Cartoon by the fabulously talented Haidee Soule Merritt

This is a precautionary tale. Don’t forget, as I did, that the summer heat and humidity can affect your skin, your body temp, your insulin viability, your sanity. For some summer pointers, click here, “How to deal with heat and diabetes.”

For the past two days my blood sugar has been higher than usual. Yesterday, when it went up to 180 mg/dL around 10 am, after waking at 105 mg/dL, and not having anything to eat, only a cup of coffee with cream, I froze. What the f#@k! Granted, my blood sugar rises 20-30 points regardless of no food when I wake from the Dawn Effect, but 75 points was just not right.

My mind began the tedious backtracking. Was my mealtime Humalog bad? Hmmm..maybe, it looks a little cloudy. Was my long-acting Tresiba bad? Maybe, I couldn’t remember when I started it. Were either, or both, spoiled from my hot apartment? Granted the air conditioner is on by the afternoon, but not in the morning or overnight. How hot was it anyway in the kitchen where I keep my Tresiba in a cup on the counter? The Humalog I keep in the fridge.

Quickly I asked the husband if we had a thermometer and if so to bring it into the kitchen. Of course he did. The temperature was 26 degrees. Well, what do you expect when you live with a Dutchman? 26 Celsius. Now I had to go look that up. That’s 77F. Then I had to look up the threshold for temperature and 86F is the magic number, 30 degrees Celcius, before insulin presumably goes bad.

Frankly, I had no idea what caused the rise in my blood sugar that lasted just about til 6 PM, regardless of the fact that I kept taking half units of my mealtime insulin to nudge the number down. It barely budged. Until of course it came crashing down to 70 mg/dL mid-afternoon with my Dexcom arrow pointing downward still. I swallowed three glucose tablets. My blood sugar raced up to 132 mg/dL and then seemed to leave me at 122 mg/dL and stay relatively steady for the rest of the night.

Still, I stayed up past midnight just to make sure my scariest theory – that I had no Tresiba onboard – was untrue and I wouldn’t find my blood sugar climbing to a DKA number. It didn’t.

This morning I woke up with two revelations. The one on my Dexcom was a happy 82 mg/dL. The other was given the heat wave, I haven’t done my daily hour exercise walk for the past several days. I know this daily exercise keeps me more insulin sensitive. So, was that the reason all along? Maybe my insulins are fine, my body is not dehydrated, I just wasn’t insulin-sensitive with the lack of exercise?

I can’t know for sure, but for now I’m going with this theory. While I’m writing this I’m at a pleasant 106 mg/dL so I’m inclined to think it’s a good hypothesis.

All to say, don’t forget the summer heat can play havoc with you and your insulin. This was in my inbox this morning from Hedia, a Danish diabetes app. With its oddly appropriate timing, I thought I’d share – “How to deal with heat and diabetes.”

 

10% discount off registration fee – Cost is $295 for individual, $395 for the family before discount.

I never had the opportunity to go to diabetes camp since I got type 1 at the age of 18. But I always wish I had. When I started interviewing people with diabetes years ago, young people said to me it was one of the best things that ever happened to them. They made some of their best and expected to be lifelong, friends there.

So if you’re looking for a d-camp for your child this summer, or you want to attend as an adult with T1D or a family, look to ‘V Camp’ offered by the Diabetes Training Camp Foundation. And if you indicate you read about it here, you’ll get a 10% discount off the registration fee!

V Camp runs from Thursday evening, August 13th to Sunday afternoon, the 16th. Each day offers online back to back lectures, small group sessions and fitness opportunities. You can attend whatever you like and every single session.

There will be a program specifically for teens and parents on topics such as sex, drugs, transitioning from home to college, communication and more, and here’s the schedule that was sent to me:

Thursday

6:00 – 9:00 pm
Welcome & Introductions, V Camp Orientation

9:00 – 10:00 pm
DTC Virtual Hub

Friday

9:00 – 10:30 am
DTC Virtual Fitness & Training: walk, run or bike on your own or join our fitness class

10:30 – 12:00 pm
DTC Intro & Core Principles: Dr. Matt Corcoran

12:00 – 1:00 pm
DTC Nutrition: Dine & Learn: DTC Nutrition Team

1:00 – 2:30 pm
DTC Special Guest Lecture: Dr. Michael C. Riddell, York University

2:30 – 4:00 pm
DTC Mental Skills Workshop: Carrie Cheadle

4:00 – 5:30 pm
DTC Virtual Fitness & Training: Fitness Challenge

5:30 – 7:00 pm
DTC Athlete’s Round Table: Special Guest Athletes with T1D

7:00 – 8:30 pm
DTC Medical Lectures: Dr. Matt Corcoran, Dr Kimber Simmons

8:30 – 9:30 pm
DTC Virtual Hub

Saturday

9:00 – 10:30 am
DTC Virtual Fitness & Training: walk, run or bike on your own or join our fitness class

10:30 – 12:00 pm
DTC Medical Lectures: Kimber Simmons, MD

12:00 – 1:00 pm
DTC Coaching Roundtable

1:00 – 2:30 pm
DTC Special Guest Lecture: Dr. Bill Polonsky, Behavioral Diabetes Institute & UCSD

2:30 – 4:00 pm
DTC Guest Athlete Presentation: Special Guest Athlete with T1D

4:00 – 5:30 pm
DTC Virtual Fitness & Training: walk, run or bike on your own or join our fitness class

5:30 – 7 pm
DTC Nutrition Lectures: DTC Nutrition Team

7:00 – 8:30 pm
DTC Exercise Physiology Lecture: Robert Powell, PhD

8:30 – 10:00 pm
DTC Virtual Hub: Life on the front lines with T1D

Sunday

9:00 – 10:30 am
DTC Virtual Fitness & Training: walk, run or bike on your own or join our fitness class

10:30 – 12:00 pm
DTC Medical Lectures: Matthew Corcoran, MD, TBD

12:00 – 1:00 pm
DTC Nutrition Dine & Learn

1:00 – 2:30 pm
DTC Athletes’ Round Table: Special Guest Athletes with T1D

2:30 – 4:00 pm
DTC Mental Skills Workshop: Carrie Cheadle

4:00 – 5:30 pm
DTC Virtual Fitness & Training: walk, run or bike on your own or join our fitness class

5:30 – 7:00 pm
Camp Wrap Up and Closure – Our Virtual Circle

Guest speakers include

 

In the past six weeks I’ve been consulting with a group of global diabetes experts. As a team they are assessing COVID-19’s impact on people with diabetes and how we can keep ourselves safer. I’ve published two articles as a result of this collaboration.

Published on Diabetes Daily, UK Study Under Review Finds People With Type 1 Diabetes More at Risk to Die of COVID-19 Than People With Type 2 Diabetes is an important finding that’s being studied –  once people with type 1 diabetes are hospitalized for COVID-19, they fare worse than people with type 2 who are hospitalized with it. The reason is thought to be that those with type 1 have more vascular damage after years of fluctuating blood sugars.

  “NHS (United Kingdom National Health Service) research reports that people with type 1 diabetes are at 3.5x higher risk for death if they get COVID-19 than people without diabetes. In contrast, people with type 2 diabetes are twice as likely to die as people without diabetes.”

The second article published at diaTribe, Adapting Diabetes Prevention And Treatment Guidelines During COVID-19 And Designing A New Model of Care is a summary of the group’s findings and recommendations to date.

“1. The best prevention against COVID-19, outside of the general recommendation of social distancing and washing your hands, is to keep oneself nutritionally and metabolically healthy.”

Both will help inform you how to move through this difficult time.

Let’s all stay safe: wear a mask, physically distance, wash your hands and keep your blood sugar in range as best you can. That advice we’ve been given since day one has never been more important.

 

One hour ago I received an email through my contact link from Jamie. Jamie is sixteen years old. She got T1D at the age of one and she has already been a speaker for JDRF’s Hope Gala, advocated for diabetes research funding and insulin affordability with members of Congress, writes a blog, worked with Kelly Close of Close Concerns, helped bring the first artificial pancreas clinical trial to India – and published a book of poems  – Onederland – about T1D, “sunsets and worn-out shoes,” as she says. I already feel very old and very unaccomplished.

Jamie is donating the book’s profits to diabetes nonprofits like JDRF, diaTribe and Beyond Type 1.

With a purchase of Jamie’s book you can help fund some of our favorite diabetes organizations, especially during this time when fundraising is harder than ever.

DiabetesDaily has created a super-smart and interactive timeline of the history of diabetes including each innovation. Click on anything and you’ll be more informed about the event.

I often share when interviewed that having diabetes as long as 48 years allows me historical gratitude. If I’d only gotten it a few years ago I might not know what it was like decades ago, a time I often call the dark ages. Know you can.

Imagine, or maybe you’ve had it long enough to know, people had to boil and sharpen syringes. Nobody had a glucose meter before 1982 let alone a CGM. Insulins were far trickier to time with your blood sugar; you really needed to snack at odd times because they peaked at odd times.

So while you’re discovering glucagon first came out in 1061 as I did, just think how lucky you are that so much has improved for us taking care of our diabetes today.