November 20

So, a few days ago I showed you all my favorite food that I have issues with.

So today, I wanted to show you all my favorite "free" food!

A "free" food to a diabetic means they do not normally have to take insulin for it since there are no carbs in it.

I like sugar free jello (just don't like using the energy to make it) and pickles. I really like pickles with ranch, but ranch has carbs so if I don't want to take any insulin, I'll leave the ranch out.

Normally, mostly sugar free foods are so much worse with diabetics and can make blood sugars worse than a regular food! Like sugar free candy has always been worse than normal candy. Same thing with cookies and even yogurt. I found over the years what works and what doesn't and I learned what to look for on food labels.

Sugar free really means sugar free. It does not necessarily mean it's carb free (which I count carbs, not sugar).

Oh, another is diet hot chocolate. It has carbs, but not nearly the amount of regular hot chocolate. So I live off of it during the winter.

November 19

for November 19th, I wanted to share with you a very important habit that I'm still working on developing: testing my blood sugar before driving.

I need to make sure my blood sugar is in a good range before I go and drive so that I do not cause an accident due to a too low or high blood sugar. 

Low and high blood sugar levels do affect how your brain functions. It's just like driving drunk.
People who are diabetic and are on insulin can drive safely as long as they have good control of their blood sugar levels. I'm not sure of the laws but I have heard from doctors that driving with an extreme low or high blood sugar will still count as a DUI/DWI. 

Also, ketones (produced in uncontrolled T1Ds) reads as alcohol on breathalyzer tests! 

I do not test while I am driving! I test before I head out the door or when I get in the car and let it run for a few minutes. Jeff will test me while I am stopped at a light if I really need to test.

I am still working on making this a habit. I do miss a lot of tests, but I do around 8 tests a day on average so I've got a fairly good idea of my blood sugar when I go to drive. I do also feel my lows and highs!

I have never had any accident or driving issues due to my blood sugars. I always pull over and stop if I feel low.

November 18

This one is a bit more embarrassing and hard to talk about. I have never really said much about this. Yes, that is my actual weight on the scale. I did not sharpie out the number, my parents dropped a cigarette on the plastic and it burnt.

Being at a good weight is very important for a diabetic. Added weight can decrease insulin sensitivity and is a huge factor for my polycystic ovarian syndrome. At my weight, I am very insulin resistant and have to take more insulin to make up for the fact that I am over weight.

Insulin also stores fat! So the more insulin I do since I'm over weight, the more fat my body will store and it turns into a vicious cycle. Now that I am on the pump, I'm doing about 20 units of insulin less a day and I have already lost 2 pounds from this picture.

Exercise is a key factor in keeping my blood sugars under control. But I have always had issues with losing weight due to my hypothyroidism and my PCOS (both prevent me from losing weight). I never had the energy to exercise! The asthma doesn't help either.

I eventually got fed up with my weight and sought out a quick fix. Phentermine. This is a weight loss pill that I was prescribed as a last ditch effort for me to lose weight. It is an amphetamine! I lost a lot of weight quick. But sadly, it triggered me to lose my gall bladder and I gained all of the weight back.

This is the hard part to talk about. With that weight gain, I ended up figuring out that if I made my blood sugars high and withheld my insulin, I would lose weight! I thought I had something good going on. I really didn't. This is very dangerous and is termed Diabulemia. I think it's actually considered an eating disorder now. I did not starve myself through food, I just starved my cells of glucose by not giving myself insulin.

Luckily I did not develop any complications from being so uncontrolled and I have no idea how I did not go into Diabetic Ketoacidosis.

I am now away from that point of my life and I am taking care of myself now. It took a lot of work from Jeff to help me out of that state and I found some online support groups that helped me by showing me that I was not alone. I know I had my support system of my parents, friends and family. But no one actually understood how it felt to be diabetic (besides Matt)! I was essentially alone in that. But I found the help and changed my life!

I am active on a few of those Facebook support groups and I no longer feel as alone.

I know I am still over weight. This last Endo appointment, I lost 2 lbs since I started on the pump just due to not using as much insulin. The pump is more efficient with that! I also had to change my thyroid medication and that will also help me lose weight and give me energy to start exercising again! Having the right thyroid level will also help with lowering my insulin needs.

Things are looking healthier in the future!

November 17

For November 17th, I wanted to show you all my feet!

I know what sounds totally weird, but as a diabetic (T1 or T2) I need to keep a good eye on my feet! This is due to the facts that a common complication is neuropathy (disease of the nerves). Like I have said in a previous post. Neuropathy can be seen as burning, tingling, numbness, cold or a stabbing feeling.

The feet and toes tend to go first. I get tested at the Endocrinologist to see if I have neuropathy by him putting a little pin on my feet, with my eyes closed, and telling him if I feel it. They also use vibration on the feet since the sense of vibration tends to go first in neuropathy. 

If I had neuropathy in my feet, I could easily step on something that could cut me and never feel it. That can lead to infection and even amputation of some toes and farther depending on the severity of the infection.

I do pay a lot of attention to my feet and Jeff rubs my feet also so that he can take a look to see if anything is wrong.

So far I do not have any neuropathy and I have all feeling in my feet. But I shouldn't stop checking my feet!

One of the pictures is Daisy's little feet against mine. For some reason she thought it was comfy to sleep like that.

This picture reminded me to tell everyone that animals can develop diabetes too! It's not just a human disease. The animals that develop diabetes end up having their blood sugar checked from their pads on their paws multiple times a day just like humans do. Most also have to be put on insulin based on what they eat. There is no pump for your pet so they have to be on injections! I've known a few people who have had a diabetic dog!

November 16

For November 16th, I just wanted to share with you my most favorite "bad" food.
Which as a Nutrition Major I will never really say BAD food. No food is bad. There are more healthy options than others!

So my most difficult food to bolus for and I end up having to chase high blood sugars is any kind of oriental type of food. Chinese food or what Jeff and I are addicted to is HuHott. I try to go low carb, but it doesn't always work out with all of their sauces. But we go to HuHott often and it is healthy-depending on what you get. Rice is just as bad. Those high carbohydrate foods that are dense and so very yummy are not nice to my blood sugars!

Once I'm farther with my pump.. I'll figure it all out. Eventually.

November 15

For November 15th I wanted to talk some about what blood tests I get done and why.

The first and most important is my Hemoglobin A1c (HbA1c). This test is to check my overall control of my blood sugars over the last 3 months. I have a picture of my HbA1c which is at an 8.7%. A non-diabetics will be less than around 5.7%(around 90 mg/dl average). A diabetics will be 6.5% (around 130 mg/dl average) or higher. For me, I aim to be less than 7% (around 150 mg/dl average). That means I have my diabetes fairly well controlled. There is no way I'll probably ever get to non-diabetic levels. But the lower, the better. About 3-4 years ago I was at around a 12% (around a 315 mg/dl average) when I didn't have my good insurance and when I was going through a period where I didn't care so much about my diabetes and was dealing with an issue called Diabulemia. I'll talk more about Diabulemia but it's where someone doesn't do their insulin so they can lose weight.

I have my lipids checked like my cholesterol, triglycerides, HDL (good cholesterol) and my LDLs (bad cholesterol). Being T1 with hypothyroidism and polycystic ovarian syndrome makes me at a much higher risk for high cholesterol and heart disease. My cholesterol is high and always has been which is not good since heart disease and high blood pressure run in my family and my grandpa has even had a heart attack before. One good thing is that my good cholesterol (HDL) is perfect and that's working for me to prevent heart disease. 

I need to have my thyroid checked since I have hypothyroidism (same time I was dxed with T1D). They check for TSH (thyroid stimulating hormone) which my levels were much too high recently and that needed a medication boost. I'm already feeling a whole lot better with that increase in medication. My Endocrinologist also checked my free T3 and free T4. These are two other tests to check thyroid function. 

I am also tested for protein in my urine which checks for kidney function. With uncontrolled diabetes, the kidneys are one of the first organs to be damaged and can lead to serious problems and even transplantation to save my life. Good news is my kidneys are doing great and there was no protein!

Those are just the usual tests I get once a year or more often if needed. I got many more tests done this time just because I am a new patient there and I just got started on a pump.
The last blood draw was 8 vials of blood!

November 14

Happy World Diabetes Day!
Wear blue for us today and show some support.
I know you've seen my tattoo before in another post, but here's a better picture! The date is my diagnosis date in the ribbon.

November 13

Tomorrow is National Diabetes Awareness Day! Wear blue tomorrow to show your support! I will be wearing blue and my blue circle pin and probably my awareness ribbon too!

Jeff and I went through and tried to think of common myths.
If anyone has one that I missed, I will give you my best answer!

These are ones I found online and that I have heard myself or from someone else.

Does it hurt?
Well, yeah. I'm still human and getting shots does hurt. But I do it to keep myself alive.

Can it go away? You can cure diabetes with ________.
No, there is no cure yet. Scientists are working toward one and I think the longest "cure" has been about 2 years for Type 1. And it's not like you're totally healthy either... there's a lot of drugs to be taken and surgeries and so far diabetes still comes back. No amount of slimy okra water, cinnamon, or weight loss will do anything to cure diabetes.

I ate a lot of sugar as a kid and it caused my diabetes.
No! Actually, it was more likely that a virus like the flu or a cold triggered my body to attach my insulin producing cells. It was just a fluke and it doesn't run in my family... so there's no genetic link either.

Someone can "catch" diabetes.
Not at all! Us diabetics get sick of this and tend to get bitter and mess with people. But, no. In elementary school, a lot of kids and teachers thought that if they got near me they would catch "diabetus". I only had a few friends back then that had some common sense.

You can't eat that!
Yes, I can eat that. Even sweets! I can have what I want to a degree. There are some things that I refrain from eating because it messes with my blood sugars no matter what I do. But it's not like I will die if I eat a piece of candy. I actually have a purse full of candy for low blood sugars. The only things I really need to worry about is my weight and my cholesterol levels with the calorie and carb heavy things and if I eat a lot of carbs, I have to do more insulin, which insulin makes me gain weight.

So you have the bad kind?
There is no good or bad kind of diabetes. Diabetes is diabetes. Yeah, there are a lot of differences between the types, but no ones disease is worse than another. The disease is different for everyone.
You don’t look diabetic, you’re too skinny to be diabetic, oh honey… you’re not fat though.
This is the most common that I hear. Diabetes is not always caused by being overweight, mostly Type 1. And I had no idea there was a "look" to diabetes. Am I supposed to look sick or something? This one right here is my button. I will rant.

You can’t get pregnant or shouldn’t so the kid doesn’t get it.
A lot of women with T1D get pregnant, have a healthy and full term pregnancy, and end up with a very healthy baby. It all requires good control and everything a normal woman would get during pregnancy. I found some information about it at http://www.joslin.org/info/genetics_and_diabetes.html.

[The risk for a child of a parent with type 1 diabetes is lower if it is the mother — rather than the father — who has diabetes. "If the father has it, the risk is about 1 in 10 (10 percent) that his child will develop type 1 diabetes — the same as the risk to a sibling of an affected child," Dr. Warram says. On the other hand, if the mother has type 1 diabetes and is age 25 or younger when the child is born, the risk is reduced to 1 in 25 (4 percent) and if the mother is over age 25, the risk drops to 1 in 100 — virtually the same as the average American.If one of the parents developed type 1 diabetes before age 11, their child's risk of developing type 1 diabetes is somewhat higher than these figures and lower if the parent was diagnosed after their 11th birthday.]

People who are in insulin are unsafe drivers.
People are not unsafe drivers just because they are diabetic or just because they are on insulin. They could end up not practicing safe driving because they are UNCONTROLLED and have diabetic complications like lowered cognitive function and eyesight gets blurry.

Diabetics can't get tattoos or piercings.
I have 3 tattoos and 3 piercings on each ear plus I've had my eyebrow pierced. I took my eyebrow out because I didn't like it anymore. Nothing ever got infected. If someones blood sugars are not in control at all, I would suggest not getting one due to slower healing. It is also up to your artist if they are willing to tattoo or pierce a diabetic! Mine is awesome.

You're a druggie!
I've heard that diabetics are more likely to do drugs since we have access to syringes. This may or may not be true. I know there is a higher incidence of diabetics doing drugs due to depression of having diabetes. Depression rates are much higher in diabetics than non-diabetics. I'm not sure of the statistics of that, but I've read it before. But do not assume someone is doing drugs if they have a syringe with them! I had a few issues with people thinking I had drugs because I had a syringe fall out of my backpack or purse.

Only old people will get it.
Nope, I was diagnosed with T1 at 9 years old. Anyone at any age can develop diabetes. At older ages, T2 is more likely than T1.

Sugar substitutes give you diabetes.
The artificial sweeteners are under a lot of scrutiny recently. It seems everyone wants to blame aspartame and other sweeteners for everything. But it is not a direct trigger for diabetes.

November 12

So, this the only post so far that I wasn’t sure of how to write. I do not know much about blood or how a blood sugar meter works and I couldn’t find much information online. So I will post what I found and give a few fun facts. This will be a short post!

First, this picture is my finger with my own drop of blood. This is about how much blood that is needed to do a blood sugar a test. I put the blood on the tip if my test strip and it sucks it into the meter. The meter then waits about 5 seconds and gives me a number. This is what I use as my blood sugar level and correct that number using insulin if needed. 

So, I couldn’t find much about how my meter works. I may have to do more research or figure out a different way to search for it. But I found this from http://engineering.mit.edu/ask/how-do-glucometers-work:

“Current glucometers use test strips containing glucose oxidase, an enzyme that reacts to glucose in the blood droplet, and an interface to an electrode inside the meter,” explains Michael Strano, the Charles and Hilda Roddey Associate Professor of Chemical Engineering at MIT. “When the strip is inserted into the meter, the flux of the glucose reaction generates an electrical signal,” he says. “The glucometer is calibrated so the number appearing in its digital readout corresponds to the strength of the electrical current: The more glucose in the sample, the higher the number.”

I’m not really sure how to simplify what he said. If this confuses you a lot and you still want to know, I can try to simplify! But I may end up confusing you all more.

There are two ways to measure blood glucose. Here in America, milligrams per deciliter (mg/dl) is used. Pretty much the rest of the world uses millimoles per liter (mmol/L). There is a little math required to convert from one to the other. There are websites online that will do this easily. But the math is 1 mmol/L = 18 mg/dl.  So when I say I’m at 125, a good blood sugar for me, it would be 6.9 mmol/L. I took my blood sugar of 125 and divided it by 18 to get mmol/L. In the diabetes support groups on facebook that I frequent, there is a mixture of mmol/L and mg/dl. We have learned pretty quickly to convert so that we don’t panic that someone is at 6.9 mg/dl since that’s what we are used to here in America when they are in Europe or somewhere else and use mmol/L.

That’s about it for diabetes related blood information besides the blood tests needed to watch while dealing with diabetes. But that will be in a different post!

Here are some fun facts about blood!

There are about 15 drops (about the size in the picture) in 1 ml. So during the day, I test my blood sugar 8 times a day on average. I bleed out about .5 ml a day. Which is not much at all! The human body holds about 6 liters on average (actual is based on hydration status and body weight). So a 150 lb person will have about 6,000 ml of blood in circulation.

Red blood cells (that carry oxygen, glucose, and other things in the blood) last around 120 days before they die and get recycled. This is why the 3 month average test (HbA1c : hemoglobin A1C) test is used to check overall control of diabetes. I’ll talk about about HbA1c in a different post!

And just so you all know. A diabetic who pricks their finger and sees blood daily can still be squeamish about blood! I will not watch my blood get drawn and if I cut myself I turn into a 3 year old girl and Jeff has to take care of me. 

You can see in the picture all of the marks from all of the blood sugar tests I do! This is key in managing my diabetes!

I got my information from:

http://www.sciencekids.co.nz/sciencefacts/humanbody/blood.html

http://en.wikipedia.org/wiki/Blood_sugar

http://engineering.mit.edu/ask/how-do-glucometers-work

November 11

I wanted to post about how to deal with a diabetic emergency.
The picture is of a Glucagon Kit. This is to fix a severe low blood sugar. My kit is very very old and actually found it is still close to $100 to get WITH insurance. So I'm still stuck with this old one!
The glucagon kit is the hormone glucagon, which triggers your body to release stored glucose from your body, in powder form and water to dissolve it in. It is pre-measured so you give the whole syringe to someone who is passed out from a low blood sugar.

If any of you have seen the movie Panic Room, one of the intruders has to give the girl this so prevent her from passing out. There were a lot of inaccuracies in that movie though.

If a diabetic is alone with no one to help them, they could give this if their blood sugar is getting too low and they feel they will not be able to eat any glucose or feel they will pass out quickly. It should be given if a diabetic has passed out from a low blood sugar since someone who is passed out may choke on something you put in their mouth.

If someone has used the glucagon kit, they need to call 911 and get an ambulance. Even if they've gotten their blood sugars back up, they will have erratic blood sugars for a while and may need a medical professional there to get control back.

So if you are with a diabetic and they are having a low blood sugar episode you should follow these steps:
1. If they are conscious, get them a snack. Try to go for their glucose tablets or gel if they have them, juice, candy, or even a regular soda.
2. If they are passing out or have already passed out, call 911 immediately and get them somewhere safe until help arrives. Remember to tell them that the person is a diabetic and which type they are.
3. Do a blood sugar test to make sure they are actually low. (Diabetics can still have other medical conditions!) Low is below 70 mg/dl but that number may not cause them to pass out. Like I have said in an earlier post, I've been down to 35 without passing out. It depends on the person.
4. If they have the glucagon kit, you need to follow the directions on the kit.

The steps in using the glucagon kit are:
1. Remove the cap on the vial and wipe the top of the vial with an alcohol swab if it's available.
2. Remove needle cap and inject all of the liquid into the vial of powder. Remove needle.
3. Swirl contents of vial until powder is completely dissolved.
4. Using the syringe, pull out the contents of the vial into the syringe. Adults need the whole syringe where children who weigh less than 45 lbs need only half of the syringe.
5. Clean injection site if you can and inject into the loose tissue of the butt, arm or thigh. Remove needle and put some pressure with a finger over the injection site for a few seconds so that nothing leaks out.

Once emergency services arrive, they will want to know what you have given and a blood sugar if you did one on them.

Don't be afraid to give a diabetic this shot! If they have a severe low blood sugar, this could save their life.

Do not give them insulin if their blood sugar is low, this could easily kill them! Insulin brings blood sugar down. And yes, I do need to mention this because that is one big misunderstanding of non-diabetics that a low blood sugar requires insulin.

I have never had to use one of these and actually had to look at the instructions! I've never had a severe low blood sugar enough to pass out or need a glucagon injection. I hope I never have to either!

November 10

Today I had my Endocrinologist appointment.

Endocrine System=hormones.
An Endocrinologist is a specialist who specifically watches over the endocrine disorders like Diabetes and thyroid disease.

I've been seeing an Endocrinologist since I was diagnosed. First was Dr. Kappy. Then Dr. Chase. My adult Endo then was Dr. Michels. And now the Barbara Davis Center in Denver does not take my insurance, so I decided I wanted to see an endo down here in town. So this is my new Endocrinologist... which he's a nurse practitioner working under an endocrinologist in town. This is the guy who got my pump stuff rolling and is now helping me get my diabetes and thyroid disease under control. 

He and a lady from Animas are working with me to fine tune my pump setting so I can get the most out of this type of insulin therapy. 

He is also one of the few doctors I have that I can make laugh and can joke around with.
I don't feel like I need to be serious with diabetes AT ALL TIMES like some are. I don't have the energy to always be serious. I'm serious about my care... but I do need to laugh some also!

So, he adjusted my basal doses based on my blood sugars and got my lab results back. Kidneys are good, liver is good, I need to up my thyroid medication, and I have lost weight due to not getting as much insulin as I was off the pump! 

I'll go over lab results and tests in a later post!

I just wanted to introduce Luis Perez, NP!

November 9

Here is my bottle of glucose tablets!

And that’s pretty much all they are… little chewable chalky sugar tablets. They don’t taste as bad as they sound. I like them. I keep the big bottle in my purse with me everywhere I go. I use these to bring my blood sugar back up quickly when I end up going low. 

There are so many different glucose products on the market! Glucose tabs come in sooo many flavors but I like grape and fruit punch the most. Any large grocery store or pharmacy has these. There is also little gel tubes that I like to use, but they’re more for emergencies. There are also drinks, but I’ve never tried them. 

When my blood sugar goes low, I will eat glucose tablets (fast acting carbs to bring my blood sugar up), and then some juice or milk depending on how low I am. I like milk because I don’t have to eat anything else to keep my blood sugars up since milk has protein in it. If I have juice and I’m still low enough, I’ll eat a granola bar or something with peanut butter on it so I can get the protein to stabilize my blood sugars. 

Having a low blood sugar isn’t a good thing. It’s not just snack time. It can be dangerous if I go too low. I can easily pass out, go into a coma and die if I don’t bring my blood sugars back up. I have been down to 35 without passing out. How low someone can go is different for everyone and it’s not something you want to find out either! The day I went down that low, I had a hard time staying awake. Finally Dad got me up to do a blood sugar test since I don’t normally sleep like that on the couch. That was one of the very few times I got scared. I’ve never had a blood sugar emergency where we had to call for an ambulance or go to the Emergency room! I hope I never have one either. 

A “low” for me personally is below 75 mg/dl. A normal blood sugar is between 80 and 150 for me.

So, I did want to give you all the symptoms of a low blood sugar. This is good to look out for if you’re out somewhere and someone is acting like this. You can check if they’re diabetic and possible save their life if they’ve gone too low to know what’s going on. 

Symptoms of a low blood sugar (in general) are:

Sweating

Shakiness

Weakness

Nervousness

Hunger

Nausea

Dizziness

Headache

Fast heartbeat

Confusion

Irritability

Slurred Speech

Muscle twitching or weakness

Personality Changes (I turn into a ball of irrational tears and anger)

If there is a severe low blood sugar, there can be seizures, coma, stroke and eventually death if not corrected. For these emergencies, there is a glucose shot called a glucagon kit. I’ll do a post on that later on.

Someone with a very low blood sugar can act drunk! If you know a diabetic and they’re acting drunk, make sure they’re just drunk… not low.