Real Talk with Dave: All about the Dexcom G6

Many people have been eagerly waiting for the Dexcom G6 to be announced.

Well, it just so happens that it is now FDA approved and available in June. I had the special privilege of being sent a Dexcom G6 to try out and so far, I am loving it. As promised, I wanted to share my open and honest opinion about this device, so I thought what better way to share my thoughts than through a blog.

First and foremost, I want to say how incredible this device is. I had the opportunity to see a mock-up of the device at the JDRF Type One Nation Summit and was even more excited to use this new product! The whole site and transmitter is about 33% thinner than the Dexcom G5. It is much more user friendly and has a longer wear time than the G5. You can now wear your site and get continuous glucose readings for 10 full days before you have to change out your site. You can also view your blood sugar readings on your phone, watch, and receiver that comes with the device.

One really exciting feature is that the Dexcom G6 does not require any fingerstick calibrations, which means you no longer have to prick your fingers for a manual blood sugar check anymore. You can now fully depend on this device to be even more accurate than before and allow you to have even more freedom in knowing what your blood sugars are. I have been wearing the Dexcom G6 for about a week now and have been comparing the G6 to the G5. For the first few days, I was wearing both CGMs just out of curiosity on how much more accurate the G6 really is. From what I observed, the G6 was way more accurate in comparison to the G5. I also would still check my blood sugars manually just to compare the numbers and my Dexcom was very close to the actual reading. It is intended to be 20 points above or below the actual reading, which it has been.

The device also has a new app in which there is a whole new design (similar to that of the G5, only better), and there are now more options for alerts and settings in which you can customize to your liking. Now, when having a low blood sugar, this device will alert you 20 minutes before a predicted severe low of 55 mg/dL, which I think is amazing that it can detect that for you. It truly does give peace of mind in knowing what to expect and when, giving you alerts ahead of time so you can try and prevent a bad low before it hits you.

The part of this device that I cannot praise enough is the insertion. Before, you would have to plunge a big needle into your skin and then remove it, leaving a plastic cannula deep into your skin. Now, all you do is apply to device to your skin, push a button, and within seconds, the device is in your body! When people ask me what it feels like to insert the G6, I like to describe it as “a puff of air hitting your skin, that’s it!”. The first (and only) time I inserted my CGM, I was blown away at how painless it truly was. This is going to be a huge game changer for children who have to wear a CGM as they will not feel a thing when the time comes to insert the device into their skin.

All in all, this device is great. I am obsessed at how this product works and helps me feel as a Type 1 Diabetic. It definitely allows me to live my life and not worry as much as I truly can trust what my readings are and know what is going on inside of my body. If medical technology is this good now, I am even more excited as to what the future holds for Type 1 Diabetes. With the Dexcom G6, Diabetes is not all bad.

Live well,

Dave

THE MORNING SUGAR: A Window into your Type One Management

I lie in bed with one eye open, ears still ringing from my poorly selected, overplayed alarm tone. I sit half hunched over my glucose monitor attempting the first blood-drop-to-test-strip co-ordination of the day. Its 05h30, I have fasted for 6 to 8 hours, it’s time to dive into diabetes. My test strip sucks up the drop of blood and counts down to my first glucose reading of the day:

BEEP: 4.6mmol/l (84)

OR

BEEP: 9.6mmol/l (173)

OR

BEEP 16.6mmol/l (299)

The good, the average and the ugly.
These are the 3 general ranges of readings that might greet me at the first finger prick of the day. It’s only one of the many sugar readings that lie ahead, but it is a special one to pay attention to, as your morning glucose reading can provide important insight into your diabetes control.

A fasted reading has a myriad of information which you can choose to ignore, or preferably dissect and investigate for optimum diabetes control. I believe it is vital to ask myself why? Why is my blood glucose this level and what were my preceding actions?

I will take you through my 3 ranges and my general approach to morning sugar readings and how I personally troubleshoot these readings. We each tackle diabetes differently, but hopefully the following brings some insight into your morning sugars or encourages you think critically of those interesting rise and shine numbers!

The “Gem”
My personal values are 3.8-5.6mmol/l

Oh this is a sweet, gem of a reading. It’s the real “roll out of bed on the right side” number.
Perfectly in range, it is still important to acknowledge the formula that achieved this number. We could all do with a little positive reinforcement and mindfully recognize and enjoy our diabetes successes! I always ask myself, “What did I do well?”

This sugar reading generally informs me that I have correctly dosed my long acting insulin as it did not bring me into the clutch of hypoglycaemia when fasting during my sleep. It was also sufficient to meet the cascade of morning hormones such as cortisol and hyperglycaemia it brings along with it. This sugar happily greets me when I don’t snack after dinner and I eat around 3 hours before bed-time. This plan allows for an honest, stable blood sugar reading before bed where my injected insulin has already peaked in activity, and I can expect predictable glucose readings as I sleep.

The “Meh”
My personal values are 6-9mmol/l

It’s a sugar range that is higher than I would like for a fasting blood glucose level, but it’s not remotely the end of the world. To solve this morning glucose and to prevent it creeping higher, I have my insulin dosage for my breakfast plus a dash more insulin to correct. I wait 20-30 minutes for my insulin to start working and bring my glucose down before having my breakfast. I ask my “why?” and make a mental note of how I could improve and act accordingly. If went to bed with a great blood glucose level and I woke up high, it could be various things:

1. Insufficient long-acting insulin: The Dawn phenomenon

When I have my continuous glucose monitor (CGM), the Dexcom, attached, this will be displayed as a nice steady graph with readings in glucose range for the first 2/3rds of sleep, only to find in the few hours before waking my blood glucose slowly and steadily increases. This is due to the get-up-and-go hormones that pump through your body to prepare you for waking and tackling the day. These sneaky buggers include growth hormones, cortisol, glucagon and epinephrine and they increase your insulin resistance, causing blood sugar to rise.

2. Too much insulin: The Somogyi effect

This is an interesting stress response of your body, a rebound effect of low blood glucose while sleeping. If you have too much insulin, long acting or short acting, and you experience a low while sleeping your body mounts a survival response and encourages your body to release sugar back into your blood via adrenaline and cortisol. This low may not be rapid or severe enough to cause a seizure, but sufficient to mount a physiological survival response from your body.

3. Not enough short-acting insulin

This is usually prompted by snacking before bed and eating late. My stomach is still full and has not emptied. My blood sugar will be in range when I get to sleep, but as my tummy works to digest my food, sugar trickles into my blood which I thought I had sufficiently covered by my short-acting. This especially occurs if I eat meals that have a carbohydrate, protein and high fat content. It has even been dubbed “The Pizza Effect”, where fats and protein delay the absorption of carbohydrates from a meal. The most challenging part is that you don’t know when the carbohydrates are going to be dumped into your bloodstream as sugar. It could be more than 5 hours until you feel the true effect of your meal. This could also be a reason for a really high morning blood glucose reading, the one where you would rather turn over and head back to sleep, which brings me to my final morning range, which I like to call the “Lie in Bed for a Few Minutes in Denial”.

The “Lie in Bed for a Few Minutes in Denial”
My personal values are anything double digit

The “Man, I messed up” feels. I most likely did not give myself enough insulin for the previous night’s meal, or I ate complete rubbish, did a massive carbohydrate count guestimate (that’s right folks- guess and estimate can really be combined into one perfect word), it could be “the pizza effect”, or I forgot my long acting insulin.

The alternative explanation is that I woke up with low in the middle of the night and quite passionately, dove into my bedside glucose stash, bathed myself in sugar before falling back asleep in a pile a sweet wrappers. (Yes, I have awoken with gummy sweets melted into my back and bed sheet).

If my sugars are really bad in the morning, there is usually a pretty grand, blatantly obvious reason as to why they are absolutely deranged. I find myself glancing in the mirror, at my poor, hard-done-by face to ask myself why? My expression smirks, “Oh girl, you know why. You know.”

This is where the power of the mind can transform your day. You can switch to victim. You can choose guilt and actively bring yourself down. You can choose to let a number on a plastic monitor define your day or you can free yourself from mental binds, for you are capable, you are strong and you are going to tackle the day.

My go-to plan of action:

1. Massive bottle of water with loads of top ups
2. Small simple, low sugar breakfast (I find waiting for my sugars to come down before eating leaves me more frantic and stressed)
3. More water
4. Add Insulin
Tip: Don’t give yourself 70000 units because you are panicking and desperately want your sugar to go down as quickly as possible (TRACY SANDERS I am talking to you girl). A resultant severe hypoglycaemia does not make it easier to improve the day.
5. Forgive yourself, give thanks to your body for all the other goodness it brings to you and power forward.

Transform your WHY’s into WISE, pay attention to each nugget of information your body and glucometer communicates to you. By building up an understanding of your sugars, you build a stronger relationship with your body and mind. Work closely with your support network, endocrinologist and diabetes educator to make the correct adjustments to suite your body, always ask questions and challenge your knowledge and experience of type one.

Real Talk with Dave: How to Stay Positive with T1D (Dealing with Burnout)

Have you ever felt overwhelmed with Type 1 Diabetes to the point where you just don’t want to deal with it anymore? You may feel the need to cope with your Diabetes in a different way. Many will go off their Insulin pump for a while and go back to daily syringes/ pen injections as a way to feel a sense of freedom from this disease. Unfortunately, us Diabetics cannot just “stop” Diabetes. We have to fight daily in order to stay alive. We have to take Insulin in different moments throughout the day and watch our blood sugars fluctuate from stubborn highs to difficult lows. At some point, we all go through a burnout phase where T1D just doesn’t feel bearable anymore, that is why I have put together a little guide as to how you can stand up to the burnout phase and keep on pushing through!

1/ Keep a positive mindset – This seems easier said than done, but trust me, in order to feel a positive presence on you as you go about your day, every morning, start the day fresh and new and remind yourself of all your accomplishments in life and how far you have come. Always let yourself know who you are and how brave and strong you are.

2/ Self-talk – Every day is different and some days (as we all know) can be very bad in terms of our Diabetes. There is a lot to think about throughout our day, things such as what our blood sugars may be, what supplies we need to have with us as we go somewhere during the day, and also planning for emergencies, that being said, we must make room for thoughts of reassurance. We need to talk ourselves through a bad low and tell ourselves that everything will be okay, just like it always is. We need to be our own friend who will be there when no one else is. Having positive and calm self-talk is a good way to walk you through your day and be your own hero.

3/ Do what makes you feel alive – we all face Diabetes every moment of everyday, and it can almost feel as though everything is about Diabetes. Sometimes, we may not want to think about Diabetes all the time (within reason), that is why we need to make time for other things in life that bring us true joy and help take our minds off of T1D for a bit. Doing something you love, such as going out with friends, playing a sport, or spending time with family can be the very thing that can help you cope with T1D burnout.

4/ Take a pump holiday – Though it may be difficult to keep your blood sugars in your normal range, taking a break from wearing your Insulin pump (if you wear one) can make you feel free and have one less thing constantly reminding you of your Diabetes. You can do this for a day, a week, or even a whole month, it’s really up to you. However long you need to take a break from wearing your pump, go for it, because what some don’t realize is that wearing a pump can change a person and mess with their emotions (in some cases) to the point where they feel “different”, which isn’t that case at all. Wearing a pump is a blessing and is what essentially keeps us alive each and every day.

5/ Accept your struggle – Just know that eventually, this T1D burnout phase you may be going through will go away and you will be able to get back in the game. Remember, we ALL face burnout periods in our life, but guess what? We all get over them eventually. Accepting the fact that you are stressed out, annoyed, and tired of T1D is sometimes what we need to get over that phase. Sometimes, just feeling the sadness you are going through is important and perfectly okay, because when you feel it, you work through it. It’s all one big learning process on how to cope with your thoughts and emotions. At the end of the day, we’re all humans. Diabetic or not, we go through tough life situations and working through them is just one way to grow as a person and be able to allow for empathy towards others going through difficult life situations.

6/ You are not alone – When you feel like all things are going wrong with your Diabetes, a great way to vent off and work through it all is turning to the amazing T1D community that is out there, waiting to help out in any way. Connecting with others (in person or online via social media) can help you as you will soon realize that you are not the only one dealing with burnout at the moment and that you can fight T1D together. This has been especially helpful to me as I was in a dark place for a while until I turned to the community for help and support. Now, I am at the happiest place I have ever been with my Diabetes and I realized that T1D is not all that bad.

7/ Live your life! – I get it, T1D is a horrible disease. But just remember, you are bigger, better, and stronger than T1D. Remember to smile through it all, laugh daily, and be kind to others. Make life how you want and always choose to stay actively positive, because when you are positive, whether you’re high or low, you will have motivation and strength to keep on going and T1D will just be one of those things in life we end up getting used to. When we feel like we’ve mastered T1D, we’ll be able to accept what’s on our plate at the moment.

I truly hope these tips and tricks on how to cope with T1D burnout helped you out if you are feeling this at the moment. It’s okay to be frustrated at times, but be sure to never stay in that phase forever. Life is too short to stay in a bad place with your Diabetes.

Live well,

Dave

Real Talk with Dave: Trusting Your Gut

When first diagnosed with Type 1 Diabetes, we are told how we will feel. Doctors and nurses come in and tell us what we may experience when we are faced with a low or a high blood sugar, but that’s about it. Mind you most of these medical professionals are NOT Diabetic, which means that they don’t truly know what Diabetes “feels” like. Not only are we not able to fully know what symptoms of T1D feel like until we experience them on our own, but we are never actually mentally prepared for how life is going to feel like from now on, from the good times, to the not so good moments. How we know how Diabetes is exactly like is by simply living with it and experiencing all the possible situations on our own time.

For example, in the hospital, a doctor would typically educate you on low and high symptoms (shakiness, headache, fast heartbeat, etc.), but that doctor doesn’t actually know what it genuinely feels like. When we are faced with our first low blood sugar as a Type 1 Diabetic, it can be a real shocker in the sense that we are not expecting it to feel the way it actually does.

I can remember my very first low when I was essentially “on my own”. I had just gone back to school (6th grade) two weeks after being diagnosed and hadn’t fully understood how important carbohydrates were when on Insulin. I went to lunch that day and didn’t like the bread on the sandwich I was eating, so I decided to not eat the bread and eat the protein inside the sandwich instead, as I thought I was being healthy. Of course, shortly after lunch and having not eaten the carbs I took Insulin for, I had a very bad low. The sweats, shaking, and fast heart beat were so prominent in that low of mine and I needed a friend to walk me to the nurse’s office, where I was given some apple juice to quickly bring my sugar levels back up. Scary, I know, but that was necessary as I then learned why this happened and how to prevent it from happening again.

Trusting your gut is key in living with T1D. You may have just checked your blood sugar minutes before and had a good number. Minutes later, you feel a bit funny but don’t think you could have gone low (or high) in such a short amount of time, but then, you do. You listen to your gut and trust your feelings and, you guessed it, a low. Had you not trusted your own gut, you could have been in for a really bad experience. This can happen in a variety of different situations as a Type 1 Diabetic. You can feel low symptoms when you are actually just fine. You can feel as though your blood sugar is high, when actually, you’re low. Knowing your body and how you feel when certain situations arise can be the thing that saves your life.

Nowadays, we have Continuous Glucose Monitors (CGMs) that tell us what our blood sugars are and where they’re headed, which can give us peace of mind as we go about our day, but can also create anxiety as we can see when we may be going severely low or high at a bad time (work, school, meetings, etc.). Though we can see our blood sugar readings being updated every few minutes, we should not rely on the level of accuracy 100% of the time. Often times, the readings on our CGMs can be way off. That is why we must trust our gut and know our bodies. Every now and then, I may find my CGM readings to be about 100 points off of what my actual blood sugar is, which is extremely dangerous. That just comes to show, always be the one in control of your body and your feelings. You can only depend on yourself to determine how you are truly feeling, and when you do, there is a level of peace in knowing that you were able to catch a bad Diabetic feeling before it caused an emergency.

 So always remember, YOU are in control of how you feel. Not your CGM, not your Doctor, but you.

Live well,

 

Dave

Real Talk With Dave: The Importance of Wearing a Medical ID

Wearing a form of medical ID can be the factor that can potentially save your life. As a Type 1 Diabetic, it is important that we wear some type of medical ID at all times (especially when out alone in public). When we go out into the world and live our lives, we may often times face situations that we might not have control over. Thankfully, we have devices to hopefully help us be in the know at all times with our Diabetes, such as a continuous glucose monitor (CGM), but still, at times, we may experience severe situations with our blood sugars that may result in an emergency.

Without getting too deep into a dark topic (as I am sure we all already know about), I do have to say, there is always a danger, regardless, when it comes to Diabetes. Let’s be real, T1D is considered a “disease” which does have some pretty serious consequences such as really high blood sugars (ending up in DKA) or severe low blood sugars to the point where we may pass out or go into a coma. These are fears none of us want to think about, but somehow, they’re always on our minds. Fear. Something that takes over when diagnosed with T1D. There is nothing to worry about though! We are all on top of our Diabetes and know all the potential risk factors, we just have to be aware and plan ahead.

Where does the role of medical ID come in? Well, say we do experience a medical emergency, if we are alone but are wearing some form of medical ID, such as a bracelet, necklace, ring, tattoo, or ever a simple wallet card, that will help the general public/paramedics know what may have caused the emergency and they can help out as much as possible in saving our lives as they will know what actions they need to take, as essentially, time is everything in an emergency.

I guess you could say that medical ID is more for someone to be able to reference in the case of an emergency. Either way, it will give you the assurance and peace of mind in knowing that you will be taken care of properly in the case of an emergency.

I know that you may not want to wear a medical ID all the time, as it may make you feel “labeled” as a Diabetic, and trust me, I have felt that way at some point in my life, however, so many amazing brands have created casual and modern medical ID jewelry that can go with just about anything on any day. You have to find what your style is and what you feel most comfortable wearing. Once you do so, you will be able to wear your ID wherever you go, feeling confident and safe all the time!

Live your life and don’t let T1D slow you down one bit! All you have to do is take a few simple steps towards your safety as a Diabetic and you will be good to go!

Live well,

 

Dave

 

 

 

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/

Interests - Select all that apply