved one or friend may be considering suicide, McAuliffe-Fogarty said it’s OK to ask, though some people consider the word suicide to be taboo. “Ask, ‘Are you thinking of hurting yourself or thinking of not being here?’ Sometimes people are relieved and will open up.”

But McAuliffe-Fogarty also cautioned that every misuse of insulin may not be a deliberate act of self-harm.

“It’s not always self-harm or a suicide attempt,” she stressed.

One such example, “Some people use insulin omission to lose weight. It’s a type of disordered eating, but they’re not trying to hurt themselves,” she explained.

Getty Images/iStockphoto

Olivia Yang was stunned when she learned she had type 2 diabetes six years ago, when she was 19. Her doctor was shocked, too. In fact, her physician tested her twice to be sure there wasn’t some mistake. Yang was young, had a normal weight for her 5-foot-2-inch frame, and didn’t consider herself a particularly bad eater. She certainly didn’t seem like someone at risk.

olivia-yang.jpg
Olivia…

Ten signs of uncontrolled diabetes

Uncontrolled diabetes can be fatal. It can also lower quality of life.

People who do not manage the condition well may develop uncontrolled diabetes, which causes dangerously high blood glucose. This can trigger a cascade of symptoms, ranging from mood changes to organ damage.

People with type 1 diabetes, a disease that causes the body to attack insulin-producing cells in the pancreas, are diagnosed, typically, in childhood. However, as many as a third of adults with the most common type 2 diabetes variant of the disorder, do not know they have it. Without taking measures to treat it, these people can develop uncontrolled diabetes.

The following 10 symptoms are signs of uncontrolled diabetes. Anyone experiencing them should consult a doctor promptly.

High blood glucose readings are the most obvious symptom of uncontrolled diabetes.

As diabetes raises blood sugar levels, many people with diabetes think it is normal to have high blood glucose. Normally, however, diabetes medication and lifestyle changes should bring blood glucose within target ranges.

If blood glucose is still uncontrolled, or if it is steadily rising, it may be time for an individual to review their management plan.

FREQUENT INFECTIONS

Diabetes can harm the immune system, making people more prone to infections. A person with diabetes who suddenly gets more infections, or who takes longer to heal from an infection they have had before, should see a doctor.

Some of the most common infections associated with diabetes include:

• skin infections, such as cellulitis
• urinary tract infections
• yeast infections

Yeast feeds on sugar, and so the combination of lowered immunity and high blood glucose makes people with diabetes particularly at risk from frequent yeast infections.

INCREASED URINATION

Increased urination is known as polyuria. Most adults urinate 1-2 liters per day, but people with diabetes urinate 2-3 liters per day, and sometimes more.

People with diabetes urinate more frequently because the body tries to rid the blood of excess glucose. With uncontrolled sugars, people also drink more frequently, causing them to produce more urine.

A rare form of diabetes not related to blood glucose, called diabetes insipidus, can also increase urination.

INCREASED THIRST

People with diabetes sometimes experience polydipsia, a form of extreme thirst.

High blood glucose can make people with diabetes very dehydrated, so that they feel thirsty. It also undermines the body’s ability to absorb water. A person may feel an overwhelming need for water, may have a chronically dry mouth, or may feel dizzy.

Even though people with polydipsia drink more fluids,…

Inflammation damages retina of diabetics: Study

Diabetic retinopathy has been classified into two types. Non-proliferative diabetic retinopathy and proliferative diabetic retinopathy.

 Keeping blood sugar blood pressure levels in check, adhering to the prescribed diet and medications, physical activity, etc. can help prevent or slow the development of diabetic retinopathy.
Keeping blood sugar blood pressure levels in check, adhering to the prescribed diet and medications, physical activity, etc. can help prevent or slow the development of diabetic retinopathy.

Visakhapatnam: A growing body of evidence supports the prime role of inflammation and ‘angiogenesis’ in inducing progressive damage to the retina in diabetes patients, leading to diabetic retinopathy (DR).

Now, the findings of a recent study, carried out by the researchers at Andhra University College of Pharmaceutical Sciences and LV Prasad Eye Institute, Visakhapatnam, concurred with the same.

The study revealed higher levels of circulating inflammatory cytokines and vascular endothelial growth factor (VEGF) in patients with DR compared to the patients without the ocular condition. Cytokines are regulators of host responses to infection, immune responses, inflammation, and trauma. The pro-inflammatory cytokines act to make a medical condition worse.

On the other hand, the vascular endothelial growth factor is a major regulator of new blood vessel growth and an important inducer of vascular permeability, playing a role in diabetic retinopathy. Vascular permeability characterises the capacity of a blood vessel wall to allow for the…

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