New book, Doing Diabetes Differently, helps readers get healthier by “un-normalizing” diabetes

Doing Diabetes Differently is worth a read, and I’m not saying that because its author, Chad Lewis, has become a friend, or because I’ve written several pages in it. No, I say this because from cover to cover the book offers provocative ideas and methods on how to achieve our best health.

The premise of the book is in its last paragraph, “…you don’t have to accept diabetes as a progressive condition. You don’t have to accept falling apart and dying young. It is possible to safely maintain healthy blood sugars using much less medication. It is possible to live a long and healthy life.”

The promise of the book is in the author’s contrarian thinking about what it really means to live with diabetes, and the attitude and management techniques he shares that arose from that contrarian viewpoint. 

I should first confirm Chad Lewis’s street cred. He has lived with type 1 diabetes for more than 50 years and used his own protocols to dramatically turn his eating and activity habits around to support his health, and has sustained a 40 pound weight loss for years. 

Having spent a career in higher education and the publishing industry, Chad also clearly sees how we’ve laid a foundation for disempowering people with diabetes – from our well-intentioned health professionals who know little about diabetes and less about human behavior, to “normalizing” diabetes, to standardizing treatments and goals, to an industrialized healthcare system more vested in its own interests than yours, to the coddling and medicating of people with diabetes so that they are less committed, and skillful, to do the rigorous work to be well. 

In all honesty when Chad approached me to write one of the several commentaries in the book, after reading his rough draft, I said, “You know, I don’t agree with everything you say.” I think he liked me all the more for it. I do agree, however, with many of his ideas and see their value. For example, his macro-nutrient teeter-totter, that devices should rest on an already stable foundation, and the sense-making of ‘eating to the meter’ and ‘sugar surfing’ as key steps to dynamic management.

One of Chad’s more provocative ideas is his 12-step perspective; calling out your diabetes as a recovering alcoholic would call out his condition. The point being to acknowledge its seriousness.

“Who would you rather be?,” Chad writes, “An acknowledged person with diabetes thinking … “Hi, I’m Bill, and I’m a diabetic, and eating an abnormally restricted diet to safely maintain healthy blood sugars using the minimum amount of medication possible – an approach that leads to glycemic stability, daily peace of mind, and better health. Or…a person who, thanks to the miracle of drugs and devices, can and should eat pretty much like everyone else? Even though doing so may lead to diabetes distress, devastating complications, and possibly an early death?” Actually, this paragraph reflects Chad’s basic management philosophy.

You’ll have to read the book, and my commentary, to learn what I don’t agree with.

Throughout the book is supporting research, resources and each chapter ends with questions to ask your health professionals. Notable endocrinologists Irl Hirsch and Stephen Ponder pen the Foreword and I am joined by four other diabetes patient advocates in the commentaries who add their unique insights, knowledge and lived experiences: Ginger Vieira, Dr. Jody Stanislaw, Delaine Wright and Dr. Randy Elde.

If you’re someone who’s doing diabetes just fine, you might be curious if there’s something here that can help you do even finer. If you’re struggling with your management, or feel overwhelmed by society’s pressures and judgments, I think you’ll find much to utilize here for steady improvements that can lead to a major overhaul. For $2.99 on kindle, how can you go wrong?

All sales benefit the Diabetes Daily Grind, a nonprofit dedicated to providing resources and support for people with diabetes.  

New York Senator Chuck Schumer pushing for insulin cost cap for all

I was invited to Chuck Schumer’s grass roots-diabetes advocates rally yesterday. I was there to speak on behalf of Medicare members who gained a win with the insulin cap of $35/month (per script) going into effect January 1, 2023 under President Biden’s Inflation Reduction Act. And no deductible will apply.

Schumer was there because he fought for this. Advocates were there from JDRF, T1 International’s ‘#Insulin4all’ movement, and others, to show their appreciation, and support for Schumer’s resolve to continue to fight for a cap for those on private insurance and those not insured.

Schumer shared that Republicans voted down the cap for those on private insurance and the uninsured, and I shared that last year the husband brought me back 10 insulin pens from Toronto, where it was 1/10th the price (retail). $21/pen in Canada with no insurance needed. Similar to how insulin is priced in most developed countries. The irony of my Canadian haul is that Canadian scientist Frederick Banting, and his fellow scientists who discovered insulin, sold the patent to the University of Toronto for $1.00 so that everyone would be able to afford it.

I also shared my shock when I discovered four months after going on Medicare I would fall into what’s called the “donut hole.” Insulin would then become as costly to me as if I had no insurance. So I hoarded almost two years worth of insulin. Even past-its-date insulin will generally work.

While this win is a long-awaited victory, the reality is people with type 1, and many with type 2, must use two different insulins/day, making the cap more realistically $70/month. That said, those on Medicare will benefit sizably and those who worked hard for the Medicare cap are to be applauded.

If you want to be part of the push to help bring down the cost of insulin further, and for everyone, you can contact your local senators (including Mr. Schumer) and congress people, and join the ongoing efforts of JDRF and T1 International.

Learn more about using the Tandem Control IQ and Omnipod 5 insulin pumps

Here in New York City, diabetes educator Carolyn Robertson, seems to be known and adored by all. I never met her since she moved out West before I had the chance, but she offers informative/educational webinars every so often under her group, Strong on Insulin, and several are coming up soon on insulin pump therapy.

The zoom sessions below cover the basics of the Tandem Control IQ and Omnipod 5 pumps, as well as identifying your patterns, how to use pump reports and each includes Q&A and sharing at the end. These meetings are open to all, but geared to type 1s.

Meeting days and times:

Tandem Control IQ, Monday, October 10, 8 pm EDT. Click here to register: https://us02web.zoom.us/meeting/register/tZwkde-spj0qGdI6dLuIplJ-xPRxKxaKdhIn

or

Tandem Control IQ, Thursday, October 13, 4 pm EDT. Click here to register: https://us02web.zoom.us/meeting/register/tZcod-mvqzoiE9QlOWP_5jFFJh3Av93Eq31-

Insulet Omnipod 5, Monday, October 17, 8 pm EDT. Click here to register: https://us02web.zoom.us/meeting/register/tZErcOuhqzwvGdNB2lZ6KjsKBJE27IxO5hje

or

Insulin Omnipod 5, Friday, October 21st, 4pm EDT. Click here to register: https://us02web.zoom.us/meeting/register/tZUocOurrDIiHdWMd_yN-zXKygnvwtrnF4YN

To sign up for Strong on Insulin, click here.

A preventive focus on type 1 diabetes death with the new T1D index

Developed by JDRF—the leading global organization funding type 1 diabetes research—alongside Life for a Child, International Society for Pediatric and Adolescent Diabetes (ISPAD), International Diabetes Foundation (IDF) and Beyond Type 1, the T1D Index uses global survey data from more than 400 publications and 500 endocrinologists to simulate the prevalence and impact of T1D.

The Index was launched in the medical journal, The Lancet and this article from Beyond Type 1 explains its history, aims and projections. As Beyond Type 1 points out, knowing how many people with T1D might be alive today if they’d had access to care, can support advocacy efforts. Knowing the rate of people with T1D globally has more than tripled in 30 years, is a story we should tell.

You’ll find the Index here.

I’ve written before about the wonderful work TCOYD (Taking Control of Your Diabetes) founder and endocrinologist Steven Edelman, and his fellow endo sidekick, Dr. Jeremy Pettus, are doing getting almost monthly virtual conferences of diabetes info to us.

Their educational material is filled with fun and humor and you’ll also learn everything that’s on the cutting edge. Below are two videos I’ve swiped from their most recent email to me that’s chock full of these shorter and longer gems.

The Quest Diagnostics care replacement

I go to Quest Labs every year for my annual blood work for my endo. I’m very lucky, Quest is only two blocks from where I live. Still, I almost missed my 8:20 am appointment this morning. Not that I overslept, rather I awoke at 6 am, but I completely forgot about the appointment.

Then, while pushing down the thingamajig on my French press at 8:12 this morning, the appointment popped into my head. Dressed in five minutes, I practically ran the two blocks.

But what greeted me at Quest was not a person, you know one of those animate objects that sits behind a desk, but a check-in machine. A most irascible one at that.

It wanted reams of information and needed to take photos of my ID and primary and secondary insurance cards, front and back. By time I got to the last of 10 screens, it told me I was more than 10 minutes late for my appointment. And I was by two minutes, but I wasn’t when I first started entering my name, letter by letter, box by box, on this beastly interference-runner between me and the technicians.

Not only did it tell me I was over the time limit to check in, but now I had to pick another appointment day and time. Well, I didn’t think this was fair, since I did start the process within the ten minute limit, so I walked inside and told the two lab technicians what had happened. One said to wait and she’d come and help me.

And she did. Within five minutes she was running me through the machine again (because they must) and took me back to take my blood. I’ve written about industrialized health care, how we have removed the care. But how visible it was to me this morning that this machine reduced me to screen inputs, while it took a human to apply reason, consideration and warmth to fairly easily make the situation work, and soothe me in the process.

In fact, while with Antoinette, the lab technician, and her filling god knows how many tubes with my blood, we talked about how fast time goes, how little she looks like a grandmother, how my coffee was still waiting for me on my kitchen counter, how grateful I was for her defying the beastly machine and how happy she was to do it. We both enjoyed 10 minutes of the joy of interconnectedness, the elation of helping another and the comfort of knowing you are in someone’s care.

I really do not understand why and how we are erasing care, the most healthful ingredient, from healthcare. Why and how we do not think this saving of money, and perhaps greater efficiency, is not biting us on the other end with the outrageous costs of obesity, diabetes, mental health, health insurance, suicide and death.

Once home, I watched this video which is a wonderful overview, in 10 minutes, of the broader picture. The world, and all its creatures were not meant to live without care.

Just 2 minutes of walking after a meal can lower blood sugar

That’s the conclusion from the NY Times story today, “Just 2 Minutes of Walking After a Meal Is Surprisingly Good for You.” Scientists have long said 15 minutes of walking after a meal could reduce blood sugar levels, but now it turns out just a few minutes can activate benefits.

I still remember walking home from a restaurant after dinner, just ten minutes, unexpectedly tanked my blood sugar.

Turns out standing also has a small benefit. Even housework after a meal will have an effect on blood sugar. And, as the article concludes, “The benefits of physical activity are … a gradual effect of more activity, better health. Each incremental step, each incremental stand or brisk walk appears to have a benefit.”

Oh, woe, not one, not two, but three compression lows!

I wrote about compression lows just recently, so it really stood out for me this morning looking at my overnight blood sugars courtesy of Dexcom’s G6. There they are – three CLs (can I name them now?) clear as day, or rather night.

I’m wearing my sensor right now on my left thigh, I wrote about that too recently. A very comfortable spot I’ve found, and don’t intend to abandon.

Had my iPhone been beside me last night, it would have awakened me three times with these lows. I wake up enough these days in the middle of the night, so ever since wearing the G5, I have placed my phone in the living room overnight so it won’t wake me up when these occur.

I am not telling you to do this. Not! not! not! I do not need to be responsible for anyone missing a true overnight low. I trust I can sleep apart from my CGM because of years of oversight and experimentation, I have garnered enough knowledge of where my blood sugar roughly has to be before I go to sleep and how to keep myself from truly going low overnight.

In short (although this is just for me since we know YDMV), I like to be around 100 mg/dl before going to sleep and based on my routine eating, exercise and insulins – Humalog or fiasco and Tresiba or Toujeo – I’ll pretty much hang there all night.

Anyway, I thought this snap of my overnight blood sugar was amusing enough to post, particularly since it illustrates so clearly compression lows.

I also think as I find myself awakening during the night more frequently, (ah, yes, age, well now I’ve covered my last three posts) these are likely times I awakened and turned over on the opposite side that I fall asleep on, which I have noted I do, thus, putting all my weight on the sensor.

I’ve been invited to try out the new Freestyle Libre 3, which I expect to start end of week. Will be interesting to see if the same phenomena occurs. Stay tuned.

Sixty-nine is the new sixty-eight, except with more gray hair

Today at precisely 11:05 pm EDT I’m officially 69 years old. Yes, many a joke is, and was, made when my birthday actually falls on Labor Day every few years.

Maybe 69 means I don’t care what people think of me anymore. Rather obvious from my falling apart plastic jacket above. But then if I ask a young(er) person, she’ll tell me, I am sure, that it’s cool to walk around in shredded clothing.

Staying still Covid safe, there’s no big plan with the husband to fly off to Asia or Australia or Capetown, which I still do want to see. Nope, everything’s close to home. A visit with mom, figure it was a big day for her too long ago, and meet friends for dinner on one of my friend’s Manhattan rooftops. These small blessings seem big enough to mark another year in such an uncertain world.

My birthday wish is for more love, more peace and more brightness in the world. And laughter. Perhaps that can be supplied by this photo of early me 😉

“Did you really say I have to get up on stage and speak to hundreds of people?” Today one of my greatest joys.

And here’s to the love. Lately animals seem to do it better than humans.

Where to wear your Dexcom

No, I’m not aiming for any Betty Grable pin up fame, for those of you old enough to know who she was. This is just to show you the new site I found for my Dexcom G6 CGM sensor. My usual, as I know it is for many of you, is my arm. But, I decided maybe it was time to give my arm a rest. I only use my left arm because I sleep on my right side.

Dexcom is only approved in the US for wear on your abdomen. That’s because when they applied for FDA approval, that was the only site they tested it on. But we know you can wear it many different places and it will work just as well. In Europe Dexcom has a CE mark for wearing it on several different sites.

So, I watched this video (Best Sites for Dexcom G6 Sensor Placement) made by an entertaining German who puts out videos at Type One Talks on YouTube, and thought, what the heck, there’s plenty of fat down there, let me give my thigh a try. And, I couldn’t be more pleased.

I totally forget I’m wearing it, it doesn’t bump into anything that could dislodge it and it works just as well (accuracy-wise) best I can figure, as wearing it on my arm or abdomen.

My one caution is, be mindful when wiping yourself dry from the shower or bath. One unthoughtful towel swipe and that could be the end of your sensor session.