Weekend for (Diabetes) Women, May 3-5, Raleigh, North Carolina

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Join me and other diabetes advocates and luminaries for a great weekend of learning and bonding provided by Diabetes Sisters.

‘Weekend for Women’ is two and a half days that offers a unique opportunity to gather with an intimate group of about 100-150 of us women, type 1 and type 2, to share experiences, learn from experts and each other, have fun, take a short walk through town to raise diabetes awareness, and come away – renewed, invigorated, smarter, wiser and more able to manage our diabetes. You can’t lose.

Friday night kicks off with a social gathering, Saturday is a day of health, wellness and transformation with the most influential voices in diabetes leading incredible talks, break out sessions, and giving practical tips and tools. Sunday is packed with more information and opportunities to cement the new friendships you’ll be making. Here’s the full schedule.

Also, you can bring your partner or spouse. They’ll be a whole track of seminars for them to have their needs addressed, bond, and better understand how to support you.

I’ll be speaking along with Kerri Sparling Morone and Ginger Vieira, fellow PWDs and top diabetes educators, dietitians, nurses and PhDs.

Early registration is open now til February 15th for just $125. General registration $150.

Phoenix airport syringe disposal and shooting up

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It’s kind of a double-edged sword when we get to see something just for us. Nice, and an unfortunate reminder. But I was glad to see this syringe disposal nestled in the bathroom of the Phoenix airport. I didn’t bother to think, whose syringes are they targeting? I just enjoyed the fact that maybe there’s some recognition for those of us using insulin.

I try to take my insulin discretely, meaning I don’t flaunt it in front of anyone. After all, I don’t particularly love watching others inject. But I never try to hide when I need to give myself a shot. And, I often wonder – where are all my fellow insulin users? I never seem to see anyone else “shooting up.” 

But I do it in the open as I like to think of it as a ‘teachable moment.’ So while seated on the plane, waiting for the last few passengers to take their seats, I took out my Lantus Solo star pen trying to inject before the last passenger arrived to take his seat next to me. And there I was, pen in stomach, when my husband leaned over and said, “Are you OK?” I looked up and there was my seat mate standing at our row waiting to take his seat. I finished, extracted pen from body, and in he came without a word, as if he hadn’t just watched this woman take a needle out of her body.

Later, my husband told me he had asked the gentleman if he could just wait a moment while I finished giving myself my insulin injection. The gentleman politely nodded. My husband also remarked that, the stewardess standing not far away, caught my husband’s eye and smiled. Comraderie? Knowingness? Compassion? 

I will never know, but maybe one or two more people were reminded that diabetes exists in the world, as so do those of us who live with it.

 

Dr. Anne Peters reviews new CGMs

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For those of you who use a Continuous Glucose Monitor, or think you’d like to, here’s an excerpt from Dr. Anne Peter’s review of Dexcom’s newly available fourth generation, the G4, and MiniMed’s CGM, Enlite, which will be available in the Spring. Dr. Peters is an extremely respected endocrinologist, well known in the diabetes community, who practices at the Keck School of Medicine of the University of Southern California in Los Angeles.

I love that Peters wears the sensors, although she doesn’t have diabetes, to understand what it’s like for patients. With all their advantages, one thing she finds burdens patients is the devices many alarms. Funny, we think of the benefit, alerting us to low and high blood sugar, but not the annoyance factor – I guess unless you wear one, I do not. 

Excerpt: With Dexcom G4 continuous glucose monitoring, the patient can easily insert the sensor under the skin — …on the abdomen or the back of the arm. A small transmitter is then placed on top of the sensor. The transmitter sends the interstitial glucose value to the device so the patient can see the blood sugar level. It transmits this information wirelessly every 5 minutes, so a patient can get a sense of whether their blood sugars are going up, going down, or staying the same.

…the new Dexcom G4 is somewhat smaller [than the earlier-generation device]. It is not as wide, similar to an iPhone, and is easy to put in your pocket. It has a pretty good range so that you can be moving around in your house and the signal will still reach the device. A blood sugar level that is 100 mg/dL and is going up may require much different treatment from a blood sugar level of 100 mg/dL that is flat and the patient might be just fine. Or, if a blood sugar level is falling fast, it may mean that the patient needs to ingest carbohydrate to avoid a low. The patient can get a lot of information in real time from this device. Then, in my office, I download the device and interpret the data for the patient so I can help the patient analyze the data retrospectively, so that in real time patients can make more reasonable choices.

…we also have the new MiniMed continuous glucose monitor, the Enlite™ sensor, which is supposed to be available in the spring. This is similarly inserted under the skin and taped down. In most cases, this device is talking to the patient’s insulin pump. The insulin pump has the tubing necessary to give the patient insulin, but now this pump also becomes the receiver for the signals from the sensor. The patient can look at the pump and see what the blood sugar levels are doing.

A lot of patients want the pump to automatically give insulin based on their blood sugar levels, but that is not what happens. This is truly a sensor, and the patient then needs to use the Bolus Wizard [calculator] to interact with the pump to calculate the insulin dose. That coupling of the sensor and pump is part of the development of the artificial pancreas. Substantial research is being done to make pumps that can use continuous glucose monitoring data so that the patient does not have to think as much about diabetes management. [Those advances] are in the future. 

For now we have sensors that sense interstitial fluid, giving continuous real-time data, and we have pumps that patients interact with to give themselves insulin. You can couple the MiniMed sensor with the MiniMed pump. The Dexcom device does not interact with a pump, although the manufacturer is working on collaborations with some pump manufacturers.

Peter’s full review appeared in Medscape Diabetes & Endocrinology Jan 25, 2013, “Continuous Glucose Monitoring: Practical Uses in Diabetes.”

TCOYD comes to Tucson February 23rd, pre-register now

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TCOYD, which stands for Taking Control of Your Diabetes, has been a fixture in my life for the past 10 years. It’s an incredible one day health fair that’s offered around the country, and it’s coming to Tucson February 23.

For only $15 (or $10 apiece for 2 people or more) if you register by noonFebruary 20th, you get a full day of learning from diabetes experts, endocrinologists, pharmacists and personal trainers who will ignite your motivation, answer your questions, share advice and recommendations, offer hope and can even change your life, or that of someone you love, who’s living with diabetes! Day of the event registration costs $20 per person.

I attended my first TCOYD conference eight years ago and it was there in a workshop being led by psychologist/CDE Bill Polosnky that I heard words that changed my life. He said, “Diabetes doesn’t cause diabetes complications like heart disease, blindness, kidney disease and amputation. Poorly controlled diabetes does.” When I heard that I knew if I really took care of my diabetes, I could improve my health dramatically.

Now here’s your opportunity to learn, do better, take charge of your health, help prevent or delay complications, have fun – and meet other people with diabetes in the process. 

TCOYD’s founder, Dr. Steven Edelman, has been living with type 1 diabetes since he was 15 and decided learning about diabetes shouldn’t just be for medical professionals, but directly reach patients. Now that’s a doctor who “gets it.” So since 1995 TCOYD has been educating patients around the country. Dr. Edelman is 57 today and living well with his diabetes, as am I.

To register, or to get more information, call 800.99.TCOYD (800.998.2693) or visit www.tcoyd.org. If you can’t make it to Tucson, the next event will be in Santa Clara, California on March 23rd. Trust me, you won’t be sorry. This can be the first day of the rest of your better life with diabetes.

Be brave with your life so that others can be brave with theirs

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I make no New Year’s resolutions because I know it’s just wishing on fairy dust: what I intend to do I will and what’s not that important to me I likely won’t. So, why set myself up for failure and disappointment?

But what I do want to do in 2013 is be a little more conscious of two practices I employ. The first is to be kind to everyone, in every interaction. For sure it’s not always easy, but I know even when someone is caught up in negative emotions – anger, frustration, jealousy, whatever – if I’m kind, their mood shifts from dark to light and they are more likely to greet the next person they interact with with kindness.

Second is the quote above I read some time ago, “Be brave with your life so that others can be brave with theirs.” I’ve forgotten where I read it, although I do know it was written by a woman named Katherine Center. 

I think in some ways this is a life lesson for me. For me it means go after your dreams, dare to be successful, be true to yourself, reach to be your best, brightest self. Even if that means you stand out. For someone who grew up shy, that’s a tall order.

But I’ve realized not a selfish one, as you might first think, but an unselfish one. The more we shine, provided we do it not from arrogance, but authenticity, striving to be our best self, the more we inspire others to shine, be brave, dare to go after their dreams. 

The photo above signifies this for me. I took it last week on my morning walk. The single tree in bloom, reaching ever upward, reminds me of this quote. Stand tall, let your gifts shine and those around you will be moved to do the same. 

These are the two things I’ll be practicing this year.

Two new diabetes food books worth chewing on

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Not food in the sense of recipes and cooking, but food in the sense of how to eat healthy. This Spring I had the pleasure, along with several other women, to contribute to Amy Mercer’s new book, The Smart Woman’s Guide to Eating Right with Diabetes: What Will Work.

This is a great read if you’re still trying to figure out how to eat sensibly and not give up everything you love – and who among us isn’t to some degree? Amy shares her own struggle and successes with food and invites about 10 of us fellow smart, successful women with diabetes to share what we do so that we manage to control our blood sugar, and manage our carbs, while still eating things we love. Not only will you get tips, but I guarantee you will feel you have a community of women to hang out with while yore reading and a cheering squad who get “it”.

This is also an exceptional book for health care providers to get, and share, a real-life picture of what actually works for patients, rather than just dispense the standard dietary guidelines.

Two weeks ago I read Ginger Vieira’s new book, Emotional Eating with Diabetes: Your guide to creating a positive relationship with food. Ginger is not only an amazing diabetes videographer, power-lifter and writer, but she’s also a health coach. So when Ginger talks about ‘emotional eating’ she knows of what she speaks.

The book is big in size, yet short in pages. Just the right length to cover just the essential, most important topics regarding eating: both the difficulties and hardships, the battling and fighting food, and how to be more successful with an eating plan and staying positive. 

Ginger’s topics include: Habits that lead to overeating, Over-treating lows, (boy, don’t I remember early on eating everything in sight from pie to toast and jam, cookies and fruit, all at the same time, to get my blood sugar up!), Using food to stuff emotions and then coming into the light to develop a more positive relationship with food. 

Psychologist, Dr. Bill Polonsky writes the forward and there are several worksheets in the book, for as any good coach does, Ginger asks you to do the work. You’ll also get Ginger’s insightful questions to help you, and her mantra, which I love, which is that we are all a work in progress. 

 

Dear Santa, won’t you please take this diabetes away?

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You may have seen this before as I’ve decided I will repost this every Christmas, because, frankly, fun is healing. And if you’re stuck with diabetes, you need as many laughs as you can get!

Dear Santa,

All I’d like this Christmas is for you to take this diabetes away. I’m so tired of it already. All the time stabbing my fingers for blood and guessing when my sugar’s too high or too low.

Now that I’m in menopause I can barely tell whether I’m sweating because I’m losing estrogen or because my blood sugar’s crashing at 50 mg/dl!

And, can we talk… I mean the constant figuring out how many carbs are in a ravioli or bread stick or that fried calamari that will be at the company Christmas party. Some days I just want to lie down and shoot myself. Please, please, Santa, would you take this diabetes away?

Sincerely,
Riva

***
Dear Riva,

I’m very sorry you’re having a tough time during my favorite season. I only want people to be singing carols and drinking eggnog and feeling good cheer. Unfortunately, it says in my contract that I’m not allowed to interfere with life’s natural occurrences. So here’s my suggestion: although you’ve already opened your holiday gifts, go back and look under your Hanukkah bush for the gift in having diabetes.

You may have to spend a few days looking, so why don’t you schedule it for the week between Christmas and New Year’s while you have some down time? Then you can start the new year fresh.

Best wishes,
Santa and the gang

***
Dear Santa,

A gift in my diabetes? What are you, crazy? Meshuggah? Thanks, but no thanks!

Riva

***
Dear Rabbi,

I seek your wise counsel. I wrote to Santa to take away my diabetes, but he wasn’t helpful at all. Surely you who have studied the Torah and represent our people who have suffered throughout history can help me with this awful diabetes.

It’s such a strain, Rabbi. I have to test my blood sugar when I really want to be lighting the sabbath candles. I forgot all about the High Holy Days this year because I was so busy counting carbs in the Challah, bagels and honey cake.

Rabbi, please, what solace can you offer me? What words of wisdom? Surely you would tell me to just forget about this diabetes thing and go shopping, right?

Please write soon,
Riva

***
Dear Riva,

Santa and I just returned from the Caribbean, and he told me about your difficulty. He said he told you to look for the gift in your diabetes. I concur with Santa; there are many gifts to be found in diabetes, if you look. For one, my child, you won’t have to drink the traditional Manishewitz holiday wine anymore. The Counsel all agree that it is much too sweet. Bring out the Chardonnay!

When Santa asks you to look for a gift in your diabetes, he is not saying this because you are not Catholic and he is not bringing you anything, although this is true. He is speaking like our brothers the Buddhists, who profess that there is a gift in everything if you look for something positive that it can bring into your life.

Let me tell you a story, my child. My own Aunt Sheila had diabetes, and after she stopped kvetching, she went to a spa and learned how to eat healthfully. She shopped along Rodeo Drive and bought a cute little jogging outfit and started running. On her jog along the ocean she met her fourth husband, Marvin, and they’re very happy. They just moved into a $6 million mansion in Jupiter, Fla. — right next to Burt Reynolds! Everyone’s plotzing! The house was in foreclosure so they have even more money to decorate!

Darling girl, find a gift in your diabetes, because to be honest, since you’re not orthodox, and all I have are these great wigs I got on sale from my cousin Schlomo, I’m not bringing you anything, either. And really, it’s not very pleasant to whine.

Shabbat Shalom
Rabbi, Local Union 107

***
Dear Rabbi,

I thought about what you and Santa said and have decided to become a Buddhist. I picked up the Dalai Lama’s book, “The Art of Happiness.” He says, “Happiness is a butterfly, which when pursued, is always just beyond your grasp, but which, if you will sit down quietly, may alight upon you.” I told my friend Joe I like butterflies, and I like the robe, so these aren’t bad gifts.

Joe said the quote meant that we are the source of our happiness, that happiness can only come from inside us, regardless of what happens in our lives. Hmm, I said, maybe I need to learn more. So I booked a flight to Tibet.

Now if only I didn’t have to drag all this damn diabetes stuff with me…. ohm… ohm… oy.

4 Ways To Boost Diabetes Funding and Holiday Cheer

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‘Tis the season to be jolly, and I can’t think of an easier, faster way than by doing something for someone else. As my own financial planner, who’s still dealing with the fall-out from Hurricane Sandy, said to me recently, life’s not about money or possessions, it’s about friends and family and who will take you in when you need it.

So I did a little investigation and saw there are four ways in which you might like to spread some holiday cheer and “take someone in” who has diabetes. These four worthy causes help fund diabetes research, put a smile on a child’s face, let someone know you care about them, and are guaranteed to turn a little glow light on in your heart.

Santa and the Diabetes Research Institute Foundation have joined up. With a $15 donation, Santa will send a personalized letter to your child, niece, nephew, grandchild, or anyone you designate, anywhere in the world — complete with a North Pole stamp! Santa will even congratulate your child for how well they’ve been taking care of their diabetes if you wish. You supply the letter’s details. How can you lose? A child goes to bed happy and we all take a step closer to the cure. Deadline: Dec. 18 at midnight.

A Tribute Through JDRF. It’s a true tribute to recognize someone special by making a gift in their name through JDRF’s “Make a Tribute Donation program. The person whose name you donate in receives a letter that they were honored by you. I know I’d feel rich if someone did that for me. 

American Diabetes Association’s Gift of Hope. Founded in 1971 by parents of children with diabetes, “Gift of Hope” has raised more than $24 million to help find a cure for diabetes. You’ll find an array of beautiful and affordable gifts, from candles, cards and ornaments to jewelry, kitchenware and travel gear — and 100% of the profits go to fund research for the millions of children and adults living with diabetes.

The ABCs Of Loving Yourself With Diabetes. This is my first book, from which each year I donate a portion of the proceeds to organizations making life better for those of us living with diabetes. Its inspiring, positive and educational essays guide you to develop greater self-love, strength, appreciation and emotional resilience, which makes managing diabetes easier. Plus, the fanciful, colorful drawings make it a perfect read for adults and families alike, as you can see above. Donations have been made to the Diabetes Research Institute, JDRF, Diabetes Hands Foundation among others.

So don’t miss the opportunity to give yourself a gift this holiday season. Make a choice above that changes a life. That truly is the greatest gift of all.

My first trial with Lilly’s HumaPen. Pen: 3, Syringe: 3

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For a couple of years now [yes, takes me a long time to weigh things ;-)] I have silently urged Apidra to come up with an insulin pen that allows me to dose half a unit. 

Each time I saw a rep at a health fair, I’d ask whether this was in the works. Most looked at me with amazement, “You want to be able to take a half unit?” they decried?

Yes I do. Eating a low carb diet and power-walking an hour a day, I often only need a half unit to dose for a meal of, for instance, veggies and chicken or fish (Please DO NOT take my dosing for yours, we each have individual needs). 

As you can sort of see in the post below, I use the Lantus Solostar pen for my long-acting insulin and wondered about having the same ease for my meal time insulin. Tis true, after 40 years with type 1 diabetes, I may be ready to give up my vial and syringe. Like most people I find an insulin pen easier to use than the few extra steps vial and syringe requires, and prefer the non-medical-ness of it all. Maybe even more, since I use so little rapid-acting insulin, when I have to throw the bottle out after a month, I’m throwing away four-fifths of it. That waste makes me crazy each month.

But Apidra told me if they come out with a pen that would dose half a unit it wouldn’t be before 2014. So I found HumaPen LUXURA HD. HumaPen is the only pen that offers half a unit rapid-acting insulin. I checked with some diabetes educator friends who said Apidra, Humalog and Novolog (rapid-acting insulins) are all pretty similar, so I printed off my free coupon for the Humapen, called my doctor’s office to get a prescription for the pen cartridges and waited til my Apidra was up for the month.

Now I’ve spent a day dosing with HumaPen. Here’s the good news:

• It’s a solidly-made insulin device. 

• It’s rather gorgeous, especially for a medical device, in its Italian deep forest green color. 

• It doesn’t look like a syringe when it’s hanging off my body

Yet, having recently discovered I need to take the insulin cap off each time I dose, and put it (or a new one after a while) back on before the next shot, it feels as multi-step a procedure as sticking a syringe in a vial. 

And while the weight assures me of its state-of-the-art craftsmanship, it’s weightier in my purse than a vial and syringe.

And, while that gorgeous green tube sticking out of my stomach for the 5 seconds I have to keep it there with my finger on the dose button to make sure I get my full dose, may perhaps be less discrete, considering a syringe is comparatively tiny and I jab it into my body, and out, in a second, it hardly seems so. 

So, far as I’m concerned right now the playing field is level: Pen: 3, Syringe: 3. I’ll give the HumaPen a run, but don’t know whether I’ll switch for good. 

Tip: For those of you on pens who wonder, as I did, whether the extra insulin you use to prime the pen takes away from the amount left in the pen for your dose, the answer is no. I spoke to a Lilly rep this morning who told me they overfill pens and insulin cartridges to cover those extra units used for priming. 

 

Musings about World Diabetes Day

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I’ve written before, that more than once, my “smart Timesulin cap” has saved me from missing my daily long-acting insulin shot. So the Timesulin folks asked me to be among the people to write a blog post on their blog about World Diabetes Day. 

As I wrote it, I realized I’m not entirely happy we have a World Diabetes Day. If you want to know why, read the post. You might agree with me.

If you want a Timesulin cap for your insulin pen, unfortunately you’ll either have to have someone bring one over for you from Europe, or hope Timesulin gets approval to make them available here in the US next year as they’re hoping.

Happy Holidays