Reflecting on my Experience with Metformin

A couple of years ago, I wrote a blog post series about my experience with Metformin. As I was paging through my blog, looking for either an old post to republish or inspiration for a new post to write, I came across that series and got to thinking about how I felt on Metformin.

If you aren’t familiar with what Metformin is, it’s an oral medication that’s typically used to help stabilize blood sugar levels for people with type 2 diabetes. This is where you might be thinking…I (Molly) have type 1 diabetes, so why was I prescribed this medication?

Well, my endocrinologist at the time wanted me to try taking Metformin in tandem with doses of insulin in an attempt to reduce my overall insulin needs. She expressed concerns that my daily insulin intake was high (something I disagree with now, as I think about it a couple of years later), and that she had some general awareness of studies that indicated it might not be good for my future health if I continued using so much insulin each day. (Note: I don’t know what study or studies she was referring to, and this is where I should’ve done more research before just taking her word for it and going on the pill. This is an example of poor patient advocacy on my part.)

I did not enjoy my time on Metformin.

Even though I met her sentiments with skepticism, I trusted this endocrinologist, so I decided to give Metformin the old college try. And I hated it. Hated it! I tried taking it per my doctor’s instructions for two separate spans of time (each lasting a month or so) and made the decision to stop using it because I simply didn’t see that it was making any sort of difference. Actually, it was affecting something, just not my blood sugar levels or insulin intake – it was affecting my anxiety levels. I was afraid that Metformin, coupled with my insulin, would cause me to have low blood sugars all the time. While in reality, I didn’t experience many lows, I was still always paranoid about them and it was an unpleasant thing to have to deal with.

So now, about two years later as I think about these ineffective encounters with Metformin, I realize that I should have done a lot more before even considering taking it. I should’ve asked more questions. I should’ve done more research. I should’ve asked around the diabetes online community to see if anyone had advice for me. I should’ve pushed back more with my doctor to get to the bottom of the reason(s) why she wanted me to take Metformin. Going back to my point above…this was a big lesson in patient advocacy. It’s important to ask questions and gather all the facts, especially in situations like this where there was so much uncertainty, in order to receive the best care possible. And it’s important to remember that even the most trusted and well-liked doctors aren’t always right when it comes to the medical guidance they suggest or give. At the end of the day, I’ve got to keep in mind that nobody knows my body and brain better than I do, so it’s okay to challenge the authority of the experts (in a respectful, kind way of course).

Change is on the Horizon

In the last year and a half, change and I have grown to be more than just acquaintances: We’re very good friends now.

The big changes that I’ve experienced in that span of time (to name just a few) include buying my first home, getting my puppy, Violet, and naturally, coping with the numerous ripples of change that were brought about by the pandemic. As someone who has always found comfort in the “known”, these changes made me anxious and scared because of all of the uncertainties associated with them…but they also taught me that I’m capable of adapting to them.

So I figured, why not add one more change into the mix?

Another big change is headed my way.

Today is my last day with my employer of the last six and a half years. On Monday, I start a brand-new job at an organization that means a lot to me, one that I’ve happened to write about here many times before…

…and that is the College Diabetes Network!

I’m pleased to share that I’ll be joining the talented CDN team as their new Community Engagement Manager.

This job represents so much to me. It’s a career shift, for sure, but it’s a shift into a field that obviously is very near and dear to my heart. I’m excited to see how my personal passion, advocacy skills, and creative energy will translate to this professional role. And I’m even more thrilled to know that I will be working with an absolutely amazing group of individuals, both internally within CDN and externally with a community that I care so much about.

While I will miss my colleagues from my now-former employer very much, I do feel that taking this opportunity with CDN is the best possible decision I could’ve made. It feels like a dream come true. I’m honored that I was selected for this role and I am determined to achieve a lot with it.

For the first time in a long time, I’m looking forward to going to work on Monday and starting this new chapter…and I really can’t wait to see (and share) what the CDN team and I will accomplish in the future!

What My Dog Thinks About My Diabetes

The other day, I decided to ask my puppy, Violet, what she thinks about my diabetes…

…and she just stared at me, nonplussed, because obviously she’s a dog and she can’t respond to me with anything other than tail wags, barks, or playful growls.

Violet’s expression when I asked her about my diabetes.

But really, I’ve been thinking about how much she notices my diabetes. I know that she sees my devices from time to time – and sheer curiosity causes her to poke and prod them with her nose in what I perceive to be an attempt to dislodge them from my body.

I know that she wakes up in the middle of the night when I’m experiencing a low blood sugar and have to come downstairs to correct it.

I know she watches me during every pod change, gazing up and tilting her head from side to side whenever my PDM beeps throughout the process.

I know that she gets excited when I get a box of insulin or Dexcom sensors in the mail – she’s right by my side, jumping up and down as I tear into the packages, thinking that it might be a special delivery for her.

I know she waits patiently when I have to pay more attention to my diabetes in a given moment than I can pay to her.

It’s just interesting to bunch all of these moments together and mull over the fact that she is definitely aware of my diabetes, though her understanding of what it is and why it takes up so much of my time is just as likely to be something she’s not aware of.

For her, it’s blissful ignorance.

For me, it’s blissful knowledge that my dog is seemingly patient and understanding when it comes to all diabetes matters.

I’m lucky to have her.

5 Ways Hot Weather Affects Diabetes

This blog post was originally published on Hugging the Cactus on August 6, 2018. Call it an “oldie but goodie” because the ways in which hot weather can affect diabetes haven’t changed in the last few years and they won’t be changing any time soon…and with summer just around the corner, it’s good to remind ourselves of the extra precautions we might want to take in order to combat the heat. Read on for more on the ways summer weather can affect people with diabetes…

The summer heat seems to be here to stay in Massachusetts. We’ve experienced several weeks of soupy, high-heat weather that *almost* makes me long for cooler, autumnal days…but not quite, because that just means winter (and snow – blech) is right around the corner.

Truly, I do enjoy the summertime. To me, summer is about trips to the beach, ice cream consumption (and lots of it), barbecues with family and friends, long walks in the neighborhood, and endless outdoor adventures. Aside from all of those lovely things, summer also means that it’s time to be a little more diligent when it comes to my diabetes. That’s because hot weather can play some cruel tricks on a T1D’s body. What do I mean by that? Here’s five ways diabetes can be affected by hot weather.

Mr. Sun, Sun, Mr. Golden Sun, please shine down on me (and don’t make me go low or high…)
  1. Dehydration can lead to high blood sugar. Everyone knows that it’s important to stay hydrated when it’s hot out, but it might be less common knowledge that dehydration can directly affect blood sugar. There’s a scientific explanation for this: If not properly hydrated, the body sees an increase in blood glucose concentration because blood won’t flow as easily to the kidneys, making it difficult for the kidneys to get rid of excess glucose in urine. The best way to prevent this, naturally, is to drink plenty of water and monitor blood sugars.
  2. Sunburn can drive up blood sugars. I’m very familiar with how a sunburn can result in higher blood sugars; in fact, just last week I was dealing with a particularly gnarly sunburn on my thighs and belly that not only made my numbers higher, but also really hurt. My skin was literally damaged, so the stress from the injury lead to retaliation from my blood sugar. Luckily, it only lasted about 48 hours, but those couple of days were challenging as I dealt with sticky highs that were practically resistant to insulin. And for the record, I DID apply sunscreen – numerous times – when I was at the beach. Next time, I’ll seek shade under the umbrella.
  3. Sweat can make it difficult for devices to stick. I don’t know a single medical device that’s immune to prolonged exposure to moisture/water, but that doesn’t prevent me from spending as much time as I can outdoors/at the beach/by the pool in the summer. Thank goodness for Skin-Tac wipes and medical adhesive tapes that help preserve my precious pods and sensors!“
  4. Insulin can overheat. There’s a reason why insulin vials come packaged in cartons with directions that specify what temperature insulin should stay at in order for it to be safe to use. Insulin can spoil easily when it reaches a certain temperature, so it’s important to store it in a cool place when the weather’s warm. I alternate between a mini portable cooler (that can hold 3 vials of insulin) and a pouch from FRIO – both do an excellent job at keeping my insulin cool.
  5. Low blood sugars can occur more frequently. Summertime is prime time for outdoor activities that result in higher energy expenditure. So it’s no wonder that blood sugar tends to plummet in hot weather. Looking at it on the bright side, it’s an excuse to eat even more ice cream – but it also means that monitoring how I feel and checking blood sugars often is that much more important.

Regardless of the diabetes challenges it may cause, I love summer weather, and I know I’ll miss it the moment the first snowflake falls this year.

Diabetes in the Wild: Caught-Off-Guard Edition

“Diabetes in the wild” is a phrase I first learned about several years ago from, of course, the diabetes online community.

The phrase refers to those moments when you’re out in public and suddenly, randomly, you happen to spy another person with diabetes. Perhaps their pump site gives them away, or maybe they’re doing a fingerstick check. The person could have a diabetes tattoo, or they might be doing an injection. Whatever the scenario may be, these moments can be kind of exciting because they often trigger me to think, hey, there’s someone just like me right over there – it’s like that instant knowing that this person knows better than anyone else what daily life with diabetes is like that results in an inexplicable comfort, that feeling of realizing you’re never alone. And it’s truly a powerful feeling.

More often than not, these diabetes in the wild moments also come with some level of interaction with the other person. Maybe I’ll toss a compliment their way (nice Omnipod!) or the other person might ask me a question about my diabetes devices, because they’re curious about them and considering whether or not they should try it. These interactions are almost always super polite and the awkwardness is minimal…

…but naturally, there are times when diabetes in the wild moments are not so nice and just plain weird.

Here’s the story behind my most recent, bizarre, and mildly uncomfortable diabetes in the wild experience.

This particular diabetes in the wild incident made me feel like an ogled animal at the zoo…not a pleasant feeling.

I was at the grocery store on my lunch break, taking great care to somewhat hustle up and down the aisles because I had a short window of time in which to complete my shopping. The store was pretty empty and for the most part, I was able to go from aisle to aisle without bumping into other people.

Until John and Jane (not their real names, I actually have no clue what their names are) appeared.

John and Jane were what I like to call…spatially unaware. They had zero regard for my personal space and apparently, no manners, which I deduced from the fact that I had to move my cart and my body so close to the shelves of one aisle that I was practically touching the shelves in order to make way for them as they trod down the aisle in a wide berth as opposed to walking down single-file (like I would’ve done had I been with another person).

I was mildly annoyed, but it definitely wasn’t a big deal. I continued shopping and was dimly aware of the fact that John and Jane were going down a haphazard path, ignoring the arrows on the floors of the grocery store that indicated how to navigate up and down the aisles.

As I made my way to the next aisle, I realized that they were approaching me again, and even though we were the only three people in the aisle, they got extremely close. This time I was absolutely annoyed. I couldn’t understand why they felt the need to encroach on my personal bubble like that, but it got worse when I heard Jane say to John, directly behind my back, “Look, that’s a Dexcom like Stevie wears.”

I could feel my cheeks redden as two pairs of eyes ogled at the Dexcom sensor that I was wearing on my arm. I froze, wondering if I should acknowledge the comment, but before I could do so they were both wandering away.

The incident left me confused and a little angry. I couldn’t understand why they felt the need to discuss my Dexcom right within earshot of me – really, they literally talked behind my back. They could’ve waited until they were further away from me to talk about it if they wanted to, when I couldn’t overhear them and feel uncomfortable by the whole exchange, which left me feeling like I was a caged animal at the zoo. I can’t remember a time when people had so openly stared at my Dexcom like that, and it’s a weird feeling…and it’s one thing to stare, and a whole separate issue to comment on it without addressing me directly.

I don’t know, maybe I was being overly sensitive about the whole thing, but I can’t help how it made me feel. It would’ve been a much different story had they maybe talked to me about it – I can imagine spending a couple minutes talking with them about their little Stevie and ending the exchange by telling them to take care or sharing some other pleasantry. Who knows how it could’ve been different. But one thing it taught me is that diabetes in the wild moments, as fun as they can be for me, they can also be not so great for others. I’d hate to think that I ever made anyone else feel awkward or strange about their diabetes because I called them out on it.

I think that context is key when it comes to experiencing diabetes in the wild…sometimes it’ll be totally appropriate to talk about it in public, other times not so much. We all just have to be a little more careful about determining the right contexts.

T1International Launches “100 Years: From Gift to Greed” Campaign

The following is a post that was featured on the T1International blog on May 17, 2021. I’m sharing it here today because I want to help spread the word about the Gift to Greed campaign. Learn more about it by reading on (and visiting the links at the end of this piece)…

On Monday, May 17th – 100 years after Banting, Best and Macleod begin their first experiment trying to extract insulin in Toronto – T1International and its advocates around the world launch their year-long campaign. 100 Years: From Gift to Greed will tell the story of insulin’s discovery and how it went from being a gift to the world to a profit machine for the pharmaceutical industry. The campaign will be led by a combination of social media education and a variety of actions.

“A gift to the world has become a tool for price gouging patients all over the world.” – Elizabeth Pfiester, Founder and Executive Director of T1International

Insulin is as essential as oxygen for all patients with type 1 diabetes and many with type 2 or other forms of insulin-dependent diabetes. Globally, insulin rationing is common, and half of those in need of insulin cannot afford or access it. For every two people alive with type 1 diabetes, there is a third who did not survive. The production and distribution of insulin is dominated by three companies – Eli Lilly, Novo Nordisk, and Sanofi – who control more than 90% of the global market.

In the early 1920s in Toronto, Canadian physician and scientist Frederick Banting began working on an idea in the laboratories of J.R.R. McLeod to isolate and extract insulin. Medical student Charles Best and chemist James Collip worked with Banting to test, purify and refine insulin for clinical trials in humans.

After vowing that insulin would not be something to profit on, the discoverers sold their patent for $1 CAD each and eventually passed the rights to the pharmaceutical company Eli Lilly and Co. so that it could be mass produced and widely available. Banting famously said, ‘’Insulin does not belong to me, it belongs to the world.’’

While this incredible advancement was intended as a gift from the discoverers, Eli Lilly and the two other major insulin producers, Sanofi and Novo Nordisk, have turned insulin into profit machines, assisting in bringing in billions of dollars in profit every year. By 1923, insulin was the highest-selling product in Eli Lilly’s history, and profits from it accounted for over half of the company’s revenue. As we know, the prices have continued to skyrocket ever since. Since 1996, the list price of insulin has increased by over 1200% in the United States. Eli Lilly’s Humalog insulin increased in price by 585% between 2001 and 2015 alone.

T1International’s Founder and Executive Director, Elizabeth Pfiester, said, ‘‘A gift to the world has become a tool for price gouging patients all over the world. The greed of the pharmaceutical industry is keeping insulin out of the hands of millions. This greed leads to the loss of countless lives and dampens the dream of Banting and his colleagues, which was to make insulin a gift to the world. It is outrageous that this is the reality, and T1International will continue to speak out until the pharmaceutical industry is held accountable.’’

T1International advocates will be speaking out and educating the community about the story of insulin and how to get involved in T1International and the global #insulin4all movement. The aim is to put an end to the reality that far too many people die or suffer grave physical, mental, and emotional health consequences due to pharmaceutical greed.

Visit the campaign page and read more at: t1international.com/100years

Questions about T1International and this campaign should be directed to press@t1international.com.

How a Normal Pod Change Turned Into a Bloodbath

WARNING: If you are at all squeamish when it comes to blood…then this blog post is NOT for you! I will not be posting any graphic photos or anything, but I’ll be telling a bloody tale that might make the faint of stomach a bit queasy. Read on if you have no fear…

There’s nothing quite like waking up and doing a routine pod change…only to have blood literally pour out of your body the moment you tear your old pod from its site.

Okay, so using the word “bloodbath” in the title might be a gross exaggeration (LOL at my pun because yep it was GROSS), but I digress…blood really did stream in a rivulet down my arm. It sounds wild, but it’s true!

This happened to me a couple of weeks ago. I don’t often change my pod first thing in the morning, but every now and then, I’ll time it so that my pod is set to expire (like, really expire – pods expire for good 8 hours after receiving the initial “pod expired” message on the PDM) as soon as my wake-up alarm goes off. My only goal in prolonging the pod like that is to use up as much insulin as possible that’s left in the reservoir…naturally, I don’t like the idea of tossing a pod when it’s still got 50+ units of insulin left in it.

So I literally woke up on this particular morning at 6 A.M. to my pod screaming because I’d hit the 8-hour mark. I rolled out of bed and stumbled over to my mirror so I could have a better view of the pod, which was sitting on the back of my arm, and proceeded to rip the pod off. That’s when I saw blood – not just a tiny drop, but a full-on stream running down my arm!

The ‘betes can get bloody from time to time.

I was surprised, but still had my wits about me to the extent that I was able to run into my bathroom and grab some tissues so I could start wiping up the blood and apply pressure at the site. I barely made it in time – the blood was coming out so fast that drops were falling on the floor and my sink was getting dotted with red. I wasn’t really freaked out, per se, because I knew that if I just pressed hard enough with a tissue, then I’d be able to staunch the wound. And sure enough, within 5 minutes or so, I’d successfully done just that. I peeked under the last tissue I’d used and noticed a purplish mark at the old pod’s site, which indicated to me that I must’ve hit some sort of vein when I had put that pod on. Definitely not intentional, but something I hope to avoid going forward.

And undoubtedly…definitely not my favorite way to start the day!

How My ‘Betes Behaved During Bachelorette Weekend

Last week, I shared that I was going on my first overnight trip since being fully vaccinated. I also explained that it was a very special trip that I was taking: It was my childhood best friend’s bachelorette weekend!

Fun fact: We took hundreds of photos this weekend and my diabetes devices aren’t visible in any one of them. This was done on purpose: I just didn’t feel like having my devices out on display for all to ogle at.

As much as I was looking forward to it, I was also a little apprehensive because packing for trips with diabetes can be tricky. I’ve learned, courtesy of too many mistakes made over the years, that it’s extremely important to pack not just back-up supplies, but back-ups for the back-ups, and maybe even then some extra extra extra back-ups. It involves lots of careful thinking and planning to ensure that nothing is accidentally left at home.

And somehow, I managed to remember basically everything! I had plenty of supplies on me at all times and was more than adequately prepared to treat any scary high or low blood sugars.

But while I’m pleased to share that I didn’t need any single one of my back-ups over the weekend, I’m less than thrilled to divulge that my blood sugars were pretty rotten the entire time. I’m mostly to blame for this…it’s because of the food and beverage choices that I made. For example, foods like quesadillas and pizza are rare indulgences for me, and I not only consumed both, but I ate them in the same day. What was I thinking?! They can be tough enough to bolus for on a normal basis, but throw alcohol into the mix (I confess that I was, indeed, drinking) and I basically set myself up for failure.

In hindsight, I should’ve opted for lower carb drinks like vodka with seltzer water or whiskey mixed with diet soda. But I wanted to be like everyone else and enjoy a margarita or two and have the pretty pink drinks that we made at the Airbnb. And maybe I could’ve made smarter food choices, but truly, I didn’t have many options because we chose to eat at one restaurant with a limited menu and order takeout from a pizza joint that didn’t have anything like cauliflower crust.

To be fair to myself, I was carefully watching my blood sugar all weekend long. I was running temp basal increases. I was stacking insulin to bring my high levels down. I was drinking plenty of water and I was avoiding snacking on the delicious, tempting treats that all of the girls brought – I didn’t even eat one of the chocolate mocha cupcakes that I’d baked. And I did have great blood sugars overnight, which I had been really worried about. I was nervous about my CGM alarming and waking up everyone when we were all trying to sleep, but that never happened because I was in the low 100s for most of the night…much to my relief. (Side note: Even if I had gone low, I wouldn’t have been worried about getting support/help if I needed it. Basically, three-fourths of the guests are medical professionals so…I couldn’t have been in better hands!)

So yeah, my blood sugars could’ve been better this past weekend. But you know what? There are hundreds of times in my life that my blood sugar could’ve been better. It could, pretty much, always be better! For me, though, diabetes just wasn’t my main focus. My friend was my focus all weekend long. I wanted to celebrate her and this next chapter in her life and put my diabetes on the backburner.

And I know for a fact that the bride-to-be had an incredible time. We laughed as we told stories, we played games, we enjoyed yummy food, we visited a beautiful winery, and most importantly, the other ladies and I honored my friend and made memories together. That’s what matters, and as hard as it might try to interfere, diabetes can’t take that away from me.

Congratulations, R & T! I love you guys.

Diabetes and the Blame Game: Time to Stop Playing It

This post originally appeared on Hugging the Cactus on June 13, 2018. I’m sharing it again today because the blame game is played far too often in life with diabetes. People pass judgment on others for how they choose to manage diabetes, and it does more harm than good. Read on for my thoughts on why we need to stop shaming others.

Here’s a little disclaimer: This post is highly personal. I’m going to dive deep here and talk about a few things that bother me when it comes to how others perceive T1D. My opinions are strong, but I’m entitled to them – just like you are.

“I can’t believe his blood sugar got that low. He really needs to have better control over his diabetes.”

“Why wasn’t she carrying a snack with her? That’s so irresponsible, she should know better!”

“They’re unhealthy. The way they manage their diabetes isn’t okay and it’s no wonder they go to the doctor so much.”

These are words that others have spoken about people with diabetes in my presence. While these thoughts and feelings aren’t necessarily about me, it doesn’t mean that I don’t take them personally.

Why do they bother me? Because they’re dripping with judgment.

The blame game can cause a whole lot more harm than good in the life of a person with diabetes.

It’s easy for someone who simply doesn’t understand diabetes to make assumptions based on a couple of observations they make about someone with diabetes. But just because it’s easy to assume things, it doesn’t make it okay.

Just because you see someone have a tough diabetes day, it doesn’t mean that’s what it’s like all the time.

Just because someone forgot to carry a low blood sugar remedy on them, it doesn’t mean that they always forget one.

Just because you know of someone who frequently visits the doctor, it doesn’t mean their diabetes is “out of control.”

Just because you blame someone for not taking “proper care” of themselves, it doesn’t mean that they don’t try their damnedest.

That’s what’s so wrong about making assumptions about how someone manages his/her/their diabetes: It’s impossible for anyone to know the full story about that individual’s diabetes, because they are the one solely in charge of it. They know how it behaves 24/7/365. They know it better than their doctor, spouse, family, friends, and coworkers. And the funny (and by funny, I mean really shitty) thing about diabetes is that sometimes, you can’t predict what it’s going to do next. So you have to be prepared to roll with the punches at a moment’s notice. And you’ve got to be that prepared all the damn time: when you’re awake, asleep, traveling, exercising, working, and just plain living.

Sounds exhausting, doesn’t it?

So that’s why I think the blame game is especially cruel when it’s played to cast judgment on people with diabetes. We have the incredibly difficult task of taking care of something that most other people never have to worry about, and blaming someone for not “doing what they should be doing” is heartless and does nothing to help them.

I challenge anyone reading this to think twice before they jump to conclusions about how a person with diabetes takes care of themselves. Remember that just because you may have witnessed them going through a difficult diabetes experience, it doesn’t mean that it’s like that for them all the time, or that they aren’t doing everything they can to take the best possible care of themselves. The world is occupied by enough critics – do your part to be supportive, not shameful.

CGM Sensor Adhesive: Not as Sticky as It Used to Be

I’ve had four CGM sensors fall off in the last six weeks or so.

Four! And they’ve all been in different locations, too – both the left and the right sides of my thighs and my stomach. I’ve worn overlay patches – at times multiple – to help keep them on, and I’ve still dealt with adhesive that just doesn’t want to lay flat against my skin.

What gives? I can’t recall a time in which I’ve had worse luck with my CGM sensors staying stuck.

I’ve gone through quite a few overlay patches in the last few weeks in an attempt to get my CGM sensors to stay stuck on my skin…with mixed success.

Normally, I’d blame it on weather, but it hasn’t exactly been warm here in New England yet. Temps have mainly stayed in the 50s and 60s, so it’s not like I can pinpoint the problem on heat.

The only silver lining in this scenario is that Dexcom does have a nice replacement program. They make it really easy to submit a patient support request online that goes straight to Dexcom support for processing. Filling this form out takes me no more than five minutes and by doing so, I’ve received a replacement sensor for each one that’s fallen off in the last month and a half. And while I was starting to worry that I was submitting too many requests, Dexcom hasn’t further inquired me on the matter yet, so I feel a little better knowing that I can count on them to give me replacements for sensors that won’t stay stuck.

Until the adhesive improves, though, it looks like I’m stuck wearing at least two or more overlay patches on my sensors to ensure their 10-day lifespans.

I guess they just don’t make ’em like they used to…