Do We Take Medical Technology for Granted?

This was originally published on Hugging the Cactus on December 4, 2019. I’m sharing it again today because there have been many diabetes tech outages since then – and I’m certain there will be more in the future – but my question still remains: Do we take medical technology for granted? I ponder the answer to that below…

Alright, now that I’ve got THAT out of the way…

For the last several days, the DOC has been in a bit of a panic. And when I say “bit” I mean “a helluva lot”. That’s because the day after Thanksgiving, Dexcom Follow stopped working. This means that parents/caretakers who rely on the technology to monitor their child’s/loved one’s blood sugar levels were left in the dark. It sparked confusion, outrage, and downright fear, all of which only seemed to intensify over the weekend and into this week when the problem was only partially solved for most users.

Rather than coming together to support one another, the DOC swiftly divided into two camps: The first consisted of individuals who sought to gently remind others that this technology is still pretty new. It hasn’t even been around for two decades. That meant that for many years before then, people with diabetes were doing things the “old school” way, and getting by just fine. Doesn’t this mean that we should all be able to make it through unexpected technology blackouts, knowing that we have our blood sugar meters to fall back on?

The second camp was in a greater fury over the issue. This camp relied on the Dexcom G6 system because those within it simply didn’t know a life without the continuous glucose monitoring technology. For them, the outage was a bit like asking them to Google something without access to the Internet – it’s pretty much impossible, unless you’ve got an Encyclopedia handy. Oh, and it’s MUCH higher stakes, because people who don’t recognize symptoms of low or high blood sugar need this technology to work in order to stay on top of fluctuating blood sugar levels. Let’s not even get into how much is PAID for this expensive piece of medical equipment…one would argue that the high cost of supplies means that the technology should work at all times, no matter what.

If you’re like me, you can see that both of these groups have perfectly valid points. I’ve had diabetes long enough that I didn’t even use – and didn’t see the point in using – continuous glucose monitoring or insulin pumps until a few years ago. I took care of my diabetes the old fashioned way growing up: doing fingerstick checks multiple times per day, treating low blood sugars with 15 carbs then waiting 15 minutes, checking blood sugar levels about an hour after injecting insulin to make sure highs were coming down the way they should. This way of handling diabetes worked for me for a long, long time…throughout elementary, middle, and high school, right up to college.

Then I got a continuous glucose monitor (I believe it was the Dexcom G4) just before starting my freshman year of college. And I haven’t really been without a CGM device since then. It’s changed my life and helped me navigate adulthood with diabetes. Whenever I do experience periods of the technology not working the way it should, it’s infuriating because I feel like it’s not worth throwing away buckets of cash on it in those periods of inconsistency and inaccuracy.

But here’s what I’m wondering, as a result of this Great Dexcom G6 Outage of 2019…do we take this technology for granted?

Do we truly appreciate the times that it works the way it should?

Do we expect too much from something that, technologically speaking, still has a long way to go in terms of working perfectly?

Do we rely too heavily on continuous glucose monitors to provide us peace of mind when, in reality, they simply provide us with real-time updates of our blood sugar levels (i.e., it’s a stream of data)?

I don’t have answers to these questions. I can reflect on my own answers to them; furthermore, I can ponder how and why the DOC gets so divisive in these times where we should try to come together, listen to (and learn from) differing perspectives, and figure out what we can do to best support one another during trying times.


Another Day, Another Annoying Diabetes Reference

I have controversial taste in entertainment.

While I’m a huge fan of trending shows like The Last of Us and Wednesday (I recently finished both first seasons and fell in love with the characters on both shows/mourn the fact that they likely won’t produce second seasons until 2025), I’m also really into what my mother calls “trash TV”.

This is synonymous with reality television – think along the lines of anything that the Bravo network plays. Most of those shows symbolize pure escapism and innocently mindless entertainment for me, and I’m addicted, so much so that my trash taste in TV translates to my podcast listening.

I listen to a handful of podcasts hosted by personalities that either appear on the Bravo network or talk often about Bravo-lebrity drama, and while I usually find them wildly entertaining, I’ve noticed an emerging trend on these podcasts in recent months that makes me incredibly irritated. And that’s how often diabetes comes up as a topic on these podcasts.

Nine times out of ten, it’s about Ozempic (the type 2 diabetes drug that famous and non-famous folks alike have started using in order to lose weight). Usually, the podcast hosts are poking fun at it or spending way too much time speculating who is and isn’t using it, and it drives me up the wall. NOBODY is talking about the morality of taking a type 2 diabetes drug when they do not have that condition themselves, or the fact that since it’s become so popular it’s made it scarce and potentially unavailable to the people that really need it. Now, I’ll take a step off the soapbox for a second because obviously I 1) don’t have type 2 diabetes and 2) don’t use or need to use Ozempic; therefore, I don’t have a true stake in the game other than that I could imagine myself being even more worked up if it were a matter of people taking Humalog for similar reasons (goodness knows the rage that I would feel if Humalog was becoming virtually fetishized because taking it resulted in some desirable outcome).

I also shouldn’t sit here and judge people who go on Ozempic who have maybe tried multiple other weight loss methods that have failed them, and they’re genuinely using the drug to try and get healthier – I can empathize with that more. No, what really bothers me is the resulting dialogue that seems to happen every time Ozempic is brought up, and that is pure ignorant bliss regarding what diabetes actually is and how significant of a role it plays in the daily lives of people living with it. Multiple podcasts that I listen to have covered the Ozempic “fad”, explaining to their seemingly naive audiences that it’s a drug for diabetes, followed by a punch line about how they don’t even know the difference between type 1 and type 2, and saying things along the lines of how they hope they get diabetes just so they have an excuse to take Ozempic.

It’s gross. And quite frankly, embarrassing for these podcast hosts to admit that they know so little about a condition (and I’m speaking broadly here about both T1D and T2D) but then claim they want to be diagnosed with it so they can maybe indulge in their vanity and lose weight. There’s much better ways to make clever little jokes about diabetes and I’m getting tired of people being lazy in their comedy by continuing to be misinformed.

Maybe all of this is a signal to me that it’s time to take the trashy podcasts out of my rotation…

What I Eat in A Day for My Diabetes

I guess I’m hopping on the “what I eat in a day” bandwagon.

This trend has existed long before the TikTok videos and Instagram reels in which vloggers share what they typically eat on any given day of the week – it’s also been something that tons of celebrities have been asked to share in interviews. And while I’m far from a celeb (especially Gwyneth Paltrow, who allegedly is sustained by a cup of coffee, bone broth, and steamed veggies on a day-to-day basis), I do have a certain meal routine that’s centered around my diabetes. Nobody asked me about it, but I figured, why not share it on the blog? After all, so many of the “what I eat in a day” videos and articles I’ve viewed sound a little too perfect. I often wonder how realistic folks are when they’re covering this topic, so I’m going to be pretty matter-of-fact when going through my “meal plan”, and cover how it varies on a weekday versus a weekend. So here we go:

Breakfast on a weekday: I am usually eating breakfast between 7:30 A.M. and 8:30 A.M. I love all breakfast foods, but lately my go-to has been a baked oatmeal. I prep this myself on Sundays and it makes enough servings for 6, so I’m covered for breakfast for the week. I add a couple of scoops of protein powder to it and top it with berries so that I make sure I’m getting a nice balance of carbs, fruits, and protein. One serving is roughly 30-35 grams of carbs, and I’ve found that my blood sugar fares well whenever I eat this meal, maybe spiking a bit in the hour after consuming it but settling back down nicely in no time.

Breakfast on a weekend: Anything goes! My wake-up time could be as early as 8 or as late as 10:30 or even 11 (though I don’t like sleeping my mornings away). Depending on when I wake up, I might want a breakfast sandwich or a protein smoothie, but there are other times that my partner will make me a breakfast consisting of something like hash browns, eggs, bacon, and salsa – no matter what we do, I try to keep breakfast no more than 30-40 carbs because that feels like a sweet spot for my blood sugar levels, whether I’ll be exercising in the hours after eating or even if I’m just lounging around until the afternoon.

Lunch on a weekday: I almost always have a salad or a sandwich. I like to load up my salads with lots of extras – tons of veggies, feta, bacon bits, croutons – and always top them with a protein like hardboiled eggs or chicken. If I’m having a sandwich, I’ll almost always eat it with a side of baby carrots or veggie straws (and if I’m in the office, I might indulge in a buffalo chicken wrap which comes with house-made chips – so yummy but much higher carb compared to what I’d make at home). I will eat an apple or any other fruit I have on hand for something sweet. My blood sugar is usually good after lunch, but if I see it going up too quickly or if it stays higher than I’d like it to for an extended period of time, I’ll combat that with a walk in my neighborhood or around my office suite.

Lunch on a weekend: Admittedly, it’s almost non-existent. If I have leftovers from the night before, I’ll eat that, or maybe my partner and I will split a box of frozen samosas or share a cheese plate so we’re not totally starving by dinnertime. It’s just what works best for me since all of my weekends are totally different in terms of our plans.

Dinner on a weeknight: I like to either meal prep on a Sunday night and have whatever I make carry me through the first few days of the week, or I’ll make something on a Monday evening that will produce my dinners for the next few nights. I’m a semi-lazy cook, so I like tossing veggies, starches, and proteins on a sheet pan and roast everything up (I love recipes from this website). And I have a sweet tooth, so dinner is often followed by a single serving of ice cream or a chocolate-covered frozen banana. My carb intake at dinner hovers around 45-60 grams of carbs, which I find works well because I get busy in the evenings catching up on chores around the house or running errands. The extra carbs help me stay level (and full).

Dinner on a weekend: I enjoy whenever my partner and I have a chance to make food together, because he’s a great cook and very conscientious of my diabetes when making something to eat. He helps me carb count and if we’re going out somewhere to eat/ordering takeout, he’ll offer to split higher-carb dishes with me so I can still have them without totally wrecking my blood sugar. I don’t really place limits on my carb intake for meals out because I love getting sushi, flatbread, and other high-carb menu items – I just try to keep an eye on my blood sugar levels in the hours after a meal out so I can stay on top of highs.

Snacks: I’m a grazer through and through, meaning that it’s hard for me to resist the temptation to snack on foods in my pantry throughout any given day. So I try not to keep bottomless bags of anything in my home, though I do keep things like bags of light kettle corn and single-serving snack bars on hand. But I’m also a sucker for a bowl filled with chocolates like Reese’s or Ghirardelli squares which I will shamelessly help myself to, never having more than a couple in one day because ~*balance*~ matters. Grazing can really screw up my blood sugar, though, so I try to be smart and time it so any snacks coincide with periods of higher activity (such as before I vacuum or head out to run errands).

Drinks: I try to stay hydrated on a daily basis. Besides plain water, I drink Powerade Zero to get in extra electrolytes and I’m an absolute sucker for fizzy and carbonated drinks as long as they are carb-free. I do drink beer/wine/cocktails from time to time that definitely have extra carbs, but I have learned over the years how my blood sugar will respond to a given alcohol and plan accordingly around that.

So, that’s it – an honest explanation of what I eat in a day as a person with diabetes. Some days I am more balanced and “healthy” than others, and some days I just go to town and whatever I like. My relationship with food will never be perfect because my diabetes undoubtedly influenced it, but that’s a post for a different day. For now, I’m off to have a snack to keep my blood sugar (which is 113 mg/dL as I write this) steady throughout my evening workout routine.

The Last Time I Cried About My Diabetes

It was around 4 o’clock in the morning. Rain was pounding relentlessly outside my window. The power must’ve gone out, because flickering lights and the sudden sound of my heat turning back on woke me up with a start.

I tried to let the sound of the falling rain lull me back to sleep, but it was loud. I tossed and turned, doing my best to resist the temptation to check my phone and mindlessly scroll through various feeds until I felt sleepy again, but before long I gave in. As I almost always do every time I unlock my phone, I tapped on the Dexcom app so I could see what was going on with my blood sugar.

At that present moment, I was 92 and steady, but what my graph indicated to me in the previous couple of hours made me audibly gasp.

I had fallen to below 55 at some point in the middle of the night, and stayed in fairly low territory for nearly two full hours before making the slow climb back up.

That’s when it came surging back to me: The memory of waking up, some hours before, to the sound of an urgent low alarm. And then me totally ignoring it in favor of sleep.

The realization hit me as hard as the rain was striking against my rooftop, and then the tears welled in my eyes. I lay there, crying quietly, as I tried to accept the reality that choosing sleep over fixing my low blood sugar could’ve been an extreme error on my part. What if the rain and the power outage hadn’t woken me up? I recognized that given my current blood sugar graph, I would’ve been just fine, but regardless I had still slept through a low and that frightened me – I’m not sure if I’ve ever done that before. Just as I was beginning to really freak out, I felt a rush of gratitude toward my Omnipod 5. After all, it had seemingly detected the low blood sugar and then lessened my basal rate (or perhaps completely stopped delivering any basal insulin altogether) in order to bring my blood sugar back up. I felt as though the system had possibly just saved my life.

So I couldn’t help but lay there and let the tears fall, marveling at the technology that I felt indebted to at this particular moment in time, before I found myself drifting off into a dreamless sleep again.

What Keeps Me Going When I Have a Tough Diabetes Day

Experience a bad diabetes day? Been there, done that – a countless number of times, really, in the last 25 years.

Most days with diabetes are “good”; by good, I mean predictable and smooth, with my numbers staying in range and absent of pod failures or inaccurate Dexcom readings. The bad days, as you might expect, are the polar opposite. Bad diabetes days are defined by rollercoaster blood sugar numbers, the ensuing side effects ranging everywhere from irritability to frustration to enraged and to downright exhaustion (just to name a few likely outcomes). Bad diabetes days happen much less often than the good days, but there’s no denying the emotional toll that they take. So what possibly keeps me going on the days that I feel most defeated by my diabetes?

Honestly, it’s the knowledge that it’s temporary. The phrase “this too shall pass” comes to mind when I think of a bad diabetes day. It’s a great reminder that as insurmountable as some bad diabetes days may feel, it won’t last forever, and the opportunity to try again will greet me the next day. To adapt from another well-known adage, the sun will rise in the morning, and I can try again and have faith in my knowledge that not every day with diabetes is bad.

It might sound trite or even a little eyeroll-worthy, but it’s the truth, and it goes a long way in comforting me throughout the days when diabetes acts up at every twist and turn.

What works for you?

My Thoughts on *That* Insulin Cap News

Just over a week ago, Eli Lilly announced a 70% reduction in price for its most commonly prescribed insulins that resulted in a cap of patient out-of-pocket costs at $35 or less per month.

This news was huge and spread like wildfire across the diabetes online community. And for good reason – it’s something that so many people with diabetes have needed to happen for a very long time. Most reactions I saw were that of complete and utter joy and relief. I’ll admit that’s what I felt at first, too, until I saw the more displeased responses that directed additional frustration and rage at Eli Lilly for not taking this action sooner, or reducing the cost of insulin to make it free altogether. Those posts got me thinking.

I’ve had time to reflect and gather my thoughts on the matter, and I think I land somewhere between thrilled and bummed, myself.

This news is absolutely something to be celebrated, as it will undoubtedly assist people who struggle to afford insulin with astronomically high price tags. This is an issue that I’ve spoken about on the blog before, and while I feel very fortunate to never have personally struggled with affording my own insulin (though I’ve certainly complained about out-of-pocket costs in the past), I’ve read countless stories about individuals in the United States who’ve had to take drastic measures in order to obtain this life-saving medication. So this news is wonderful, for sure, but it also feels a little too late.

Is this response from Lilly induced by the pressure that they’ve felt from diabetes advocates in the last several years? Is it a genuine call to action to other insulin manufacturers to follow suit and slash prices? Is it all just some sort of PR stunt? My suspicion is that it’s a mixture of all three, and while this feels like a victory for now, I don’t think that I will personally be satisfied until all people with diabetes are able to get insulin for free – no bottom line, no gimmicks, no nothing other than access for all.

My Diabetes Does Not Make Me Brave

“I’m a big brave dog, I’m a big brave dog, I’m a big brave dog…” is a mantra that little Chuckie Finster repeats to himself, over and over again, in an episode of The Rugrats that I recall vividly from my childhood.

It’s probably so cemented in my memory because I identified a lot with Chuckie as a kid – I was constantly overly cautious, nervous to try new things and scared about breaking rules or going against the norm. While I’ve overcome many trivial fears as I’ve gotten older, I still don’t think that I’m brave, despite many people telling me that I am…almost always in the context of my diabetes.

“You inject yourself with actual NEEDLES?! You’re so brave!”

“You wear two medical devices at all times? You’re so brave!”

“You put your diabetes story out there to share with others? You’re so brave!”

These are comments I’ve received from family, friends, and total strangers over the years, and while I appreciate the sentiment, I definitely don’t think that my diabetes has made me brave. I do these things because I have to. If I chose to not take care of my diabetes, or talk about my lived experience with it, I would be a much less healthy and happy individual. In my opinion, this isn’t equivalent to bravery – it’s common sense. It’s my reality that I accepted a long time ago.

As someone who is generally anxious and constantly worried about so many things besides diabetes, I’d much rather be admired for being brave about anything else that doesn’t remotely relate to my diabetes. Call me brave for trying something new that I was genuinely terrified about, or maybe say “you’re so brave” in a situation in which I took a stand for something I believe in. Hell, I don’t even mind if you continue to think that I’m brave in my journey with diabetes, but just recognize that my diabetes doesn’t make me brave – there are so many other facets of life that require genuine courage and spirit, and for me, I prefer to think of my diabetes as one teeny, tiny speck in that much larger, grander picture.

7 Questions People Always Ask Me About Type 1 Diabetes

This was originally published on March 1, 2019 on Hugging the Cactus. I’m sharing it again today because these questions (and answers) are truly timeless: I feel like I’ve been answering them to a certain degree for the last 25 years, and I fully expect to have people continue to ask me these questions in the future. Fortunately, as someone who enjoys being a diabetes advocate, I don’t mind answering them and providing insight…but that doesn’t make some of these questions any less eyeroll-worthy. Read on to see what I mean…

Human beings are naturally curious creatures. So it’s never really surprised me when, upon discovering my T1D, people tend to ask me boatloads of questions about what it’s like. And it’s definitely not at all shocking that many of these questions are recurring.

Here’s a list of seven questions that I’m almost always asked when I encounter someone who’s just learning about my diabetes. You’ll notice a trend as you read, because even though there’s “no such thing” as a stupid question, this list kinda gets dumber as it goes on. There, you’ve been warned…

7. What does it mean when your blood sugar is high/low?
This is definitely a fair question. I never expect someone who is unfamiliar with diabetes to know the meaning of hypoglycemia or hyperglycemia. I actually kind of appreciate being asked this question, because it helps me spread awareness. The more people that know how to react in severe high or low blood sugar cases, the better, IMHO.

6. Why do you wear all of those devices?
Another decent question – I never mind explaining how my CGM and my pump work, but I do mind when people say ignorant things, like “Oh, are those patches to help you quit smoking?” *Eye roll*

5. Can you eat/drink [fill-in-the-blank]?
Ugh…I get why people ask me this, but it’s a little more tiring to explain. My answer is usually along the lines of: “I can eat or drink whatever I like, but I need to take insulin to account for it. So I try to eat a limited amount of carbs at a time, because that means I have to take less insulin, and there’s less room for error.” But even after that easy-to-understand explanation, the typical follow-up questions are “BUT CAN YOU EAT CAKE/COOKIES/ICE CREAM/ANY SUGARY FOOD?!” And that’s when I lose a bit of my patience, TBH.

4. Does it hurt when you check your blood sugar/give yourself a shot?
I mean, no? I’m not trying to be facetious or anything, but really, after 21+ years of checking blood sugar and giving myself insulin multiple times per day…there’d be a real issue if it hurt every single time. I concede that there are the occasional sites that sting, but it’s not nearly as bad as many people seem to assume.

3. What’s that beeping sound/ARE YOU GOING TO EXPLODE?!
Honestly…use common sense. What’s the likelier scenario here: That my devices have built-in alarms, or that I’m going to spontaneously combust?

2. How did you get diabetes/WHAT DID YOU DO WRONG?
This. is. such. an. ignorant. question. Nobody, myself included, did anything “wrong” that resulted in my diabetes diagnosis. I didn’t catch it and no number of lifestyle changes could have prevented me from developing diabetes. My immune system merely decided to attack and destroy the insulin-producing beta cells that lived in my pancreas. There’s no real answer as to how diabetes is caused, though genetics likely play a role in it. Don’t worry, you won’t “catch” the ‘betes by being in my presence.

1. Do you have the…bad kind of diabetes?
This question is THE WORST of them all because there is no good kind of diabetes! Gestational, type 2, LADA…none of them are favorable. They all suck. They all require constant care, regulatory medications, and endocrinology expertise. So please for the love of all that is sacred and holy, next time you hear someone ask this question, gently inform them that there’s no such thing as good/bad diabetes.

Don’t Say This to a Person with Diabetes

This blog post was originally published on Hugging the Cactus way back in 2018. I’m sharing it again today because I think it’s important for people to know that they don’t have to feel sorry for me when it comes to my diabetes. Read on to understand why that’s my perspective…

Today’s blog post is going to be short and sweet, and about a subject that I think every person with diabetes deals with whenever they tell someone new about their diabetes.

It doesn’t matter how diabetes comes up in conversation. Whether it’s in a joking, serious, educational, happy, sad, or angry manner, the person I’m talking to almost always says…

“I’m sorry.”

Sometimes, I think it’s because society has instilled this weird reflex in people to apologize for something that they didn’t do. Other times, I think it’s because people just don’t know how else to respond to something that may be sobering or grounded in reality. But the simple fact of the matter is…

People need to stop apologizing to me, and other people with diabetes, for having it.

Here’s why:

  1. It doesn’t make sense.
  2. We weren’t given a choice – it’s a simple truth that we’ve learned to accept.
  3. It makes me feel strange, because it’s almost like the other person is taking accountability for my diabetes.
  4. I believe that human beings apologize too much, in general, and it diminishes apologies when they matter most or are most sincere.
  5. I’m not sorry that I have diabetes, so why should someone else be?

While I genuinely empathize with and appreciate people who apologize as a knee-jerk response, I’m just here to gently tell them that it isn’t necessary. Save “I’m sorry” for times that it’s warranted, and not for something like having diabetes, a matter in which no one has a choice.

The Language of Diabetes: Is it a “Chronic Illness”, a “Disease”, or a “Condition”?

What would you say if someone asked you to identify diabetes as one of the following: 1) a chronic illness, 2) a disease, or 3) a condition?

My response would be…it’s not so clear-cut for me. It’d change depending on how I felt about my diabetes at a given moment in time.

What word(s) would you use to identify diabetes?

So for example, on the days when diabetes dominates all of my thoughts and emotions with its unrelenting nature, I’d be more inclined to call it a chronic illness. On those occasions, my diabetes seems determined to remind me that it’s not going anywhere, and that I’d better just accept that it’s here to stay.

But when diabetes is straight-up pissing me off – say because of a medical device failure or a stubborn high blood sugar that won’t come down – I’d call it a disease. It seems to be a fitting title for something that’s acting in a disordered nature, and goodness knows it infuriates me to no end when the elements of diabetes that I can more usually control act out unpredictably.

And then it’s when diabetes and I are just mutually co-existing. I’m aware of it, and it’s aware of me, but it doesn’t have the ability to impact my emotions like it does when it’s behaving more like a chronic illness or a disease. When diabetes is my condition, I have it – it doesn’t have me.

I could be reaching a bit here with my musings on associating diabetes with different words, but truly, language is powerful in diabetes (and really, in all aspects of life). Words and phrases have connotations and significance depending on the contexts in which they’re used, making their endless combinations utterly fascinating. Because of this, I believe that examining the specific language around diabetes is extremely interesting as I think about the ways I describe my own diabetes experience and how that involves my emotions.

And what’s really cool is that there’s no right or wrong way about the words I choose to use regularly around my diabetes because it’s my story to tell. Here’s a friendly reminder that the same applies to you, too.