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Merging Family with Applied Science: My Diabetes Story

Throughout my life, I’ve been surrounded by many family members who have fought or are currently fighting diabetes. I’m from Vietnam, where education on healthy lifestyles and an emphasis on preventive health is almost nonexistent. In my culture we consume white rice, French baguette as a main dish, and sugar cane Coke — which is as common as water. Partially because of this, along with genetics at play, my mother was diagnosed with Type 2 diabetes almost a decade ago. Three years later, her older brother (my uncle) endured kidney problems and passed away from diabetic complications. Meanwhile, my other aunt and uncle on my mother’s side are both prediabetic and at serious risk for developing the disease. 

The distance from my family — and their health —  is hard. One way I stay connected to them (aside from visits across oceans and conference calls) is through my company, Bonbouton, a preventive medicine startup that is currently focused on developing products for diabetic patients. This decision to focus first on diabetes was solidified when the disease made its way even closer to home: My wife developed Gestational diabetes in the U.S. when she was pregnant with both of our boys, now 7 and 2.5 years old.

Bonbouton is developing a smart insole that can detect foot ulcers in diabetic patients before they form, reducing the risk of amputation. (200 people a day lose a toe or a foot due to diabetic-related ulceration.) I developed and patented the insole’s sensing technology in school while pursuing a doctorate in chemical engineering. 

Throughout my life, in addition to family, I’ve always been motivated by applied science. I never excelled in scientific research but was always interested in how to apply science to various applications and figure out ways to inject the technology into products that help people. Watching my mother, aunts and uncles, and wife battle diabetes was a driving force for me: I wanted to figure out a way to tie the two together. 

Another life changing event occurred in 2015 was my dad passed away from stage 4 colorectal cancer, a disease the doctors caught too late. Enough was enough: I didn’t want to see anyone get diagnosed too late anymore. I wanted to commit to preventive health, early detection, and patient empowerment. I wanted to create sensing tools that help people better understand their health so they can take action and maintain wellbeing. 

In fact, that’s the exact vision of Bonbouton: to sense the invisible and enable every human to live a healthier life.

Although there are several causes for the different types of diabetes, being autoimmune, inflammation, lifestyle, and genetics —the symptoms and complications remain similar, and that is what we care most about.Whether Gestational, Type 1, or Type 2, they each render similar lifestyle issues: one when you’re wondering what’s going on inside your body. When there’s so much to maintain, so many boxes to check. Having developed the empathy from my family, I wanted to build my life and career around sensing and healing. The way forward for me is my work as an entrepreneur with Bonbouton.

#RealT1DLyfe Chris’s Story: Type 1 Diabetes and Suicide

As anyone with Type 1 diabetes knows, life can be an absolute roller coaster. I would like to take you on a personal journey of mine going into the darkest of hours, but coming out in the brightest of days. Back in June of 1988, my diagnosis marked not the first or second, but fifth Type 1 diabetes diagnosis for my family. Already having lost an uncle to Type 1 in the same year, my diagnosis likely hit my family harder than I will ever know. However, growing up having two family members who passed from T1D complications weighed heavy on my mind. It didn’t help that at a young age, I heard a doctor tell my mother, “if he sees 30, feel lucky.” Growing up, T1D never completely stopped me from doing things, but often had a way of interfering. Going to play soccer as a kid, I had a coach say I couldn’t play because he didn’t want a kid dying on his field. Name calling, being told I wasn’t good enough, and the like made me angry in the moment, but ultimately sat deeper within my subconscious for twenty years into adulthood, slowly taking its toll.

Getting out on my own is where my life took a darker turn. Around 2011, I fell into a deep depression and I almost didn’t make my way out. My blood sugars were rarely where I needed them to be. It was also a constant roller coaster at work. Eat then work, forget to bolus, go high, then crash, and repeat. Although I was consistently out of range, my reasonable a1c kept my doctor at bay, all while hiding the fact I was miserable mentally. Relationships were impossible to maintain with my depression and blood sugars as they were and I began to isolate myself alone with my thoughts. The thoughts escalated from “your diabetes has destroyed your life” to “your life isn’t worth living with diabetes.” Mind you, at this point in time I already had one beautiful son. I pushed the thoughts back as much as I could for his sake. However, in doing so it enabled my thoughts to escalate even further. I was telling myself that my son would be better off without a father. I started looking up those who completed suicide and how they did it. However, even with everything I was feeling, I couldn’t leave my family with the thought that I would do so on purpose. After having crashed my blood sugars numerous times over the years to counteract extreme highs, I decided insulin was my best option.

On a Saturday morning, I woke up in tears and decided that was the day. I got up and took a fatal dose of short acting and went about my morning routine with the idea that at some point, I would have an insulin reaction and go unresponsive. For whatever reason, by an act of God, the insulin took hours to work. Later that day, when I was on line to have lunch, the last thing I remember was reaching for a plate. I woke up surrounded by EMTs in my manager’s office. Lucky for me, the guys I worked with knew me and my diabetes very well. Upon coming to, one of the EMTs said it was the first time he had a patient so low it wouldn’t read on his meter. We still don’t know how low I truly was when they got there. I finally got to the point I could stand on my own and was feeling okay physically. However, my mental state was still in shambles. Per policy at my work, I had to be sent home. I begged with my manager to let me stay. I said “I’ll just sit in the back, no one will know I‘m there.” I couldn’t go home in the state of mind I was in. But none the less, I was on my way home. The short 5 minute drive was nerve racking, tears falling, thinking “should I try again” and “I can’t be alone” and “I don’t want to live.” My best friend was sitting on the couch as I walked into my apartment and he immediately looked up at me, knowing something wasn’t right. He put his arms around me, like any brother should, and gave me a much-needed embrace–the kind of hug that lets you know someone loves you. We ended up going for a long walk where I explained what I did. He was the only one who knew what I did for years. During our walk he said, “I know the greatness you have ahead of you, you just have to be here to find it.” His words have sat with me for years.

With my two children and the Betes Bros, I have a family that pushes me to succeed. Brothers who reach out for my support as well as check on me. The men and women who have come into my life have filled my cup and continue to make life even better. If you are struggling, that is okay. As someone who almost experienced an end to my life, if I had the support then that I do now, I probably wouldn’t have gone that far. If you’re ever in a place like that in your life, talk to someone. Seeking a professional counselor doesn’t make you weak, it actually makes you stronger. Reach out to a friend who may be struggling that you haven’t talked to in a while, let them know you’re there. A simple text, note, message saying, “I’m here if you need me” can literally save a life.

#RealT1DLyfe Chris Pickering Family

Get real with T1D! #RealLyfe

For additional resources on Depression and Diabetes, check out this article from our friends at Diabetes Daily!

New Workout App for People With Diabetes – And Christel is an Instructor!

Have you ever dreamt of working out with a trainer who understands diabetes, who might even live with diabetes, and who gets what it takes to get through a workout without wonky blood sugars?

Well, that trainer could be me!

Today, my 12-week fitness program “STRONGER”, that I developed for GlucoseZone, is available in the GlucoseZone app. I’d like to personally invite you to come train with me. To join me for a program that will push you to be a stronger version of yourself.

Sign up HERE and use the “STRONGER” code to get 30% off your monthly subscription

The beauty of joining GlucoseZone is that you’ll get access to not only my program but to 6 other exercise programs, as well as live workouts, all developed specifically for people living with diabetes. You can do all of the workouts in your own home or bring it to the gym.

Regardless of your fitness level, you can find qualified instructors to take you through the workouts that are right for you, and always with your diabetes in mind.

One of the reasons why I’m so excited about working with GlucoseZone is that it’s the first-ever clinically validated digital exercise therapeutic for people living with diabetes, and it’s endorsed by the American Diabetes Association.

Stronger Getting Started

Sign up HERE and use the “STRONGER” code to get 30% off the monthly retail (You’ll only pay $9.09 per month) when you sign up for the GlucoseZone app.

 

Connect with Christel on Facebook: @DiabetesStrong; Instagram: @diabetesstrong_ig.

Wearing a Diabetes Medical ID On-The-Go!

Medical ID Bracelets

Living life on-the-go can be fun and busy, however, doing so with a chronic illness requires a few extra steps and planning along the way.

 

Hi, my name is David and I have been living with Type 1 Diabetes for 10 years now. I was diagnosed at the age of 11 and let me tell you… I have been through a lot. In living with this disease, I have been able to experience so much and learn from my mistakes. In doing so, I have come to realize that as a diabetic, I am one of those who should wear a medical ID and why it’s important for all life’s experiences.

For years on end, I never wore a medical ID bracelet. I could never find a bracelet that I simply liked or wanted to wear daily. When I became a part of the Diabetic Online Community (DOC) back in 2014, I was exposed to several different people who shared the same struggle. I also saw a variety of amazing brands and companies who understand this struggle and have found ways to make ID bracelets, dog tags, necklaces, and more so much nicer and pleasing to the eye and the patient. I own several different medical ID bracelets, I think when one finds their style with Diabetes, it’s always nice to have options and create your own look, which is why owning multiple forms of emergency ID that go with different looks is a great idea!

I have mentioned several times on my Instagram, @type1livabetic, that when wearing my personalized Paracord bracelet from American Medical ID, I felt so very safe. I felt as though if anything Diabetes related could go wrong, I would be prepared. On my engraved bracelet, my name, condition, and emergency contact information were all located on a small piece of metal, attached to the Paracord bracelet. At a recent trip to Disneyland with a large group of people who also had Type 1 Diabetes that could vouch for me if there were to be an emergency, I still encountered times in which I was alone at the park (walking to and from my car, walking to meet the attendees, or simply stepping to the side to grab a snack), rest assured, I was confident with my Diabetes at the time.

So why is it so important to wear a form of medical alert jewelry for Diabetes? Well, not to get too dark or technical, however, the fact remains that we do have Type 1 Diabetes that does come with some symptoms and consequences. If our blood sugar drops significantly low, we could pass out and become unconscious or go into a coma. Same with high blood sugar, if we are severely high and go into DKA, we could in fact experience some symptoms that could limit our ability to function, which can prevent us from acting in the moment to get help. Say you were in public, alone, and you experienced one of these symptoms, if you were wearing a medical ID, someone nearby would mostly likely come to check for various hints or signs on you if something doesn’t look entirely right and search for an alert jewelry in particular sites on the body: wrists, around the neck, tattoos, etc.

In being diagnosed with any chronic disease and being told you have to take extra care of yourself can be a lot, however, allowing yourself some relief by wearing a form of ID can truly reduce a lot of the stress surrounded by various diseases. One should never leave the house without some form of ID as you never know when these emergencies could happen.

American Medical ID Healthy Packing List

The CDC includes having a form of medical identification such as alert bracelets, necklaces, or wallet cards as part of a healthy travel packing list.

I believe that some may also feel safe in knowing that they have a medical ID card in their wallet as well, for added peace of mind. One should also wear a form of ID at home, just in case. For those who live alone, I understand that it may feel as though you are not in need of wearing an ID at home as you will be alone, but that could just be the very tool that can keep you alive, say you have an emergency, it could be that neighbor walking by and seeing something isn’t right that could barge in and save your life and being able to identify you have a particular medical condition that needs attention.

We each have our own busy lives that takes up so much time and mental focus away from our health, which is why wearing medical alert jewelry can protect us as we are on the move, daily. School, work, the playground, a coffeeshop, wherever you may be, ID is necessary. No matter how old the patient is, whether a child, teen, adult, or elder, wearing a medical ID all the time can protect us from the dangers of our diseases and more.

 

Live well,

David

Real Talk with Dave: All About the JDRF Type One Nation Summit

Last Sunday, April 22, 2018, I had the amazing opportunity to volunteer at my very first Type 1 event. JDRF hosted their annual Type One Nation Summit in Pasadena as part of the Los Angeles chapter. My goal for this year has been to get more involved in the Diabetic community, so I just knew that I had to reach out and see if I could be a part of this amazing event! I was given the privilege to work with children who also have Type 1 Diabetes, which was such a surreal and eye-opening experience. Also, throughout the day, I was able to meet many new and amazing Diabetics, many of whom I have met through the online community and now was able to meet them in person.

As the day started, I was greeted by some very kind people working the event who helped get me situated and allowed me to find my way around the place. As I walked through the convention center, many different Type 1 brands and companies were there with their very own booths, which allowed us T1Ds to get some more knowledge and have our questions answered. Brands such as Dexcom, Medtronic, OmniPod, Myabetic, and so many others were there with a few very kind reps from each brand. They were all so nice in welcoming quests and helping them find their new favorite T1D brand. I for one was fascinated by the Dexcom booth as they were promoting their latest and greatest device, the Dexcom G6. It was so neat to be able to see the product right then and there as the Dexcom reps were there showing how it works.

As I went to help the children who lived with T1D, I found myself in a room of so many wonderful kids. You would think that these kids would be somewhat down for the fact that they have to live with T1D, but that wasn’t the case at all. The kids I worked with were so happy to be at the event and meet new friends. I would ask them different questions such as how long they have had Type 1 for, what their blood sugars were (and we would compare our numbers with each other), and what devices they use. There was an instant connection with many of the kids as they were so responsive and excited to share. The day went by and they were thrilled to be in this space with each other as they worked on different projects and had different guests come in and talk with them.

Throughout the event, I would go back and forth from the T1D kids to the T1D adults and found myself fascinated with each and every special bond that was formed with one another. I was able to attend a few break-out sessions and listen in on some very interesting panels, some of which I was familiar with the speakers, which made them much more interesting and enjoyable. I must say that whoever put together this event really knew what Diabetes is actually like as they thought of everything to be presented that day. The topics that they talked about were so relatable to people living with Type 1, which made it so special to be a part of. We even got to meet a T1D hero who has been living with Type 1 for 58 years! He was such an inspiration.

As the day went by, more friendships were formed, more amazing T1D brands were discovered with some amazing purposes in the Diabetic community, and all in all, this event was a beautiful space where we could all come together as one big T1D family. Whoever was there was in support of one another and would lift each other up. New people came, but were immediately invited into the group and fit in right away. Many traveled from near and far to be together on this special day for this extra special event, and that right there made me realize how when we stick together as one big T1D family, this disease has nothing on us. We are brave, strong, and true fighters, we won’t give up and we will rise above in times of trouble. Diabetes doesn’t own us.

If you want to get more involved with the T1D community (which I highly recommend, it will definitely change your life for the better), get in contact with your local T1D organizations and be on the lookout for events/meet-ups in your area and just go for it! It just takes one time to get involved and you will be hooked! Being with other Diabetics is contagious and you will want to meet even more Diabetics each time!

 

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

Moving for Your Body

Let’s be real, working out can suck. Like really, really suck.


Growing up, running was always my punishment for the other sports I played (tennis, volleyball, and softball). We would run if we missed, run if we lost, etc. Running was never something I got to do, but had to do, rather. I’d had a distorted view of working out (outside of playing sports competitively) and I saw working out as punishment for what I ate, etc.

By pushing my body too hard, at the age of 21, I’ve already had shoulder surgery, five stress fractures in both my shins and lumbar spine, as well as four cortisone injections. So after years of putting my body through intense workouts to train, I am finally working out to heal my body and mind.

So what shifted in my love-hate relationship with “movement”? My mindset. While I used to view running, cycling, swimming as the enemy or the “worst part” of training, I now view it as something I GET to do. I get to move my body, as quickly or slowly as I please. I get to be outside. I get an hour to move how I want to– however feels good for my body. 

I used to push myself through a run when I could hardly walk, or through shin splints on a long run, now I don’t. Now, I run or bike when I want, put on a great playlist, and enjoy the movement, the celebration of what my body CAN do. I practice yoga daily because it is sustainable for me, and I love the mental and physical reset it provides for me. I focus on how it feels, what I need, and am very consious of my blood glucose levels when working out.

My advice to those who have a distorted view of gyms or physical activity, or even just need motivation to start working out is to find something you love, that you can sustain. Maybe for you this is dance, yoga, boxing, a long walk– or a multitude of act ivies combined.

“Speak like you love yourself. Eat like you love yourself. Move like you love yourself.”

Real Talk with Dave: Tips and Tricks on Making Peace with your Diabetes

All Diabetics know how difficult it can be to find a common ground with their Diabetes daily, between the highs, the lows, the fears, and the pain, however, at some point, this can lead to a burn-out phase in our Diabetic lives, making it much harder to keep on moving forward. At the start of the new year, I have almost gained a new mindset for my Diabetes in which I am a bit more relaxed, knowing that it will all be okay in the end, that is why I want to share some of my own personal tips and tricks on how I manage my Diabetic stress & anxiety in the best way possible.

Over the past 9 years of living with T1D, I have come to realized that Diabetes is a really hard thing to go through in life, but finding ways to cope with your Diabetes as much as possible can be so rewarding in the long run! Don’t do Diabetes alone. Find a group of people to lift you up and motivate you to keep up the hard work you do! Diabetes is already a stressful thing to deal with, that is why these three helpful tips I use daily may help in finding a light at the end of the Diabetic tunnel:

1) Plan ahead – When out and about with T1D, many times you may not want to even think about Diabetes and don’t want it to get in the way of your outing, no matter where you are headed, however, always being prepared for the worst is the best way to avoid any unwanted stress, as T1D is a serious disease that needs to be treated and cared for 24/7. Just imagine how it would feel to be an hour or more away from your house, all to realize you forgot your Insulin at home… and your blood sugar is high (that wouldn’t be fun). In that case, I definitely recommend making a checklist (yes, an actual list) where you list all the necessary items that have top priority in managing your Diabetes on any outing, whether at school, work, and especially on a vacation. Each time you plan on going somewhere, be sure to check off the list prior to your outing and make sure you have all you need, and maybe even some extra supplies, all packed in a designated pouch or bag in which you can transport quickly on your way out. Better to be over prepared and over packed than the other way around.

2) Self-talk – One thing that I still struggle with is being in a constant fear of going low or excessively high when I am in a space (such as school) in which I cannot get out of very easily or am surrounded by many others who may not be aware of my T1D. In cases like these, I feel as though it is strictly up to me to take care of myself and make sure I am okay at all times, but, as we all know, Diabetes is an unpredictable disease. We all wish to never have lows or highs at certain times, but they can honestly happen whenever, wherever. In that case, let it be. If you go low, treat. If you go high, treat. Yes, you may have a bit of anxiety in having to deal with that all alone sometimes, but it is more important that you treat and take care of yourself, rather than the horrible outcomes of a severe high or low. The theory of self-talk comes into place by you having to mentally think to yourself that everything is going to be just fine. Think how you’ve been low and high before and made it out just fine each time, some were more difficult than others, but somehow, you managed to survive it… and like a pro!

3) Finding a support system – Most of the work I do in the Diabetic community is done via Instagram, @type1livabetic, where I try and encourage other T1D’s to look at life in a positive light and make life any way they want, regardless of their Diabetes. I didn’t always have that intention though. During my first few years as a Diabetic, I didn’t fully feel motivated or see the positive side to Diabetes as I do now. How did I overcome that? Well, I began to find other Diabetics via social media and just…talk! I began to connect with them and start talking with others on the true daily struggles we face and the feeling of connecting with someone who simply understands EVERYTHING you are feeling is indescribable. I found my support group online, but there are many other ways to do so. There are many in-person support groups at local hospitals, nowadays, a new trend is hosting a Diabetic meet-up, and simply attending a local Diabetic organization research walk or event can be life-changing and memorable.

In short, if you want to find peace with your Diabetes, give these three tips a try! Always have your medical supplies (and a backup plan) ready and with you in an accessible manner at all times, remember to think only good thoughts to yourself, especially in the hardest times, and find a group of people that you can be 100% yourself around, Diabetic and all, and hang on for the ride, because Diabetes is a huge roller coaster with many ups and downs. Find what brings you peace with your Diabetes and go with it!

Live well,

Dave

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Naturally Sweet



I think it is safe to say that we Diabetics are naturally sweet, but what does that really mean? Well for starters, the saying, “naturally sweet”, can mean an array of things.

Most non-Diabetics will hear the term “Diabetes” and think of people who ate too much sugar or are overweight, but we all know that’s not the case. People will assume that Diabetics cannot consume any sugar or they will die, again, not the case.

Over time, we endure so many different assumptions, labels, and hurtful comments towards our Diabetes that honestly don’t feel good to hear. I’m 20 years old and have had Diabetes for 9 years and still get those comments from non-Diabetics. When I was first diagnosed, those comments didn’t affect me. Fast forward to today, I have educated myself and lived/experienced so much in my Diabetic journey to the point where now, I truly cannot tolerate hurtful assumptions people may say to me or near me. I’m not just speaking for myself. The whole Diabetic community has expressed their frustrations and experiences on dealing with people who viewed them as the stereotypical Diabetic. Some of those comments include: “oh, did you get Diabetes from eating too much sugar?”, “Diabetics can’t eat sugar.”, or “you don’t look Diabetic”. These are just some examples and trust me, I’ve heard much worse.

We are getting so close to the end for Type 1 Diabetes and living out a normal and healthy life has become so much easier and much more manageable due to all the advanced forms of technology, specialized medicine, and even just by spreading awareness and building a community.

The typical stereotypes should not determine our future or our own individual decisions. We can eat sugar. We can do whatever we put our minds to.

And we are so much more capable of doing things that we want to nowadays due to all the advancements that allow us to do so.

Diabetics work hard each day just to stay alive. I think sometimes we all can get carried away and take life for granted, but when you really think about how critical and complex Diabetes management truly is, that in itself can be the main motivator in your life to keep you going.

My point right now is that we are naturally sweet for all these reasons. We are hard-working, focused and motivated, and in it to win it (it being a cure!). We are sweet because we can not only be of an assistance to other Diabetics by creating a kind and inviting environment but at the end of the day, when you look back at all you went through that day and how you took care of yourself, good or bad, you’re simply…sweet!

So go ahead, make a change in this world, prove them wrong, eat that sugary donut or ice cream (with Insulin of course!), because, with that natural fighting spirit we Diabetics are given, we can do literally… ANYTHING!

Live well,

Dave

Real Talk with Dave: My Thoughts on T1D this Past Year

A lot has happened within the last year in the Diabetic community and we are getting so close to finding a cure. I am filled with hope each and everyday as I go about my own individual duties in the Diabetic community, as so many people are doing good each day in changing the way we manage our Diabetes and spread awareness. So many are dedicating their own lives to encouraging, supporting, and helping other fellow Type 1’s one way or another.

That very aspect fills my heart with happiness as I love seeing kindness in the Diabetic community.

Within the last year, I have seen more and more faces joining the online aspect of the Diabetic community. Lots of great opportunities have come from that and have been changing Diabetes management in such a positive aspect!

As part of my contribution to the Diabetic community, my main focus is on making Diabetes look “cool” in a sense by providing fun and creative content on my Instagram account, @type1livabetic, for others to enjoy.

I try and engage others by asking Diabetes related questions, post a photo about a relatable issue or struggle in Diabetes management, etc. By doing so, I have come across so many new accounts/followers who are wanting (and striving!) to make a change and a positive impact, even if that means they post a photo everyday. And hey, that is more than enough! Just by making that effort to spread awareness through a photo is more than enough.

Along with that, a lot has changed in the Diabetic world. As it is 2017, so many new advances in technology for Diabetic care has become a reality to so many that a cure seems only a mile away! Nowadays, many use Continuous Glucose Monitors (CGMs), Apple Watches with Dexcom integration, Insulin Pumps, and the list goes on!

These devices haven’t always been around, which makes them pretty special and as some may like to call them, “life savers”.

I totally agree! Just by seeing that now we can view our blood sugars on our phones or watches tells us that things are only getting better. Pretty soon, there will be a medical breakthrough which will allow Diabetics to practically ditch their daily duties as a Diabetic while a very advanced, new device does all the work, and boy oh boy, what a relief that will be! Then, the only thing that will be in the works will be the real cure that will end T1D once and for all, literally!

Community has been a big deal to me lately. I have noticed that though we have family members and friends who are in constant support and are willing to help us in any way possible, if a non-Diabetic doesn’t truly know what a low or high may feel like or what it’s like to have needles become a new normal to their body every moment of every day, then they really don’t know what T1D feels like. That is why I depend so heavily on the Diabetic community for my actual Diabetic support. I seek support and understanding from those who are dealing with the exact same thing as me.

That is so comforting to know that messaging, calling, or visiting with another Diabetic for support is just a click away!

I couldn’t be more grateful for the community and all the amazing organizations that don’t leave us hanging by providing events, support groups, and other amazing activities that help connect and bring us Diabetics together, as well as stick together!

So to sum up, lots of great things have happened within the last year for us Diabetics. As we wrap up this year and start a new one, I can’t help but remain hopeful for a better tomorrow where we can finally put T1D behind us!

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…

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