A Check In on Diabetes and Mental Health

Today is Day 18 of the #TrueDiabeticChallenge that I’ve been posting about on Instagram all month long! I’m using the prompt to inspire the topic of today’s blog post: mental health. Read on to learn how I’ve been juggling my diabetes and mental health lately…

When I think of “diabetes and mental health”, a lot of things cross my mind: Burnout, self-care, and a whole slew of emotions, to name a few of them.

So as I pondered what I’d write about when it comes to this topic – and be totally transparent as to how my mental health is lately as it pertains to my diabetes – I knew that one emotion in particular would be the focus.

Loneliness.

I’m actually a bit envious of this cartoon girl because at least she has a furry friend to keep her company.

For the first time in my life, I’m living alone (mostly by choice). While this new chapter is certainly exciting, it’s also downright petrifying at times, especially when I’m contending with literal highs and lows of my blood sugar.

I struggle the most with being alone and managing my diabetes when I go low. This probably isn’t uncommon among other people with T1D who also live alone and I knew to expect to feel this way to a certain extent before making this transition. But I didn’t realize exactly how much comfort I take in the presence of others when my blood sugar is low.

I don’t know what it is, exactly…it’s not like I suddenly forget how to treat low blood sugars. It’s not that I ever relied on someone else to bring low blood sugar treatments to me (though I’ve always appreciated that on the occasions it’s happened). And I benefit from having a Dexcom CGM to monitor my blood sugars 24/7 and alert me to sudden changes. So…what gives?

As I search for that answer, I’m going to try to remember to be patient with myself as I navigate my new circumstances. It takes time to acclimate to a new environment and diabetes can make that more challenging. I mentioned self-care at the start of this post…maybe it’s time I start practicing it more deliberately to help make this transition smoother!

“Doesn’t Your Pump Do All the Work for You?”

The answer to the above question is a big, fat, resounding…

NO.

I’ve written blog posts in the past about questions I’m frequently asked about life with diabetes, but shockingly, I neglected to include this one…which is so surprising because it’s probably among the more frustrating questions.

Don’t get me wrong: Diabetes technology has come a loooooong way, particularly in the last couple of decades. There are options when it comes to insulin pumps and pens alike (that is, if the choices are covered by insurance…that’s another story for a different post). There are tubed, tubeless, touchscreen, CGM-integrated, and waterproof pumps out there. There’s even a couple with intelligent software that can kick in and predict low or high blood sugars. And there are smarter insulin pens available that far surpass the ones I used just 7ish years ago…some can track insulin intake and are bluetooth-enabled.

It sounds like our pumps should be equipped to do all the work for us…but the simple truth is that they can’t.

Our diabetes devices are far from perfect.

_Doesn't Your Pump Do All the Work for You__
No…these two pieces of plastic simply CANNOT do all the work for me. They actually rely on me quite heavily.

Failures happen.

Batteries drain.

Error messages pop up.

When it comes to dealing with diabetes, technology certainly helps us, but sometimes things can go so awry with it that it almost makes life even more frustrating.

Certainly, the reward outweighs the risk; after all, I don’t believe that many people would continue to use pumps, CGMs, etc. if they didn’t work for them the vast majority of the time. I know that I wouldn’t.

But there’s too many variables happening independently of these devices doing their jobs that it essentially guarantees imperfection.

Stress, miscalculated carbs, medication dose/timing/interactions, too much/too little sleep, expired insulin, temperature, exercise, menstruation, alcohol consumption, family and social pressures…these are JUST A FEW of the things that are known to impact blood sugar levels. Just a few!!! I can barely keep track of those factors, let alone how they each affect me…and to expect a machine to know how to do that is placing a little too much faith into something comprised of wires and chips.

My point is that I really wish that people living without diabetes didn’t make assumptions that our lives are easy because of these devices. They are easier, most of the time. But there’s that other portion of time in which a lot of spare mental energy is used on maintaining that technology and making sure it functions the way it should, which is far from easy.

The short answer to the question-as-a-title of this blog post is no, I (we) do all the work for my (our) insulin pump(s)…they’re smart and capable, but only with the input of the people handling them.

World Diabetes Day 2020: Celebrating Nurses Making a Difference in the Lives of People with Diabetes

One thing that hasn’t changed in 2020 is the significance of tomorrow’s date: November 14th is internationally recognized as World Diabetes Day, a day specially reserved for diabetes awareness and advocacy.

Several weeks ago, when I realized this date was rapidly approaching, I was unenthused about it, to put it mildly. My life has been super-duper busy lately…I’ve dealt with high stress and anxiety levels, an overloaded schedule, and not enough time for self-care. So when it hit me that diabetes awareness month was just around the corner, and with that it would bring World Diabetes Day, I just felt “meh” about it. This year has been so sucky that celebrating didn’t feel right or something that I could muster up the energy to do.

However, that was before I realized that there’s a theme for this particular World Diabetes Day…promoting the role of nurses in the prevention and management of diabetes.

World Diabetes Day is tomorrow…what will you do to celebrate?

Nurses are heroes under normal circumstances. But in the context of 2020? They’re more important than ever. I read more about the reasoning behind the World Diabetes Day theme on the International Diabetes Federation website and immediately understood why nurses deserve recognition on 11/14:

Nurses currently account for over half of the global health workforce. They do outstanding work to support people living with a wide range of health concerns. People who either live with diabetes or are at risk of developing the condition need their support too.

People living with diabetes face a number of challenges, and education is vital to equip nurses with the skills to support them.

As the number of people with diabetes continues to rise across the world, the role of nurses and other health professional support staff becomes increasingly important in managing the impact of the condition.

Healthcare providers and governments must recognise the importance of investing in education and training. With the right expertise, nurses can make the difference for people affected by diabetes.

The International Diabetes Federation, 2020

So tomorrow, on World Diabetes Day 2020, I’m going to express my gratitude for all nurses, especially the ones who work specifically with people with diabetes. They deserve all the recognition and support in the world, and in a year in which the world is faced with a pandemic, the work that they do (along with other healthcare workers and essential employees) for people with and without diabetes is invaluable.

Thank you to all nurses and healthcare workers…and Happy World Diabetes Day to my fellow people living with diabetes. Wishing a wonderful day for you all filled with good blood sugars, education, and positive advocacy experiences!

A Song to Describe Diabetes Today…

On Instagram, I’m participating in the #TrueDiabeticChallenge all throughout November. Today’s post was inspired by the prompt for Day 9 of the challenge – name a song that describes diabetes today. Here’s a song that I think describes my relationship with diabetes today, even though it’s a throwback tune…

I’m a child of the 90s, so you can bet that I listened to a whooooole lot of boy bands and girl groups growing up – N*SYNC, Backstreet Boys, Spice Girls, and Destiny’s Child were just a few of them.

But of course, I loved my solo artists…especially Britney Spears.

Speaking of 90s throwbacks, doesn’t this color scheme remind you of Lisa Frank’s colorfully designed notebooks, folders, and pencils?!

Her first album, “…Baby One More Time”, was everythiiiiiiiing…oh, the NUMBER of times it was played in my house! Like most kids my age at that time, I couldn’t get enough of her bubblegum-sweet voice and catchy-as-heck lyrics/tunes. No matter what your opinion of her has been throughout her contentious career and life in the spotlight, you can’t deny her talent as a singer, dancer, and entertainer.

Brit’s been on my mind lately (I know I’m not the whole one – #FreeBritney!), so a few times throughout the workweek, I tend to listen to her music from all sorts of albums she’s put out over the years. I’m happy to report they’re still absolute BOPS today, but what’s more is that I found one that perfectly fit this prompt for me:

(You Drive Me) Crazy!

Okay, besides being an all-around excellent song with an entertaining music video (yes, that’s Melissa Joan Hart AND Adrian Grenier making cameos in it), it also tooooooooootally describes how my diabetes makes me feel these days. It drives me CRAZY!!! Let’s look at some of the lyrics…

Baby, you spin me around, oh

The earth is moving, but I can’t feel the ground

-Me when my blood sugar is low

You drive me crazy, I just can’t sleep

-Me every dang time my blood sugar interrupts my sleep

Oh, oh, oh crazy, but it feels alright

Baby, thinking of you keeps me up all night

-Definitely NOT alright because I hate when diabetes keeps me up at night and it sure as hell isn’t my “baby”

So maaaaaaybe it’s a bit of a stretch to say this song is perfect for me and my diabetes, because the way Brit sings it and how the lyrics are written, she’s enjoying being driven crazy. But not me! This is one of those songs where I could easily rewrite it and make it an eff-you diabetes anthem.

Really, though, the hook of the song captures it all: YOU DRIVE ME CRAZY.

The “you” here is YOU, DIABETES!

National Diabetes Awareness Month is Right Around the Corner

November is National Diabetes Awareness Month!

…And I am NOT! READY! FOR! IT! AT ALLLLLLLLLL!

I can’t be the only one in the diabetes online community who is feeling apathetic (at best) for a month that I’m normally thrilled to celebrate. After all, I love being a diabetes advocate!

But this year…the mere prospect of it just feels like it’s a little much.

National Diabetes Awareness Month 2020 is happening soon…how can this be? Aren’t we still in March 2020?!?!

It’s a little much in a year in which the world is facing a pandemic.

It’s a little much when potentially the most important U.S. presidential election in history is also happening this month.

It’s a little much when I’m dealing with a HELLUVA lot of other things in my personal life – mostly good things, but ones that happen to be highly stressful.

It’s just…when I think of it…how can I approach this National Diabetes Awareness Month with all the enthusiasm that I’ve showed it in past Novembers?

I don’t know how to answer that question right now, but I do suspect that I’ll muster up some of my advocacy spirit once I start seeing posts and prompts from the diabetes online community.

Which makes sense…after all, we turn to one another when we deal with the literal and figurative lows of life with diabetes. So it’s perfectly logical to have faith in knowing that this will be a great November with the trusty DOC supporting me.

Reflecting on NDAM 2019

November ended a couple short weeks ago: just enough time to allow me to reflect on how I feel about National Diabetes Awareness Month (NDAM) 2019. My experience can be summed up with the following three sentiments:

It was exhausting. It might not seem like it takes a lot of effort to post daily on Instagram, but for me, this was a major commitment! It was pretty tough to come up with an engaging post for every single prompt of the Happy Diabetic Challenge. I wanted each of my posts to not only generate interest in learning more about diabetes, but I also hoped that others would notice the thoughtfully written captions and, more importantly, blog posts that went with a handful of them. I’m not sure if I succeeded, but I was proud of myself for keeping at it. But man, I still feel like I need a bit of a social media cleanse after all that posting, liking, and commenting.

It was educational. This may have been one of the most enlightening Novembers I’ve ever experienced, diabetes-wise. I feel like I heard and listened to many diverse voices in the diabetes community – and not just the T1D ones. In particular, I found myself paying closer attention to T2D perspectives, especially on Twitter. By doing that, I realized that I need to make it a point to be more inclusive when describing diabetes, in general, to others. In the past, I think I’ve made the mistake of talking about certain experiences about life with diabetes in a way that sounds exclusive to type 1, and that simply isn’t always the case. So it’s my new mission to make sure I represent other types of diabetes as best as I can on social media and in person, going forward, so that I can do my part to end diabetes stigma about all forms of it.

Happy Independence Day! (1)
National Diabetes Awareness Month 2019 was a jam-packed 30-day period…to say the least.

It was empowering. Although NDAM 2019 kind of kicked my butt in terms of showing me how much I have to learn and triggering a social media burnout, it still doesn’t mitigate the fact that our amazing diabetes online community really comes together during this period of heightened awareness and advocacy. There’s something special about all of our interactions during diabetes awareness month: Whether they’re comments about how one person can relate to another, or a story about how someone changed someone else’s perspective, there’s power in these exchanges. Plus, it’s pretty neat to see how sharing the most mundane aspects of life with diabetes can result in positive change and growth.

Now that I’ve reflected on it, I’m ready to put the insanity of NDAM 2019 behind me…and feeling thankful that I have another 11 months to prepare for NDAM 2020 to make it an even better experience for myself and others.

Setting and Sharing Diabetes Goals

It’s November 29th which means it’s day 29 of the Happy Diabetic Challenge! Today’s prompt is about diabetes goals. I decided to use this as an opportunity to share and set my diabetes goals as National Diabetes Awareness Month draws to a close…

Goal-setting sounds like an ambitious activity. It implies that goals will be met, and we all know that sometimes that just doesn’t happen.

Why? Occasionally, we set goals that are simply unattainable. As an example, let’s pretend that you have a goal to lose weight. Well, if you tell yourself that you can shed 20 pounds by next week, then you’re setting yourself up for failure – ‘cuz it’s unhealthy to lose that weight so quickly, not to mention practically impossible.

But setting a goal to lose those 20 pounds over the course of, let’s say, two months…that’s FAR more realistic. You give yourself a workable time frame in which you can accomplish the goal and you can take small steps each day to work towards it, rather than doing anything extreme or overly difficult in order to meet the goal.

Setting and sharing diabetes goals
It’s always very satisfying when you can say that you’ve met a goal you’ve set.

That’s why they say it’s important to set SMART goals. The acronym stands for Specific, Measurable, Achievable, Realistic, and Timely. Goals that are set with this criteria in mind are far more likely to become a reality, so with that in mind…I’m going to share and set a few diabetes goals for myself, right now, that I hope to accomplish in the coming months (think of it as an early diabetes-themed list of New Years’ resolutions.)

  • Goal #1 – I’d like to go back to checking my blood sugar with my actual meter at least 4 times per day. I’ve come to rely on my not-always-totally-reliable Dexcom a little too much. And since I have a well-stocked stash of test strips, I figure that it makes sense to use them before and after each meal, as well as when I’m not sure about my Dexcom’s readings.
  • Goal #2 – Change my lancet weekly, instead of monthly…ish. This is the other underused diabetes supply in my possession. As long as I decide on a particular day and time to do this quick little task, then I think it’ll be easy to follow through week after week.
  • Goal #3 – Stop snacking on “free” foods. I need to get it through my semi-thick skull that there’s no such thing as free foods when it comes to diabetes! I used to be able to eat a short stack of crackers, a handful of popcorn, or a bite-size piece of chocolate at any hour of the day and notice a very minimal bump in my blood sugar levels. This sure isn’t the case these days, and I want to set myself up for success by making sure that when snack cravings strike, I have plenty of water or gum on hand to help distract from faux-hunger pangs.

These goals may seem very minor to you, but for me, they’re all examples of some things that I truly think I need to address when it comes to my diabetes care and management. And the fact that they are “easy” makes them that much more attainable: It won’t take much for me to incorporate them into my routine, but over time, I’m bound to notice a difference (especially when it comes to that last goal).

Also, I think it’s wise to avoid setting overly ambitious goal – at least for the time being – because I’m not seeing an endocrinologist again for another month. When I do have that appointment, I’ll have a much clearer picture of what my diabetes goals should be as we approach 2020, and I can go about formulating a plan as to how to pursue them.

And on that note, this blog post wraps up the Happy Diabetic Challenge posts on my blog for National Diabetes Awareness Month 2019. I hope you enjoyed them, learned from them, or at least got to thinking more about your own diabetes as a result of reading them. I’m proud of myself for sticking with the challenge for the month, but boy, was it an exhausting 30 days of nonstop diabetes advocacy! I’m looking forward to December: It’ll be a nice change of pace to slow down and appreciate time spent with loved ones throughout the holiday season. I’ll still be blogging regularly throughout the month, just a little less intensely.

Hoping you had a wonderful Thanksgiving no matter how you chose to spend it, and wishing you continued success with your diabetes as the holiday season gets into full swing.

5 Things I’ve Learned about Exercising with Diabetes

It’s November 26th which means it’s day 26 of the Happy Diabetic Challenge! Today’s prompt is about diabetes and exercise. There’s so much I could say on the subject, so I decided to settle for a bit of a round-up post that explains what I’ve learned about exercising with diabetes over the years…

I exercise on a daily basis.

This statement is not a faux-humble brag, nor is it an exaggeration. Unless I’m sick, I work out in some form or fashion every single day. My workouts will vary in their intensity, but one thing is consistent: My diabetes plays a major role in how long, when, and what type of exercise I choose to do.

Since I grew up playing sports, I’ve had just about my entire lifetime with diabetes to figure out how to make it peacefully coexist – or, at least, merely coexist – with whatever exercise routine I’m completing. As a result, I’ve learned quite a few lessons along the way, and I’ve come to recognize several patterns that my diabetes follows when I exercise:

Your only limit is you.png
My diabetes is practically BFFs with exercise.

1. My diabetes is happiest if I work out first thing in the morning. I never thought I’d be the type of person who works out before eating breakfast, but trial and error has taught me that this is the way to go in order to better manage my blood sugars during a workout. Fasting exercise has worked wonders on my blood sugars: I never have to worry about dealing with an insulin-on-board-inducing low blood sugar, nor do I have to be concerned about what the food I ate prior to my workout will do to my blood sugars while I’m exercising.

2. Different types of exercise affect me (and my blood sugars) in different ways. Many people probably relate to me when I say that weightlifting and high-intensity interval training (HIIT) often yield stable blood sugars during workouts but then trigger the need for more insulin hours later, whereas cardio (such as dancing, running, or circuit training) usually causes sudden drops in blood sugar levels. Of course, it depends on the timing, duration, and intensity of the workout, but it’s interesting to see how different types will require me to react in different ways in terms of my diabetes care.

3. Sometimes I need to suspend my insulin, sometimes I don’t. Again, whether or not I suspend my insulin – or even run a temp basal – depends heavily on when and how I exercise. If I’m doing my morning routine (which happens 75% of the time), then I don’t really do anything with my basal rates: I just keep them running normally. But if I’m taking a midday walk or decide to exercise in the evening, I often have to do something about my basal rate to avoid crashes or spikes. Insulin suspensions or temp basals are wait-and-see situations in those cases.

4. The hardest part about exercise and diabetes is that I can do the exact same routine every day and get different results. If I worked out at precisely the same time, for the same amount of time, and with the same sequence of movements every single day, then…my diabetes wouldn’t give a damn. Every day of life with diabetes is different because of the variables that inevitably cross my path. Things like mood, that time o’ the month, stress, diet, illness, and more can cause major changes in my blood sugar levels. It’s my job to react accordingly to those changes, but that doesn’t mean I always hit the mark on the first try. So with that in mind, it can sometimes be hard to accurately predict how my blood sugar will fare after every single exercise routine. Just thinking about it can be more exhausting than the workout itself.

5. My diabetes is my biggest motivator/fuels my desire to exercise. At the end of the day, I work out because of my diabetes, not because I’m trying to sculpt washboard abs (though I wouldn’t complain if that actually happened). My diabetes loves exercise: It results in an increase in insulin sensitivity and it helps tame my blood sugar levels overall. How could I not be motivated to work out every day with outcomes so tangible?

It’s Not Just About the Money: The Cost of Living with Diabetes

It’s November 25th which means it’s day 25 of the Happy Diabetic Challenge! Today’s prompt is about the cost of diabetes. Naturally, I started thinking about just how much diabetes costs me, not just in terms of money but also emotionally and physically…

We all know that diabetes is an expensive chronic illness.

Diabetes is associated with doctors appointments, pricey medical equipment, and maybe even the occasional trip to the hospital…all of those things aren’t cheap. My insulin alone would cost me $4,962.32 per year if I was uninsured (and if I do the math, this means that I would’ve spent over $100,000 in the past 22 years on JUST INSULIN). Those are not small sums of cash!

Diabetes hits those of us who are affected by it hard financially, but there are also significant emotional and physical costs associated with it.

It's Not Just About the Money_ The Cost of Living with Diabetes..png
Diabetes is so greedy, and not just in terms of how much money it costs to care for it.

Emotional – Diabetes takes a toll on my mindset (un)fairly often…and it can happen so rapidly that I barely have time to process the emotions. For example, I can go from being happy-go-lucky to angry because my Dexcom alarm went off and it’s telling me that my blood sugar is high. The anger will hit me hard and I’ll spend too much time stewing over my blood sugar and the best way to correct it.

Plus, I’d be remiss not to mention diabetes burnout. It’s the feeling of total defeat, of no longer having the desire to take proper care of diabetes. It happens to the best of us, and it’s not fun to experience. But it makes sense to feel this way from time to time, because diabetes is so demanding and relentless. People with diabetes never get a break from it, so it’s no wonder that it takes a toll on emotional well-being.

Physical – Diabetes is a physically present in many ways on my body. The OmniPod insulin pump that I wear, as well as my Dexcom CGM sensor, leave the most obvious lumps and bumps underneath my clothing that often prompt unwelcome stares from strangers. And although these devices have improved my quality of life with diabetes, they’ve also undeniably altered my body image. I never had much self-confidence when it comes to that, anyways, and my devices certainly don’t improve how I feel about my own body. I know plenty of people with diabetes who can relate to that sentiment.

There are also the scars that diabetes leaves behind. My fingers are dotted by dozens of permanent black scars left from lancets pricking them multiple times per day for the last 21+ years. I sport purple circles under my eyes pretty frequently from a lack of sleep that is, more often than not, my diabetes’ fault. And sometimes, I have unsightly red marks when I remove old pods that practically look like zits and can take days to go away because the pods’ cannulas pierced sensitive spots. These are all unattractive, physical reminders of diabetes that I can’t do a damn thing about, and it’s frustrating to have even less control over how my body appears because of this stupid chronic illness.

Diabetes is a friggen’ greedy disease.

It depletes my wallet and emotional state, and it manifests itself on my body in ugly, visible markings.

It tries so hard to rob me of everything I’ve got.

But luckily, my determination to fight back harder against it is stronger than my diabetes will ever be.

Who Inspires Me from the DOC

It’s November 22nd which means that it’s Day 22 of the Happy Diabetic Challenge! Today is called #FollowFriday and we’re encouraged to share who inspires us from the diabetes community. Rather than capture the dozens upon dozens of names in a blog post (because truly, there’s practically an endless list of people who inspire me in the DOC), I’m going to write about what I think makes someone in the DOC inspiring…

I’ve lost track of how many years I’ve been involved with the diabetes online community (DOC).

It’s somewhere between five and eight. Regardless of what the true number is, I can tell you this: I’ve “met” and interacted with countless people who’ve shared their stories with me. Each story is unique and marked by different struggles and victories, but the common theme is diabetes.

But what else do these storytellers share that make them so inspiring to me?

Happy Independence Day!
Chances are that if you’re reading this post…you’ve inspired me in some way. Thank you.

Here are three qualities of people with diabetes who inspire me:

  1. Vulnerability. I’ve come to value this more than just about any other trait when it comes to talking about diabetes in an online space. Nothing makes a person more relatable (or more human) than when they speak uninhibited and honestly. In a social media world where everyone is so concerned with capturing and filtering the “perfect” photo with the “flawless” caption to go with it, I find that it’s the stories that are raw and obviously imperfect that pack more of a punch. It’s important to stay grounded, and those who aren’t afraid to share their tribulations as much as they share their successes are truly inspiring to me.

2. Kindness. The Internet can be harsh and judgmental. (Okay, that’s a total understatement). It’s brutal out here in cyberspace, and unfortunately, the DOC isn’t immune to all brands of savagery. In the past, I’ve seen disputes erupt because of hateful comments made about all aspects of life with diabetes. So when I notice thoughtful, supportive, and downright nice comments between perfect strangers in an online space, it restores a bit of my faith in humanity. Those who take the time to send a tweet to another PWD in need or who use their presence online to do some good don’t go unnoticed by me, and I applaud each and every single person who does their best to reduce the negativity in the diabetes online community.

3. Willingness to listen and learn from differing perspectives. Those of us who live with diabetes can be wildly, passionately opinionated. Pumps! No, MDI! Carbs! No, keto diet! Your diabetes is just like mine! No, it’s not! – Those are just a few examples. While some may be quick to judge others for dealing with diabetes in a way that is different or just plain “wrong” to them, I’m far more impressed by those who remain open to having conversations and learning from those who disagree. After all, what matters most is that a person finds what works best for them. It shouldn’t matter that it’s different from what I or anyone else might do. So I really admire those who are able to put aside differences and focus on learning and growing from others.

Thank you to each and every single person out there in the diabetes online community who possesses one or all of these qualities. This means you’ve inspired me in some way, and I am incredibly grateful for you and your willingness to share part of yourself with strangers online. Keep doing what you’re doing and I can guarantee that you’ll continue to inspire many more people.