My Top 10 Tips for Managing T1D at Family Gatherings

A version of this blog post originally appeared on Hugging the Cactus on November 23, 2017. I’ve decided to share it again today (with some slight updates) because I felt like I needed a reminder as to what a successful game plan looks like heading into a food-centric holiday! Read on for more…

Holidays that are centered around gratitude and eating…what’s not to love? As much as I enjoy the holidays, though, I can’t quite say that my diabetes feels the same about them. Fortunately, I’ve developed a bit of a game plan as to how to handle diabetes when family feasts come rolling around – here are my top 10 tips for making the most of eating-centric holidays with diabetes!

The only thing missing from this picture is the massive pre-bolus that I’ll likely be taking before sitting down at a major meal.

10) Don’t skip breakfast in the morning. This helps me avoid over-eating when dinner is served later in the day. Breakfast doesn’t have to be a huge thing, maybe just a bowl of oatmeal or a piece of fresh fruit – anything that will sate me for a few hours.

9) Volunteer to prepare a couple of dishes. If I’m going somewhere for the feast, I like to know what my host needs me to bring. If I have creative control over the dish, I prefer to make it something that I know won’t be too hard on my blood sugars, such as a side of veggies or a sugar-free dessert.

8) Familiarize yourself with what’s being served prior to sitting down for the meal. Before my family sits down to eat, I like to know what exactly we’re being served so I can plan accordingly. I can usually get away with strolling around the kitchen to get an idea, but sometimes the chef (my aunts or my mom) kick me out while they finish cooking dinner!

7) Don’t feel pressured to try everything. It all looks and smells so good, but I have to remind myself to use some restraint when piling my plate with food. I’ll add staples like turkey and green beans (both of which are low-carb!) and take smaller portions of the heavy things, such as stuffing and potatoes.

6) If it’s necessary, extend my bolus. This all depends on what my blood sugar is before the meal, but sometimes, I’ll extend it in order to prevent lows or highs post-feast.

5) Check my blood sugar often. I’d rather have an idea of where my blood sugar is headed than leave it to chance and guess incorrectly.

4) Go for a walk or organize another outdoor activity. The weather doesn’t always cooperate with this idea, but I’ve found that dragging my cousins on a 20-minute walk after eating helps my blood sugar and provides us all a chance to hang out while our uncles take control of the TV and our aunts chitchat over cups of coffee.

3) Wait a bit before having seconds or starting on desserts. I try to indulge a bit on the sweets, but I know that it never works out for me if I help myself to desserts too soon after consuming the main course. So I avoid the temptation by staying busy after eating dinner – my mom and aunts always appreciate an extra set of hands to assist with clean up!

2) Look up carb counts if I’m struggling to come up with them on my own. Sometimes, I can’t quite determine how many carbs are in a serving of pumpkin pie – I’ll guess too low and end up high, as a result! But I know that there are tons of carb counting resources at the tip of my fingers, thanks to my smartphone.

1) Remember what the holiday’s all about: being thankful! Enjoy the day and time with loved ones! Whether you’re part of a large family like mine, a small one, or choose to spend the day with friends or a partner, just relish it for what you want it to be.

My Take on Diabetes and Support

I wrote a version of this post on November 20, 2019. I wanted to revise it and share it today because, as we approach a week in which we recognize gratitude for our loved ones, I want to express how grateful I am for the people in my life right now who support me throughout the highs, lows, and everything in between that comes with life with diabetes.

Emotional support is a lovely thing. It feels good to have people in your life who you feel have your back. And it’s twice as nice to have when you’re dealing with a chronic illness like diabetes.

I talk extensively about diabetes and support in the most recent episode of the podcast, Ask Me About My Type 1. (Here’s the link in case you haven’t listened to it yet.) Rather than rehash everything I said in that episode, I’m going to use this post as an opportunity to reflect how my wants and needs in terms of support for my diabetes have changed over the years.

It’s interesting (at least, it is to me) to think about how and why my desire for support has changed as I’ve grown older. My childhood was very normal despite diabetes. It was always there and it was always a thing I had to deal with, but I definitely didn’t feel compelled to talk about it as much as I do now, let alone lean on others in difficult times. Why is that?

I think it has a lot to do with getting to know myself better as I’ve aged.

In this post, I get all self-reflective-y on diabetes and support.

After all, they say that with age comes wisdom. And though I don’t exactly consider myself a wise old sage or anything of the sort, I do think that I’ve acquired some enlightenment about myself and the way that I process things in my adulthood.

Specifically, I realized in the last few years that diabetes has instilled in me a strong desire to feel in control of every aspect of my life…not just diabetes. When something doesn’t go according to whatever carefully thought-out plan I’ve cooked up, I get upset. And I tend to either bottle up my dismay, which is never a good thing to do, or I totally take it out on the whichever poor soul happens to be within my vicinity, which isn’t fair. Neither of those reactions is a healthy method of dealing with things, but at least I’m aware of that and I’m actively trying to improve how I cope.

I think that this example shows how important diabetes support has become to me because I’m able to lean on others in those times that all of my diabetes plans don’t work out the way I envisioned them. I’ve figured out, over time, that it’s just about the only thing that really works for me. Talking to other people with diabetes (and without diabetes) about struggles that I’ve faced makes me feel less alone. It used to be scary for me to be so vulnerable with others, but I’ve found that it’s worth it because it helps me heal, move on, and forgive/accept myself for feeling whatever I’m feeling.

And now, two years after I wrote this original post and two years of life experience later, I’ve finally fostered my perfect support network from the different people and relationships in my life. I’ve got the lifelong support of my family members, the years of support that my friend groups have provided to me, support from coworkers who work with me in the diabetes space (bringing a whole new meaning to people who really and truly “get it”), and the support in my romantic relationship that I’ve been missing my entire adult life. It feels incredible to have a partner who always asks questions and demonstrates a willingness to learn about my diabetes, adds new perspective and helps me identify solutions when I’m being challenged by my diabetes, and shows up for me when I really need him to. That, and the support I get from the other groups I’ve mentioned, is truly powerful…and when it’s combined with learning how to rely on others and best support myself, support becomes magical and absolutely enhances the quality of my life with diabetes.

What I Wish People Knew About Life with Diabetes

As National Diabetes Awareness Month speeds by in a lightning-fast pace, I keep finding myself going back to this question: What do I wish people knew about life with diabetes?

My answer to this question changes depending on the kind of day and experiences I’m having with my diabetes. For example, on the occasions that I have a pod failure or my Dexcom loses signal for hours, I wish that people knew life with diabetes is marked by a dependence on technology. When I have several bad low blood sugars in the middle of the night, I wish that people knew life with diabetes means you lose out on a lot of sleep. And the times that it seems like I live at the doctor’s office or spend all my spare time on the phone with insurance companies, I wish that people knew life with diabetes can be a giant (and expensive) time suck.

While there’s obviously a lot that I wish people knew about life with diabetes, I think that I can identify the number one, most important thing that I wish people knew…and that is: life with diabetes is unpredictable. No matter how many years I’ve lived with it, no matter how often I think that I’m doing the right thing in my care for it, it can still prove me wrong all the time. It’s challenging, frustrating, stressful, and draining, and I really wish that people realized how much work it requires to have diabetes. It’s not as simple as counting carbs, injecting insulin, and eating right – it demands mental and physical energy in order to care for it properly, and people living with diabetes don’t ever get a break from that.

I do my best to smile, even when diabetes is at peak unpredictability.

Despite that, I try to smile through it all…because diabetes and its curveballs are a lot easier to handle with a positive mindset. But that doesn’t mean that I don’t wish that people knew how difficult it can be, too.

3 Nighttime Lows in a Row

The night of the first low, I was “good” and treated with glucose tablets.

The night of the second low, I shamelessly treated with a leftover Halloween candy blondie (okay, two of them) that I had made earlier that day.

The night of the third low, I was exhausted. And feeling nothing other than a desire to sleep, I treated with both glucose tablets AND sour patch kids, because my body decided it needed that many carbs in order for my blood sugar to level out for the rest of the night.

By that third night, I was so dang tired. I’d had to go downstairs to get the sour patch kids, and by the time I was done eating them, I couldn’t fathom walking all the way back up the stairs to get into my big, comfy bed. So I just crumbled onto the couch, pulling a blanket over me, and snoozed there for a bit. I probably could’ve curled up into a ball on my carpet and slept just as soundly, even if only for awhile, because I was so spent from being woken up in the middle of the night for the third evening in a row to treat a low blood sugar.

I wish that people knew that diabetes is truly a 24/7/365 condition.

I hate having my sleep – which seems harder and harder for me to get enough of as I get older – interrupted by something as stupid as a low blood sugar.

I hate having to eat in the middle of the night and ruining the minty taste leftover from my brushed teeth prior to bedtime.

I hate that sometimes, the low is bad enough that I get woken up one or two or even three more times in the same night because I’ve got no choice but to consume more carbs.

It seems fitting to write about this – how disruptive my diabetes has been to my sleep over the course of three nights, let alone my entire life with diabetes – during National Diabetes Awareness Month. Because I don’t think the rest of the world really understands that diabetes truly does not have an “off” switch. People who live with diabetes don’t have the luxury of sleeping peacefully without having a single worry about diabetes: It can and will disturb the soundest of sleeps, and it’s frustrating, inconvenient, and annoying every time it does.

3 Things I Wish I Knew About Diabetes in College

My blog post earlier this week probably made it very clear to you that I work for a nonprofit called the College Diabetes Network – but in case you didn’t know, now you know.

In my position with the organization, I semi-regularly interact with current college students living with type 1 diabetes. This causes me to reflect every now and then on my college experience and what I would change, knowing what I know now, about how I managed my diabetes when I was in college. I came up with 3 things that I wish I’d known then that would’ve likely made life on campus a lot easier for me – and it seems very appropriate to share these things this week, which is College Diabetes Week. Here’s what I wish I knew…

Me, almost 7 years ago, on the day that I officially became a UMass alum!
  1. I wish I knew then that an insulin pump would greatly benefit me. Hands down, this is the biggest diabetes regret that I have when I think about my time at college. I can’t tell you how many times it was inconvenient for me to whip out my insulin pen in the middle of the dining hall and inject before every meal. My rationale at the time was that there were already too many changes happening in my life (because as we all know, the transition from high school to college is huge), and that I didn’t want to toss learning a new piece of diabetes technology into the mix. Plus, I was stubborn – I figured that my then-current MDI regimen was doing a good enough job for me and my diabetes. If I’d only known that a pump would’ve allowed me so much more freedom…
  2. I wish I knew then that I should’ve asked my parents sooner to let me take over ordering diabetes supplies. All throughout college – and admittedly, for a few years post-graduation – my mom took care of reordering my diabetes supplies for me. She’d keep track of how much insulin I had left in the fridge, and my main responsibility was to let her know when I was running low on test strips or CGM sensors. I really wish I’d asked her (before I turned 26) to let me order supplies on my own, or at least walk me through the process so I had a better familiarity with it by the time I aged off my parents’ insurance plan. I had to learn a lot, and very quickly, when age 26 came around, and I could’ve avoided the steep learning curve if I’d been more proactive about it at a younger age.
  3. I wish I knew then that I could’ve avoided many diabetes mistakes by doing more research and getting more involved with the diabetes online community. Namely, I wish I’d known more about how to “party safely” with T1D. I went into college not having a single clue about how alcohol would affect my diabetes – and that is something that is incredibly dangerous. I learned a couple lessons the hard way in college, and I’m lucky that I didn’t have to pay any serious consequences. Knowing what I know now, I should’ve turned to the diabetes online community for guidance, tips, and tricks from people who could’ve helped me avoid some scary highs and lows I had after a weekend of partying. Imagine what I could’ve learned from Reddit threads, had I known they were available!

While I can’t change anything about the way I took care of my diabetes in my college years, I can say that I’m proud of myself for eventually gaining these insights about it. I may have done better had I known about these things sooner, but what matters is that I did find out about them in due course, which has led to positive changes in my diabetes care in the long run.

How CDN Makes Me Feel 100

This year, National Diabetes Awareness Month is an especially important time to me as it’s the first one that I’m celebrating as an employee of the College Diabetes Network. I’m commemorating the occasion by celebrating College Diabetes Week (which begins today and runs through November 14, World Diabetes Day) with all of our Chapters and by fundraising for CDN. Let me explain (as concisely as I can) why your support matters and how CDN makes me “feel 100”.

I’m a former CDN Chapter leader, past volunteer, and now a current employee. CDN has obviously shaped my career, but it has also had a tremendous impact on my physical and mental well-being as a person with type 1 diabetes.

Without CDN, I never would have realized the power of peer support in managing a chronic illness that is as demanding as T1D. I would have severely struggled to find the confidence and independence in my adulthood that is necessary in order to live and thrive with T1D. I would not be the diabetes advocate that I am today, I definitely would not have a successful blog about T1D, and I never would have made so many incredible friendships and connections that CDN helped make possible.

CDN makes me Feel 100, which is why I want to Raise 100.

Those are just some of the ways that CDN helps me “feel 100” about life with diabetes. “Feeling 100” is a colloquial term that describes feeling your absolute best and at your optimal level of happiness. That’s why it was chosen as the overarching theme of College Diabetes Week this year – we all want to feel 100, especially when managing the many challenges that comes with living with T1D while in college.

CDN has given me so much. Please consider helping me give back to CDN. Help me raise $100 (or more) and that money will go towards CDN Chapter stipends for the year, outreach kits, the ability for us to provide grants and sponsor Chapter activities, and so much more. We appreciate your support as we continue to empower and make positive changes in the lives of young adults with diabetes across the country.

I Finally Had an Endo Appointment, and…

…and it went well. Much better than I anticipated, both to my surprise and delight.

I’ve written here and here about my long overdue endocrinology appointment and my struggles deciding whether or not to pursue a new doctor. I eventually settled on taking an appointment with a nurse practitioner at my current endo’s office (mostly because I wanted advice from a professional sooner rather than later).

But my expectations for the appointment were low. I was doubtful that the NP would take the time to listen to, let alone address, my concerns. Fortunately, she proved me wrong.

My appointment – and the NP herself – really exceeded my expectations.

After we introduced ourselves to one another, I opened up to her that my previous appointment with the endocrinologist had been disappointing. I’d like to think I was gentle but brutally honest in my approach: Using kinder words than this, I explained to her that I felt like my last appointment was a waste of time and that I disagreed with the doctor’s assessment that I was doing just fine with my diabetes management. My sentiments were met with sympathy as the NP let me vent to her about where I felt I was lacking in terms of my diabetes care in the last several months.

The appointment lasted roughly 20 minutes or so, and by the end of it, several things happened: 1) I was given a new test kit and test strip prescription (I told the NP that I distrust my Livongo meter and want a reliable back-up for when I’m not wearing my CGM), 2) I had a referral to see a podiatrist due to concerns I expressed about my feet, 3) We agreed on a minor tweak to my correction factor that will hopefully help eliminate some mid-morning highs I’ve been experiencing, and 4) We set up a follow-up appointment with one another to take place in 3 months in addition to an appointment 6 months from now with the endocrinologist to make sure all of my bases are covered and I don’t have to go so long without seeing a doctor for my diabetes again.

I can’t remember the last time that I felt so heard by a diabetes clinician (or even any kind of clinician).

As the appointment concluded, I told the NP that I’m the type of person who relies on accountability in order to stay on top of my diabetes, and this appointment was the exact sort of accountability wake-up call that I needed to hold me over for the next few months until my next one.

And I daresay…thanks to the affability and receptiveness of this NP, I’m actually looking forward to our next visit in early 2022.

Happy National Diabetes Awareness Month!

It’s that time of year again – National Diabetes Awareness Month!

Did you know that the blue circle is the universal symbol for diabetes? It represents the unity of the global diabetes community in response to the rising number of people affected by diabetes.

I’m not sure if it’s because I work for a diabetes organization now, but sheesh, this month seems to have arrived more suddenly than it ever has. I’d say it’s caught me off guard, but after literally months of preparing for it as part of my job, it’s really just got me marveling over how fast time flies.

It’s also got me reflecting on how I’ve participated in NDAM in the past. Previously, I’ve done daily postings on my Hugging the Cactus Instagram account and replied to various prompts throughout the four weeks here on the blog.

This year, I’m not so sure I have the bandwidth to dive so deeply into the spirit of the month – but that doesn’t mean I’m mentally checking out of it altogether.

Rather, I’m plan on being more intentional in my approach. Instead of replying to daily prompts (that, over the course of the month, start feeling like homework – in other words, an unenjoyable task), I’d like to post when I feel like I actually have something to say. I don’t want to post filler content, I want to post things that are meaningful and capture my feelings about diabetes, NDAM, and the broader diabetes community.

That’s not a knock on the everyday post inspiration that many members of the DOC take part in – I think it’s wonderful that they have fun with it and use it as a very effective way to raise diabetes awareness throughout the month. It’s just that for me, as someone who’s been part of digital NDAM activities for the better part of a decade (!!!) now, it’s time that I mix up my routine a bit and also step back so I don’t spend all of my mental diabetes energy on NDAM in lieu of my actual diabetes care.

Here’s to deliberate diabetes awareness and care this month!

T1D and Haunted Happenings

Halloween is just a few days away, and even though I don’t have any specific plans, I’m really looking forward to it.

Now that I’m in my late 20s, Halloween is less about the candy – though I still very much enjoy that part – and more about having fun dressing up, even if it’s just for my own entertainment. But this is also my first Halloween at my condo, so I hope that I get to see a decent number of trick-or-treaters and cool costumes.

Diabetes can’t steal my joy on a day like Halloween.

Thinking about Halloween as an adult got me thinking of Halloween and haunted happenings from my childhood, and I’ve got to say, T1D never once got in the way of my enjoyment of the spooktacular holiday. Sure, there were plenty of other things to do besides trick-or-treat – I watched the Charlie Brown Halloween special (and still do) every year and I almost always make a point of carving a pumpkin or two each October – but collecting (and feasting) on candy was still a key component of Halloween for me that diabetes couldn’t take away. In fact, I think that it helped me feel a little more “normal”, like I had something in common with my peers without diabetes.

I’ve seen posts over the years about treats that T1D kids can be given in lieu of candy – things like pencils, sugar-free sweets, fruits or vegetables, and stickers – and that’s perfectly okay. But I think it’s also totally okay for T1D kids to have a break from worrying about diabetes and how it makes them different from everyone else every now and then, especially on a night like Halloween. I guess what I’m trying to say is that I’m really grateful that I always had super positive experiences around Halloween throughout my childhood that were never tainted by memories of anyone telling me I can’t eat a piece of candy or that I shouldn’t partake in the holiday because of my chronic condition.

So that’s why I’m excited to celebrate it just as I always have this Halloween weekend…though maybe with the added trip to the store the day after to see how much of a discounted low blood sugar/emergency candy stash I can accumulate.

Happy haunted happenings, Cactus Huggers!

An Endo Update

So I’ve got an update on my whole I-haven’t-seen-my-endocrinologist-in-8-months situation.

It’s not exactly the update I was hoping for, but it’s one that I believe just might push me into making some positive change around my diabetes care.

As it turns out, my endocrinologist is on leave and not taking appointments until February 2022, at the earliest.

What’s even crazier than that February 2022 wait time? The fact that I haven’t been at an in-person endo appointment since 2019.

I found this out after contacting her office and receiving a message back that I could either wait until that time to see her, or I could schedule an appointment with a doctor at a different location that the office would suggest to me.

At first, I wasn’t sure what the right move was. I was almost certain that I couldn’t (and shouldn’t) wait another 4 months to see someone about my diabetes; after all, I’ve been unhappy with my management for most of this year. But even though I have been similarly unhappy about my relationship with my current endo (it’s practically nonexistent), I admit that I felt fear over the prospect of seeing someone new because any other provider would only know me based on the information available to them in my records. In other words, they would only know me based on numbers, not based on who I am and my personal diabetes management style/beliefs.

So I sat on this news for a few days as I pondered whether or not to take this as a sign that it’s time for me to find a new permanent endo, despite the mere thought being incredibly daunting to me.

During my pondering period, I happened to get a call from my endo’s office that wound up making my mind up for me.

They called to let me know about an available appointment with the nurse practitioner who works closely with my endo – an appointment that I could get this week.

I hesitated for a moment (I really hadn’t anticipated getting an appointment before the end of the month) before agreeing to take the open slot. And I’m glad that’s what I decided to do, because 1) at least I can talk to someone about what I think I’m lacking in terms of my current diabetes management; 2) I might end up getting some quality advice that will redeem my endo’s office in my eyes; and 3) even if I don’t see eye to eye with this person, it will be the push I need to start actively pursuing a new endo that will more closely match my diabetes care style.

We’ll see what happens.