A new study regards healthcare and living long with T1D

Out to dinner with the husband. Notice the syringe and wine cork. Sort of says everything 😉

Day to day diabetes can have its own mind; certainly I recognize patterns, but sometimes I have no idea why my blood sugar is doing what it is doing.

I don’t really worry about this, I know enough to get through it, make a few guesses, ask my endo if necessary, and at some point it all settles down.

That said, I can tell you quite honestly, I do have some uneasy feelings about the future. At 68 years old now, how will it be when I’m 80? What will happen if I start losing my faculties?

So, I was delighted to discover there is a movement to shine a light on those of us living a long time with diabetes, particularly type 1.

The good news is we didn’t used to, so I guess I have to accept that, for now, as my blessing.

Here’s the study I just read about how healthcare can make it easier for us who live into our senior years with type 1 diabetes.

My blood sugar was 33 with no symptoms

After spending three weeks with my mom, packing up her apartment and moving her into assisted living, and spending the first night in her new place so she wouldn’t awake disoriented, I returned home. Tired, but knowing in my heart she was in the best possible place, the husband and I were ready to celebrate all that had been accomplished.

So we walked to our local Italian restaurant and sat outside in the glorious 70 degree sunshine for a delicious dinner. I had grilled swordfish with salad as my main. We shared two slices of bread with artichoke and parmesan cheese as a starter, and a cannoli with cheesecake filling as desert, and a bottle of vermentino wine, although he drank 3 glasses and me 2. My blood sugar was nicely around 100 mg/dl before starting the meal, so I took 2 units of Humalog, one for the bread and one for the dessert. I thought I probably needed more for desert, but I knew the wine would lower me a bit.

After dinner, we took a 10 minute walk home. An hour later my blood sugar had dropped to 41 mg/dl. I was wearing my Dexcom, but honestly I didn’t hear it because I had on my earphones watching a video on my iPad. And, I felt no symptoms of hypoglycemia. I am not surprised looking back now because I had a lot of lows over the past few weeks physically packing my mother’s apartment up, dragging furniture to the recycling plant and eating less than usual.

The husband came over to show me on his phone the drop. Over the next two hours, my blood sugar descended to 33 mg/dl before it started rising. I ate 3 glucose tablets, a teaspoon of honey and a teaspoon of preserves, some more stuff I no longer remember, and waited for what felt like forever before my blood sugar was at 98 mg/dl. That was around 11 pm and I went to sleep knowing it would likely rise a bit more, but I didn’t know how much so I didn’t do anything further.

When I awoke at 8 am, my blood sugar was 148 mg/dl. That was fine with me given what could have happened.

It was a mystery to me how 2 units of rapid acting insulin could have knocked me so far down, and how long it took for my blood sugar to rise. My only guesses are maybe my blood sugar was dropping before dinner, maybe the bread, not being dense but airy, only needs 1/2 unit. Maybe the cannoli, albeit sweet, didn’t have that much sugar. I’m also guessing the wine and the fat from the cheesecake filling in the cannoli delayed the rise in my blood sugar after I started treating it.

When I was at 33 mg/dl, the husband asked me if I wanted the baqsimi that has sat in my drawer for a year and I said, “no.” As long as I can chew and swallow I’d rather eat my way up. Was that smart? I have no idea, but I know the baqsimi would have brought me up to around 180 mg/dl and I didn’t want to have to contend with then fixing the high.

Fifty years with type 1 diabetes will never mean that every day isn’t a new day. Every day brings its own blood sugar ride. It was scary to watch the descent and scarier to wait so long for the ascent. It was scary I felt no symptoms. But I know I need to go now for a week or two without a low to regain those symptoms.

Still, I’m grateful that going this low is a very rare occurrence. This is just the fourth time in my life with diabetes it has happened. Every day is just another day with diabetes –– and no one and nothing is to blame.

Technological advances from presented at the ATTD international conference

I haven’t posted much lately as I’ve been busy helping move my mom into assisted living. If any of you have done this, or something similar, you know what it means and what it takes.

That said, I’m not going anywhere. This blog will continue.

Here’s an article from diaTribe, one of my favorite diabetes resources, of new technological advances presented at the Advanced Technologies & Treatments for Diabetes conference that just concluded in Barcelona, Spain.

PAHO/WHO global conference on NCDs and mental health conditions

This week I had the pleasure to participate as a speaker in the collaborative conference held by the Pan American Health Organization (PAHO) and World Health Organization (WHO). This body has been, over the past year, working to create a framework to include the voice of people living with non-communicable diseases and mental health conditions as equal co-creators of policies, programs and principles. I am honored to be part of this esteemed group of professionals who are passionate, committed advocates of public health.

If you care to, you can watch the two day conference using the links below. The two days are a mix of very short presentations and groups working to come up with how to make this “meaningful engagement,” or inclusion of our voices, happen in the most productive and sustainable way:

Day one: https://www.youtube.com/watch?v=EJp5B2E_9bA

Day two: https://www.youtube.com/watch?v=U7Gu7kq-lE4 I I present for 5 minutes at 11:48)

The “Glucose Goddess” has 4 hacks for you

Two weeks ago I heard Jessie Inchauspe, who goes by the name “Glucose Goddess”, interviewed on the Dhru Purohit podcast. It’s podcast #90 released March 31st of this year. I found the content illuminating. I learned brown rice isn’t necessarily better than white regarding blood sugar rises, and eating your meal in a certain order, particularly not grabbing the bread first thing, can save you a glucose spike.

She also has an interview on YouTube, “How High Blood Sugar Wrecks Your Health.” Inchauspe is a biochemist and has long been studying the effect of food on our health. Of course it all began with her personal story of how she discovered what she ate as a teen was causing various conditions and a broken back at 19.

Much of her learning comes from wearing a CGM (as a person without diabetes) and seeing what food did to her blood sugar. When asked why a person without diabetes should bother about their glucose levels, Inchauspe says she discovered 80% of people with out diabetes do experience glucose spikes and crashes. Her motivation, she says, is to help people who don’t wear a CGM, most of the world, have more insight into how food affects their blood sugar and take actions to help avoid those spikes and crashes.

This morning the Goddess Inchauspe shares four hacks in the article, “Surprising Hacks To Balance Blood Sugar That Don’t involve Changing Your Diet,” in the journal “mindbodygreen.”

Here’s the gist, but I recommend reading the article to understand why. Inchauspe also has a book out, Glucose Revolution. I put it on hold at my local library, I think I’m number 37 on the list! Obviously lots of people want to know the details when it comes to what we eat and our blood sugar

4 Hacks

  1. Eat Your Meal in Order (as I mentioned above). “Science shows that if you eat the constituents of a meal in a specific order, you can reduce the glucose spike of the meal by 75%,” says Inchauspe.
  2. Put Clothes on Your Carbs. When eating carbs, eat them with some protein, fiber or fat to help lessen a blood sugar spike.
  3. Beware of Sneaky Spikers. For example, sweetened yogurts and rice cakes.
  4. Move your Muscles. It just takes 10 minutes of movement after a meal to steady the glucose rise.

If you’ve read my blog or articles you know I argue we can’t “control” blood sugar. That said, I’ll take every weapon in my arsenal to make it a little easier to work with.

Among the best blogs of 2022

It’s always an honor when this blog gets recognized for being among the best of the best out there. I was informed it’s been recognized among eMediHealth’s list of 18 best diabetes blogs to help manage the condition.

It’s lovely to see some of my comrades-in-arms also recognized such as Kelly Kunik of Diabetesaliciousness and Christel Oerum from Diabetes Strong. We’ve all been doing this for many years because we feel a personal passion to help others succeed.

I’m grateful to be among the lot, and humbly even more grateful for you who turn up here now and again to learn something new, and support me.

A smart and soulful conversation about diabetes and life with Dr. Char

Well, it took me a week to watch this conversation I had with Dr. Char, educator, therapist and type 1 person herself, but that’s my bad. I’m not very good at watching myself.

That said, I was most pleasantly surprised. It’s a ‘cozy girlfriend chat’ (males welcome too) that covers an array of topics from resilience to diabetes friends to a particularly bad boyfriend that changed me.

So, make yourself a cup of coffee or tea, or pour a glass of your favorite wine, and come get comfy with us.

Use your strengths to improve your diabetes and your blood sugar management

April 12th from 7 to 7:30 pm (EDT) I’ll be sharing the secrets of my success after living 50 years with diabetes. This half hour is being run by Eating For Your Health (EFYH), and I’ll share my story, sources of strength and ’lessons learned.’ It’s free, so please join me.

I’ll also offer a ‘sneak-peek’ of a 5-week diabetes program I’m doing with EFYH in May. It’s called “Nourish to Flourish: How To Live Successfully With Diabetes”. Each Tuesday an outstanding expert will share the latest information on food, activity, medication, and attitude as it relates to diabetes. In the first class, I’ll guide you, as I have done in many workshops, to discover and identify your own personal strengths. Then throughout the 5-week program you will use those strengths, and the information you receive that evening, to raise your health to a new level. I guarantee you this program is unlike any other.

Register here for April 12’s free webinar. Click here to get more information about the “Nourish To Flourish: How To Live Successfully With Diabetes” program. Why wait any longer to have better health?

50 years of historical gratitude

I was diagnosed in 1972, and yes, this year celebrated living 50 years with diabetes. The celebration included Joslin’s 50 year medal and a dinner out with the husband. Often, when I speak to audiences of people with diabetes or health professionals, I say living so long with diabetes has given me historical gratitude. I almost feel badly for those relatively newly diagnosed who don’t have it and can only feel the heartbreak of getting this disease.

I am well aware I didn’t have to boil and sharpen syringe needles like the people who came years before me. The insulins I used during my first two decades required lots of planning, when to take them, the long hours they lasted and when they peaked. Then you had to match your eating to all that. Inevitably, you were feeding your insulin. My mother still begs me to take food with me when I leave her home and head for my two hour train ride home. Today’s insulins, and certainly insulin pumps, have liberated us from this.

If you use an insulin pump, they came along in the early 1990s. Apparently the first one was the size of a back pack. There is a photo of it floating around online. Insulin pens were launched around the same time. Personally, I’ve always been on MDI (multiple daily injections) and my basal pen, Tresiba, is a breeze to use. I tend to use a vial and syringe for my rapid-acting insulin because sometimes I want a third or a quarter of a unit and manufacturers obviously haven’t found any cost benefit to create such a pen.

And I surely never could imagine while I was poking my fingers round the clock every day, that one day I could wear a tiny device (CGM) that would tell me my blood sugar every five minutes, and whether it was going up or down, or not, and how quickly. Or that we’d have smart pens or an insulin pump and CGM that operate together, or looping created by people with diabetes?

Whether you’ve had diabetes, like me, for decades, or are new to the game, seeing how much our medicines, knowledge and devices have improved over the decades, can lift your spirits. I know it does mine.

Dexcom Clarity App’s Malfunction

I’m being a little cheeky about ‘malfunction,’ but let me provoke your thinking. This is a typical blood glucose report for me from Dexcom’s app, Clarity. The app is on my iPhone and I see this weekly when it arrives as an email.

Yes, I’m typically above 90% in range. I’m not boasting. My high time in range is the result of eating a low carb diet, walking everyday, and wearing and responding to my numbers on my Dexcom CGM. Routine, for me is a major tool managing my blood glucose: eating the same type of foods, eating about the same time of day, walking an hour a day usually at the same time, checking my blood glucose frequently, if it’s going higher than I like I take more insulin, if I see I’m going to crash in 20 minutes, I grab a glucose tablet or honey, whatever’s needed. You get the idea. I’m disciplined, pay attention, do the work, and the regularity of routine reduces the fluxes of unpredictability.

And yet, if you look under Patterns above, it says “No patterns were found for this date range.” Really? Don’t I have healthful patterns? Doesn’t Clarity detect that most of the time I’m in range? Why is it Clarity only tells me I have patterns when my results are less than desired, as featured below.

Those overnight lows by the way are largely compression lows, when I roll over and my body presses on my CGM. Yet, that’s really not the point. Why, when I spend most of my time in range, does Clarity not tell me I have Patterns, like “You spent significant time in range between 6 AM and the following day 6 AM for 7 days in a row”? Or something like that. Cheeky, I know.

But I find it interesting that our human proclivity is to focus on the negative, the problem, the fly in the ointment. C’mon, Dexcom, patterns are not only to be found when things go wrong or results are less than desired. How about just, “lovely patterns were found for this date range”? Well, it’s a start.