Sugar surfing with Dexcom, sometimes just wait

Above is a screenshot of my Dexcom just a short while ago. Months ago when I’d look at my Dexcom screen I’d only see that arrow going up and think I needed to take more insulin to stop the spike. (Of course depending on how long ago I ate and took my insulin and when the next meal was coming.) But I learned an enormously valuable tip from Dr. Stephen Ponder. Ponder is a beloved pediatric endocrinologist, type 1 himself, and inventor of what he calls ‘sugar surfing.’

Ponder’s book, Sugar Surfing: How to Manage Type 1 Diabetes in a Modern World, gives many guidelines and strategies for managing your blood sugar by watching and evaluating the spikes, and shall we say valleys, you see on your Dexcom – what Ponder calls ‘trendline pattern recognition.’

Here’s the simple tip he gave me that I use: see the arrow, and then look at the last three black dots that represent your blood sugar. Are they going up, leveling out or going down? As you can see the last two dots are leveling out. That means my blood sugar will not be rising much, or for long. The best action then to take is – do nothing.

Sure enough, the screenshot below was five minutes later. Had I taken more insulin my blood sugar would crash within an hour. I know, I’ve done it many, many times in my fierce desire to avoid high blood sugar.

This was a simple case, luckily. Ponder’s book gives you a world of guidance how to read your Dexcom numbers and trends from every angle so that you can be pro-active, to keep your blood sugar in range. As he calls it ‘sugar surfing,’ to ride the waves and stay as stable as possible (on your board).

Of course, as a girl who grew up in New York City, surfing is not exactly my sport, but I’m grateful to anyone who can help me stay on my board.

The Diabetes App, a one stop shop to help you manage your diabetes

This is a guest post from Jazzmine Hale with the company, The Diabetes App. The App was founded by CEO, Sean Zaboroski, last July after watching a loved one struggle after being diagnosed with type 1 diabetes later in life. Zaboroski discovered there was little support to help people take on 24/7 management. He decided himself to develop a platform that could, and would, support people in the diabetes community. The Diabetes App is that platform. 

From Jazzmine:

“These days we keep hearing about the negative effects of social media, but we all know it can be extremely helpful too, particularly when it comes to our health. So I’d like to tell you about The Diabetes App, it’s one app where you have many resources, including the ear of health professionals, to help you manage your life with diabetes. We also have big plans this summer to include the ability to purchase supplies right on the app.

That will be just one of the many services on The Diabetes App. Multiple services in one place, and community, are our two priorities. On The App you’ll find dedicated groups for people with type 1 and type 2 diabetes to connect with each other, as well as groups for loved ones, parents who have diabetes themselves and/or have a child with diabetes. There is also a group where everyone affected by diabetes, all types as well as supporters, can find each other. 

What you will find on The Diabetes App

Here are some of the resources available:

  • Diabetes technology
  • Meal plans & recipes
  • Exercise videos
  • Podcasts
  • Articles & blog posts 
  • Livestreams
  • Health professionals’ guidance
  • Discussions with peers

Health professionals engage with you

The App has physicians, nurses, pharmacists, mental health professionals, diabetes health coaches and educators, fitness trainers and dietitians ready to answer your questions and provide up-to-date information and advice. 

You’ll find them in the “Find A Professional” section of the app or on a livestream. Livestreams occur weekly and are hosted by a health professional or member of the diabetes community.  Livestreams cover topics like, “Ask the Endo,” technology reviews, and fun stuff, like paint night, cooking classes, even makeup tutorials! And if you miss a livestream, you can find it in the livestream archive to watch and re-watch whenever you like. 

How The Diabetes App is different from other apps

The App was designed to simplify the search for resources and support, and to eliminate the need to use multiple apps to manage diabetes. In our dedication to creating community and the sharing of information we encourage users to post a podcast or a blog, or other social media accounts that they find valuable. Users can also directly message any member of The Diabetes App team regarding questions, feedback, or requests for something that you’d like to see added to the app. 

Currently there are 10,000 users and this summer version 2 will be launched as mentioned earlier. It will include an e-commerce feature to allow users to purchase their supplies within the app, and a future update will also include a diet and lifestyle tracker. 

You can access The Diabetes App for free on your phone (available in the Apple App Store and the Google Play Store) or via desktop.  

We know diabetes is a condition where we do better working together. We hope The Diabetes App can be that for you – a platform to make new friends, meet your peers, take advantage of our professionals, and find all the resources and information you need to make your everyday management a little easier, and your triumphs more frequent!”  

Note: In full disclosure, I (riva) don’t use diabetes apps, but you may find it useful for you.

New ‘smart’ insulin pen cap that works with Freestyle Libre 2 CGM

If you use a Freestyle Libre 2 continuous glucose monitor and insulin pens to dose your insulin, you just got good news. Bigfoot Biomedical’s new smart pen cap got FDA approval.

The pen cap fits on most disposable insulin pens and uses glucose data from the Libre CGM to give you insulin dosing recommendations. Bigfoot Biomedical CEO Jeffrey Brewer says the new system is designed to help answer the question: “How much insulin would my doctor recommend I take right now?”

The app the pen runs off also has two hypoglycemia alarms and will alert you to a missed basal dose. Not available for direct purchase users will either get it from their doctor or with a prescription.

Here’s diaTribe’s full article about features and functions.

“How I realized that even the sky is not the limit with Type 1 diabetes”

Kristina Loskarjova (above) sent me an email about her book, Yes, You Can! In it she shares a multitude of stories and strategies from people she interviewed around the world who are living well with type 1 diabetes. Below is a peek into her personal story.

Kristina Loskarjova: “I still remember my 20-year-old self standing on stage and thinking, ‘Is this really what I am destined for?’

I was pitching my start‐up to a jury in a competition in London, and I was experiencing a severe hypo. Back then, while still a student, I was devoting all my efforts to building a start‐up called E77. I was extremely proud of it and had invested all my work and free time into making it a success. I had experienced the side effects of low blood sugar in pressured situations before – in golf and dance competitions, while doing my daily exercise, in school during exams – but it had never occurred to me that it would happen during a truly significant event in my life.

When I finished my presentation, I patiently listened to the feedback I was given, then managed to elegantly (I would like to believe) walk out of the room and rush to my hypo kit. My caring friends kept asking, ‘How did it go?!’ But all I could focus on was getting my blood glucose level up in time. In the end, of course, I didn’t win the competition – but by that point my prize was a steady and safe blood sugar level. 

This was the first time in my life I had truly felt beaten by diabetes. It was the first time I realized that diabetes is not just a convenient excuse that I can childishly use every time I make a mistake on an exam or play a bad golf shot. It could also become an obstacle between myself and my dream life, preventing me from doing things that truly matter to me. 

Nevertheless, I refused to accept that this was the only way it could be, so I devoted time to exploring ways to work with, and not against, my diabetes. I know that I learn best from good examples, so I embarked on a mission to find out how other Type 1 diabetics tackle their blood sugar while performing and excelling in their daily life.

As someone who comes from Hungary, where diabetes is barely discussed, I discovered the inspiring online diabetes community only when I started searching for advice. And I was wowed! Actors, singers, TV presenters, professional sportspeople and those who have no fame– so many role models, so many individuals who could tell me how they managed to handle diabetes while pursuing their goals. And I reached out to them, trying my luck and not quite believing that they would respond to requests from an unknown person like myself. 

But guess what… they did! And their advice was full of stories and life events that reassured me: if they can, I can!

The more individuals got back to me, the more I realized that every story was unique in content yet similar in advice. I immediately started to apply the best practices to my own life. Some of them worked immediately while others took time to master. However, overall, I now find it much easier to give presentations as I know the dos and don’ts that the ‘best of the best’ apply.

Today, every time I’m about to step onto the stage to present, I find a silent space, remember the strong individuals who shared their advice with me and tell myself loudly, ‘Yes, you can!’ I then confidently head onto the stage knowing that I will not find myself in a hypo during this significant moment in my life. 

The more I applied the best practices to my own life, the more confident I became. With time, my diabetes and I became great friends. Today I know – I can! And, in fact, I know that everyone can! 

I wanted to share the advice I had received from professionals, knowing that I couldn’t keep it to myself. I wanted to share it with the wider Type 1 diabetes community. So I classified all the best practices into life events (e.g. careers, activities, nights out, interactions with friends) and turned them into a book called Yes, You Can! This book contains interviews with people from various professions across Australia, Brazil, several European countries (including the UK), Russia and the USA. Among them are champion sportspeople, astronauts, celebrities, actors and everyday individuals who all live happy lives and teach us that even the sky is not the limit with Type 1 diabetes!

The lesson I have learned from this experience is that if you ever doubt yourself – whether due to diabetes or something else – sometimes all it takes to believe in yourself and achieve the life you want is to explore the wider community, find your role models, get inspired and, most importantly, keep on believing that ‘Yes, you can!’”

Note: You can purchase Yes, you can! on Amazon. If you wish to find out more about the book, you can follow @yesyoucan_t1d on Instagram or send an email to Kristina@loskarjova.com.

My note: When Kristina began writing her book at the age of 18, she wanted to inspire those newly diagnosed with T1D to feel anything in life is possible. We also agree that all our situations are unique, so never feel you are a failure if/when your road becomes bumpy. We hope you find ways to achieve your personal best whatever that is, and we know too, in time and often with hindsight, we discover the bumps were exactly what helped us find our way forward.

The TCOYD boys are back Saturday with their enormously fun diabetes show & tell

Yes, endocrinologists Stephen Edelman and his sidekick Jeremy Pittus, bring another virtual day of diabetes education that is as entertaining as it is educational. In all, life-enhancing. It seems these boys are running their educational events about once a month. Very much a silver lining during our pandemic hiatus.

I’ve already learned from these two how to dose if you want to eat three donuts (sort of) and how alcohol affects blood sugar. And both lessons had me howling. Yes, yes, there’s the regular stuff too, but TCOYDs conferences are the only place you’ll actually have fun learning how to deal with your diabetes.

Get all the details and register here. Then join me, I’ll be tuning in too.

A loving note to all our type 3s

When I got my Dexcom CGM, the idea of sharing my numbers wasn’t difficult. I like the idea of someone else looking out for me. But he knew it was an adjustment. So the first time he saw on his watch that I was low, he quickly said, “Your blood sugar’s 63!” Then he paused and added, “Does it bother you that I tell you that?” I paused and said, “Not yet!” We laughed, and frankly no it’s never bothered me, whether he catches it before me, or not.

I took this photo just now while we were chatting. If you look closely you’ll notice a small bright blue something with white letters on it in his pocket. I took this photo because I realized that little something is a plastic container that holds four glucose tablets.

Several years ago, the husband decided whenever we went out that he would carry that container of glucose tablets. He told me, “I know there’s not much I can do to help you, but this is one thing I can do.” When I took this photo I realized that he carries that container around in our small one bedroom apartment too.

Thank you husband. And thank you all our type 3s (loved ones) out there who love and support us. There isn’t a type 3 day that I know of but maybe there should be. Those of us who have them know how lucky we are.

CGM supplied for virtual clinical trial aimed at improving time in range

I read this in diaTribe this morning so wanted to share. A clinical trial, that will be done remotely, is recruiting 300 people with type 1 and type 2 diabetes and supplying them with continuous glucose monitors (CGM) for free.

The trial will last six months. Its aim is to see whether using a CGM, with personal support, helps people stay in target range more of the time.

I can, and do when asked, say a CGM is life-changing; its the most critical offering in devices since syringes.

Think about it, a glucometer tells you your blood sugar when you check; for most people a few times a day or week. A CGM tells you your blood sugar every 5 minutes, 24/7, and whether it’s stable, going up or down and how quickly. Being able to take action based on this data, already has shown to help many people with diabetes have better management.

The trial is taking place in several states and you must be 18 or older. For other conditions and more information I direct you to the article, “Can A Virtual Diabetes Clinic Improve Time in Range?”

Those with type 1 diabetes in U.S. now eligible for COVID-19 vaccine

The U.S. Centers for Disease Control and Prevention (CDC) has finally recognized the elevated risk of COVID-19 to people with type 1 diabetes (T1D).

This recognition now officially moves people with T1D into the 1c priority group, nationally.

The JDRF deserves credit in being part of this victory. Organizational leaders, representing JDRF research and advocacy, engaged extensively with the CDC, sharing the growing body of scientific evidence that adults with T1D are at an increased risk of severe illness from COVID-19, similar to adults with type 2 diabetes (T2D).

I contributed an article myself on this on a study held in the U.K. that found people with T1D, if hospitalized, were even more at risk of death than people with T2D.

This new prioritized access to vaccines will save lives and reduce the risks of additional COVID-19 complications for those of us with T1D. No matter what state you live in, it’s my understanding that you are now eligible for a vaccine regardless of your age. Hallelujah, and thanks to everyone who fought to make this happen!

Almost 50 years with type 1 diabetes. What’s next?

Next February will be my 50 year anniversary with T1D. Certainly I am proud of having made it this far. Proud of all the hard work I’ve done. But this is not a rah-rah, ain’t it great post. Because I am a bit fearful when I think of what may befall me as I live more and more years with this condition.

Right now I’ve got a sprained thumb. A connective tissue issue. Makes typing an odious task I can tell you. Since my diagnosis I am prone to getting cramps in my calves, especially at night, I have had numerous sprained ankles and I have already had two frozen shoulders. One was worked out over three months by a chiropractor using heat and manipulation. The other required surgery. And my surgeon, who perfected the technique, told me I may get more on a timeline of 15 years apart. Thankfully, more than 15 years have passed since my last episode, but never say never.

But the truth is a truth we rarely speak about, hear or read about. Living with type 1 diabetes a long time, even with well-managed blood sugar, makes you prone to various conditions involving your body’s tissues, nerves, bones etc. Many people will have eye issues like retinopathy, others neuropathy, others trigger fingers.

This paper, The Musculoskeletal Effects of Diabetes Mellitus is 15 years old, but I just read it today. I can’t say whether any of the information in here no longer applies, or if we have better treatments than we did 15 years ago. But I can say, I think it’s worth a read. Even though I’m feeling a little sorry for myself at the moment, it helps just a bit to know if you run into an issue, you know it’s not your fault, it’s not necessarily that you didn’t work hard enough at this, and you know you’re not alone.

WHO’s new Global Diabetes Compact includes people with diabetes

Last week I was honored to be part of a 3 day conference run by the World Health Organization. The aim of the three days was to glean from almost 100 people living with diabetes-participants how to, through our expertise and partnership, form, structure, govern and implement this new Compact. The mission of the Compact is to bring diabetes treatment to all who need it around the world. That includes: Prevention (focusing on the reduction of obesity in young people); Improved access to medicine and technology; Set global targets for diabetes to improve monitoring/accountability of progress.

If it seemed a bit obscure above, people living with diabetes will be actively involved in the development and implementation of the Compact. Our conference was abuzz with its participants’ expertise and it was especially lovely to be locked up in a room (okay zoom room) with some of the best and brightest diabetes activists and advocates whom I sorely miss.

The Global Diabetes Compact will be launched on April 14th in honor of this 100th anniversary of the discovery of insulin. That miracle, by the way, was performed by medical scientist Frederick Banting. So that no one would have to go without insulin, Banting then sold insulin’s patient to the University of Toronto for a mere $1.00. Well, we know how that worked out.

At its launch next month, WHO will bring together leaders in government, business and society to make commitments to people living with diabetes having access to affordable health services, medicine, treatment and also to deliver on the political commitments they made at the 2018 and 2019 United Nations General Assembly on Non-communicable diseases (NCDs).

After its launch the Compact will be focused on accomplishments it hopes to share at the second high-level meeting at the United Nations on Universal Health Coverage in 2023, and the fourth high-level meeting on NCDs in 2025. The number of people around the world who are expected to have diabetes in 2030, only nine years from now, is 366 million. That’s more than twice as many as today, 171 million.