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How I Accepted My Type 1 Diabetes

My name is Rebecca Sellin. I’m 22 years old and I live in a city called Jönköping in Sweden. Right now I’m studying to become a pre-school teacher at Jönköping University. I’ve been living with type 1 diabetes for the past 6 years, but sometimes it feels like even longer, because I can’t even remember how it’s like to live a “normal” life.

But what is a normal life anyway? Everyone is struggling with something, T1D is my struggle.

But I have decided to see the positive sides of it. I love to have an active and healthy lifestyle, but I don’t like to be treated differently because of my T1D, and that’s why I hid my condition for some years, because I didn’t want people to see me as a weak person.

My diabetes was discovered when I was involved in a minor car accident in my neighborhood when I was 16 years old. Thank God I wasn’t badly hurt, but in the hospital a doctor asked me if I had diabetes, since my blood glucose was really high. I told them that I didn’t have diabetes. At that point, I didn’t know anything about diabetes, except I had a lot of prejudices about it. In hindsight, I can see I had all the classic symptoms such as thirst, weight loss and lack of energy. I had to stay in the hospital for almost a week to learn about T1D and how to manage it. I’m still learning new things and it has taken me 6 years to accept my condition. Diabetes is like a puzzle where some pieces are always missing, and you can’t see the whole picture. It’s like a full time job where you get no vacations, not even on your birthday.

I used to always take my insulin shots in the bathroom, or hide my insulin pump. But eventually I learned that I made my disease even harder when trying to hide it from everyone and trying to fit in. I felt so alone, since I didn’t know anyone with diabetes, and I knew I just had to meet other people with diabetes that fully understands what it’s like. My family and friends are super supportive, but they will never fully understand what it’s like to always have diabetes, and constantly be thinking about it. So I decided to start a group on Facebook to organize meetings and be able to meet with other T1Ds in my city. We meet up a couple of times a month and do stuff together like bowling, taking walks and going to cafes. This has been so helpful for me in the process of accepting my disease, and I can only thank my diabetes for meeting all my new friends, or my diabuddies, as I like to call them.

Also, I’m really happy for the diabetes community that I found on Instagram. To be able to meet people who go through the same things on a daily basis as I do gives me energy to keep on fighting every single day. Together we are stronger and can support each other. My goal is to inspire others who live with T1D, and to never let diabetes stop me from doing what I want in my life and chasing my dreams. I’ve grown so much since my diagnosis, and I’m so excited to see what life will bring.

A month ago I got a diabetes tattoo with my diabuddie, Elin. The tattoo says “I am greater than my highs and lows” which is a great reminder everyday when struggling with your blood glucose.


Follow Becca on Instagram @type1becca

Living With My Diabetes Diva

I have been living with my Diabetes Diva for nearly six years now.

Six years filled with drama, sleepless nights, and frustration, but also amazing memories and lots of special encounters with inspiring people from all over the world.

I got diagnosed with a pensionary at the age of 14 on my first day of upper school. It was a pretty stressful time then – my mom, my two siblings and I were moving into a new house because my parents got divorced. Besides drinking a lot, I remember having to go to the toilet constantly, getting sick all the time, being super tired and struggling with painful foot cramps.

Fortunately, my aunt’s sister, who is working as a doctor at the children’s medical unit, instantly told my mom to take me to the hospital to get some blood tests done. If it were not for her, I don’t know what would have happened if she had not sent me to the hospital since my blood sugar was above 1200mg/dl (66.6 mmol/L) at the time of my diagnosis. There I had to stay for nearly 2 months, however, thanks to the amazing support of my medical team at the hospital, I quickly learned how to adapt to my new full-time job as working as my pancreas.

The first few weeks after getting out of the hospital were a bit challenging. Having to think about so many new things like testing your blood sugar, injecting insulin and carb counting while getting back to school, moving into a new place and preparing for upcoming exams. At first, I was a bit scared of what my new classmates & teachers would think about me – would they judge me because of my pensionary pancreas? During the first few weeks I would go to the toilet to inject my insulin because I was worried about what they might say to me. However, I quickly overcame my fear and became comfortable with injecting and testing my blood sugar in front of other people because there is nothing to hide. I started fully embracing type 1 diabetes, holding lectures about T1D in front of my classmates and visiting newly diagnosed kids to give them strength, support and to show them that they are not alone. Living with Type 1 Diabetes can be really tough and nerve-wracking sometimes. Having to take care of your body 24/7, 365 day of the year is a huge responsibility a performance you can be very proud of.

To share my thoughts & experiences, to motivate show other type 1 diabetics that you can live a great life with a pensionary pancreas, I got inspired to start an Instagram account  (https://www.instagram.com/onnepe/) and writing my blog www.onne-pe.com where I write nutrition, vegan food, traveling and my journey with my Diabetes Diva. 

Since then I got to attend medical conferences and blogger meetings in different cities & countries and got to meet so many inspiring & strong people from all over the world. Being part of the amazing diabetes online community is like having in a huge family. I just love how everyone is so supportive and that there is always someone you can talk to when you need something or when just feel the need to vent when it is one of those days where dealing with T1D feels a bit more challenging than on other days.  

Like Oscar Wilde said: “What seems to us as bitter trials are often blessings in disguise” and I strongly agree with that. Living with Type 1 Diabetes is a challenge – but sometimes only the most challenging times only make us stronger.

I’ve grown and changed so much over the past years and diabetes definitely was a huge part of it. Living with a Diabetes is a large part of who I am, but it does not stop me from doing the things that I love or living the life that I choose.

Even though I would sometimes appreciate just taking a day off from all the blood sugar drama, thinking about changing infusion sets, lancets and counting carbs – I can definitely say that the diagnosis has changed my life for the better. I am extremely grateful for having access to insulin and advanced technology within diabetes care & the opportunity to wear an insulin pump as well as a CGM which makes everyday life so much easier. Dealing with diabetes can be very difficult and frustrating sometimes however it made me work harder and healthier. It taught me so much about my body, to love myself and to never give up. I want to inspire other diabetics to live beyond and to show them that living with this disease certainly does not stop you from living your best life. You can eat the food I enjoy, travel the world and explore new & exciting things.  

All the love,

 Anna xx

How to Form Healthy Habits after a Diabetes Diagnosis

When someone gets a diagnosis of diabetes, the first question often is, “What can I do?” Patients want to know what changes they can make to better manage their diabetes. Often, the answer is that you can make lifestyle changes, like exercising more and improving your diet. These changes, however, can often be easier said than done.

Breaking the Habits of a Lifetime

To make lifestyle changes, you have to change your habits. This can be challenging, because you may have built up some of these habits over a lifetime, but it’s not impossible.

The first step is to understand how habits form. There are three steps. Step one is a cue that tells your brain to do something. The second step is the behavior itself. The third step is the reward you get from performing the behavior.

If you want to form a healthy habit, you’ll need to determine what your cue will be. You know what the behavior is – that’s the healthy habit you’re trying to instill. Then, you’ll need a reward.

Putting Your Plan Into Action

Here’s an example. One of the key habits you want to develop if you’ve recently gotten a diabetes diagnosis is to get more exercise. Let’s decide you’ll walk for half an hour to start. You’ll need a cue to lace up those sneakers and get on the treadmill.

If you are used to watching the local news for half an hour every day at 6:00, set up your treadmill so you can see the TV from it, and take your walk while you’re watching the news. Your cue to start walking is the beginning of the news.

Just as the news begins, get on your treadmill and start walking. Keep going until the news is over. Time spent on a treadmill can get a little boring, so watching the news at the same time can be a nice distraction.

Developing an Appropriate Reward System

Now you need to reward yourself for taking your walk. This part can get a little tricky because, for many people, the idea of a reward is synonymous with food. But you’re also trying to watch what you eat, so you’ll have to come up with another reward. Perhaps you can keep track of the number of days you accomplished your new habit, and when you’ve reached a certain number of days, treat yourself to a shopping trip or a movie.

After a month or two, you will have gotten into the habit of walking for half an hour a day. Next, you can develop healthier eating habits, another change you’ll want to make if you’ve recently been diagnosed with diabetes. Use the same three steps – cue, behavior, reward.

To increase your chances of succeeding at making this new behavior a habit, here are some tips.

Focus on one habit at a time. You may be trying to get more exercise and eat healthier at the same time, but focus on one goal first to make it a habit. Once it’s second nature, move to the other goal.

Be positive. Your new habits will make you a stronger, healthier person, so focus on that. Don’t think of it as depriving yourself of your favorite foods or forcing yourself to exercise.

Forming new habits like daily exercise and healthy eating will help you better manage your diabetes or another chronic disease.

My Go To Stretching Routine

I thought I would share my go to stretch routine. I do this after any type of workout in order to lengthen my muscles, maintain flexibility, and to ease the delayed onset muscle soreness (DOMS) that is bound to make an appearance the next day.

If you want to follow along, I would recommend a short pulse raiser to start. Jogging on the spot for a few minutes should prepare you. Let me know what you think?

Rowena x

I’d love to connect with you on Twitter, Instagram and Youtube.


Check out more workouts and posts by Rowena on https://www.type1active.com/

With Diabetes, You Can Do Anything!

Diabetes has been a part of my life for 22 years. On February 9th, I celebrated my Diaversary. I always knew diabetes wasn’t my purpose, my purpose is to live my life the fullest and that’s what I communicate to all people with diabetes –

“you’re the purpose, not diabetes, so do everything you can to not let diabetes stand in the way of your dreams”.

I have had type one diabetes since the age of 4 (1995). Many people think that I’m used to it because I was diagnosed as I child and I don’t remember life as a healthy person. But as every person with a chronic disease, I dream of a life without it. Unfortunately, I remember some images from the hospital and feelings of pain, fear, and sadness. Till this day I’m afraid of taking venous blood samples for tests in clinics, because of how traumatic it was to me when I was diagnosed.

In the begging I was treated with insulin injections, then I was on insulin pens and in 2003 I got my first insulin pump. Since that time I became a “full-time pumper” with no breaks. For most of the time, diabetes was just a normal part of my everyday life, nothing special. I only experienced some teasing and discrimination in elementary school, but time heals wounds, especially when you meet some nice people after a tough time in your life.

Now I am a Diabetes Youth Advocate, a Diabetes Educator, and a Diabetes Blogger. Raising diabetes awareness is an important issue to me…but how did it happen?

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It all started with my diabetes burnout in 2013 – when my disease “turned 18.” I felt kind of depressed that it’s “an adult” now, and so many years have already passed. I was exhausted and unhappy at that time. One day I thought that maybe I could overcome it with running a blog. I was writing a lot of poems, stories, and songs, so that’s why this idea came to me in a natural way. With the support of my family and boyfriend, the blog was finally created.

I’ve decided that the symbol of my blog will be a blue sugar cube because I think sugar cubes are so cute and of course blue is our color. 🙂 At first, it was only my personal thing, but to my surprise, people started to read my posts! It turned out that I’m not only helping myself but also other people with diabetes, and parents of children with diabetes.

Then many things in my life changed for the better! I received both Bachelors Degree and Masters Degree with honors (in Exhibition Design Study) and my Masters’ diploma was presented on Coming OuT Best Diplomas of Academy of Fine Arts 2014. I also managed to finish my second field of study on the Academy – Pedagogical Study, which allowed me to gain experience in teaching arts and crafts to children, adults, and people with disabilities.

I wanted to use my artistic skills to change diabetes somehow. That’s why in 2014 I have created two adorable monsters – Hypo (blue) and Hyper (red), which represent hypoglycemia and hyperglycemia. I wanted to encourage people with diabetes to talk about symptoms and emotions related to those states and to explain to healthy people how it works. Hypo and Hyper were heroes of the calendar which were designed for diabetes clinics in Poland in 2014.

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I’ve started to be involved in many different social campaigns and actions (Menu for diabetic, How to Live with Diabetes, Human Library and more), write articles and feuilletons for diabetes magazines or portals and even lead free lectures and educational meetings for people with different types of diabetes in Polish Diabetes Association. I became certificated Diabetes Educator by participating in course organized by one of the polish diabetes foundations. Recently I founded the diabetes group Blue Sugar Cubes on Facebook to give people with diabetes and their families more support.

Last year was truly a turning point in my life. I was a participant in International Diabetes Federation Europe Youth Leadership Camp 2016 and now I act as IDFE Diabetes Youth Advocate. For World Diabetes Day 2016, together with two friends from camp, we led our first diabetes campaign eUrMOVE in collaboration with IDFE. I designed logo and graphics with Hypo and Hyper. The campaign was a huge success and we look forward to doing more for diabetes cause this year.

Now I only hope that my fiance’s patience will stay on its’ high level forever, because I’m one crazy diabetic girl 😉 With diabetes you can do anything!

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My Diagnosis With Type 1 Diabetes

Everyones’ diagnosis with Type 1 Diabetes is different. This is why I started my blog – to share my story and this post was the very beginning.

This is my story…

Every person diagnosed with Type 1 Diabetes may have similar symptoms but not everybody’s diagnosis is the same. This story is from my account but parts within my memory are hazy. I don’t know whether It is because I was so ill or that It was a sensitive time so I’ve blocked it out.

It all started when I was in year 7 around the summer term. Everyone who took part in the stage production of Oliver at my high school was taken down to London to see Hairspray the musical as a reward. All I can remember was being incredibly thirsty. Within a few hours of my journey, I had drunk nearly all 3 bottles of my water. So as you can imagine after drinking all that water I started to need the toilet. Realizing myself that I’d drunk a lot on the way there, but just putting it down to the fact that it was a novelty to be allowed flavored water, on the way back I tried not to drink any. However, after falling asleep, I woke up to find my mouth incredibly dry, resulting in me drinking another bottle. It’s just the hot weather making you drink a lot I thought to myself.

Later in the term, I was becoming incredibly tired. By the end of the term, I was exhausted. I was still drinking lots and during the end of year exams, I started to annoy one or two of my teachers constantly asking to fill up my bottle and asking to go to the toilet. Standing outside my form room, I remember this like yesterday, I fiddled with my skirt and it very nearly fell to the floor. That night we had to buy a new skirt from the school shop before speech day at the end of the week. My mum and dad put it down to a growth spurt and I thought nothing of it.

The summer holidays rolled around. At the beginning of the holidays my cousins, sister and myself went to Filey for a week with my grandparents, something we did nearly ever year since being little. I continued drinking lots and going to the toilet a lot. My gran always tells me how she remembers I was drinking so much Robinsons fruit squash – looking back I agree. Constantly needing the toilet when you are at the beach leads to many difficulties – mainly the lack of toilet! Dragging my gran to the sailing club many times a day she knew something was wrong.

‘Promise me you will go to the Doctors when you get back from Spain’ – Gran the Pan (as we call my Gran haha)

 I dismissed it – I didn’t think anything was wrong.

Our holiday in Filey ended and we headed straight for our friend’s villa in Spain. This time with my parents, sister, cousins, auntie and uncle. This is where I became ill quickly. I was eating constantly  (I developed a love for ham toasties) and losing dramatic weight. Every night I would get up around 5 times and every morning I’d have drunk around 4 litres of water (It’s hard to hide how much you have drunk when the water is in a bottle abroad!) Every morning when I’d wake up I was as tired as I had been that night when I had gone to bed. But everybody is sleepy and lazy on holiday – that’s what I thought my tiredness was down too! My dad and uncle tried to throw me in the pool, ‘don’t snap her she’s like a twig!’ my dad joked (unknowingly of course!)

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When we arrived home my mum took me to the doctors, I tried to persuade her not to go but it was no use. This is a TMI warning – so they wanted me to wee in a bottle and as a 12-year-old girl, I refused. We took the bottle home and was told to bring it back the next morning. Finally, after sleeping on the idea I reluctantly did. The doctors then ran some tests and told my mum the results should be there later that day and they would ring us. But an hour later there was a phone call…

It was Doctor Brophy my godparent and GP. He told my mum and dad that I urgently needed to go to the hospital because I had extremely high blood sugar and ketone readings. We rushed all the way to the hospital and I had some more tests. They weighed me and took some blood samples. My mum and dad were both really nervous but I didn’t really understand. They told me that I was Type 1 Diabetic and that my bloods were 38! They explained to me that a non-diabetics blood sugar is between 4 and 7. I weighed around 4.3 stone and my condition at the time was severe. They told us that I was very lucky and that if we had not gone to the doctors on that day I would have been in a coma (shortly followed by death from DKA (diabetic ketoacidosis))

5th August 2009 – The date I was diagnosed.

It was really hard being diagnosed with a ‘disease’ (ergh I hate that term!) that you have never heard of and there is no cure for. It hit my parents especially hard. I remember being sat in a room and my dad having to leave – I know it was because he was trying to process it and didn’t want me to see him upset. My mum with soft Northern Irish heart just cried. (I’ve just cried writing this). I refused to stay in hospital that night. I just wanted to go home. I was told I was allowed if I did my own injection at home and came straight back the next morning. ‘ (From what I recall – my dad may have a different version) What would you like?’ My dad asked when we were sat in the hospital. Instant laughter from the nurses and my dad when they found out it was going to cost my parents an iPhone 3. Every cloud and all that ? haha!

The rest of the summer is just a blur to me – I remember going to Clumber Park in our caravan, we always go to Clumber when a big event happens in our life. But apart from that, all I remember from the rest of the summer is my parents helping me (mostly them) carb counting my dinner, scales, carb ratios and insulin injections.I did my own injections from the start – I refused to let anyone else inject me.

September rolled around and with all my new diabetic supplies I headed off to my first day of year 8. I was lucky enough for my mum to work at school so she let all the staff know that I had Type 1 – however, I was petrified of telling my friends. Our first lesson was Biology and I think all the stress got to me because I felt really strange. From what I remember I’d only had this feeling once before. I checked my blood sugars and they were low. I remember being really embarrassed having to tell my teacher I was low but she was lovely. Some of the symptoms of low blood sugars are lack of concentration, dizziness, and shakiness. I had two plain digestive biscuits to bring me back up as my eyes were welled up with tears. My friends on my table asked what was wrong. Newly diagnosed I didn’t know how everyone would react. Only knowing about Type 2 before I was diagnosed and how it was portrayed in the media I thought they’d think it was because of my weight (which to be honest) you must have been able to tell it wasn’t!

 I wrote it on my wrist – ‘I have Type 1 Diabetes’ – That took so much of my courage.

Being Diagnosed with Type 1 wasn’t the be all and end all. It was the beginning and the start of a long journey but not a bad one – it’s a roller coaster. It was a learning process, it still is and it always will be. I hope by sharing my story it will be relatable to other Type 1’s – the unknown, the confusion and the symptoms. If you didn’t know what it was like to be diagnosed with Type 1 I hope it’s given you more of an understanding (and well done for reading to the end!)

Lots of love The Backpacker and the Pod xxx

If You Are Living With Diabetes, You Are Not Alone

My name is Bia and I have been a type 1 diabetic for 16 years. I was diagnosed when I was six-years-old. I don’t remember much, but I remember my parents crying and I remember my doctor saying: if you learn how to control it, you can live a normal life.

My parents understood that and they taught me to be a strong and responsible person. I knew that I had a chronic disease and I couldn’t play with it. My life depended on my decisions. I had some bad days when I didn’t want to check my blood sugar or count carbs correctly, but it was only days. I don’t have these days anymore. I haven’t for years 🙂

I’ve worn an insulin pump for 10 years and it’s my best friend! I call it “bombinha,” and I love it as I love my family. It helps me control my blood glucose, and has given me wonderful freedom!

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I have the support of my parents, friends, and boyfriend in every decision that I make. They are everything to me. I believe that everything in life must be conquered. Good things happen to the good people. If you are kind to others, life will be kind to you. We need to put our heart into the things we do, and not only think about the life prizes.

In 2015 I decided to write about my diabetes to my Facebook and Instagram friends. I’ve never hidden it, but I began to explain everything to everyone online. People used to stop me on the street to ask about my insulin pump and I always loved to explain how it works! Writing a blog about diabetes it’s one of the best things I’ve ever done! I LOVE to answer questions and share some good information for the diabetic public.

In Brazil, we have a poor public health system when it comes to diabetes and knowledge. I believe that with my blog I help more than some of the doctors here.

Controlling diabetes it’s not an easy task, but with patience, self-love, and knowledge, it can be possible!

My plans for the future is to continue my work with Biabética and help more diabetics every day. I want to be known so I can reach more and more people with good information about diabetes! Let’s be more positive, and let’s help those who need support and love to treat their own chronic disease!

My message to everyone is: you are not alone. The internet is the best way to find others like you. Don’t hide your condition, don’t be ashamed of it! You are beautiful and great with it. ❤

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Using Diabetes To Inspire Others

Diabetes has been a constant in my life for the past 9 years. It’s been a rough and bumpy few years, and I can honestly say that this disease has really shaped me to be the person that I am today.

This disease is real. It has no breaks, vacations, or a pause button. Since the day I was diagnosed, I remember sitting in my hospital bed and my mom telling me how I will use this disease to help others, but at the time I didn’t think I could do that task. I struggled as a young teen dealing with Diabetes and wanting to feel “normal”. Growing up, I always felt like I had this thing that I could never get rid of. I wanted so badly to go out with friends and feel safe knowing that I won’t have a low blood sugar or have to lug my meter case around everywhere I went, and have to explain to them what I had in it. I remember feeling like I wanted to just give up. I ended up slacking a lot on my health. I didn’t check my blood sugar as frequently as I should have. I didn’t count carbs the way I used to. I seemed to have lost all means of being a Type 1 Diabetic. As a normal Diabetic does, I went to the Endocrinologist and received my life-changing news.

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I had just gotten my Hemoglobin A1C blood test and the Diabetes educator sat me down to tell me that my blood sugar average had been very high for a long time and if I didn’t gain control of my numbers, I could loose my vision, have arm and leg amputations, or have heart problems. Since that day, something clicked in me and I decided I needed to make a difference in my life and in the lives of those that I came in contact with on a day to day basis. I began making better choices in what I ate, exercised more frequently, and took initiative in dealing with this chronic disease. Shortly after, I went for a visit to the Endo and I began to improve more and more each time. That motivated me to use my positivity and excitement for improvement to create something that I could share with others going through the same thing or something similar as me. That’s when I got the idea to create @type1livabetic on Instagram.

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I chose to create something that I can use my love and passion for photography as well as my love for sharing positivity in Type 1 Diabetes. Since then, I feel as though I have really grown as a Type 1 Diabetic and became a part of this wonderful growing community. I am so blessed and privileged to do what I get to do every day. My goal is to inspire others with my disease so that they know that they can do whatever it is they put their mind to.

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This is why I am here, to be a voice in the Diabetic community in hope of one day being freed from this life altering disease! One day at a time! 


If you would like to share your story with Lyfebulb and our readers, please e-mail contact@lyfebulb.com.

Becoming a Chronic Patient

26 June, 2009

I had woken up with Michael Jacksons’ “Ben” streaming out the radio. The news of his death had reached South Africa. I wrote my last mid-year examination of Grade 10 and celebrated by watching the newly released “The Hangover”. While we discussed the obsceneness of the film, I received a not-so-average phone call from my mom who had taken my little brother to see a doctor.

“Tracy, your brother has been diagnosed with type one diabetes”

Sure, my brother David had looked exceptionally unwell, stick thin and couch ridden, a far cry from his athletic build and energetic character. But what on earth is type one diabetes (T1D)?

“So what does that mean? Does he need antibiotics?” I replied.

Little did I know the whirlwind that was about to hit my brother and my family. We all grappled with the concept of T1D. What do you feed a type one? Is sugar bad? Insulin injections? What is insulin? Daily monitoring of blood sugars? We were a family unit exceptionally confused and desperate to help David through this diagnosis, but not fully understanding how.

David had gone from carefree 14-year-old to being his own doctor and primary caregiver- administering his medication every day.  He singularly experienced crippling low blood sugars when injecting excess insulin and the exhaustion of high sugars when he did not take enough. He was alone with these feelings as we could only try to understand and help where we could.

The integration of diabetes into an individual’s life and further more into a family’s life is challenging with mental, emotional and physical hurdles. Education regarding T1D came through websites, the endocrinologist, courses, and books, but more potently- through the experience living with a T1. We learned together through trial and error. We now knew and understood the symptoms, lifestyle of consequences of this chronic illness. (That most definitely does not require antibiotics, thank you Tracy of ‘09.)

At least, we all thought we had the subject waxed.

20 October, 2013

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I stared at my skeletal body in the mirror, my 20-year-old, incapable and broken body. My body and mind were permanently exhausted and constantly failing me. My bloodshot eyes searched and traced my bones. My head was surging and nausea scratched at my dry throat. Surely not, I thought.

With a knotted stomach and shattered threshold, I asked David to test my blood sugar. The countdown of the tester was excruciating, how could 8 seconds feel like an eternity? The monitor greeted me with a beep and a cheeky “HI”. Simple as that, I was diagnosed with type one diabetes. The tears flooded my eyes and streamed across my face.

My heart felt an incredible amount all at once.

It broke and ached.

It felt immense relief finally knowing why I was sick.

It broke again, for now I needed to break my parents’ hearts.

It sang that my brother and I were now a team.

I went from standing on the outside of T1D, curiously and helplessly peering in at my brother, to stepping in, right by his side with my own T1D diagnosis. I watched David tackle it for four years, expressing my sympathy and support. Now I was fully thrust into a position of empathy – I now knew what he felt.

With 10 years of exposure to T1D from David’s diagnosis to my own, I have felt the obvious lack of knowledge surrounding T1D in society. We don’t know the symptoms and we cannot seem to recognize the lethal combination of exhaustion, excessive thirst and bathroom breaks, unintended weight loss, blurry vision, irritability, and nausea. I was a second-year medical student, with a T1D brother yet it still took me months, to acknowledge my symptoms, to recognize my disease and act accordingly.

The thought that I possibly had T1D did flash across my mind in my last weeks leading up to my diagnosis but I kept dismissing my symptoms:

I am exhausted from being so busy.

I am thirsty and losing weight because I am doing Bikram Yoga.

I am crying, angry and frustrated each day because it has been a tough year.

I am simply burnt out.

The symptoms are problematic as they can be explained by most stressors in modern daily activities, which effectively delay an important diagnosis. Further impairing prompt and vital healthcare falls upon the shoulders of health-care professionals. The T1D diagnosis is often missed. It is a tragic oversight as it can be suspected by simply taking a patient’s history and performing affordable bedside tests. A urine dipstick or a finger prick glucose test can often scream T1D. The delay and failure of diagnosing T1D carries a heavy price, such as the heart-breaking stories of little Kycie Jai Terry (5), Claire Taylor (17) and Nicola Rigby (26), all losing their lives to undiagnosed T1D.

Living with this chronic illness has made me acutely aware of spreading my knowledge and insight into T1D. This inspired me to start my own Instagram account, type1tracy. Diabetes has enriched my approach in my medical studies, as I have become the chronic patient. It has made me mindful, grateful and present. Accepting my diagnosis, I have achieved more than imaginable and am blessed with appropriate medical health care. It has made me strive to be the best doctor I can be.

If you have T1D, you are empowered with knowledge. You never know whose life you may change by injecting your insulin in public, sharing your diagnosis, your symptoms, and your experiences. Above all, you can change lives and your own, by fully embracing type one diabetes – all while being unapologetically you.

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Diabetes Doesn’t Have You

Chris Dudley played basketball in the NBA for 16 years. The Yale graduate gained notoriety around the league as a voracious defender, energetic rebounder, and formidable shot blocker. He played Center as a member of the Cleveland Cavaliers, the New Jersey Nets, Portland Trail Blazers, New York Knicks, and the Phoenix Suns. Dudley was born in Connecticut, but grew up primarily in the San Diego area of California where he started playing basketball. A bit of a late bloomer, Dudley played Junior Varsity basketball through his junior year of high school when he was first diagnosed with diabetes at the age of 16. Committing to Yale University during his senior year, Chris Dudley played for the Bulldogs from 1983 to 1987 before becoming the first ever Type-1 Diabetic to play in the NBA when we was drafted by the Cleveland Cavaliers in the fourth round of the 1987 draft.

Dudley’s professional career achievements include playing in a total of 886 games, scoring 3,473 points, 375 assists, 1,027 blocked shots, and 5,457 rebounds. The NBA rewarded Dudley with the J. Walter Kennedy Citizenship Award in 1996, and USA Today named him the Most Caring Athlete in 1997.

I was fortunate enough to interview Chris Dudley about his experience playing basketball as a type-1 diabetic.

It was in his spring semester in 1981 after his sophomore year that Chris Dudley started to experience the classic symptoms of increased thirst and frequent trips to the bathroom. His close uncle had diabetes, so after advising Dudley and his dad to test his blood glucose level (BS) at a home test kit from the local pharmacy, he realized he had T1D.

Initially shocked, Dudley remembered that the life expectancy for diabetics was well below that of non-diabetics in the early 80’s. Nearly as important to the 16-year-old was the question of whether or not he would be able to keep playing basketball.

Lucky for Dudley two main factors kept his spirits high in this tumultuous time. One, his endocrinologists in San Diego were fairly progressive in that knew the value of athletics in maintaining steady glucose levels. Although not a lot had been confirmed in this time as it related to the effect on sports and diabetes, his doctors did not deter Dudley from continuing to play. Second, Dudley looked to National Hockey League star Bobby Clarke for inspiration. Bobby Clarke was drafted into the NHL in 1969 as a diabetic, ultimately winning two Stanley Cup Championships and being inducted into the Hall of Fame in 1987. Clarke inspired confidence in Dudley that achieving athletic success was possible for a type 1 diabetic.

Most diabetics typically receive their insulin through two methods: multiple injections via an insulin pen or syringe, or through an insulin pump. Through the bulk of Dudley’s career, he received his insulin through multiple injections, as pump use had not been as highly advertised until the early 2000’s. Dudley commented that he wears the pump to receive his insulin currently, and would have considered wearing the modern day pumps back in his playing days, had they been available.

Other than his impressive doctors back in San Diego, Chris Dudley credits a particular nurse, Molly Meyer (who worked at Yale where Chris played in college) as incredibly instrumental in helping him out to manage his diabetes when it was most important and the level of play was at its highest. When asked about the most important person who currently helps Dudley the most with his diabetes management, he notes that his wife, also named Chris, is responsible for keeping him on top of his health.

Exercise of any kind with diabetes can be arduous. Playing basketball at the highest level for 16 seasons certainly presented unique challenges for Chris Dudley. When I asked him what the hardest aspects of his career were, he spoke about all the spikes in bis blood sugar from adrenaline he experienced, playing night after night in front of ten of thousands of screaming fans. The schedule of an NBA player also presents plenty of variables that may affect his glucose level management, from altitude of certain cities to back-to-back games on the calendar. The lag time for insulin in the 1990’s was also closer to 45 minutes, rather than the 15 to 20 minute absorption rate diabetics are blessed with today. This meant Dudley had to operate with a tremendous amount of foresight to try and keep optimum BS levels for game time.

I asked Dudley to share with me his average game day schedule, including testing times, in order to get a better sense on how regimented an NBA player with diabetes’ agenda must be.

Assuming the game was at home:

    • Dudley would wake up and test
    • Eat Breakfast
    • Prepare to drive into the arena for a pregame shootaround and test
    • Arrive at the arena and test
    • Participate in the pregame shootaround and test
    • Complete a quick workout, this might include a light lift and/or a solid stretching session, all while testing
    • Drive back home and test
    • Take a nap, wake up and test
    • Eat a balanced meal, chock full of protein
    • Relax for a bit and test
    • Drive back to the arena for the actual game and test
    • Get more shots up, complete pregame workout is necessary to get loose and test
    • Prayer/Mediation in the pregame Chapel and test
    • Pregame meeting with the team and test
    • Right before game time test
    • The Trainer will test (4x) throughout game
    • At Halftime test
    • After the game, get changed, test, and drive home
    • At Bedtime, test

If you’re counting at home, that’s roughly 20 times a day that Dudley tested his blood sugar. He notes how convenient it would have been to have been playing professional basketball in the Continuous Glucose Monitoring (CGM) era where he could read a continuous plotting of his blood glucose levels.

Unlike golf, swimming, or singles tennis, playing basketball as a diabetic is complicated in that you are a member or a team. With that team aspect, comes a level of responsibility and accountability to your teammates. It can certainly be intimidating to talk about your issues as it relates to your disease when you are the only diabetic surrounded by others who know very little about your needs. A member of many different teams in many different cities, Dudley asserts that his teammates everywhere were largely supportive. Even though many of peers never quite understood his condition, they showed a genuine interest. When I asked Dudley what may have contributed to such a positive response, he recalled back to early in his career, when he purposively didn’t miss any games or practices. Dudley credits his durability, at a time when his reputation had yet to be fully molded, to be responsible for players around the league to recognizing Dudley would not lean on diabetes as a crutch or excuse to not work hard and hustle.

Despite an incredible display of toughness and durability, like all diabetics, Chris Dudley has certainly had his fair share of hypoglycemic (or low blood sugar) incidents. One can imagine how stressful it must be to in the heat of the moment in a big game, unsure of whether or not you are just tried form running up and down to court or if you’re experiencing an issue beyond your control. What Dudley feared most wasn’t just playing terribly, it was letting his teammates down and embarrassing himself in front of 20,000 fans. When a diabetic’s blood sugar initially starts to drop, the symptoms mirror that of just being tired. Every athlete’s natural response to fatigue is to push through that feeling, to tell your body it can take on more, when in reality there’s a possibility it truly can not. Dudley was fortunate enough to have had these experiences, but was never forced to miss an entire game. The all to familiar act of having to binge drink juice in order to maintain a normal blood sugar level was definitely a phenomenon Dudley says he experienced.

When I asked him about any particular scary moments he’s faced when having a low, he recalled a game he played against the Denver Nuggets. The game was already decided, causing every player to worry less about execution and more about running up and down to the court and scoring to perhaps leave an impression for the games ahead. Dudley’s blood sugar crashed dramatically, and he ended up leaving the game entirely and needing an IV to deliver glucose and replenish lost fluids. In addition to the increased elevation of the Mile High City, Dudley also suggested he might have been a tad ill, which could have contributed to his erratic BS.

Despite occasional hiccups, it is without question that Chris Dudley found success playing basketball in the NBA. In talking about his greatest achievements as a basketball player, Dudley includes his 16 years of playing professionally, being the first ever type-1 diabetic to play in the NBA, leading the NCAA in rebounding while at Yale, and being amongst the leaders in the NBA in rebounds per minute played. Dudley recalls one his most proud moments to be when he won the Eastern Conference Finals playing for the New York Knicks in 1999. It was the first time in NBA history an 8th seed had beaten a 1 seed, beating the favored Miami Heat 3 games to 2 at home in front of their fans at Madison Square Garden.

Outside of the court, Chris Dudley has been serving the diabetic community through his Chris Dudley Foundation for the last 20 years. Operating out of Oregon, he holds camps through which his foundation aims to empower kids with type-1 diabetes. Dudley promotes achieving dreams by through acceptance, staying active, and taking care of yourself. Dudley adds that his foundation has teamed up with the Portland Trailblazers and the Pacific Northwest Diabetes Union to promote healthy activity and encourage diabetics during the Pacific Northwest Diabetes Awareness week.

I asked Chris Dudley what message he would give a newly diagnosed teenager with professional athlete aspirations, like himself all those years ago. Dudley paused and echoed again acceptance.

“You have Diabetes, Diabetes doesn’t have you”

It’s normal to ask “Why me?” but you cannot get too caught up in wondering what cosmic forces aligned for you to be diagnosed with diabetes. Dudley remarks instead that you should work through it.

Looking ahead, Dudley has no end in sight for his annual camp until a cure is found. In fact, he is looking to potentially expand his camp across the West Coast. He will continue to work with the Portland Trailblazer and Pacific Northwest Diabetes Union on Diabetes Awareness week and has some very revolutionary ideas for the NBA. In 2015, American sports leagues have used their influence to bring awareness to such causes as Breast Cancer or Military Appreciation. Dudley has expressed a desire for the NBA to potentially join forces with the American Diabetes Association to raise awareness. The month of awareness is in November, as is the beginning of the season, maybe the two associations could even incorporate a color scheme to be worn throughout the league. I, for one, would be ecstatic to see such a notion actually manifest itself.

Before finishing our interview, I told Chris Dudley that I’ve always kept a dynamic Top 4 diabetic athlete Power Rankings, a Mount Rushmore if you will. Diabetic Athlete Gary Hall Jr. introduced me to the idea that diabetes did not have to inhibit your athletic dreams when he won the gold just weeks before my own diagnosis, so he earns a spot. I was playing basketball in high school around the time of Adam Morrison’s heroic performances at Gonzaga, so he earns a spot. Jay Cutler balances his blood sugar levels while playing in the National Football League. Spot. I added myself last both because I came up with this idea and we need a little ethnic diversity. After laughing at my foolishness, Chris Dudley was gracious enough to offer me his Diabetic Athlete Mount Rushmore:

1. Bobby Clarke (NHL): Mentioned earlier in this piece, Bobby Clarke is an NHL Champion and Hall of Famer who had achieved many accolades around when Dudley himself was diagnosed.

2. Ron Santo (MLB): Santo was a star third baseman for the Chicago Cubs from 1960-1973, the Five time consecutive Golden Glove winner also batted .300 and hit 30 home runs in four of his fifteen seasons

3. Bill Collision (Triathlete): Coming out of California, this triathlete was the first ever to win the competition as a diabetic.

4. Chris Dudley (NBA): Chris Dudley was the first diabetic to ever play in the NBA, paving the way for plenty of others to follow in his footsteps. He’s well in his rights to put himself on top of that mountain.

As a player, Chris Dudley embodied grit and determination, he has taken that effort off the court in the present day to encourage and inspire diabetics like him to flourish at the highest level of competition. We should all take a page out of Dudley’s book and accept the terms our lives have given us, but to not be defined or deterred by them. As we work towards both a cure and better methods of management, let this be our battle cry:

“You have Diabetes, Diabetes doesn’t have You!”

For more updates and tips on how to use fitness for diabetes management and prevention. Follow me on twitter @roycHealth !

Going For Gold

Gary Hall Jr. is a three time Olympic swimmer out of Phoenix, Arizona by way of Cincinnati, Ohio. A product of a strong swimming lineage, his father Gary Hall Sr., uncle Charles Keating Ill, and maternal grandfather, Charles Keating Jr., all have competed and won medals in previous Olympic games.

Hall Jr. himself competed in the 1996, 2000, and 2004 Olympic Games, winning a total of 10 medals. At only 21 years of age in the 1996 Olympics, he won two individual silver medals and two team relay golds, including helping set the world record in both the 400 meter freestyle and medley relays. Hall won 2 gold medals in the both individual and relay events in the 2000 Olympics and an additional gold in the 50 meter freestyle in 2004.

Although highly decorated, Greg Hall Jr. had to overcome being diagnosed with type-1 Diabetes Mellitus in 1999 before the 2000 Olympics. He faced a decision whether or not to give up swimming entirely.

I spoke with Gary about that tumultuous time in his career.

Hall was diagnosed in march of 1999, after we underwent the very typical stages of grief and shock he says he remembers there being few diabetic athlete standouts at the time. Most importantly, there were certainly no Olympic athletes.

Two separate doctors told Hall that his diagnosis would mean the end of his career. They told him the strenuous Eight or more hours he would have to spend practicing in the pool would be too great a risk for someone having to regulate their blood glucose levels with insulin injections.

Unsatisfied with this news, the determined Hall eventually sought the advice of Dr. Anne Peters, who he credits most for her encouragement to not give up early on. The UCLA (now USC) endocrinologist and her team worked closely with Hall to utilize his strict workouts positively to control his sugars, rather than as an obstacle. Gary Hall credits Dr. Peter immensely for helping him find a routine that ultimately allowed him to continue competitive swimming at the highest level.

When he returned to swimming competitively, he broke the world record in the men’s 50-meter freestyle race with a time of 21.76 seconds at the 2000 Olympic Games.

Most diabetics are instructed to regulate their diets and control their blood sugars with multiple insulin shots delivered through syringes and pens. Insulin pumps offer a lot of flexibility with the amount of insulin that can be delivered over specific periods of time, but can be burdensome, as they must remain attached to the body. Choosing which method of insulin delivery can be challenging, especially for a world-class competing athlete.

Hall noted that he alternated back and forth between wearing a pump and taking multiple injections as he trained for the Olympics Hall attempted unsuccessfully to wear an Omnipod pump in the water for training and meets as he adjusted to swimming as a diabetic. Unplugging his pump and no longer receiving basal insulin, his blood glucose levels would shoot up hundreds of points after a training session. Here he was competing in a sport where swimmers shave off their body hairs in attempts to gain an edge and facilitate speed. Hall on the hand was wearing injection sites for his pump that would fly off his body, forcing him to try such extreme measures and using duct tape to adhere the sites to his skin in the water. He settled finally on multiple injections for competition.

The daily activities of an athlete are so regimented; it’s nearly catastrophic when there are disruptions. Unfortunately, diabetic athletes are all too familiar with challenges which may disrupt their routines. When I asked Gary Hall what his biggest challenges were, he responded with his beliefs about the lack of resources for diabetic athletes on topics such as: post workout spikes, competition adrenaline spikes, and the differences in blood sugar management between anaerobic and aerobic workouts.

The best way to combat these challenges is to maintain a stringent routine of the same activities before competition. I am well aware that diabetic and non-diabetic athletes alike will follow a particular routine that works for them like a bible. I asked Gary to share with me his routine for the day leading up to a big race:

  • Gary claimed he would test his blood sugar 20-25 times a day.
  • He would carry his blood glucose meter with him at all times all the way up to the Ready-Room before a particular race (A small room near the pool where only competing athletes were allowed 5-10 minutes before each race)
  • After the race he would test again, his blood sugar typically had shot up, sometimes up to 300 points
  • He would then proceed to giving himself a bolus of insulin to get his blood sugar back down to a comfortable level (below 200) before it was time for his heat to participate in the next race

Despite all the precautions we take, diabetic athletes can still fall victim to complications related to their blood sugars. “Going Low” or experiencing hypoglycemia is a condition where blood glucose levels are too low. The body usually undergoes symptoms such as dizziness, sweating, and an elevated heart rate. If not treated, hypoglycemia’s can lead to seizure, coma, or death. Surprisingly, most diabetic athletes or far more concerned with not being able to compete than they are about their own safety.

Gary Hall recalls a hypoglycemic episode at the 2001 Goodwill Games in Australia. He remembered testing throughout the day, but approximately 15 minutes prior to the race, he checked his blood sugar (BS) on his meter and it read 60 mg/dl (anything under 80 is considered low and exercising at a two digit BS is not recommended). He quickly grabbed and drank a sports drink and waiting a few minutes before checking again. After the second reading he realized his blood sugar had actually dropped even more, and it was officially time to panic. He chugged down another sponsored sports drink in the ready room and grabbed a third on the way to the actual race. Holding his third sports drink during swimmer introductions, he gulped it down on the starting blocks legitimately moments before the sound of the gun. With a belly sloshing full of sugary hydrate, he started the race, but unfortunately vomited underwater at the 35 meter mark. Gary Hall Jr. solidified his cult hero status as he completed this task on national television, but still finished second in the race.

Hall admits his biggest fears related to going low include the serious risk of having a Seizure in the pool and drowning, but also the soul-crushing possibility of potentially having to stop what you love to do.  

On a more positive note, I asked Hall what he appreciated about his experiences participating in the Olympics as a diabetic athlete:

“I could not have imagined the level of support from the T1D community. I received letters of support from all over, motivating me to train harder.”

Hall continued to say his greatest accomplishments were being able to represent the USA and win on the greatest stage, and representing the entire diabetic population worldwide.

In November of 2008, Gary Hall Jr. retired from competition. Since retirement, Hall has been extremely involved in health initiatives related to diabetes and Type-2 diabetes prevention.

Alongside groups such as the Aspen Institute, the Clinton Foundation, the American college of sports medicine, and the T1D Exchange, Gary Hall works tirelessly with policymakers to improve the lives of Americans looking to take control of their health.

Hall is currently promoting “Project Play”, an initiative looking to increase youth access to physical activity and sport. Hall has testified before Congress and believes that when it comes to insurance, discounts that currently exist for corporate gym memberships and safe driving should be extended to children and families who consistently engage in physical activity and sport. He believes American children and families should be rewarded when they proactively protect themselves against obesity and Type-2 Diabetes.

When I asked him how he envisions the rest of us as citizens can help aid the cause, he replied that we should all be advocates. Anyone touched by diabetes in any way should open up and speak about the challenges he or she faces. He recalls that legislation back around the time of his diagnosis would not have allowed him to buy health insurance, despite being able to win a gold medal in the Olympics. Hall doesn’t believe in us as diabetics settling with the rules as they currently exist, and moving forward would like diabetics to have the ability to join the military. Overall, he preaches that more people should get involved.

I too agree more should be done, especially for those willing to work for their health and well being. I think we should all follow Gary Hall’s lead and take it upon each and every one of ourselves to promote initiatives beneficial to our cause.

When asked what other famous athletes or celebrities might’ve inspired Hall throughout his career, he chuckled and replied simply: “The people who touched me most weren’t world champions, they were ordinary folks doing what they loved, who wouldn’t be denied” In august of 2004, a 13-year-old version of myself sat and watched Gary Hall win the gold after a television segment explaining what he had gone through as a diabetic athlete aired. About a month later that boy would receive the news from his doctor that he too was diagnosed with Type-1 Diabetes. After recovering from the initial shock, he remembered Gary Hall Jr., and found comfort in knowing that he too could achieve his highest athletic dreams.

I will always be grateful for the inspiration given to me that year from Gary Hall, his performance encouraged diabetics and athletes across the world not to allow any shortcomings to stand in your way to greatness.

For more updates and tips on how to use fitness for diabetes management and prevention. Follow me on twitter @roycHealth !

Pancreas 2.0

I am fortunate to have been SICK enough to be eligible for a pancreas transplant, BUT the surgery itself and the life-long immunosuppressive therapy I will have to undergo to keep my body from rejecting the foreign organ, were huge risks to my very being.In fact, there was a 10 % mortality rate in the surgery, and each day I use immunosuppressive therapy puts me at a greater risk for cancer or serious infections.This was evidenced by my recent fight against sepsis after contracting salmonella while on vacation in the Dominican Republic.

While the surgery I underwent was dangerous and the immunosuppressive therapy holds risks, it was well worth the struggle, compared to the risks of not having the surgery. Without surgery, my Type 1 Diabetes placed me at a risk of not waking up from a normal night’s sleep, passing out while driving my car, exercising, or just walking on the beach…

I had so called “hypoglycemic unawareness”, a condition which often happens after many years with diabetes, and makes the person vulnerable to lows in sugar because they cannot feel the warning signs. I also had late-stage complications of diabetes, including kidney failure and eye disease, requiring a kidney transplant to survive, and multiple surgeries to prevent blindness. Due to my life-saving kidney transplant, I was already on immunosuppressive therapy, making the decision to go forward with the pancreas transplant easier.

I am a so-called beta version of the Cure – this means that my treatment, the pancreas transplant, was experimental and not applicable for everyone. But the outcome has been incredible and I can now convey to others how they would feel if they could experience perfect pancreatic function back. The more advanced version of this treatment may involve the use of beta cells that are infused through the liver, but it would still require immunosuppressive treatment.

Though complicated, at least this form of treatment would not pose the risks surgery entails. In my mind, the 2.0 version is cells that are grown in abundance in vitro, expanding the supply. However, these cells need to be protected against the immune system and not require the person to use immunosuppressive drugs. Companies such as JNJ and San Diego based Viacyte are working on this technology. Just recently, a fantastic scientist from Harvard took a big step forward. Dr Doug Melton is a Father of two children with Type 1 Diabetes. He changed his scientific path and dedicated his life to finding a cure. Now, he may be onto something. He has developed a way to grow embryonic stem cells in culture into insulin-producing beta cells that can be infused back into the person needing them. Check out his work here.

http://news.harvard.edu/gazette/story/2014/10/giant-leap-against-diabetes/

My current life without insulin injections, fears of going low, or having late-stage complications proves that it is worth the effort and money to bring Dr. Melton’s science to the market and allow for all people with diabetes to live normally and freely.

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