Goodbye to all my fellow people with diabetes. This is my farewell blog. I have trully enjoyed sharing information and
reading your responses. My parting suggestions are don't listen to garbage. Demand that the information you get is not
just a regurgitation of the local news, but true life experience from people that live this life with diabetes 24/7.
Thanks for making me feel that what I had to say mattered. Sincerely, Cindy Tucker BSN, RN, CDE and person
with type 1 diabetes.
Note: The contents of this blog are for informational purposes only and should not be construed as medical advice or substitute for professional care. For medical emergencies, dial 911!
Update on Glucose Monitoring Technology
A comment by Alexis generated my curiosity also about what is on the horizon for minimally invasive or better yet,
non-invasive blood glucose monitoring. There are a few really promising things that I discovered after some searching.
Some of the main drawbacks with the earlier non-invasive monitors include inaccuracy, lack of real-time results, cost
and the large size of the device. Many of us with diabetes heard of, and got quite excited about, the GlucoWatch.
GlucoWatch was developed by a company called Cygnus which was recently purchased by Animas Corporation.
The GlucoWatch is currently available for patients with a healthcare provider. Unfortunately, for the few advantages the watch has, it has way more disadvantages, including the need to still do fingersticks to check for accuracy and to calibrate it. There are some interesting glucose sensors that are implanted or inserted just under the skin that actually give real-time results. What I thought was very interesting was the development of devices that analyze the fluid of the eye and give up-to-the-minute glucose results. If you can stand reading medical jargon, you can find out the latest and greatest at this web site www.diabetesnet.com. Click on technology and then future monitoring in the drop down menu.
The GlucoWatch is currently available for patients with a healthcare provider. Unfortunately, for the few advantages the watch has, it has way more disadvantages, including the need to still do fingersticks to check for accuracy and to calibrate it. There are some interesting glucose sensors that are implanted or inserted just under the skin that actually give real-time results. What I thought was very interesting was the development of devices that analyze the fluid of the eye and give up-to-the-minute glucose results. If you can stand reading medical jargon, you can find out the latest and greatest at this web site www.diabetesnet.com. Click on technology and then future monitoring in the drop down menu.
More info: Traveling with diabetes
The entry I posted on traveling with
diabetes was--as a comment by Edie pointed out--missing some hook-up information to get travel specifics. Thanks Edie
for bringing this to my attention because there is a way to get all the details you will need to travel worry free from
the American Diabetes Association (ADA). Try logging on to www.diabetes.org and
then in the search box type “travel with diabetes." It will pull up a list of things people need to know
about traveling with diabetes supplies. They also have a link to the Transportation Security Administration (TSA) that
gives pretty much the same information, only not quite as easy to read as the ADA. I apologize for the lack of info. I
am still new to blogging and putting all my thoughts on paper (so to speak!), and since I am confessing my
inadequacies, I would like to encourage anyone to please make suggestions about my blogs like Edie did, so I am
including information that is not just anecdotal, but really helpful too! It is interesting that when I read the travel
guidelines I was actually thankful that none of the security screeners got that nit picky. If they had my trip to Dallas
would never had happened!
New diabetes info-- are you in the know?
I have to blog about the fact that many, many
of you out there with diabetes are totally ignorant to what is happening in the world with standards of care and new
medications to treat diabetes. Aren't you frustrated to learn of some new treatment or strategy for managing diabetes
by chance? Especially if you have had diabetes for a while and haven't been clued in to the new stuff out
there.
Honestly, if I was not privy to the information because I'm an educator, I'd be pissed off by the way information is disseminated! That is because I have diabetes and to a certain extent, am in the same boat as my fellow "friends with diabetes." The only reason I say "to a certain extent" is because I have the privilege to meet with drug representatives and read things designated for healthcare professionals that basically keep me in the loop. I do however, try my hardest to spread the word about new drugs and new treatment strategies so my compadres are "in the loop;" also, and not looking at my blogs going "what the hell is she talking about?" In that same vein, I would like to encourage people with diabetes that look for information on this blog site to please, please and please again, comment and put forth ideas and suggestions, as well as questions, and we can all try to answer them.
Traveling with diabetes
I was reading a post by Paul Chaney
that had to do with traveling and carrying diabetes supplies. I thought that I would address this issue because I
travel pretty frequently, and as a matter of fact, I actually flew to Dallas this past weekend. As far as wearing a
pump goes, I've never had any problem. I actually have more problems because I've got a pacemaker. I am always
physically searched when I tell security that I have a pacemaker. My pacemaker never made its presence known until I
went through the security thing at the airport and it caused my pacemaker to revert to some weird mode and it started
shocking me! I was in Chicago and I live in Maryland so naturally I was scared to death. When I got home the doctor
suggested that the airport screening thing deactivated my pacemaker. Obviously, I changed my boarding habits and requested to be physically checked for dangerous stuff. On the other hand, my habit is to tell the airport screener that I have an insulin pump and they have always thanked me for pointing it out and that was it. I used to carry a note from my doctor saying I have diabetes controlled by an insulin pump, check my blood sugar and possibly use a syringe to inject medication. This is definitely the best thing to do. Unfortunately, I could not find my note from the doctor and have made it through airport security without it while I hold my breath. The advisory from the American Diabetes Association (ADA) is to have a note describing your condition and have everything labeled. I recommend checking out the ADA website for current guidelines for travelers. The screeners that I've encountered are just trying to do their job. They don't want a fight. If you talk to them like human beings and appreciate the job they have to do, I really don't think that you will have a problem. But you never know when you might encounter a screener having "a bad day."
New insulin coming out
Has anyone heard about the new insulin analog Apidra yet? It is the newest offering in the insulin army of
fast acting analogs. An analog for those that aren't quite sure is insulin that is designed to mimic the natural
insulin produced by the pancreas. The most common ones that people know are Humalog and Novolog. Apidra is a product of
Sanofi-Aventis and is already in some endocrinologist's offices, but not offered on the market for us regular folk just
yet. At this point there does not seem to be an advantage to Apidra over the other analogs, except that it offers one
more choice, and choice is ALWAYS good. It is indicated for the insulin pump. "Indicated" simply means that
it is approved by the FDA for use in a certain way. Now do we care about that? Well the government cares, but many,
many pump users have used Humalog in their insulin pumps without FDA approval. Still I imagine for those prescribing,
the idea that certain insulin's are actually "approved" means the difference between prescribing and not
prescribing. Keep an eye out for this one only because it is something new and might be worth trying. Just an FYI, it
is made by the makers of Lantus. Lantus is in a pen device and Apidra will be too. This could be an easy transition if
you already use the Lantus pen. Just think, no learning a new device, but pay attention to the packaging. Lantus and
Apidra look very similar and because of that, there could be some confusion about what a person is taking...
Killer neglect
I received Amanda's link to a MSNBC
Dateline report on the case of a mother being charged in the death of her young daughter who had diabetes. The charges
stemmed from the fact that the child died from a high blood sugar even though the mother supposedly knew how to care
for her daughter's diabetes. First, I have to say that as shocking as this is, I'm surprised that there aren't many
more of these stories. People in healthcare are often in the position to witness horrible mismanagement of chronic
disease in children, sometimes because of ignorance and also because of abuse. There is a difference. Not to make any
excuses or assumptions of guilt, but I'd like to see documentation of this mom's teaching and ask the question of those
around her "Why didn't anyone see this coming?" It would make more sense to me that this child died of low
blood sugar which happens suddenly, though blood sugar is usually seen in advance of it causing problems--IF blood
sugar is being monitored. Tragically, a child is dead who shouldn't be and it looks like we won't know what happened
until this mother goes on trial.
How do you cure a hypo?
I have had some interesting responses to my post about hypoglycemia, and they have sparked a thought about how people
take care of low blood sugar. For me, juice is the remedy of choice most of the time. I don’t care if it gets warm
if I leave it by my bed at night, although I usually just throw it out in the morning. It is very important to have a
plan. Anyone who has had a severe low or an experience like Jon, Bob or me knows (at least now) that a plan is crucial
to survival. It is also very important for friends and family and probably even co-workers to know you have diabetes
and, if you are acting weird, how to help. One of the easiest things to have on hand is a bottle of glucose
tablets.They work fast, and they don’t melt or go bad. They also raise your blood sugar without causing it to go
through the roof. Most people need to eat 3-4 of these humongous tablets to fix a low, but they really only raise your blood sugar about 45 mg/dl and therefore don’t cause you to go so high you then have to worry about fixing that. These are ideas for people who are still able to eat or drink. For those of you on insulin alone, especially people with type 1 diabetes, you absolutely must have glycogen. It is a medication that is injected into someone who is unconscious, and it stimulates the liver (which stores sugar) to release it immediately, raising the blood sugar of the person receiving it. This is extreme emergency stuff, but it truly is a lifesaver. Talk to your health care team about this if you don’t have it, because it is a must-have item in the arsenal of “things to help you stay alive.”
Reporting from the AACE front
This is my first report from
the front line of people deciding the best “evidence based” medical ways to take care of people with
diabetes that are in the hospital. It is Day One of the American Association of Clinical Endocrinologists (AACE)
meeting and the sole purpose is to develop a consensus statement about how patients with diabetes should have their
blood sugar managed in the hospital setting. I spent an entire day inside a hotel with physicians, nurses, dietitians
and even hospital administrators listening to the compelling evidence that controlling blood sugars in hospitalized
patients with diabetes not only saves lives and prevents complications, but protects them from complications long after
they are discharged. What an exciting day! As I said in a previous blog, this is and certainly was today, the Academy
Awards of diabetes medical treatment research presentations. The speakers were passionate about their research findings
and results. At this point in the conference, everyone is simply presenting compelling reasons to do a good job managing
blood sugars when a person with diabetes is in the hospital, so no conclusions have been reached. The wonder of it all
is the process of presenting such incredibly stunning statistics that in the final analysis will benefit everyone with
diabetes. As one of the presenters stated after presenting his results “as far as survival, it is an advantage
now to have diabetes”! I am paraphrasing, but as a person with diabetes I honestly felt that way after hearing
the presentations! P.S. Doctors eat really well at these events!
A little sweet can go a lot sour
I am happily on my way to Washington,
D.C. for the American Association of Clinical Endocrinologists consensus statement meeting Jan. 30-Jan.31, 2006. This
is a meeting where endocrinologists (doctors who specialize in diseases like diabetes) come together and put all
their research findings in a position paper, which is then what other doctors reference when they treat patients. This
year, the conference is focused on hospital medical care for diabetic patients. For those of you who have never
had an inpatient stay for diabetes, you are very lucky. Not only because you’ve not been so sick as to be
admitted to the hospital, but also because you have not been the target of substandard care. The thinking for most of
the healthcare community has been to keep patients with diabetes “a little sweet” (hyperglycemic) because
of the fear of hypoglycemia. Unfortunately, we know now through multiple research studies that tight glucose control in
the hospital is critical to recovery and lessening the chances of complications. This conference is--at least for those
of us working on the issue of better in hospital care for diabetics--like the academy awards of researchers in this
area. I will happily share the results of this conference as I attend the different sessions. My feeling is that people
with diabetes are going to experience much better care in the very near future.Should Everyone Know This?
There have been several different studies reported lately that have to do with altered brain function in the
person with diabetes that has high blood glucose. The latest was reported in the magazine Diabetes Care, which compared
a normal blood glucose level of 81 mg/dl to high blood glucose of 297 mg/dl in a group of individuals. The people in the
study did not know what their blood sugars were. All the participants had to answer questions about their mood and have
assessments of their mental capabilities during each 90 minute period of the normal or the high blood sugar. The
results were very interesting. During the time that the study people had high blood sugars their information
processing, memory and attention were significantly altered. All of them also identified feeling more agitated, having
higher levels of anxiety and what most of us already know-feeling tired. I guess my fear with information like this is
that employers and insurance companies could use this to their advantage. Maybe I am just a cynic!
An Excellent Book
Has anyone out there read anything by Dr. William Polonsky, PhD, CDE? If you haven't I strongly encourage you to
check out his writing. He has been published extensively, served as a behavioral consultant during many research
projects, currently serves as an associate editor of Diabetes Forecast as well as an editorial board member for
Diabetes Care, Diabetes Interview and Diabetes Self-Management. One of his newest projects is the founding of the
Behavioral Diabetes Institute. I could wax poetic on a million more of his accomplishments, but my main point here is
to encourage people to read his book "Diabetes Burnout: What to Do When You Can't Take It Anymore". This is
by far one of the most insightful books ever to deal with the real feelings of people with diabetes. Dr. Polonsky is
not only completely tuned in to the feelings associated with diabetes, he is compassionate, empathetic and humorous
while offering reality based ways to understand and deal with a very frustrating disease. Buy it, borrow it from
a friend or the library, sit back and hopefully you will be singing the praises of the man and his book.
Hypo Scares the **** Out of Me-What About You?
Well it has been a while since I've blogged anything, but that doesn't mean that nothing is happening in the world of
diabetes. Sometimes it just seems that you have to have a break from it. Although that is really impossible, it is
still nice to dream. I've had a few especially trying episodes of hypoglycemia. It is sooo frustrating to try and do
the best you can to keep your blood sugar under control and as a reward you may actually kill yourself! Usually, I am
much more relaxed about keeping my numbers a little bit on the high end, but for some reason I got caught up in the
"keep your blood sugar low or you'll die" frenzy of the holidays and as a result my husband found me
wandering around our house early one morning in a state of total unawareness. After several large glasses of juice
which he forced on me, I finally came back to the land of the living and was able to test my blood sugar and
was 50 mg/dl. Undoubtedly I am very lucky my husband knows the revival drill, or my blogging days would certainly have
come to an abrupt end. Anybody have some stories to tell about low blood sugar? How about some hero stories about the
people that save us in times of sugar distress?Hypo-Do You Know?
I've been thinking of hypoglycemia (low blood sugar),
because I have had a few episodes lately, and it brings to mind the questions my blog readers like "How do those
of you with diabetes know your blood sugar is low? Do you test to find out? Do you only go by symptoms? If it is low,
how do you treat it? As an educator and a person with diabetes, I teach people to pay attention to their body signals
and if they are pretty sure they're low it is safer to treat, rather than wait to test and possibly get into serious
trouble. Of course there are some guidelines. First, know your body signals! How do you feel if you are low? Do you
know the symptoms of a low blood sugar? Classic signs/symptoms of a low blood sugar are:
- An uneasy feeling-like you are agitated, antsy, fidgety
- Shaky
- Sweaty
- Tired
- Confused
- And it just gets worse from there!
What numbers are considered low? Generally a blood sugar of 70 mg/dl or less is considered low. However if you feel bad at 75 or 85, I say treat it. Meters can be off by as much as 20 %, so numbers, along with symptoms are the best way to tell if you are low. If you don't take medication and think you are low, you can take the time to test to be sure. If you take a medicine that can cause a low blood sugar my opinion is don't wait, test. Low blood sugar is a life threatening event (for those taking insulin or a drug that makes you produce insulin) if ignored, whether on purpose or by accident (like when you are low-dah!).
Cinnamon and Diabetes: Good Combo?
Cinnamon is really getting the press these
days in the world of diabetes. The newest issue of Positive Magazine chronicles the wonders of cinnamon and how it is
being reported as an adjunct therapy for diabetes. Interestingly, the endocrinologist in my town is telling his
patients to try it. The recommendation is to take ¼ teaspoon twice a day. That is pretty easy to do since it is
such a versatile spice. At breakfast mix with some Equal or Splenda and sprinkle on toast or add a pinch to your
coffee. It tastes great in applesauce, on oatmeal and well, you all get the picture. If you don’t like the taste
of cinnamon there are capsules that you can take. My understanding is that cinnamon actually potentiates the action of
insulin. It was actually shown to improve insulin resistance, which along with at least two other conditions-high blood
pressure, high triglycerides, increased belly fat or low HDL (high density lipoprotein) cholesterol, commonly referred
to as “metabolic syndrome” which is a precursor to type 2 diabetes. There was a study done in Diabetes
Care, 2003, that showed taking cinnamon decreased fasting blood sugar, decreased LDL (low density lipoprotein)
cholesterol and lowered triglycerides and total cholesterol by as much as 30%! That really is amazing. It got a lot of
press at the time and then kind of faded off. Well it sounds like we need to be raiding the spice cabinet once again.
My curiosity is always piqued when stories like this are reported so once again I ask you guys and gals out there
“have you tried it and does it work”?
