10 Countries, 10 Global COVID-19 Perspectives

This blog post was originally published on the T1International website on April 10, 2020. I am highlighting it here on Hugging the Cactus because 1) I think it sheds a lot of light on the healthcare systems in other countries and 2) it’s a reminder that we’re all in this together.


Hear from ten people living with type 1 diabetes as they share their perspectives about the impact of the coronavirus on their country and their health.

Bolivia – Laura
Things are complicated here, and our health system is already problematic. There are no masks and a lack of other correct equipment to treat patients. The government has been very careful about prevention, and quarantine has been going on for several weeks already. Many people are poor and live day by day with what they earn. The government began to give money and food aid to older people and families who receive other types of government bonds, but not everyone can receive it and many say that they do not have enough money to eat. Based on the numbers on our identification, we know when we can go out to get groceries or medications – only on specific days. Still, there is a lot of ignorance and people are not following instructions. There are 200 cases confirmed, with 15 deaths and it is increasing every day. People who have to travel long distances to get medicine do not have good options. I have a friend who has no blood glucose test strips and her blood sugar keeps going too high, but because she does not have test strips, she doesn’t know it. It is very dangerous.

Costa Rica – Dani
Our small country is on lockdown, with only 10 people in ICU at the moment. The country is making at-risk patients a priority and currently even shipping their medicines to them to prevent them from going to the hospital and getting infected. Families have been given extra insulin for the next two months, and the community is supporting each other if there is an urgent need for support or extra supplies.

Germany – Katarina
Germany has one of the lowest COVID-19 related death rates so far. A lot has been undertaken to prevent the virus from spreading – test centres have opened their doors to the general public, hospitals are increasing their capacities for intensive care and ventilation, and research teams are working hard to improve diagnostics, therapy and find preventative methods. The pandemic is challenging our healthcare system, our economy, and our society, but it also opening new pathways. A lot of diabetes care centres are transitioning to telemedicine, and people with diabetes can get prescriptions and supplies by mail. Being a doctor on the frontline and a high-risk patient at the same time is not easy – I am constantly torn between my profession and my wish to self-isolate and stay safe.

Ghana – Yaa
With the rise in COVID 19 cases in Ghana, the government made it mandatory to close down schools for a month, to limit the number of people to no more than 25 in a social gathering, and to start a two week partial lockdown in contiguous districts (3 regions). This means no one is allowed to go out unless it is to buy food and drugs. Borders are closed, and importation of goods are restricted. For people with type 1 diabetes who get supplies at the government hospital using the national health insurance scheme, they still have to go all the way to the hospital for their supplies. The hospital is a major reservoir of the virus, so it increases the chances of people with type 1 who are already at high risk. The only other option is to go buy from the pharmacies, where there is currently a surge in prices. People with diabetes were asked and encouraged to stock up on their diabetes supplies, but not everyone was able to do this. We fear for the unknown and the long term impacts.

India – Apoorva
As a medical doctor I have been working and seeing new cases, but now my entire department is in isolation. I took steps back to prevent getting sick. Delhi is one of the hotspots, and we had sudden surge in cases. Rural impoverished areas are problematic due to people living in close quarters. Our government initiated a lockdown, but many tried to leave quickly, especially migrant workers who come and go from the city centres because they lost their livelihoods. This caused the virus to spread despite drastic measures taken by the government. Currently, there are no insulin shortages as all medical services and pharmacies are operational, but we have seen a possibility of analogue shortages and hope to try to ensure that does not happen. Our main aim is to support the actions of the government and I plead everyone to stay home and protect their families.

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Kuwait – Mohammad
We have been on lockdown for four weeks, and people who came to Kuwait from other countries were tested. If someone had symptoms, they were put in quarantine. Cases have been contained and so far, there has only been one death. It is interesting that there is now a COVID-19 database that was created rapidly, but there has never been a database of people with type 1 diabetes in Kuwait. Our medications tend to be provided and some are being delivered. Overall, things are OK now, but we are concerned about access to medication and food supply in the long term because most of it is imported.

Lebanon – Cyrine
Our country has been facing tricky political problems for the past five months, since we had a revolution in November. The banks have no money, and there is no money from the government. We can only have access to a specific amount of our money per month. We are facing shortages of medical supplies including ventilators and medical protective equipment. The whole country is in an emergency state now and there are military personnel on the streets. As cases continue to rise, people are only allowed to go out at certain times and we can only walk. I have been on self-quarantine for the past few weeks. What worries me most is the people who already struggled to afford their basic insulin and supplies. With 80% or more of the population having lost their jobs, what are those who cannot afford their insulin doing now? I am trying to help those I know about, but there is no government plan for people with type 1 diabetes. People do not have money anymore, so how can they cover their insulin costs?

South Africa – Estelle
Testing here is slow. On April 2nd, I heard only 46,000 tests had been done, which is not even 1% of the population. It looks like we have small numbers of diagnosed patients but there is so much unknown. Apparently there is enough stock of medication for up to a year. Medical aid, our version of insurance, said they will cover all treatment related to COVID-19, so that is a relief. A large proportion of individuals might not be taking it seriously enough. The biggest concern is keeping the virus out of the rural areas, which are densely populated. If it spreads there, it could be catastrophic because we do not have enough hospitals.

Tanzania – Johnpeter
We only have about twenty cases identified so far. I am currently in Serengeti which means I am far from cities where cases were confirmed and spreading. I am staying put and I had to cancel my doctor appointments and other appointments. I have had to reduce my insulin dose because I cannot get any insulin here in this rural area. I have some insulin in Dar es Salaam that my doctor gave to my brother for me. So right now I am working with my brother to try to find a way to get the insulin. I am not supposed to travel to cities to risk my health, but I am risking my health by staying here without insulin. It is incredibly stressful on top of the challenges I already face accessing and affording my insulin.

USA – Karyn
In Georgia, where I live, we are also on lockdown, with cases increasing every day. The biggest issue is shortages of ventilators and protective equipment for hospital staff. Cost and affordability issues are already a problem in the USA and this will likely be an even bigger challenge now. Due to the broken healthcare system here, it’s uncertain if people will even get tested if they go to the doctor. Some people are getting billed for the test even though it has been said they shouldn’t be. Last year around this time, I went to Canada to buy a year’s supply of insulin. I have a bit more, but I’m not sure what I’m going to do without being able to travel abroad this year. I already struggle a lot with the costs. Many people are losing their jobs, and therefore losing their insurance, which will inevitably also impact their ability to afford essential medicines.

Supporting T1D Students with my #SensorSelfie

I’m taking a departure from a “traditional” blog post today to tell you, my dear readers, that you should consider celebrating a special holiday with me today: National Selfie Day! Before you roll your eyes at the mere idea of that, please keep reading to learn how participating will help support students with diabetes.

Dexcom has partnered with a nonprofit that is very important to me – The College Diabetes Network (CDN) – to help put some focus on the diabetes community and raise money. They’ve created the #SensorSelfie social media campaign to encourage people with diabetes to take photos of themselves proudly donning their Dexcom sensors.

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Here’s my #SensorSelfie, which wouldn’t be complete without my cactus shirt.

But what exactly do you need to do in order to take part in the campaign? There’s four simple steps to follow today, June 21st:

  1. Take a picture showing off your Dexcom sensor
  2. Post the photo to your Facebook and Instagram pages
  3. Use the hashtag #SensorSelfie and tag @Dexcom
  4. Tell ALLLLLL your diabuddies to do the same

For every post that uses #SensorSelfie today, Dexcom will donate $1 to CDN. Can you imagine how much money could be raised if you got all the T1Ds you know to participate?

If you’re looking for some more information on this social media campaign, click this link. Otherwise, what are you waiting for? Get to snapping, posting, and tagging!

7 Questions People Always Ask Me About Type 1 Diabetes

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

I've missed you terribly!

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

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

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

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

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

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

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

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

 

No More Fingerpricks Campaign

Diabetes Awareness Month may have only started a few days ago, but boy, has it been jam-packed with advocacy and awareness efforts so far! In fact, I think this is the most active year yet for most social media platforms. I’ve seen tons of different campaigns, hashtags, and posts that were all created especially for this month, and it’s absolutely wonderful to see such inspired content as well as high participation rates.

And I hope to keep the ball rolling on this! That’s why I’m sharing my #NoMoreFingerpricks post today. This campaign was launched by Dexcom and Beyond Type 1. Participants are encouraged to take a picture or video wearing the foam finger from Dexcom, or to draw an “X” on an actual finger (if they don’t have a foam finger). For every photo or video posted on Facebook/Instagram with an @Dexcom and #NoMoreFingerpricks, Dexcom will donate $1 to Beyond Type 1.

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Here’s my #NoMoreFingerpricks campaign photo! And yes, I deliberately wore blue – the color of diabetes awareness.

Yup, it’s that easy to do! And it’s exactly the kind of social media campaign that can catch on quickly. Recruit your family and friends to take photos and get posting! And be sure to teach them a couple of diabetes facts and what the whole #NoMoreFingerpricks hashtag is all about. For instance, you could mention that:

  • 34% of people with T1D know nothing or little about CGM
  • 80% of people with T1D still prick their fingers more than 3 times a day
  • 96% of CGM users would recommend CGM

You could even direct inquiring minds to visit nomorefingerpricks.com to learn more about continuous glucose monitoring technology and this campaign.

So…what are you waiting for?! Draw an “X” or grab that foam finger and post your photo to educate, advocate, and celebrate living beyond!

Hugging the Cactus is One Year Old!

October 2, 2017: The day that I hit the “publish” button and Hugging the Cactus went live.

I can’t believe it’s been one year (and one day) since this blog was officially born. So much has happened in my life in the last 365 days, both related and not related to my diabetes.

HTC Birthday

And this blog has gone through so many changes in that time span. From aesthetic to logistical, it’s been a (welcome) challenge to figure out the best way to write and run Hugging the Cactus. I’ve learned so many new things along the way and I continue to learn more on practically a daily basis.

Although I wish that diabetes wasn’t a part of my life – or anyone’s life – I’m grateful that I’ve mostly made peace with it after 20 years of living with it. Actually, scratch out the “living with it” and replace it with “thriving with it”. I used to think that was totally cheesy, but that phrase really does encapsulate what it’s like to be undeterred by diabetes.

I’m also grateful for you, the reader. There are times in which I question why I write this blog. Those times are fraught with self-doubt, writer’s block, and listlessness. But then someone reaches out to me – directly through the blog, via social media, or even in-person – and they offer support or let me know that my writing has resonated with them in some way. And that, right there, reminds me why I write this blog: to connect with others, to remind people in the diabetes community who deal with this isolating chronic illness that they’re not alone, and to raise general awareness of T1D. There are many people in this amazing tribe of ours who write better blogs, take prettier pictures, and impact a larger audience than I do, but like them, I’ve found my own voice that has allowed me to channel my experiences with diabetes in my unique, storytelling way. And I plan on continuing to do so for a long time to come.

So thank you, reader, for stopping by here three times a week and supporting my mission. I hope that you enjoy the next year’s worth of Hugging the Cactus. For now, let’s celebrate today by reminding ourselves that we’re more than our current blood sugar values or A1c levels. Celebrate by choosing to do more than just live: thrive.

I Know, I Know: I Talk Too Much About Diabetes

Diabetes is never far from my thoughts.

I write a blog about it. I vent to family about it. I almost always casually mention it to new people that I meet.

I have multiple social media profiles dedicated to it. I own several t-shirts that identify me as a person with diabetes.

It’s the first thing I think about in the morning when I wake up, and the last thing I think about before I fall asleep at night.

And yet, sometimes people complain – jokingly and seriously – that I talk about it too much.

Of course I do! I totally own up to that fact. But think about it…

Doesn’t it make sense that I talk about it so much?

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…but there’s a reason for it.

It affects the most mundane decisions that I make on a daily basis. It affects my mood. It affects my body. It affects the foods I consume. It affects what I carry in my purse each day and what I pack in my luggage on vacations. It affects my finances and my gym routine and the doctors I have to see.

If someone thinks I talk too much about my diabetes, then I’d like them to understand this:

Talking about diabetes spreads awareness and saves lives.

Bold, italicized, and underlined so the message and its significance is clear. Too many people in this world just don’t understand type 1 diabetes. They don’t realize how dangerous it can be, or how it is managed. In my personal experience, being open with others, answering their questions, and dispelling diabetes myths has resulted in nothing but positive outcomes.

It’s even helped people I know save a life, because they knew what to do when a T1D close to them was experiencing a hypoglycemic event.

All because I “talked too much” about diabetes.

With that in mind…you can bet that I won’t be shutting up about it any time soon.

Memory Monday: That Time I Planned a School Walk for Diabetes (Part 1)

One Monday per month, I’ll take a trip down memory lane and reflect on how much diabetes technology, education, and stigma has changed over the years. Remember when…

Okay, so I’m deviating slightly from my typical “Memory Monday” post as I take a walk down *my personal* memory lane. I’m reminiscing about that time I planned a School Walk for Diabetes at my high school as a freshman. This is going to be a two-part “Memory Monday” as next month, I’ll write about how that same year, I had to create a lesson plan and educate a whole group of middle school students about T1D, too!

But let’s focus on this part – the School Walk for Diabetes bit – first.

I’ll admit my memory’s a bit foggy on the matter. But fortunately, I kept the binder that documented my hard work on this project, a binder that was both hilarious and horrifying for me to look through 10 years later. I’ll also admit that it was somewhat impressive; after all, this was a massive project for a high school student to tackle. I had a project partner who contributed a great deal, though, so that absolutely helped make it a success (ahem, we got a 100% – an A+ – as our final grade, NBD).

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The nerd in that picture (A.K.A. me) would end up with a 100% on this project!

As I leafed through the binder, I found a description of what it was like to organize the Walk component. We met with a couple of local teachers who were in charge of the event and told them we wanted to do anything we could to assist them as part of our project. After many email exchanges and in-person conversations, we had an action plan for how the day of the Walk would flow.

Here’s my oh-so eloquent description of the day of the walk:

May 31, 2008 – Time Spent on Project: 5 Hours

We arrived at 8:30 to help set up for the Walk. We hung a large sign in front of the school and decorated the track with balloons and motivational signs. For three hours, we stood on the track and punched holes in paper bracelets for the Walk participants as they completed a lap. A reporter was present and took our picture for the paper. The Walk was successful and we raised just under 5,000 dollars for the American Diabetes Association. We helped clean up after the Walk, which took half an hour.

Really riveting material there, huh? But truly, it’s kind of neat to see that my passion for diabetes awareness was strong even in those days. I think participating in this project marked the beginning of my comfort level with my diabetes increasing, and it’s cool to have a record of that.

I could do without the photos of me as an awkward teenager, though…

Happy Diabetes Awareness Month!

It’s November 1st, which means…

Diabetes Awareness Month is here!!!

To celebrate, I’ll be posting a variety of content that’ll give non-T1Ds a bit more insight into life with diabetes. I’m going to *attempt* to respond to the many wonderful prompts provided by Beyond Type 1 and the College Diabetes Network, starting today!

Beyond Type 1’s first prompt is easy enough: Post a photo of your #bgnow! (This is a hashtag commonly used on Twitter to share current blood sugar readings.)

So here it is:

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Hey, not bad! Especially for a post-breakfast blood sugar! I’m hoping for some tighter numbers this month, seeing as I just saw my endocrinologist a few days ago. I had a good A1c reading, but not my best, so I was a little disappointed. But she reminded me that my A1c is just an average, and that I should be proud of the progress I’ve made in the last few years. Her faith in my ability to take the best care of my diabetes that I can is super reassuring. That, combined with my excitement to advocate all month long, is exactly what I need to meet my personal goals.

Looking forward to an awesome month of diabetes advocacy!