Happy Birthday to My Brother!

Today’s blog post is taking a personal turn because I’m using it to wish an extra-special birthday to my big brother!

It’s a milestone birthday – let’s call it age 29.999999 – and as such, I wish that I could celebrate it with my brother in person. But seeing as he lives about a thousand miles away from me (no exaggeration), coupled with the fact that travel isn’t exactly something that I personally feel is a smart idea right now, we’ll have to settle for a virtual celebration at the moment.

Happy Birthday to My Brother
A sunshine-y birthday graphic for the kind of guy that is FAR from dull!

So before I continue with this birthday post, one thing you should know about my brother is that he’s just about the polar opposite of me in every sense of the word – I’m 5’3, he’s over 6 feet tall. I have blue eyes, blonde-ish hair, and fair coloring, whereas he has brown eyes and hair, and a much tanner complexion. And I choose to share my life pretty freely on the Internet (case in point: this blog), but he’s much more private in comparison. (As a result, my bro shall be known as “my brother” to help maintain his privacy.)

And now to tie everything together a bit – this blog about diabetes, this post for my brother, and my relationship with him – another thing you should know is that I don’t have a single memory in my lifetime of my brother treating me differently because of my diabetes.

I’ve never heard him complaining about living with two T1D women (my mom and I), not once.

I’ve never felt judged by him for any choices I’ve ever made about my diabetes.

I feel like he may be the only person that I’ve ever met (and possibly will ever meet) who is completely, 100% impartial to my diabetes…and that’s really cool to me, for a bunch of reasons. But mainly because I think he realizes that I have plenty of other sources in my life that will judge me, treat me differently, or react in some way to one or more facets of my life with diabetes, so he just stays out of it.

I’m thankful for that.

One final thing you should know about my brother (besides today being his birthday, how different he is from me, and how nonchalant he is about my diabetes) is that he’s pretty effing fearless – he goes beyond being chill about my diabetes, he is chill about errrrrythang. He moved to a brand-new state, met all sorts of new people, found a nice living situation, started a new job, and oh, he also got into the best shape of his damn life and has officially run a marathon and become a certified personal trainer, all in the last three years. And he’s acted borderline blasé about all of his achievements. Like, WTF!!! In contrast to my high-stress, always-anxious, and wound-up-tight self, he’s the coolest cucumber and I hope that he knows I’m proud of him and can’t wait to see what he does next.

Happy birthday, bro – please don’t be mad at me for telling the world (okay, the 7 people who read this blog) about how awesome you are.

From Anxiety to Adrenaline Rushes: How Extreme Emotions Affect My Blood Sugar

You know that feeling you get in the pit of your stomach when you receive bad news? It’s like your heart falls to the floor and your stomach starts swirling from the perceived sensation.

That’s unpleasant enough on its own, but for me, it can also cause blood sugar issues.

The same thing can be said for when I’m on a literal roller coaster (which doesn’t happen often, but when it does, involves extreme coercion from family or friends) – I get that awful swooping sensation on top of some sort of blood sugar impact.

Every leaf speaks bliss to me, fluttering from the autumn tree.
Do you know how difficult it is to find a picture depicting an adrenaline rush that isn’t a cliche shot of a roller coaster or skydiver? Hence…a slew of moody “smiley” faces.

Whether it’s anxiety, adrenaline, fear, or just a rush of unidentifiable feelings, there’s no doubt about it: Extreme emotions tend to make my blood sugar unhappy by causing it to spike.

I’ve always been somewhat aware of this phenomenon, but I started thinking about it more last week when I got some upsetting news. (I’m okay, please don’t start to speculate on what it was…just a personal matter that I don’t care to discuss in greater detail here. Love y’all for understanding and respecting that.)

Actually, it’s kind of interesting to think about how the sequence of events unfolded last Thursday. I received a message that caused me to instantly panic. I was going to learn the context behind the message about a half hour after I got it, so in the interim, I was pacing all around the house and trying to figure out what exactly was going on. My stomach was roiling, my palms were coated in a light sheen of sweat, and my already-unruly hair frizzed out even more….

…and my CGM trend started going up, up, up, ever so slowly but noticeably.

I didn’t do anything to correct my blood sugar – at least, not right away. I waited until after I heard the specific news that had gotten me so worked up to really pay attention to my rising levels. I probably could have made my high blood sugar less severe by running a temporary basal increase right after I initially freaked out, but obviously, I had other things on my mind than my diabetes at that moment in time.

The whole experience was a stark reminder that food and insulin are far from the only things that impact blood sugar levels. Raw human emotion did that to me, and it will do that to me again in the future.

It sucks, but isn’t it also fascinating to think about how diabetes is totally a physical and emotional chronic condition, in every possible way?

My Top 10 Low Blood Sugar Treatments

Anyone who has ever experienced low blood sugar knows that it’s an icky feeling.

The shakiness. The sweating. The desperate desire to eat the entire contents of your kitchen.

It’s an unpleasant experience, but the one thought that has always made low blood sugars slightly more bearable for me is that I have to consume fast-acting, sugary, yummy carbs that are medically necessary. I’ve had some fun with that medically necessary bit in situations over the years: “Hey, stay away from that cupcake, I need it for my blood sugar!”

In any case, I’ve come up with my 10 favorite low blood sugars treatments that I’ve discovered work best for me…and tend to also be pretty tasty (well, maybe not #3, but everything else is a winner for most people in the flavor department).

1. Marshmallows. Even though I feel like I’m playing chubby bunny (you know, that pointless game when you see how many marshmallows you can fit inside your mouth at once and your cheeks puff out like an adorably plump rabbit munching on carrots) any time I consume a marshmallow, I can’t deny that they work incredibly well for low blood sugars. While I don’t mind the flavor of marshmallows, I definitely don’t love it, so I can always resist the temptation to over-correct a low blood sugar when I use marshmallows to treat it.

2. Mini boxes of yogurt-covered raisins. This has been my go-to for almost 10 years now because they’re just so convenient. The mini boxes are highly portable and contain about 11 grams of carbohydrates, which is perfect for not-so-bad lows that just need a little boost.

3. Glucose tablets (or gummies). They’re the old standby for a good reason: They were specifically made for treatment of low blood sugars, and they’re also extremely quick and easy to consume whenever, wherever (cue Shakira and her hips that don’t lie).

4. Frosting. So bad for you, but so good to eat by the spoonful when dealing with low lows. I don’t often have frosting on hand, but if I have some leftover from baking, I’ll throw it in the fridge and try to forget that it exists until I need it for a low blood sugar.

5. Orange juice (or a juice box). I feel like juice was a signature treatment for lows in my childhood: Since small children often drink juice boxes, it made a lot of sense. But back when I was working in an office full-time (sigh), I had a couple of juice boxes stashed away in my desk drawer because I got a kick out of feeling like a little kid with her juice boxes while sitting her grown-ass adult woman’s work cubicle (yes, I know I’m kind of weird. Embrace it.)

My Top 10 Low Blood Sugar Treatments
These are a few of my favorite things! (drastic shift from Shakira voice to Julie-Andrews-from-The-Sound-of-Music voice)

6. Starbursts. In college, I met a fellow type 1 in my social psychology lecture hall who swore by carrying starbursts for low blood sugars. She explained that four of them had the exact same amount of carbs as four glucose tablets, but they were far superior in taste because, well, starbursts are candy. I’ve kept this in mind over the years and its come in handy: More than once, I’ve been in a situation where I’ve had to get carbs fast but didn’t have glucose tablets on me, so I bought a sleeve of starburst to treat oncoming lows. They work well and they’re especially delicious when using the pink or the orange starbursts (not the yellow or red…fight me on it).

7. Skittles. What I love about using Skittles for low blood sugars is the 1:1 rule. One Skittle has one carbohydrate, so it’s extremely easy to figure out how many will bring up blood sugar, depending on how low the low is. 10 works well for when I’m in the 70s, whereas I might have 15 when I’m in the 60s. All bets are off when I fall below 60, though, and I’ll settle for a large, uncounted handful – maybe the whole dang bag – instead.

8. A piece of fruit. Ooooh, a genuinely healthy option on this list! The horror! But it’s a fact that fruit works just as well as any piece of candy or sugary treat for bringing up a low. I’m not talking about a single blueberry or strawberry, though: I’m talking either an apple or a banana – something that has some genuine carb content to it in a single serving.

9. A couple handfuls of cereal. This is a riskier choice because the lack of restraint I have around cereal when I’m low, but who else can relate to waking up at 2 A.M. to treat a low and being too tired to measure something out, so out comes the cereal box and handful after handful of Lucky Charms or Cookie Crisp are consumed in a very short span of time?! There’s no questioning cereal’s efficacy in a hypoglycemic situation, but when it comes to controlling the amount eaten…well, that’s a hard thing for me to do.

10. Fruit snacks/gushers. Embarrassing story from my childhood: Remember those commercials in which kids who ate gushers had their heads turn into giant pieces of fruit? Well…I was convinced that eating gushers would lead me to the same fate, so I avoided them until one day I finally realized it was just a stupid commercial (albeit with very freaky graphics) and it was totally safe to consume gushers. And thank goodness, because they’re delicious and great for lows! So are fruit snacks of just about any variety, though I’ve had the most luck with Mott’s and Welch’s fruit snacks.

Do you have any low blood sugar treatments that I didn’t mention here but should consider trying? Drop a comment to let me know what it is and why it’s your favorite!

Not 1, But 2 New Blood Sugar Meters: How I Got ‘Em and Why I Need ‘Em

Unexpectedly, I just obtained two brand-new blood sugar meters.

I’ve been a fairly loyal user of my OneTouch Verio IQ meter for about a decade now – that’s a longer relationship than the one I’ve had with Dexcom or OmniPod. It’s been mostly a loving relationship: From the beginning, I was a big fan of its sleek design, back-lit screen, and overall portability/usability. It grew a little more tumultuous over the years, though, as I noticed occasional, unprompted system shutdowns and questioned the overall accuracy of the device.

So I decided it was time to explore other options.

I brought this up to my endocrinologist during my very brief appointment with her a few weeks ago, and she let me know that a new Verio meter would be available soon. She said that she would set one aside for me when she received the shipments and that I could come and pick it up whenever I was back at the clinic.

Coincidentally, my gynecologist’s office is just down the hall from my endo, so I was able to pull double duty the other day and pick up the new meter right after my annual appointment with the lady doctor!

I was super excited to have a new meter, and even happier that it would take the same strips as my old meter. But there was one problem that I discovered when I got home…

…the meter I received isn’t the fancy-schmancy one just released by OneTouch.

Not 1, But 2 New Blood Sugar Meters_ How I Got 'Em and Why I Need 'Em
My old Verio IQ (left) with my new Verio Flex (right)

Instead, it was a generation after my Verio IQ – so it’s still a new one – though it’s decidedly less impressive, technology-wise, compared to its counterpart. It’s the OneTouch Verio Flex, and it’s very compact, but lacking a charging port (it runs on a battery) and the back-light that I loved so much about my Verio IQ.

Before I could fret too much about this minor disappointment – I can’t get too upset over a meter that I didn’t have to pay for – I noticed a letter on the counter addressed to me from my company.

I opened it up and was pleased to discover that my company is partnering with Livongo to offer a free blood glucose testing kit, free lancets/strips, and free coaching to all qualified associates with diabetes.

Talk about a sick benefit, right?!

I followed the instructions enclosed with the letter and within five minutes, my information was submitted to the Livongo website and my kit was on its way to me.

I’m totally pumped about this meter and this new program that my company set up. I’ve never heard of them doing anything like this before, and it will be a huge relief to know that I won’t have to worry about ordering blood sugar testing strips (or the associated cost) any time soon. But the meter itself sounds so dang cool, too – it has a full-color touchscreen! The meter actually knows when you’re running out of test strips and will remind you to reorder them!!! I’ve never heard of anything like that before, so I’m eagerly awaiting its arrival and can’t wait to check out all the features.

The one thing you might be wondering about these two new meters is…why the heck would I need them since I already have a Dexcom G6 that monitors my blood sugars 24/7???

There are two reasons: It never hurts to have back-ups and my Dexcom isn’t always accurate.

Let’s say that tomorrow, my Dexcom transmitter fails. Suddenly, I’d be without any blood sugar readings and I’d have to rely solely on my meters for blood sugar checks. That’s why it’s incredibly important to have functioning meters at all times, because you just never know when you may have no choice but to use them.

To compound that, my Dexcom doesn’t always work the way it should. Sometimes, I receive sensor errors and it doesn’t work properly for hours. Other times, I feel symptomatic of low or high blood sugars and my Dexcom doesn’t report them, so I resort to doing a finger stick check to verify the accuracy of my Dexcom’s readings.

It’s easy to understand, then, why I think it’s crucial to have at least one spare blood sugar meter. I may have come across these two new ones suddenly and fortuitously, but I welcome their addition to my diabetes toolkit and can’t wait to “test” ’em out (and of course, blog about ’em).

 

Fighting for LGBTQ+ Justice and #insulin4all

This post was written by Quinn Leighton and it was originally published on the T1International blog on July 8, 2020. June may have been Pride Month, but it’s important every day to understand the challenges faced by the queer and trans communities on a daily basis and raise awareness. Thank you to Quinn for sharing your story, fighting for LGBTQ+ justice, and supporting efforts to make insulin available and affordable for all.

I remember stepping up to the counter to check into an appointment with a new medical provider, when the woman at the desk asked me to step to the person to her right saying to her colleague, “Can you help this…” I had to finish the sentence for her, “person. I’m a person.”

I have often felt fear and uncertainty as a person living with Type 1 Diabetes: when I wake up in the middle of the night confused, reaching for my glucose tablets because my blood sugar reads between 40-50; when my spouse is driving me to the ER because I can’t stop throwing up or get my ketones down while I’m home sick with the flu; and of course the overwhelming financial burden we face daily and monthly in order to stay alive and as healthy as possible.

All of this is assuming we don’t face additional barriers such as discrimination, bias or mistreatment the moment we walk through the front door of a pharmacy, or a provider’s office simply based on who we are and how we show up in the world. For people in the LGBTQ+ community, such as myself, this fear is real and based on lived experience. I am queer, non-binary and married. I’m also white, and acutely aware that while my experiences have filled me with anxiety and have led at times to delaying medical care, I recognize I have not experienced medical racism in the way an LGBTQ+ person of color likely has.

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“We must recognize LGBTQ+ people often do not receive the same level of treatment or care that non-LGBTQ+ do, and LGBTQ+ people of color – particularly transgender women of color – are at the highest risk of discrimination, mistreatment and fatal violence.”

Delaying care due to these fears as a queer or trans person is not uncommon in any medical setting, however if you delay care living with diabetes, it can lead to life-threatening complications or even worse. It’s imperative that LGBTQ+ people living with diabetes and other chronic illnesses have the security, affirmation and resources to access the care they need.

We also know that LGBTQ+ people, particularly transgender and non-binary people make less money, despite having the same, if not higher levels of education as their cisgender, heterosexual peers. Even with a patchwork system of employment protections across communities, states and now federally; discrimination in the workplace is still very real. Among LGBTQ+ people, cis-bisexual women and transgender people have particularly high rates of poverty at 29.4%.

Together we can work toward greater health equity, but collectively, we must recognize the disproportionately high impact of poverty, violence, prejudice, mental health issues, discrimination and fear that so many LGBTQ+ people face living with diabetes. We must recognize LGBTQ+ people often do not receive the same level of treatment or care that non-LGBTQ+ do, and LGBTQ+ people of color – particularly transgender women of color – are at the highest risk of discrimination, mistreatment and fatal violence.

Understanding these inequities is paramount in moving forward in advocacy for affordable and accessible insulin for everyone who needs it, particularly those most vulnerable to bias, mistreatment and discrimination. This includes healthcare policies protecting people with pre-existing conditions and protecting LGBTQ+ people from discrimination when accessing healthcare. Efforts to repeal or rollback protections put into place through plans such as the Affordable Care Act that seek to provide care to people who need it most, particularly during a pandemic, is simply cruel and will only result in more harm and negative health outcomes. Non-discrimination protections are critical in providing the care needed for so many LGBTQ+ people living with a pre-existing condition such as diabetes, who already face a gamut of uphill battles in other areas of daily life.

Queer and trans communities are formidable. They overcome extraordinary obstacles to gain economic self-sufficiency, put a roof over their heads, maintain their health in the best of conditions, and simply exist and live in this world. What I’ve really noticed most is the courage and resiliency to navigate these barriers while celebrating community and showing up as our true and whole selves.

I recognize structural and systemic change won’t happen easily or quickly; however, I am hopeful that the movements around us will support communities of color, particularly black and indigenous people fighting for their lives and Asian people under attack due to prejudice and misinformation surrounding the COVID-19 pandemic. I am hopeful people will elevate their support of LGBTQ+ people and those most vulnerable within our community while working to make insulin affordable so that no other person living with diabetes is forced to make life-threatening decisions. And it is my hope that this momentum of support will carry us forward toward justice.

The Dog Days of Summer…with Diabetes

August is just ’round the corner (!!!) and that…feeling is creeping up on me.

That uncomfortable feeling that’s intensified by hot and humid weather.

That annoying feeling that happens when my CGM sensors and insulin pods seem to fall off my body and wither in the summer heat – the adhesives are no match for the sun’s merciless rays.

That restless feeling that creeps up when it’s too damn muggy out for my daily afternoon walks…the walks I rely on to help regulate my blood sugars and my mental health.

That fed-up feeling that’s the result of me going outside for 15 minutes, hoping to get some fresh air, only for my blood sugar to drop rapidly thanks to the high temps.

That creeping feeling of needing some kind of relief: Relief from the hottest days of summer and from every facet of diabetes management becoming just a bit more complicated because of it.

The Dog Days of Summer...with Diabetes
Is this the picture associated with this post just because I wanted to show off my dog being cute on a boat? No! Never! Absolutely not…okay fine yes.

And now that I’m acknowledging how much I’m craving relief, it honestly just sounds like I’m going through some genuine diabetes burnout.

It’s not surprising: This year’s been a wild one for me (and let’s face it, the world) in multiple ways. Overall, my stress and anxiety levels are up and my motivation to do everything that I “should” do to manage my blood sugar levels is way down. I’m very aware of what’s good about my diabetes management lately (such as my daily exercise routines) and what’s maybe not so good (my constant desire to snack on carbs and not measure them out and/or bolus for them).

I’m hopeful, though: Maybe as I continue to cope with my seesawing emotions and blood sugars, they’ll find a way to balance out on their own and be a little less intense…just as the weather will become once Autumn rolls around.

The Periodic Problem

I thought about how I was going to write this post many, many times. I so wanted to come up with a cute or clever euphemism for what I’m about to discuss, but really, that old “Ant Flo” cliche is all I could come up with, and that’s so overplayed.

If that didn’t give you a clue as to what this is all about, then look at the title again.

Still nothing?

Okay, this post is about my period.

Yep, the menstrual cycle, that time of the month, the curse…whatever name you want to call it, I’m talking about it today. And if you’re already cringing, chill. I promise there’s no need to, I’m not about to get graphic on you or anything.

Rather, I’m about to write about a reality that many women with diabetes face: The week leading up to a period, or the week that it starts, can be hell. And I’m not just referring to cramps or mood swings.

The Periodic Problem
This picture is actually a pretty accurate cartoon version of me…cacti plants, GameBoy, and pink included.

I’m talking about blood sugars, of course. I’ve thought about how my period and my diabetes interact more and more lately because of an “interesting” (that’s the nice way to put it) pattern that I’ve noticed each week leading up to my period for the last few months, and that’s how insulin essentially becomes as effective as water when I get it pumping through me: That is to say, my insulin intake has nearly doubled the week leading up to my period, and it’s something I never really noticed until recently.

I think I caught onto the trend in April. The week before my period started, I blamed my bad blood sugars and higher insulin intake on the fact that we were only a few weeks into quarantine, so it was natural that my body was having a tough time adjusting.

In May, I wondered whether I was dealing with faulty pods or bolusing incorrectly for my foods.

By the time June rolled around, though, I realized that there was something different at play here.

Last month, I dealt with the issue by raising my temp basal for most of the day – a 95% increase for 6-8 hours through the morning and afternoon – and giving myself 2-3 units more than I normally would at mealtimes. I still didn’t have great numbers, but they were better, and that was all that mattered to me.

But this month? I’m totally confused because this “periodic problem” did the opposite of what I expected it to do…the week before my period, it seemed like I need LESS insulin! It was simultaneously bemusing but exciting. I’ll never necessarily complain about having to take less insulin, or being able to eat an entire blueberry muffin without needing to bolus for it (yes, that really happened), but damn…some consistency here would be nice.

Who knows what my body will decide to do next month. At least I feel a little bit better knowing that there is some sort of pattern going on here that I need to pay attention to, so I’ll continue to monitor so I can try to anticipate what the week before my period will look like for my blood sugars.

Just one more reason why I kind of dread “that time of the month”, but also another justification to eat more chocolate in order to cope with it when it does come ’round.

An Insulin Resolution is Necessary

This post was originally published on the T1International website on June 29, 2020, and was written by Cyrine Farhat. She discusses her participation in the WHA virtual forum on Access to Insulin and how she used it as an opportunity to voice her concerns about barriers to insulin access in her country (Lebanon) and around the world.

An Insulin Resolution is Necessary for Lebanon and the World

Diabetes has been on the global agenda in some form ever since World Diabetes Day was created in 1991,which is also the year I was born. It took 15 years to put diabetes on the United Nations agenda after that, to tackle the urgent need to pursue multilateral efforts to promote and improve human health, and provide access to treatment and health-care education. Fast forward another nine years to 2015 when the 2030 agenda was launched and the Sustainable Development Goals (SDGs) were adopted. Despite all of that, we are now in 2020, talking about access to insulin when we should have already made it widely available and affordable to all pillars of society.

Sadly, my country and many others are still facing many challenges with insulin access and affordability. Lebanon’s recent financial crisis has caused a dollar shortage that, since September, has restricted the ability of medical supply importers to import vital medical supplies. First it started with masks, gloves, and other protective gear, as well as ventilators and spare parts, and now even essential diabetes supplies are sometimes unavailable. The government has also not reimbursed public and private hospitals for bills, which has made it harder for diabetics to purchase their medication and other diabetes-related medical supplies. For example, Novorapid insulin has been hard to find at pharmacies over the past two weeks.

I had the honour to participate in the WHA virtual forum on Access to Insulin and to address all my concerns as a patient advocate from Lebanon. The aim of the virtual forum was to facilitate a wide discussion between a group of experts and advocates on this issue. The crucial problem is that almost a 100 years after the breakthrough that has saved millions of lives worldwide – the discovery of insulin – many people still cannot access or afford it.

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Patients like Cyrine have the power to change the world.

The fact that I was able to voice my concerns as a person with type 1 diabetes among the panellists that the forum included was very empowering. The panel included Zachariah Muriuki, Project Manager – National Diabetes Prevention and Control Program at Ministry of Health, Kenya; Dr. Kaushik Ramaiya, Consultant Physician and Chief Executive Officer at Shree Hindu Mandal Hospital, Dar es Salaam, Tanzania; Greg Perry, Assistant Director General, IFMPA; and Emer Cooke Director, Regulation of Medicines and other Health Technologies, World Health Organization.

The forum started by showing a video that displayed testimonials from people living with type 1 diabetes around the world, including the barriers they face in regards to access to insulin, and responses from health care providers. Although I’ve personally lived with diabetes for almost 13 years and have dealt with so many obstacles, it still breaks my heart when I see what people with diabetes worldwide have to go through in order to get insulin and remain alive.

When asked during the forum about the barriers that the Lebanese have been facing with access to insulin and how the government needs to address these concerns, I depicted the current economic situation in Lebanon. The government is absent, especially after the revolution that spiked in October 2019 and left behind a collapsing economy. With hyper-inflation skyrocketing at 240% and the Lebanese Lira collapsing, the government has decided to remove the subsidy from bread and combustibles. The Central Bank has set their own policies restricting depositors’ access to funds in their current dollar accounts and the transfer of money abroad, making it harder to finance imports, including of medical equipment and medicine. These issues can put people living with diabetes in a very dangerous position. With no substitute to imported insulin, and the decline in purchasing power due to inflation, how will Lebanese people be able to afford their medication?

I shared that I believe in the upcoming months we will be left with an insulin crisis once the subsidy is also removed from medication. Patient advocates in Lebanon have been trying to reach out to the government, to no avail. The only thing we can do is to continue to raise our voice until we are heard.

In another question, I was asked what it meant to have the World Health Organization (WHO) and their Member States recognize and prioritize access to insulin, and how people living with diabetes and the global community can take this issue forward. I said that once the international community admits and perceives “insulin as a human right”, the entire scope of advocacy for access to insulin would have solid foundations and would shift from voicing about lack of access to actually forcing governments to comply. As advocates, we must seek accountability from governments regarding progress on WHA targets and address hurdles and bottlenecks in the process. Governments should also set state-level targets, and develop a strong participatory monitoring framework and management information system to measure outcomes of targets under SDGs and WHA.

The panel discussed other matters such as steps that have been carried out in Kenya to enhance access to insulin, how Tanzania has also worked towards improving access and the recommendations it provides to other countries, and how the WHO is committed to improving equitable access to insulin. It was concluded that the WHA resolution on insulin needs to be comprehensive in the requests to governments and to the WHO on actions they should take. Here, civil society, governments, and WHO need to define key requests and alight goals that serve making insulin accessible.

As a Global Advocate for T1International, I will continue to push for change in any way possible. Insulin is life support and no person should have to decide between putting food on the table or affording insulin. I truly believe that we are capable of creating change. The right of access to insulin is mine, yours, and the world’s. If it is our right, then we will not stop until we get it!

The Dos and Don’ts of Vacationing with T1D During a Pandemic

Every summer, I spend at least a handful of days at the same beach town. These trips have created so many memories for me, my family, and friends over the years. But back when the pandemic started and travel came to a standstill, I wondered whether it would even be possible to head up to my ocean-side oasis this year. After all, many states have restrictions about visitors right now, and protocols aren’t always clear. Luckily, though, due diligence was done before it was determined that yes, my family and I could still go on our trip, though we knew it might look a little different compared to our trips in the past.

Based on my experience, I’ve come up with a few dos and don’ts when it comes to traveling with diabetes during this pandemic:

Do wear a mask. Please, for the love of everything you hold sacred in life, wear a mask when you’re out in public. It’s not about political leanings or agendas: It’s about protecting yourself and the ones around you. I kept a mask on at all times when I was out and about and only removed it when others were more than six feet away from me. It was the smart and sensible thing to do. Just because I was by the beach for a week doesn’t mean that the pandemic wasn’t a reality for me. As someone who has an invisible illness, I know that I appreciated it (and still do) when I saw others wearing masks because they were not only protecting themselves from exposure, but they were also protecting me from being exposed to them.

Don’t neglect what works best for you and your diabetes when you’re at home while you’re away. I exercise in some way, shape, or form almost every single day. So being on vacation didn’t mean I was taking a break from that and my job. On the contrary, I can’t remember the last time I was so physically active, and my blood sugars responded well to that…at first. Then I started to neglect the fact that my diabetes does best when I eat a moderate amount of carbs per day (maybe around 120 total)…I definitely ate way more than that and paid the price with some sky-high numbers. I wish I’d been more mindful of my diet, but oh well, I learned from it.

Do have extra supplies on hand at all times. Besides all of my extra diabetes supplies, I also had access to an abundance of PPE (gloves, masks, hand sanitizer) throughout my trip. It brought me peace of mind knowing that I was prepared and wouldn’t have to worry about running out of any of these items.

 

Pink and Dark Blue Cake Quote Instagram Post (1)
I wish I could say I was at this gorgeous-looking tropical oasis; instead, I was at a quaint New England beach town for a week…which was perfectly fine by me.

Don’t go somewhere or do anything that makes you feel uncomfortable. This is absolutely common sense under normal circumstances, but times are far from normal now. It was important to me that my family and I have discussions about what we did each day on vacation so we could make sure everyone was comfortable with the plan: the number of people that might be around to us, where to eat, what to do, how diabetes might come into play…we talked about it all and I think it helped assuage some of our worries.

Do think outside the box when planning daily activities. If you’re like me, you’re probably more than a little wary about spending prolonged periods of time around groups of people other than the ones you’ve quarantined with. This meant that I was not looking to eat inside at restaurants, go into stores, or even use public restrooms (which may or may not be an extreme view of mine). So what exactly did I do when on vacation? Well, for starters, I hit the beach nearly every day. I hit the jackpot weather-wise because it was a little too cool to be totally comfortable on the beach, so it was never crowded and I could easily stay more than six feet away from others. In keeping with the “outdoors” theme, I visited a state park, rode my bike around town, and went for a hike while I was away. I ate outside at a few different places that handled social distancing rules very well, and of course, I attended the Virtual Friends for Life Orlando conference. All of that kept me pretty busy, and I found that I didn’t really miss hanging out indoors.

Don’t forget to enjoy yourself. At the end of the day, a week off from work is a week off from work! Despite my fears about going on this trip, I’m really glad that I did because a break is exactly what I needed. My anxiety is much less intense when I’m by the beach, and I’m relieved that the weirdness of the world lately didn’t take that away from me.

3 Things I Learned From the Virtual Friends for Life Orlando 2020 Conference

This past week, I attended my very first virtual diabetes conference: the 2020 Friends for Life Orlando conference, hosted by the Children with Diabetes (CWD) organization.

Before I recap my experience, I’ve got to give a heartfelt round of applause to every single individual involved in the process of turning this in-person event into a virtual one. Between figuring out the technology and adapting the program to make sense in an online format, I’m sure it wasn’t easy, but the CWD staff and many volunteers made it appear seamless. While every conference attendee (myself included) would have loved to see each other in real life in Orlando for this event, it was the right (safest) call to make this conference a digital one. And the majorly bright side of doing the conference online was that more people were able to attend *for free* – literally thousands of people! Each state in America was represented, as well as dozens of countries. The massive turnout makes me happy as I think about how much more accessible this particular conference was to people with diabetes and their families around the world.

Moving along to…the actual conference!

Attending the Virtual Friends for Life Orlando 2020 Conference
All decked out in my conference gear – t-shirt, name tag, green band, and OmniPod, to boot.

It ran from Wednesday, July 14th through Sunday, July 19th. Given that I was away with my family for the duration of the conference, I knew going into it that there was no way I would be able to attend every session or social event. (I was by the beach for a week, so when given the choice between staying indoors or logging onto my laptop…need I say more?). However, I also learned pretty quickly that many of the sessions were going to be recorded and made available at a later date (along with a report summarizing the conference, which will be ready on the CWD site in early August)…so there’s a good chance I’ll refer to some of those recordings for the sessions I missed.

But in terms of the handful of sessions that I did make it to, there were some major takeaways I got from them. Here’s what I learned:

#1: There are some important steps that I (and the rest of the diabetes online community) can take in order to address underrepresentation within our community. In the last few months, issues of underrepresentation of people of color within our diabetes online community has gained overdue attention. Individuals and organizations are working hard to address this and make everyone’s voices equally heard. However, I’m sure that I’m not the only person who felt helpless when trying to figure out how I, as just one person, can make a tangible difference. During one of the conference sessions that I attended, I learned that there are actual a few simple steps that I can take that will make a big impact over time: Follow social media accounts run by people of color. Amplify their voices by sharing and highlighting their content. Support and listen to their experiences as non-white individuals with (and without) diabetes. The bottom line is that everyone deserves to have their voice heard, no matter what, and our community must come together in order to help make this happen. It’s an uncomfortable truth that these representation issues exist, but it’s one worth acknowledging and doing everything within our power to fix it.

#2: Diabetes care and management comes in many different formats, and what works best for one person should always be respected. Of course, I’ve always known and believed in this, but this notion was reinforced for me during one of the sessions that I attended. I can’t remember the exact context, but it was brought up that sometimes people who choose to manage diabetes with multiple daily injections (MDI) take a little heat from people who use insulin pumps. In other words, those who prefer MDI might get pestered and questioned by this choice, which is unfair because it’s a very personal one. It reminded me of how I refused to even contemplate an insulin pump for nearly two decades of life with diabetes – I was so ardently against them for no real reason other than I just preferred my MDI regimen. But then when I did switch to a pump, I was instantly converted and I can’t really imagine going back to MDI. So when I saw a lot of MDI-ers reminding the rest of us that pumps aren’t for everyone, I remembered that diabetes care and management tools aren’t always high-tech (and that doesn’t make them any less effective) and that devices shouldn’t be pushed onto those who get by just fine the old-school way. At the end of the day, we’re all doing our best to take care of our diabetes in the way that’s right for us, and we should always remember that we’re in the fight together.

#3: Our community is strong, resilient, and adaptable – the virtual format didn’t put a damper on anyone’s enthusiasm. It was truly incredible to see how much energy every speaker, staff member, and attendee had for the event. You could practically feel it radiating through the computer screen in some of the sessions! Diabetes forces us to make decisions that are tough sometimes. It throws curve balls in our paths and we must find a way to deal with them, and we always do. This collective tenacity totally translated to this conference as we embraced the virtual format. It was heartwarming to see photos all across social media throughout the five days from attendees and speakers alike showing snippets of their at-home conference experiences, and I loved how everyone had so much spirit for the event. I admit that I even got up and danced  (to several songs) when we had our virtual banquet on Thursday night. I gladly draped the tablecloth and fairy lights I got in my BoFFL (Box of Friends for Life, a package I got in the mail last month containing swag from conference sponsors that was available to the first 500 conference registrants) to really set the mood as I ate dinner “with” diabetes community members across the country and ’round the world…and smiled widely because my T1D mom was able to experience it with me for the first time.

So yes, while it’s a bummer that I didn’t get to hug so many of my friends from the diabetes online community or meet new ones for the first time in-person, I’d say that the virtual conference exceeded my expectations in terms of what it delivered using the available technological resources and passion from the community. Hats off to the sponsors for doing what they could to really engage attendees, and another extra-special kudos to the staff, volunteers, and speakers who pulled off yet another amazing conference.

It just makes my anticipation for the next in-person one that much greater, knowing how wonderful it will be to see everyone in-person again.