Letter To A Diabetic

Or I Understand What You're Going Through

Tag: American Diabetes Association

A Normal Life…

I recently read an article in which a Diabetic recalled being told at the time he was diagnosed that he would be able to “live a normal life.”

A normal life…

I do normal things. I go to work five days each week. I take showers and crochet. I walk my dogs. I chat with my sister on Facebook. But other than diabetes management being something that I have to do every day, it is not normal. Normal isn’t always normal just because it becomes regular or comfortable or predictable. There is nothing “normal” about a diabetic life. It will never feel normal to go to bed each night knowing that your blood glucose could dump in your sleep, send you into a diabetic coma, and never let you wake again. There is nothing normal about having to bleed, inject, log, and measure every day. But we all do it. There is nothing normal about having to run home on a break to inject a new sensor for the week or having to set aside 10-15% of my income to cover the cost of diabetes copays.

So, let’s stop trying to lead normal lives. Let’s embrace the difference. Let’s allow everyone to see how incredibly amazing we all are just for being able to not die from this disease every day. We are Diabetics. We are not normal. We are unbelievably strong. We can complete complicated mathematical formulas in seconds just to eat a meal. We are all endocrinologists, dietitians, counselors, and diabetes experts. We know how to adjust dosages, how to recognize and treat hypo- and hyperglycemia, and how to pick ourselves up off our rear-ends and run back out into the world without anyone even noticing that we nearly just died because our blood sugar dropped 100 points in 20 minutes and we were dizzy and swaying and so close to passing out that we considered in those moments the frailty of our existence.

We are not normal. We are the epitome of amazing.

Love and light.


How To Test Basal Insulin Levels

For five days in a row, I woke up with 200+ readings. Okay, a pattern. I get it. So back to basal testing to make the necessary adjustments to my pump settings. So I tested every two hours last night and ran low 100’s, then get up this morning with a 71. If anything, that indicates my basal insulin needs to be reduced a few hours before waking. Zoinks! So I’ll see what I wake up to tomorrow and retest if needed. But it brings up a good point: do you know how to test your basal insulin levels?

For pump users especially, because we can adjust our settings, this is a very important piece of info. Even if you are on MDI therapy, it is still a must-have piece of info. How it works:

Eat your normal dinner at least four hours before heading to bed. Then don’t eat again until the next day. No food! Not even a skittle. 🙂

Set an alarm to go off every two hours. Something annoying that can’t be ignored is good.

Test just before going to bed and write down your bgl. If it anywhere between 100 and 250, don’t do anything to correct.

Every two hours, when that super annoying alarm goes off, test and record your bgl.

If the numbers stay within a thirty point range, you’re great. Don’t make any changes.

If they drop or increase more than 30 points, talk to your doc about adjusting your basal levels.

My doc has me increase or decrease in 10% increments as needed to make adjustment. Example: I have my basal insulin set at .5 units/hour. A 10% decrease to lessen the amount of basal insulin (if my numbers drop more than 30 points between any two testings) would put me at .45 units/hour. The basal adjustment has to be set for somewhere between 1 and 2 hours prior to the change in bg readings to allow time for the adjustment to take place.

BUT REMEMBER! If this whole basal testing thing is new to you (or even if it isn’t), talk to your doc!!! before making changes to your regimen.

Happy Valentine’s Day (Yes, Diabetics Can Celebrate Too)!

i love youJust because it’s a holiday doesn’t mean we have to submit ourselves to feast or famine. We can still ride the blood glucose middle line and avoid both the crazy highs from indulging in too many of those sweets, and the frustration of feeling like we can’t eat anything at all. There’s a word for this. It’s called: moderation. And planning. Yeah, they’re both the word for it. Plan ahead, use moderation, and remember that, like always, those little chalky, heart shaped glucose chunks are NOT worth a 297 reading on the ol’ glucometer. And neither are all those delicious cupcakes and cookies. Sorry guys, but our feet and eyes are far more important. 😉 Besides, Valentine’s Day is all about love and that, my friends, is always carb free.

Take a look at this WebMD article for a little more on the topic.

About 3 Words Blog Event

I came across this blog event, 20130905: day 248, and I thought to myself that surely I could keep to my mission of providing helpful info for diabetics and still follow the event rules. The words in bold are my “3 words”.  Check out the blog before you keep reading so you know what’s going on. Here we go.


Cut off from the rest of the world in an invisible bubble called diabetes, I perused the internet, newspapers, text books, and medical journals. There had to be a cure. There needed to be a cure. I searched for news of a cure but found none. I grew desperate and panicky. I was shocked, angry, indignant, and finally, burned out. I had no choice but to resign myself to the permanence of diabetes. I cried. I screamed. From what I had read, diabetes is associated with a notably shorter life expectancy. I was afraid.

After what seemed an eternity, my eyes dried. I stood up and looked toward the skies. I screamed at the heavens, “This won’t destroy me! I WILL survive this!” And I do. I do everyday. Diabetes hasn’t destroyed me. It hasn’t done much other than slow me down a bit and taught me to take very special care of my body and mind. What I thought was a curse has turned out to be a great blessing in so many ways. Sure, I would rid myself of it if I could. But I cannot. And so, I embrace it. I accept it as a part of who I am and use this blessed cursed as a means to help others. I found empowerment and I want you to have it, too.




Diabetes and Sick Days

As I sit here with a cough that won’t quit and a low grade fever (yes, I’m going to the doc…again), it occurs to me that perhaps this is a good time to share some info on what happens and what to do when a Diabetic gets sick. The American Diabetes Association, as usual, is a great resource for this. So, rather than reproduce their article here, please visit it there.

Diabetes Resources on Facebook

With so many people using facebook on a daily (and sometimes hourly) basis, I though it would be a good idea to list a few good FB pages that have info for Diabetics. Here they are:

Letter To A Diabetic (yup, this one is mine – please like and share)

American Diabetes Association

Diabetic Connect

Diabetes – Sweet & Simple

If you have found others that you think would make a good addition to the list, please include the link in the comment section below. 







Common Diabetes Terms Defined

English: Diagram shows insulin release from th...

English: Diagram shows insulin release from the Pancreas and how this lowers blood sugar leves. (Photo credit: Wikipedia)

Today we’re covering some basic terms. Many of these terms, terms which EVERY diabetic should know, were never explained to me. And with 90% of all Diabetics being Type 2, and most diabetes education classes be designed for Type 1, there’s a good chance that if you have diabetes, these haven’t been explained to you either. Let’s get started:

Bolus: A bolus is the dose of insulin give just prior to a meal (usually 15-20 minutes) to cover the carb count within the meal.

Basal: Basal refers to the “background” insulin. Basal insulin is a long-acting insulin that covers the insulin necessary to cover the glucose that your body naturally produces and uses throughout the day.

A1C: A test that measures average blood glucose levels for the previous three months.

Insulin/Bolus on Board (IOB, BOB): IOB or BOB refers to how much active insulin is in your system after a bolus. How long fast-acting insulin lasts in each person’s body varies and you must work with your endo and diabetes educator to determine IOB as well as correction factors and insulin to carb ratios.

Correction Factor: The amount of fast-acting insulin that covers a set decrease in BGL. For example, 1 unit of fast-acting insulin will bring my BGL down 50 points. Again, cover this with your doctor.

Insulin to Carb Ratio (I:C): This is the how many grams of carbs by covered by 1 unit of insulin.

Blood Glucose Value (BGL): The amount of glucose in a set amount of blood. It is measured in mg/dL.

Diabetic Ketoacidosis (DKA): An accumulation of ketones in the blood. Meters are available to check for ketones. This is a no-joke condition. If it is not treated, it can be fatal.

Hypoglycemia: Low blood sugar under 70 mg/dL.

Hyperglycemia: High blood sugar. Goals are different for everyone but as a rule, BGL levels should remain between 70 mg/dL and 130 mg/dL. Don’t be discouraged if your numbers run higher than this because they will. Set range limits with your endo and correct as needed.

Insulin Resistance: An inability to utilize available insulin in the body.

Lancet: A needle designed to fit into lancing device.

Lancing device: A spring loaded mechanism which contains a replaceable lancet that allows an easy draw of blood for use with a glucometer.

mg/dL: milligrams over deciliter, the measurement used to read the amount of glucose in a sample of blood.

For more terms, check out the American Diabetes Association glossary of common terms.


I’m Diabetic! What the Hell Can I Eat?!?!

Me and my pups.

Me and my pups.

I remember the days following my diagnosis. I sat on my living room floor, pouring over articles and books and websites and pamphlets trying to figure out what in the world I could eat that would be safe. It was so frustrating to be hungry with a fridge and pantry full of food but feel like EVERYTHING was off limits. I found advice like “celery and peanut butter is a safe and healthy snack”. Okay? How much peanut butter? How many celery stalks, damn it?!

The answer to that question is:

two stalks celery (2 grams of carbs)

1 serving of peanut butter (2 leveled tablespoons – which is usually 6-8 grams of carbs)

Ta-da! A hydrating, protein-containing, tasty snack with 8-10 grams of carbs. So, go get that if you’re starving to death (no pun intended).

The first thing to remember is that you can eat. There is plenty you can eat. Personally, I am unable to consume wheat, dairy, pre-made frozen foods, anything fried, alcohol, food colorings, or red meat without catastrophic gastronomic consequences. And I don’t feel like I am missing out. Well…okay, an eclair would be nice once in a while but am I really missing out with that one?

So here are a few things I wish someone would have told me up front that I had to figure out on my own when it comes to diet & diabetes:

-15 grams of carbs is considered one serving of carbs

-It is recommended that each meal be between 45 and 60 grams of carbs

-Consistent carb counts meal to meal (always having about the same amount of carbs at meals) makes it easier to maintain stable blood sugar

-As a Type 1/LADA/1.5, regular exercise and insulin therapy is a sure-fire way to manage your diabetes

-As a Type 2, exercise is your best medicine. And I mean exercise, man. Regular, consistent cardio will do more good for you than I can possibly express in a blog post. If you’re BGL is high, start runnin’!

-Always know your insulin-on-board (how much active bolus insulin is in your system) and sharpen your math skills!

Some helpful websites and info:

American Diabetes Association

Diabetes Basics

Think Like A Pancreas by Gary Scheiner

Common Food Carb Count – as a new diabetic you’ll have to do some experimenting. I have to use a total carb count vs. a net carb carb whereas other are able to use a net carb count

Did You Say Net Carbs?

Okay, okay. I know you’re head probably feels like it’s about to explode and you may just want to curl up into the fetal position and die right now but you can do this. Millions of people are living with diabetes every day. Millions of people carrying on and taking this disease with them. Educate yourself! Empower yourself! And remember that diabetes never takes a day off, so you can’t either. Stay on it. Do your best. And if you need help – ask!

The Diabetes Tab

5 million more people living with diabetes

By Jacque Wilson and Sophia Dengo, CNN
updated 3:59 PM EST, Wed March 6, 2013


(CNN) — Dr. John Anderson isn’t surprised by the rapidly growing cost of diabetes in America. New research from the American Diabetes Association shows the total cost of diabetes was $245 billion in 2012 — a 41% increase from the $174 billion spent in 2007.

“I know of no other disease that’s increasing at (about) 8% per year,” said Anderson, president of medicine and science for the American Diabetes Association. “That to me isn’t surprising, it’s troubling.”

What is surprising, Anderson said, is that the increased price isn’t due to rising health care costs. It’s due instead to the “sheer number” of Americans who have diabetes.

“Medication costs have gone up, but overall they haven’t gone up significantly,” said Matt Petersen, the American Diabetes Association’s managing director of medical information and professional engagement. “We have more people with diagnosed diabetes. A lot more of them. That’s the burden we face.”

An estimated 22.3 million people were living with type 1 or type 2 diabetes in 2012, according to the new report, up from 17.5 million in 2007.

The growing population is due to several factors, Petersen said. Diabetes prevalence increases with age, so the aging baby boomer population is attributing to rising costs. The obesity epidemic also plays a role. Being overweight or obese is a risk factor for type 2 diabetes, according to the Centers for Disease Control and Prevention.

Unfortunately, not all risk factors can be controlled, Petersen said. African-Americans, American Indians and Asian-Americans are all at a greater risk of developing diabetes than Caucasians, leading researchers to believe there is a genetic link.\

“People fundamentally can’t do anything about susceptibility,” he said.

Diabetes can cause serious health problems such as heart disease, kidney failure and blindness, according to the CDC. If it’s not kept under control, diabetes also can cause infections that may lead to leg or foot amputations.

Approximately 246,000 deaths were attributed to diabetes in 2012, according to the American Diabetes Association’s report.

There is good news, Petersen said. Although our diabetes costs are growing, we’re spending the dollars effectively.

“We’re picking it up earlier and caring for it better,” he said. “We’re getting the right value for our money.”

Anderson and the association hope to continue to spread awareness about diabetes. Addressing the disease on the front end, before it leads to serious complications, will help lower overall costs, he said.

“That’s a great way of preventing the growth of this epidemic.”

Letter to a Diabetic (Or I Understand What You’re Going Though)

Dear Diabetic,

I want you know that you’re not alone. I want you to know that there are a lot of other diabetics out there that get what you’re going through. They feel what you feel. They understand. I understand. And I’m writing this in the hopes that someone will see it and get some comfort from it, and know that they are not alone.

My name is Melissa Ratner. I am 32 years old. Last summer I discovered that I have adult onset Type I Diabetes. My pancreas decided to strike. Every day I have to check my blood sugar a minimum of 7 times. I have to inject myself with insulin a minimum of 4 times for a minimum of 11 needles per day in my fingers and injections sites. I’m covered in bruises and track marks at my injection sites. I have to count every carb. I have to record every number, injection, and reaction. I live my life 2 hours at a time (at most). I am aware of the complications and increased health risks associated with Diabetes. I went through fear, anger, depression, empowerment, confusion, and finally gave in to feeling completely overwhelmed. I broke down. I couldn’t function. I couldn’t feel anything but the anger and the injustice and the frustration. I hated people for eating. I hated people for not having to hurt themselves to have a meal. I hated people for not having a diseased body. I understand what it means to live with an invisible illness that few understand or take seriously. I understand that my life expectancy has shrunk, and that my quality of life is severely challenged. Everything is different now.

And here’s the most noteworthy thing I can say about my life right now. I can laugh. I can smile. And I think that there are some jokes about diabetes that are so funny I almost pee my pants. Some people think it’s poor taste to joke about diabetes but I need to laugh. Some days that’s all I got.

Look, diabetes is a disgusting, progressive, incurable disease that makes every day a pain in the ass and bitch slaps your sense of security. Even if you’re not afraid of dying, sometimes a diabetic thinks of the inevitable outcome. And why wouldn’t they? Diabetes is the leading cause of kidney failure, non-traumatic lower limb amputations, and new cases of blindness among adults in the United States. Diabetes is a major cause of heart disease and stroke. Diabetes is the seventh leading cause of death in the United States. I’m taking these stats straight from the 2011 National Diabetes Fact Sheet which you can find a link to on the American Diabetes Association website. 

But some good things have come from it. I’ve dropped from a size 16 to a size 8. I can run without getting winded. The new diet has gotten rid of 95% of my GI issues. All the exercise I have to do has helped reduce my menstrual cramps dramatically, and sex? Waaayyyy easier (and a lot more fun). Fat and fatigued…not sexy.

Diabetes doesn’t take a day off and neither can you. So you have diabetes. You can still live. You can still love. You can still laugh. And you can still play. It’s NOT a death sentence. It’s a change. It’s a big, scary change…that you can handle. You can. Really. Take control of your diabetes management. And research, research, research. Education is your best weapon.

A few fun facts before I close. I want to drive home that you’re not alone. At the time that I am writing this, there are 313,601,744 people in the United States and there are 25,800,000 children and adults in the US with Diabetes. That’s more than 8% of the population. A lot of good people are surviving and thriving with this disease every minute of every day.

Here’s the thing. Life is always uncertain. It’s not usually easy. And with diabetes, it’s definitely going to be a challenge. But like my brother always says about life and how to get through it…buy a fuckin’ helmet. Cause it’s gonna be one hell of a glorious ride.

With love and understanding,

Just Another Diabetic


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