Diabetes Daily: How Covid-19 is Affecting People with Diabetes

Background: Several years ago Diabetes Daily teamed with Thrivable Insights to create the Diabetes Research Panel. In late March 1,300 people with diabetes (48% Type 1 and 52% Type 2) responded to a survey addressing their concerns and fears about the coronavirus and what they were doing to protect themselves.

Here is an infographic sharing the results of this initial study. If you would like to read an excellent interpretation of the results by Maria Muccioli Ph.D, her blogpost at Diabetes Daily is available here. Below the infographic is information from Diabetes Daily about joining the ongoing study.


This is a copy of an email I received from Diabetes Daily. Please join the project to let your voice by heard!

Dear Friends,

Want to help with the COVID-19 pandemic? Your data can make the difference!

We have donated our rapid research platform to help leaders respond to the epidemic.

Fill out this 3-minute survey to join the project:

Join the Study Covid Project

Your anonymous insights on symptoms, social distancing, masks, the economy, and more will be analyzed by a talented group of epidemiologists and public health experts and shared publicly.

Who can participate? 

The project is open to everyone 18+ living in the USA.

How will my data be used?

Your data will only be used for research purposes. You will not receive any marketing messages. All personally identifiable information will be removed prior to the sharing or publishing of any data.

Who is behind the project?

Thrivable, the organization that created Diabetes Daily, has donated its rapid research platform to this project. The project is led by a group of leaders in public health who have important questions about your attitudes and behaviors around COVID-19. You can see the team here.

Can I share this with family and friends?

Yes! Please share far and wide. You can copy and paste this message to share:

Want to help with the COVID-19 pandemic? Your data can make the difference! Join me and sign up for the Study Covid Project at https://www.StudyCovid.org.


The Diabetes Daily Team

Talking Types with Lloyd Mann

I first met Lloyd Mann four or five years ago at a Saturday diabetes meet-up at a local Panera Bread. He was sitting at the end of the table with a big smile, an iPad, and a copy of his book about diabetes. He was discussing the possibility of being tested for MODY because of insulin signaling problems. A resident of South Dakota at that point, Lloyd was in Minnesota visiting family and had previously hooked up with this group through online friend Scott Johnson.

Fast forward a couple of years and Lloyd now lives in the town next to me. We have begun to supplement the every-couple-of-months group meetings with one-on-one lunches at the Panera Bread near his home. Yes, our relationship is built on Lloyd’s love of tomato soup and “Scott Johnson-esque” grilled cheese sandwiches along with endless cups of Diet Pepsi (definitely not Scott-inspired but Panera doesn’t carry Diet Coke).

Lloyd and I are close in age. In diabetes we are simultaneously far apart and eerily close. Lloyd has Type 2 diabetes and I have Type 1 diabetes. In most ways we are stereotypical depictions of our diabetes types. I was diagnosed with diabetes as a young adult in the mid-1970’s. I was hospitalized in an unquenchable-thirst skeletal state with high blood sugars and large ketones and have never had a day since then without injected insulin. Lloyd was diagnosed with Type 2 diabetes in 1994, took pills for many years, and then started insulin 11 years later. Lloyd’s insulin resistance is off the charts and on a daily basis he uses over 10 times as much insulin as I do. His story personifies the fact that Type 2 diabetes is a progressive disease.

So here you have two Medicare people with diabetes. Lloyd uses a Medtronic 723 pump and changes his 300-unit reservoir every day. When his warranty expires in January, he plans to move to a Tandem t:slim X2 pump and continue to change his cartridge every day. He likes the t:slim platform because unlike his Medtronic pump, it allows him to program a bolus larger than 25 units. I use a Tandem t:slim X2 pump. I change my cartridge once a week and rarely bolus more than 2 units at a time. Because Medicare CGM coverage does not exclude people with Type 2, Lloyd is in the process of obtaining a Dexcom G5 CGM. I use a Dexcom G5 CGM. Currently neither of us is using sensors provided by Medicare and we both wear an Apple Watch and carry iPhones. Lloyd and I are technology twins.

Lloyd and I are students of diabetes. Yeah, we are “Know-It-Alls.” You may like us. You may find us annoying. But we don’t care. We know our stuff and we want to learn more.

I recently asked Lloyd if I could interview him and we met at Panera two weeks ago. I did not record our talk so Lloyd’s answers are in my words with scattered quotations. I also throw in an occasional comment.

Lloyd, I know that your diagnosis story is in your book but please give me a short timeline. I was diagnosed with thyroid disease in 1980. Fourteen years later at age 44 I was diagnosed with Type 2 diabetes. What was your reaction was to the diagnosis?  I just thought “Oh no, one more pill to take!” Do you have a family history of Type 2 diabetes?  Both of my sisters have Type 2 but neither of my parents did.

How long have you had diabetes?  23 years.

How long have you been on insulin?  12 years since 2005.

How long have you been on a pump?  Since 2005. Less than one year after starting insulin, I convinced my doctor to order me a pump. I had used Lantus followed by a mixed insulin and wasn’t having good results. I did my homework and presented my doctor with a list detailing why the Deltec Cozmo was the best fit for me. Rather than specify Type 1 or Type 2 in the letter of medical necessity, he just put “Insulin Dependent” and I was immediately approved for pump therapy.

You indicated that you will be purchasing a new insulin pump in January. What features are important to you as you make that decision?  I need a pump with multiple basal rates. I currently use 8 different rates and my highest hourly rate at 3:00AM is 5 times as high as my lowest rate. Because of high insulin requirements, I require a 300-unit or larger reservoir and the option of taking boluses bigger than 25 units. I also need to be able to set an insulin sensitivity factor of less than 1 unit per 10 points. (As someone with Type 1 who is very sensitive to insulin, I want to put multiple exclamation marks after each of those numbers!)

I am planning to order a Tandem t:slim X2 to replace my current Medtronic pump. Although the  t:flex has a larger reservoir, I prefer the upgrade features, Bluetooth, and CGM capabilities of the X2. I am used to changing my reservoir every day and will continue with that practice. I expect that my total daily dose of insulin will go down using the X2.

Tell me about your decision to order a Dexcom G5 CGM. How do you think it will help you? I plan to use the G5 to help reset basal rates. Although I use more insulin now, the basal patterns are the same as I figured out using the Abbott Navigator over 6 years ago. I rarely get lows (insert another exclamation mark here!) but need a CGM for highs. I have always been forgetful and that is increasing with age. My  insulin mistakes are almost all related to forgetting to bolus and the CGM will alarm when I forget and my BG soars. I’ve been working with Dexcom since earlier in the summer and I am “waiting as fast as I can” for the arrival of my G5.

So Lloyd, what do you think of the Medicare ban on smartphone use with our G5’s?  “You can’t print that.”

What year was your book published and why did you write it?  Successful Diabetes Management was published in 2011 and I wrote it because I was doing well managing my diabetes and wanted to help others. I chose the cover from Amazon’s stock photos and the image spoke to me as “Follow the Path” to good diabetes management.

I had also been one of the many people at Diabetes Daily who knew Richard Vaughn and goaded him to write his book published in 2010–Beating the Odds, 64 Years of Diabetes Health. After Richard’s book was published, he contacted me and said “Your turn, Lloyd”.

Lloyd continues his mission to help others with Type 2 diabetes and his Diabetes Daily forum sticky note titled Type 2 in a Nutshell has over 16,000 views. He was previously a moderator at Diabetes Daily.

As we consider Type 1 and Type 2, Lloyd, how do you think our diabetes lives are similar?  Our daily tasks are the same. We count carbs, we bolus, we deal with highs and lows, we test BG, we change pump sites. And most importantly, we live with fear of complications.

How are our diabetes lives different?  My lows are not nearly as debilitating as yours and my risk of DKA is about 1/20th of yours. I think that people with T1 can eat a bigger variety of foods than a T2 aiming for tight control because they process food more normally and insulin works better. (Like many people with Type 2, Lloyd’s weight issues are intensified by high insulin use.)

What is the hardest part of diabetes for you?  “It’s forever” and “knowing what to do and doing it are two different things.”

What are your thoughts on Type 1 versus Type 2 diabetes?  I think that the naming of Type 1 and Type 2 leaves a lot to be desired. Type 1 and Type 2 are based on how you got to where you are but they don’t always address where you are. Type 2’s need to restrict carbs more than Type 1’s and we also have a problem with our livers. Metformin addresses that and I am still taking it after 23 years of diabetes. I think that my diabetes is more predictable than yours.

As this stage of your diabetes career, do you identify more with people with Type 1 or those with Type 2?  My day-to-day life is like a Type 1. My medical team thinks that I have completely quit producing insulin and that is unusual for Type 2. I have more in common with T1’s than with T2’s on pills.

Conclusion:  I asked Lloyd if he had any questions for me and he wanted my opinions on hiking and exercising. We talked about lows and he indicated that he used to get lows on older Type 2 medications and when he used to walk a lot. But he has rarely gotten lows since moving to insulin 12 years ago. Sometimes I think that my Type 1 diabetes is most defined by 40 years of lows: while driving, while taking care of my children, while mowing the lawn, while wandering lost at the mall, while peering up at concerned policemen and paramedics. Even with improved CGM technology which now mostly protects me from severe lows, my treatment decisions are always influenced by the possibility of lows and I might argue that’s the biggest difference between Lloyd and me.

Do lows make me have the “bad” kind of diabetes compared to him? No, because lows mean that my insulin is working. I can’t imagine the frustration that Lloyd must feel when oral medications in addition to hundreds of units of insulin daily are required to tame his blood sugar. Metabolic syndrome and insulin resistance are powerful opponents and I kind of wonder if my life is easier.

When I look at the differences between the types of diabetes, I mostly end up in the “I don’t know” and “I don’t care” camp. I don’t want to fight about labels, blame, stigma, cost, and who’s got it worse. I just want and need the appropriate care for my diabetes and I think that Lloyd would say the same thing. Diagnose me correctly and treat me correctly. That’s not asking too much.

In summary, I would say that the most fitting end to this blogpost is that no matter how you look at it, Lloyd Mann and I are just friends who both happen to have diabetes. Types don’t matter.

TuDiabetes: Type 2 Series


Laddie_Head SquareToday (Thursday, October 1) TuDiabetes is launching a series of live interviews that are centered around Type 2 diabetes. Does that mean that those of us with Type 1 diabetes won’t learn anything? Absolutely not! All of these interviews will have relevance for anyone affected by any kind of diabetes—whether you have diabetes or love someone who does. This series will address topics such as diet, the basics of Type 2 diabetes, diabetes myths, emotional support, shame and blame, and family dynamics.

Today’s event is an interview with journalist and author Gary Taubes. Two of his well-known books are Good Calories, Bad Calories and Why We Get Fat. I have mentioned Taubes more than once on my blog and I highly recommend that you check out his books and/or articles. His writing is clear, concise, and highly persuasive as he argues that ourtaubesFB current obesity crisis is caused by certain types of carbohydrates rather than fats and excess calories. When you read his stuff, it really makes sense.

Today’s interview of Taubes is at 1pm PT, 4pm ET, 9pm GMT. To get more details about the event, click here. This event page provides information about Taubes and links to some of his books and articles. In addition there is a teal-colored box to click at the time of the event.

Please note that you must be logged into the TuDiabetes site to view the interview live. At the top of both the event page and the TuDiabetes home page are boxes to click to Log In or Register if you are new to TuDiabetes.

If you are unable to attend the event live today, the video will be posted in the TuDiabetes video archives in about a week.

Mark Your Calendars!

The schedule and details for the other interviews in the Type 2 Series can be found here. The speakers and dates are listed below. All of the event times are 1pm PT, 4pm ET, 9pm GMT unless noted otherwise.

Today, October 1    Live Interview with Journalist and Author Gary Taubes    Details here.

October 7    Addressing Shame and Blame with Susan Guzman    Details here.

October 13    Ansley Dalbo presents “Diabetes What to Know”    Details here.

October 22    D-blogger Mike Durbin, in Conversation with Rick Phillips    Details here.

November 11    Susan Guzman, “Rebranding Diabetes”    Details here.

November 18    Corinna Cornejo on Type 2 Diabetes Myths and Misconceptions    Details here. This event is at 12pm PT, 3pm ET, 8pm GMT.

More about TuDiabetes

TuDiabetes.org labels itself as “a community of people touched by diabetes, a program of the Diabetes Hands Foundation.” On this website you will find information about all types of diabetes, forums where you can touch base with other people affected by diabetes, a live chat feature, an extensive library of video interviews, and a blog feature which is under construction but currently lists links to member blogs.

If you have never checked out TuDiabetes, come visit. You can browse the site without logging in, but it is hoped that you will register and share your voice. If you used to participate and are flummoxed by the new platform, it’s getting busier, more organized, and you are missed. If you live with diabetes, TuDiabetes will make sure that you are never alone.

NuGo Nutrition Slim Bars: As Good as Advertised?

Laddie_Head SquareI don’t do many product reviews. Most of you don’t want to read them and I don’t use many of the product types that are pitched to me. In general I am quick to share my strong opinions about the pumps, CGM’s, and meters that I use and I am comfortable with my stance of not reviewing products just for the sake of getting something free.

In mid-May I received an email from a marketing rep at NuGo Nutrition. She wrote that NuGo Slim “is a delicious snack to help effectively manage blood sugar levels. It has been tested and proven to be the lowest Glycemic Index protein bar on the market with a GI score of 24! It’s also gluten-free, non-GMO, contains no maltitol….” Blah, blah, blah. Usually that is not enough to impress me. What hooked me was: “is coated with REAL dark chocolate.”

Nutrition bars have never been part of my life although I carry Nature Valley Crunchy granola bars when I hike. I rarely eat them but pack them because they are full of sugar, taste good, and hold up well in the heat.  Although I hike long distances (10-13 miles), I have never once sampled a Cliff bar, a Kind bar, or any other high-protein bar. In general I have my steadiest blood sugars when I use temporary basals and don’t eat. Obviously on an all-day hike I need food and do my best to bolus correctly for a cheese sandwich and an apple at lunch. Frankly I have no idea whether there would be a benefit of adding low-glycemic high-protein bars to my trail food. Maybe there would be.

So I said yes to the NuGo promotion and received a large box that included the five flavors of NuGo Slim bars. I told my husband that he was allowed to eat them but he must leave a note with a taste review. He started with the Espresso bar and indicated it tasted good but was a bit dry. My first sample was Brownie Crunch bar (the more chocolate the better!) and I thought it was quite good. Both of us liked the other bars. After Brownie Crunch, my favorite was Roasted Peanut. The Raspberry Truffle was tasty and a good texture, but I personally like my chocolate without other flavors. The dark chocolate coating on all of the bars was delicious and definitely tasted like “REAL dark chocolate.”Sample Pack 2

So how did they work with blood sugar? The first time I monitored my BG, I subtracted the 7 grams of Fiber and bolused for 12 grams of carb. Amazingly I did not get a huge spike and my BG reading at 1 hour was level. At 2 hours however, my BG had climbed about 35 points. I will need more bars to keep the experiment going, but I think the best bolus profile for me might be to pre-bolus for 12 grams of carb and then use an extended bolus of 1 hour for the additional 7 grams. (Somehow subtracting out fiber has never worked great for me.) But I definitely did not get the huge spike that I would have seen with a traditional brownie.

One plus was that the “heavy” texture of the bars helped me be satisfied with just one bar.  With regular brownies and cookies, one bite usually makes me crave more and I rarely never stop at one bar or cookie. So are these bars a good choice to satisfy my sweet tooth without totally wrecking my blood sugar? Maybe. Am I better off continuing to try (not always successfully) to avoid most sweets? Maybe. But I decided to invest in another box of Slim bars to see if they make sense as a long-lasting addition to my diet. I’ll definitely be interested in my blood sugar patterns as I try more bars.

Although NuGo Nutrition Slim bars are available in many markets, I did not have much luck finding them locally. My closest “premium” grocery store does not stock them. A nearby Whole Foods carries the regular bars, but not the Slim variety. I was in Annapolis, MD last week and the Whole Foods there did carry two Slim flavors as did Fresh Market. Fortunately the Where to Buy tab on the NuGo website indicates which varieties of bars are carried at each store.

Today I ordered a 12-pack box of Slim Brownie Crunch bars online. The cheapest option I found was at iHerb.com where the price was $20.86 for a box of 12. I received a $5 credit for my first order and then paid $4 shipping. The final cost was $19.86 or $1.66 per bar. (Amazon was much higher.) A box of 12 is available on the NuGo website for $21 + $5.95 shipping ($100 order required for free shipping).

Are the NuGo Nutrition Slim bars as good as advertised? Actually I think that their claims are credible and if you are looking for a “blood sugar-friendly” nutrition bar, you should check out the NuGo website. All Slim bars are certified to be Gluten-free and 2 of the flavors are Vegan. Detailed nutrition information is available here by clicking on each flavor of bar. If you’d like to read another review of NuGo bars and diabetes, check out Tarra’s review at My Crazy Life With My Diabetic Service Dog.


I received a complimentary sample box of NuGo Nutrition Slim bars, but as always, my opinions are my own and not available for sale.

My Most Favorite Ever

6th Annual Diabetes Blog WeekToday’s Topic:  If you have been blogging for a while, what is your favorite sentence or blogpost that you have ever written?  Is it diabetes related or just life related?  If you are a new blogger and don’t have a favorite yet, tell us what motivated you to start sharing your story by writing a blog?  (Thank you Laddie of Test Guess and Go for suggesting this topic.) To read other posts on this topic, click here.

You probably noticed above that today’s topic was my!!! idea in response to Karen Graffeo’s request for help. I selfishly suggested this topic because I have a favorite sentence that I always read with astonishment that I wrote such a beautiful thought. The sentence has nothing to do with diabetes but it is part of a blogpost that celebrates all types of diabetes, dogs, cats, and DOC friends.

But look at me taking credit for this sentence! It was actually written by Abby the Black Lab whom many of you know as a guest author for Test Guess and Go. Abby is quite popular and her posts get more readership than mine. Basically who doesn’t like dogs more than diabetes? My favorite blogging sentence is part of my favorite post and was written by Abby. The sentence follows and you probably need to read the whole post to put it in context:

“It is a magical glimpse of heaven for a lucky black dog who is showered with love by a beautiful princess gray cat.”

The entire post as reprinted from 9/09/2013 follows:

The Great Divide in the DOC

Abby with Abby Crown_no backgroundI’m Abby the Black Lab and it has been a while since I have written a blog post.  Lately I have been utterly distressed by a great divide that I see in the DOC (Diabetes Online Community) and I think it is time to bring this to the attention of my readers.  You probably think I’m going to start talking about the Type 1 versus Type 2 wars that periodically surface on the Internet.  Are you kidding?  My subject is not nearly as trite as that.

No, it’s the dog people versus the cat people.  The canines versus the felines.  The lovable, loyal, goofy, tail-wagging dogs versus the slinky, aloof, meowing and menacing kitty cats.

The cat aficionados have long been led by Kerri from Six Until Me whose cat Siah is a media star who poses in laundry baskets and attempts to dominate the DOC as an “internet celeb-kitty.”  The dog people are more decentralized in their leadership.  Canines have conceded Twitter to the cats, but think that we rule Facebook.  The blogosphere is probably a toss-up, but my opinion is that dogs are truly superior in their contribution to their PWDs (people with diabetes).  Duchess is a diabetes service dog who daily keeps her owner Tarra safe.  Meri’s boys are protected from the abyss of low blood sugars by Lawton the Yellow Lab.  All human hearts have melted seeing photos of Kim’s corgi watching over the new baby “Rabbit.”  Black labs like Riley owned by Mike Hoskins insist that their owners exercise by taking them for daily walks.

Cats meanwhile are tiptoeing across keyboards and writing meaningless blog posts with the tag line “zxzxzxdjjj.”  Pissed-off and non-sleeping kitties are considered newsworthy.  Oh yeah, Chris of @iam_spartacus fame has some feisty looking cats and @KarenBittrSweet claims to have the world’s cutest cat.  Videos of Grumpy Cat are ubiquitous, but if I want to see grumpy, I can look at my owner Laddie when her meter says 286.

Fortunately the DOC universe of cats and dogs has recently been in a state of equilibrium with only a few ripples of discord.  The dog people tried to sneak one under the rug in Twitter and Facebook with the purchase of a Scottish Terrier named Bella by Cherise.  Someone needs to tell Bella that if she wants to become an icon in the DOC Canine Hall of Fame, she should learn to walk on a leash.  Also tell her that if she’s going to be a supporter of people with diabetes, lancet devices should not be on the menu.  The cat people have lost some heroes as Kerri and Pancreassasin mourn their beloved friends who have gone to the scratching post in the sky. (RIP Prussia July/2013 and Pancreassasin 2week kitty August/2013).

But the calm has been shattered!  Earlier this month the cat people added a new Abby_Loopy2superhero to their roster in the guise of a young child named Birdie.  Smiles and cute Batman Princess costumes are not adequate to camouflage the chaotic schemes of this young and seemingly innocent feline-loving child.  With no attempts to disguise her evil intent, this child suggested that the family cat Siah was lonely and needed a friend called…. Loopy.

The Loopy hullabaloo has not been all.  Another scandal has been exposed in the DOC and I, Abby, a supporter of all people with diabetes, have been accused of consorting with the enemy.  A photo of a certain black lab being nuzzled by a gray feline has been splashed across the headlines.  I confess.  I am guilty.  I like cats and cats like me.

Abby Headlines

Every year I put “Kitten” at the top of my Christmas list.  Unfortunately my owner Laddie is allergic to cats, so no personal kitty is in my future.  I am extremely fortunate that when Laddie travels, I get to go to Linda’s house and visit my friend Nikki.  Nikki is a shy cat, but I have learned to approach her slowly and lay my head down acknowledging that cats are supreme.  She rewards me with purrs and caresses of her head against mine.  It is a magical glimpse of heaven for a lucky black dog who is showered with love by a beautiful princess gray cat.

My romance with Nikki has some important lessons for everyone.  Although you seemingly-civilized people with Type 1 diabetes sometimes argue with those who have Type 2 diabetes, you pancreatically-challenged doofuses should remember that you are stronger together than apart.  Diabetes in all of its evil forms is the enemy and you should join hands and conquer it together.

More importantly, we dogs and cats should toss aside our petty differences and stop the harassing hisses and barks.  With a united army of canines and felines, we can fight a cosmic battle against our common enemy.   A enemy who taunts and teases us in our own yards and through our own windows.  An adversary who seems to think that dominance is achieved through water-skiing videos.  We have seen the enemy and the enemy is……..SQUIRRELS!

Abby Crown Against Squirrels

Other Posts by Abby the Black Lab

Abby the Black Lab Discusses DSMA Live

Abby the Black Lab Discusses Nutrition

A Diabetes Poem by Abby the Black Lab

Abby the Black Lab Discusses Community

Join the Conversation

Conversations Banner_All

Laddie_Head SquareI really enjoyed my Type 1/Type 2 Conversations with Kate Cornell of Sweet Success: My Life with Type 2 Diabetes.  Our first foray into collaborative blogposts was a four-part series.  We had ideas for about ten posts, so I don’t think that this is the end of Kate/Laddie conversations.  But for now we’ve retreated into our respective corners with a greater understanding of what the “other type” of diabetes thinks and experiences.

When Kate and I started our project, one of our goals was to inspire others in the Diabetes Online Community (DOC) to initiate similar conversations.  Real communication is often lacking in our 21st Century world and the DOC has not been exempt from conflict and misunderstandings.  Fortunately many bloggers have become increasingly vocal about working to unite as one community regardless of medical history or type of diabetes.  (A good example of this is Kerri’s post titled Learning from My Peers.)  Together we can make progress; individually we spin our wheels.  We don’t need to agree on everything and we certainly aren’t the same.  But we can talk to each other.  We can respect each other and we can learn from each other.  We can build bridges to make the DOC a stronger community.

Kate and I hope that others in the DOC will jump on the communication bandwagon and initiate some conversations.  Type 1/Type 2 discussions are great, but don’t be limited by that combo.  How about a LADA talking to Type 1 diagnosed as a child?  How about a Type 2/Parent of a Type 1 dialog?  How about a pregnant Type 1 talking to a young T1 mother?  How about a conversation with your spouse or child?  Maybe a cat-lover and dog-owner (or would that generate too many fireworks?)  The possibilities are endless.

If you would like to participate in the Conversations project, please check out the Conversations page at Test Guess and Go.  You’ll find a few hints on how to proceed and information about obtaining the Conversations banner and graphic if you’d like to use them.  (I can easily customize the graphics to fit whatever your conversation is, so be sure to let me know what you need.)

What are the rules?

  1. Be respectful.
  2. Have fun and be creative.  If you don’t want to write a long post, consider using Storify with Tweets and/or Instagram photos.  Write limericks back and forth.  Publish email conversations.  Write comic strips.  Create vlogs.
  3. Feel free to tackle controversial subjects but don’t avoid fluff pieces that will make us smile.
  4. Choose a partner.  A familiar online friend, a new Twitter follower, a big-name blogger, a new blogger, an acquaintance from a TuDiabetes message board.  Don’t be shy and send an invitation.  The collaboration is just as important as the finished product.
  5. Don’t forget #1.  Be respectful.

If you need help or ideas, please contact me or Kate through the contact form on her homepage.  Once you’re published, send me your link and I will add it to the list of blogposts on the Conversations page.

Please help the project grow.  All you have to do is join the conversation!


If you missed any of our Kate’s and my conversations, you can find them here:

Type 1/Type 2 Conversations: Talking about Weight

Type 1/Type 2 Conversations: Diabetes in the Great Outdoors

Type 1/Type 2 Conversations: Friends and Family

Type 1/Type 2 Conversations: Food, Glorious Food


Type 1/Type 2 Conversations: Food, Glorious Food

Conversations Banner

Kate_photo_RKate:  I love food, who doesn’t?  Unfortunately, I love bread way more than I love broccoli; pizza more than salad.  I will admit that my diet wasn’t very healthy through most of my adult years.  I tried, now and then, to “do better” but eventually drifted back to my usual fare.  After my diagnosis of T2 I was faced with the need to make some significant changes to what I ate.  It hasn’t been easy.

People with T2 may take oral meds, injectables and sometimes, insulin.  They may control their diabetes with diet and exercise, for a while.  The one thing that we all have to deal with is figuring out what we can eat and still control our diabetes.  Here’s where it gets really frustrating.  I have never been to a nutritionist or dietician for assistance with my meal planning.  I know that there are many, many T2s who can say the same thing.  I taught myself what to eat (and not eat).  I also know some T2s who have seen a professional to learn what/how to eat and have been amazed at some of the recommendations they’ve received.  If you participate in any online forums or FB groups, the myriad of recommendations you can receive for what you can eat is mind boggling!  “You can’t eat that.” “You should definitely eat this.” “low carb” “low fat” “lots of fat” “whole grains” “no grains” “Okra water” “cinnamon” “vinegar” “whole cows” “no meat” “bacon wrapped everything” “sugar free” “never consume sweeteners” The list goes on and on and on.  Can you blame people for being confused and frustrated?  The fact that mainstream diabetes organizations continue to push lots of carbs has always amazed me.  I am encouraged by this recent study that says that it’s better to lower carb consumption for people with diabetes.  Ya think?  I don’t push any specific way of eating for people with diabetes, that’s your choice, but I have learned that I simply cannot eat bread (even whole wheat), pasta, potatoes (even sweet), cereal (even oatmeal), crackers…so many things.  And yet, when I read “diabetes friendly” recipes online they nearly always contain these ingredients.  Heck, even “healthier” cookie recipes contain flour and sugar to a degree that makes them off limits to me.

I could go on forever on this topic.  I could write a book!  The point I’d like to make is that people with T2 simply must make drastic changes to what they eat in order to maintain good blood glucose in the long run and yet they aren’t encouraged to do that.  Yes, stopping fast food and making your own burgers at home is better but shunning the bun is better yet.  Don’t get your panties in a twist and tell me “but we can eat anything in moderation!”  Maybe you can, for a while.  I used to be able to do that too, but now I can’t.  Without insulin to lower a high glucose reading, I have to deny myself certain foods unless I’m willing to deal with the consequences.  That doesn’t mean that I’m eating cardboard.  I eat a wide variety of delicious foods; foods that take preparation and planning.  In this one area I feel that T1s have an easier time of it.  Yes, you can eat anything you want because you can bolus your insulin for the carb consumption.  I know that isn’t easy, but it’s possible.  SO jealous here.  So Laddie, what’s your take on food and how it fits into your diabetes treatment?

Laddie_Head SquareLaddie:  Last September I wrote a blogpost titled “Food” and this is one of my favorite paragraphs from that post:

Like almost everyone with Type 1 diabetes, I’ve spent my life trying to find the magical balance between food as nutrition, food as pleasure, food as a social hub, food as a deterrent to low blood sugars, and food as an emotionally-charged addiction.  Diets are prescribed like medicine with the assumption that if you play by the rules, things will work perfectly.  Anyone who has had Type 1 for more than five minutes knows that food, blood sugar, weight control, and insulin rarely play nice together and it’s hard to keep guilt out of the equation.

Reviewing that paragraph, I could easily change all of the “Type 1” references to “Type 2” and everything I wrote would still be true (except maybe the insulin reference).  Diets are handed out to people with diabetes with the implied guarantee that they are the ticket to success.  Follow the plan and you will have good blood sugars, weight loss, no diabetic complications, and so on.  Unfortunately diets are hard to follow and with diabetes, what you eat is only one piece of the blood sugar puzzle.

When I was diagnosed in 1976, I was given an Exchange diet with a prescribed number of bread, vegetable, fruit, protein, fat, and dairy portions for each meal and snack.  Because of the limitations of my once-a-day insulin shot, that diet really meant:  “Eat all of the time and hope to avoid passing out from a low at 4:30 every afternoon.”

Over the next 25 years, newer insulins led to more flexibility in the our diets and all of a sudden with carb counting, we could eat like a “normal” person.  We were told that “a carb is a carb” and birthday cake was allowed as long as it fit into our nutrition plan.  The  “heart-healthy” diet mandated that fats were bad and carbs were good.  More bread.  More pasta.  The fact of the matter is that as someone with Type 1 diabetes, I can’t match the digestion of carb-laden foods with the peaks and duration of my insulin.  I go high; I go low.  I eat carbs; I want more carbs.  I feel guilty because my numbers aren’t good and I’m exhausted from rapidly changing blood sugars.  That’s the glucocoaster life.

Some people, myself included, are looking for ways to get off the glucocoaster and these days you see many options for healthy eating with diabetes.  At one extreme is Dr. Bernstein’s Diabetes Solution: A Complete Guide to Achieving Normal Blood Sugars with the recommendation of a diet high in fat/protein with a carb limit of 30 grams per day.  At the other extreme are athletes who eat thousands of calories and 400-600 grams of carbs per day.  In the middle are people doing their best to follow diets prescribed by their medical professionals with varying carb targets and varying degrees of success.  There are people with diabetes following the Paleo diet, others eating gluten-free, and some paying no attention at all.  We’re all searching and realizing that there is no easy or perfect diet.

I personally believe in Bernstein and have dramatically reduced my carb consumption in the last 10 years.  Unfortunately as I write that, I am having a vision of chocolate-covered donuts (a constant theme in my blog).  My current BG is 83 (Bernstein nirvana!).  But it is the result of multiple boluses after afternoon highs in the 200’s from eating a bowl of cherries.  Okay, it was two bowls….  I pre-bolused an appropriate amount of insulin and still spiked.  I followed the rules, got a bad result, and ended up feeling guilty.  I sometimes wonder if eating a mostly low-carb diet has made me more sensitive to carbs when I do eat them.

Kate is envious of those of us with Type 1 who are able to use insulin to incorporate more carbs into our lives.  I can’t imagine seeing a high blood sugar and not having a tool to bring it down.  At the same time insulin is not a fix-it-all and introduces the fear of severe lows without always eliminating outrageous highs.  Insulin or not, eating with diabetes is hard.

Food Glorious Food_Nutella

Kate_photo_RKate:  We are so similar!  Your comment about donuts really hits home.  I know what I should eat and often feel very satisfied with lower carb meals, and yet the call to eat the carbier foods is never far away.  Sigh.  It’s also interesting what you said about possibly being more sensitive to carbs now that you’ve lowered your carb intake.  I feel the same way.  Two summers ago I tried an extremely low carb diet for a month and had great success.  Once I tried to slowly add some carbs back into my diet (like a bit of bread or cereal) my blood glucose went through the roof!

One of my frustrations has been my HCP’s reluctance to let me try insulin.  My A1c is quite good, even though my fasting numbers are in the 130s at best.  I am better controlled than most of her patients and so my concerns over higher numbers are dismissed.  I’m told to “lighten up” and eat a more “normal” diet but I’m commended for my better numbers which wouldn’t exist if I ate more normally.  I will admit to having dealt with burnout recently mostly because I can’t just eat whatever I want.  I’m tired of constantly thinking about food.  Like you Laddie, it’s a daily challenge.  I’ve actually “lightened up” a bit and have been allowing myself to eat things I normally wouldn’t eat and doing it (mostly) without guilt.  I feel better mentally but my numbers aren’t so great.  How do we find the balance we need between eating a healthy diet most of the time, allowing for splurges now and then and keeping the amount of medications we need to take at a minimum?  I could eat whatever I want, ruin my good numbers and be allowed to add insulin to cover my carbs.  Is that the right thing to do?  I don’t think so.

I’ve been told by a D parent online that it would be nice if their child “only had to stop drinking soda”.  I hope that this conversation shows that living with T2 isn’t that simple.

Laddie_Head SquareLaddie:  Kate is right when she indicates that the best diet for someone with diabetes is often a compromise between nutrition/physical health versus emotional health/guilt-free living.  Does that mean that we have to eat junk food to be mentally healthy?  I hope not, but most of us enjoy sweets and carb-laden foods because they are delicious and probably addictive.  Food is the centerpiece of many social functions and we want to be part of the crowd.

My mental health is the best when I follow my lower-carb diet and enjoy mostly in-range blood sugars.  For whatever reason, the rewards of that lifestyle aren’t sufficient to keep me on the straight and narrow for long.  So I try to accept deviations from my “ideal” diet to avoid a life mired in guilt.  At the same time I find that every time I return to a lower-carb diet, I seem to be able to stay on it longer than the last time.

Food is delicious.  Food is fuel.  Food is fraught with temptation.  We’re bombarded with mixed messages from medical professionals and popular media about what constitutes a healthy diet.  I wish that I had great words of wisdom for everyone with diabetes.  I don’t.  My only advice is to keep learning, be open-minded, and do your best.  And try again tomorrow.

Kate_photo_RKate: It’s obvious from this conversation that food is big in the lives of people with diabetes, despite their type.  It is a struggle for most, one that will never be easy I’m afraid.  But hey, food isn’t easy even when you don’t have diabetes.

This is the last conversation in our series.  I hope you’ve enjoyed them and that they have opened your eyes or prompted conversations between you and others.  Next week we will be publishing a “wrap-up” post inviting you to start your own conversations.  We’ll give you some suggestions and Laddie has generously offered to share the graphics that she has created.  (Aren’t they great?)  Thank you for joining us in our effort to knock down some of the barriers between types.


If you missed the first three posts, you can find them here:

Type 1/Type 2 Conversations: Talking about Weight

Type 1/Type 2 Conversations: Diabetes in the Great Outdoors

Type 1/Type 2 Conversations: Friends and Family


This post was originally published on July 29, 2014 on Kate’s blog, Sweet Success: My Life with Type 2 Diabetes.

Link-Type 1/Type 2 Conversations:  Food, Glorious Food

Laddie_Head SquareToday Kate Cornell of Sweet Success: My Life with Type 2 Diabetes is publishing the fourth and final in our series of Type 1/Type 2 Conversations.  The subject is Food, Glorious Food and you can read it here.

As in our previous conversations, we found that we have a lot in common when it comes to food.  One difference is that Kate is frustrated that her doctor won’t prescribe insulin for her and she believes that she needs this weapon in her arsenal.  (Most of us know that Type 2 is a progressive disease and many people ultimately end up needing insulin.)  As a Type 1, I want a chance to be a Type 2 and not have to take insulin!  Of course that is a silly wish because if I had one magic wish, I would wish that there was no diabetes.  No Type 1, no Conversations_FinalType 2, no Gestational, no LADA, and none of the other types.

Kate mentions in the conclusion of this conversation that we will be publishing one more post that will invite you to join the conversation.  We will give some suggestions on the mechanics of the project along with offering to share graphics and anything else you might need.


If you missed our previous conversations, check them out:

Type 1/Type 2 Conversations:  Talking about Weight

Type 1/Type 2 Conversations:  Diabetes in the Great Outdoors

Type 1/Type 2 Conversations:  Friends and Family

Type 1/Type 2 Conversations: Friends and Family

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Laddie_Head SquareLaddie:  When I was diagnosed with diabetes in 1976, there was no issue about whether it was public or private. I was new to Minnesota and the only people I knew were either family or co-workers. All of the family knew of my diagnosis and because I missed a whole week of work, everyone at my job knew about it also.

Although my diabetes was common knowledge, my self-care was private. It wasn’t private because I was hiding it. It was private because there was no blood glucose testing and I used Diastix strips to test my urine when using the toilet. In those days I only took insulin once a day and that was in the privacy of my bathroom along with my shower and teeth-brushing.

Life changed as we bought a house, made friends, and had children. My diabetes regimen became increasingly complex with blood glucose testing and multiple daily Doorsinjections (MDI). A private life with diabetes morphed into a secretive life with diabetes. When I first met people, I didn’t see a need to disclose the fact that I had diabetes. But all of a sudden I had known them for 5, 10, or even 20 years and it seemed uncomfortable to say “Hey, you know what. I’ve had diabetes ever since I’ve known you. I take shots and test my blood many times a day and I’ve hidden it from you.”

It was easier to stay in the closet than deal with that sort of awkwardness. About 10 years ago I had a big coming-out party while playing bridge with a bunch of golfing friends. They were terrified that I was having a stroke and although I couldn’t talk, I was at least able to flash my medical alert necklace. Projectile vomiting of orange juice followed by a parade of paramedics and police pretty much blew my secrets to smithereens.

Very shortly after this episode, I got a pump and became increasingly comfortable with my public persona of someone with diabetes. Most people in my life these days know about my diabetes, but some of the “I have known them forever, but don’t see them very often” people don’t. I still don’t know how to tell people that I’ve known for 30 years that diabetes preceded our relationship…. I am not embarrassed to have diabetes, but I am embarrassed to have been so secretive.

Although the “stigma” of diabetes is a big deal these days, especially the blaming of Type 2’s for “causing” their disease, that wasn’t an issue when I was diagnosed. The terms “Type 1” and “Type 2” were just emerging in the 1970’s and weren’t commonplace until the World Health Organization adopted that terminology in the 1990’s. There was no diabetes epidemic and my secrets were not an attempt to distance myself from the “Other Kind”. My secrets were a reflection of my somewhat secretive nature and occasional social awkwardness.

Now that I have been blogging for over a year, I am for the most part “out there”. Most friends know about my blog, but only a few are regular readers.  Why should they be?  If I didn’t have diabetes, I would for the most part ignore it and keep it in the category of “that’s not my problem”.

Kate, as someone with Type 2 diabetes, you have a more “invisible” illness than I do.  How does your diabetes present itself in public?

Kate_photo_RKate:  When I think back to my type 2 diagnosis, I remember being confused and upset. I received no education and was sent out the door to figure it all out for myself. It never occurred to me to hide my diagnosis from anyone.  I knew so little about diabetes, of any type, and I didn’t have any idea that there was stigma attached to my disease. I guess you could say that I was blissfully unaware. I was probably similar to a big dumb dog, bouncing around, tail wagging, oblivious to what anyone might think. Just doin’ my thing. I didn’t hide my diabetes at work but also didn’t feel compelled to tell anyone. I was happy to share my ideas and findings about food etc. should someone ask. (I probably went on too long from time to time.  I seem to remember a few glazed eyes.)  I do remember a few slowly shaking heads and looks of concern when someone learned of my diabetes. I didn’t like that at all. Don’t pity me!

As time went on and I began to do research about how to deal with my diabetes, I began to see the stigma that can be attached to diabetes. Every website I visited or book that I read told me that I needed to lose weight. Even my doctor told me “just Dog_Goofylose some weight”. Those feelings of guilt began to creep in and my weight issues that had plagued me for most of my adult life started to affect my mood. But for some reason, even then, I didn’t feel that I needed to hide my diabetes. In fact, the more I learned the more I wanted to educate others. Comments made after articles or blog posts that blame T2s for being fat and causing their condition can still inflame me to the point of apoplexy.  I have to speak up. I have to try to educate others. I can’t be silent.

The only time that my diabetes is more public is when I’m eating out at a restaurant. I may test my blood sugar to see what level of carbs I can safely consume (like bread or pasta. Usually none). I nearly always make food choices based on my diabetes. I will decline dessert, and when pressed to “go ahead and have some!” I’ll kindly explain why that isn’t a good idea for me. I try not to say that I can’t eat something but, instead, will say that I choose not to for my health. It can be glaringly apparent when I eat the middles out of a sandwich with a knife and fork. That type of activity can bring questions from others and I try to use those situations to educate.

I’ve gone through “seasons” with my diabetes. From being unaware to being a better educated patient; one who wishes to do what she can to educate others. I can understand why others may not choose to let their diabetes be known and I respect that decision. We each have to do what feels best for us.

We’ve talked a lot about friends/work, but what about our family?

Laddie_Head SquareLaddie:  My husband and I don’t talk about diabetes much. He’s not terribly interested in medical things and I’ve always been a “take care of it myself” person. Fortunately he has always been a master at knowing when I’m low. For many years whenever he asked “Are you OK?”, I would say that I was fine. He quickly learned that “Fine” accompanied by a blank stare was not fine.

My Dexcom G4 CGM has set back our diabetes relationship because in the almost two years that I have used the system, I have not once needed help with a low blood sugar.  With my low alert set at 70, I have been warned of lows before they have become too severe for me to handle. (Yes, Medicare, you need to pay attention to this!)  Except for living in a mostly low-carb household and occasionally reading my blog, my husband has been spared involvement with my diabetes. He may be getting out of practice.

As a stereotypical “successful Type 1”, I have taken complete responsibility for my self-care, warts and all. My biggest fear is the day when I am no longer able to be in charge. I have not been hospitalized since my diabetes diagnosis except for childbirth and I shudder at the nightmare hospital-stories of many Type 1’s. If I ever have a planned hospitalization, I will work hard to train my husband in Diabetes 101. But we are totally unprepared for an emergency hospitalization. It is not fair to either of us that I have allowed him to be so uneducated.

Growing up, my two sons knew little about my diabetes. I took shots in the bathroom and did the same with BG testing once it replaced urine testing. Diabetes was always there but in the pre-MDI days, it didn’t demand a lot of attention. As they got older, they were too busy to notice much of what I was doing.  Reading my blog has been a total eye-opener for them.

I did not worry about my sons getting Type 1 and never once pressed a Diastix strip into a wet diaper or tested their BG. Statistics indicate that neither they nor their children will get Type 1, but I see too many multi-generational diagnoses in the DOC to be totally confident. My husband’s father had Type 2 diabetes and statistically my sons have a higher risk of being diagnosed with that rather than Type 1.

I don’t come from a large family and I have been spared helpful comments from distant relatives about okra, cinnamon and losing weight to go off insulin. With a sister who has Type 1 and a father-in-law with Type 2, my family is more educated about diabetes than most.

Kate_photo_RKate:  It’s interesting that discussing my diabetes with my family doesn’t happen all that often. Well, except for Ray. He takes the brunt of my frustrations and railings. He’s a good man to put up with me when things aren’t great. I haven’t made a habit of “educating” my extended family, it’s more that I teach by example. They have seen me forgo certain foods at family gatherings or have just a bit of something yummy (like stuffing at Thanksgiving!)  I rarely have had “diabetes police” moments.  When asked if I can eat something I simply say, “If I want to and am willing to deal with the aftermath, then yes”.  My family knows about my recipe tweaks and use of almond flour. They know that I’ve made drastic changes to how I normally eat, but they usually aren’t there to see it. When it comes to the holidays I try to keep things “normal”. I still make all the foods we traditionally eat and adjust what I consume.  Sometimes that’s so hard to do!  Sometimes I don’t succeed.

Thinking back over how I fed my family as they were growing up can lead to some feelings of guilt. Yes, I fed them mac and cheese from a box. Yes, they had chicken nuggets and pizza. Yes, we ate too much processed foods. Yes, we were a normal family. I can’t/shouldn’t beat myself up about it. I didn’t know then what I know now.  Here’s the kicker: now I DO know that a lot of those processed foods aren’t so good for us, and yet I find myself falling back on those standards when my grandsons are here.  Should I be the “tree bark Grandma” who only feeds them “that healthy stuff” or should I be the “fun Grandma” who lets them eat what they want? I have found a happy medium, I think. There is always at least one veggie with every meal and often fruit for dessert.  Sugar free popsicles are in my freezer at all times and mixed nuts, mini bell peppers and cheese sticks are favorite snacks for them. Yes, I still make mac and cheese sometimes and I’ve been known to buy a pizza but I’m more aware now of the food I “push”. My family is aware of my diabetes but I try not to make it the only thing they see.

Laddie_Head SquareLaddie:  As a grandmother, Kate’s comments about being the ‘tree bark Grandma” versus the “fun Grandma” really hit home. I have recently tightened the reins and quit buying junk cereals and feeding grandchildren pizza every time that they sleep over. (Don’t tell their mother that although they’re eating more nutritious foods at my house, I still let them watch TV….)

Kate’s history shows more openness about diabetes than my past. I suspect that it is more related to personality differences rather than our type of diabetes. Next time that I find myself retreating into the closet, I’ll think of Kate and envision a big, goofy dog who has no secrets.

The topic for our fourth Type 1/Type 2 Conversation next Tuesday is Food. This reflects the impossibility of discussing any type of diabetes without food facts, myths, and opinions coming to the table. Please join us.

Type 1/Type 2 Conversations:  Diabetes in the Great Outdoors

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Kate_photo_RKate: To continue our discussions between people with type 2 and type 1 diabetes, I thought I’d talk with Laddie about dealing with diabetes while enjoying the great outdoors.  Living in the middle of a pine forest makes it easy to enjoy the peace and loveliness of “the outdoors”.  I love camping and hiking in the woods that are a stone’s throw from my home.  Ray and I enjoy fly fishing, which we have to travel away from home to do.  I’ve blogged before about my adventures when camping with diabetes but I’ve never given a lot of thought to what it would be like to camp with type 1.  Well, my last statement isn’t exactly true.  I have thought about the fact that insulin must be kept cold but I never really thought about how that would work or what level of stress that would add to the camping experience.

Camping with type 2 is really quite easy, at least for me.  In fact, it’s easier to control my blood glucose while camping than it is at home.  Why?  Because what I eat affects my blood glucose more than any other thing I do.  Yes, I take oral meds and yes exercise can lower my blood glucose, but if I overeat or eat too many refined carbs, my blood glucose will spike and there’s not a whole lot I can do about that.  When I’m at home I have a whole smorgasbord of food to choose from, not all of it good for me.  When camping I can only eat what I bring with us and I try, very hard, to limit the “bad stuff”.  It’s still easy to eat too much while camping but I find that the fresh air and peaceful surroundings make it easier to focus on things other than food.  I have been known to have fasting readings in the mid-80s while camping when here at home they are running in the 130s. (We currently can’t camp due to fire restrictions and my glucose could sure use the help!)

While spending time in the outdoors I am always careful to check my glucose levels, I get lots of exercise and I’m usually eating more healthfully.  I’m also much more relaxed, which helps with blood glucose as well.  Can I imagine what it would be like to add insulin to that mix?  Not really.  Intellectually I can understand what would need to be done, but emotionally not so much.  The reality of dealing with type 1 (or anyone who uses insulin, really) is beyond my ken.  (I have always wanted to use that word in a sentence, ever since I first saw The Sound of Music!)  I greatly admire my T1 friends and am always impressed with how they handle everything required to control their diabetes.  What’s it like away from home where there’s no conveniences?

Laddie_Head SquareLaddie:  Kate is correct in stating that preparing for a Great Outdoors adventure is very different for someone with Type 1 diabetes compared to most people with Type 2.  Although we can argue about which type of diabetes in worse in the long run (they’re both the “bad” kind!), in most cases there is little doubt that Type 1 is more dangerous in the short run.  Going on an outdoor expedition ill-prepared can quickly become a life-or-death crisis for someone with Type 1.

I have never had an emergency diabetes situation while in the Great Outdoors and I would attribute that to a combination of thorough preparation and a healthy dose of luck.  When I venture out into nature, I work hard to ensure that I am prepared for almost any contingency.  I make lists.  No matter how many times I have stocked a backpack, I don’t trust my memory.  I use a list and I check it twice.  I figure out what supplies I need and I double or triple that.

Luck has come to my aid a few times and I have been an attentive pupil.  Many years ago I  learned that multiple plastic bags and tape are not sufficient to keep a Medtronic insulin pump dry while whitewater rafting in Canada.  Fortunately it was a cheap lesson because the pump survived with no water damage.  I have been low and run out of glucose/food twice on long hikes and both times the trailhead and car with supplies were over the next hill.

The two scenarios that can quickly become an emergency for me are severe hypoglycemia and an absolute lack of insulin.  To prevent severe hypoglycemia, the first thing that I do is carry glucose products in both my pockets and my pack. Multiple rolls of glucose tabs, gummy fruit snacks, juice boxes, granola bars, and a bag lunch are my standard fare for day hikes.  Secondly, I always carry my Dexcom CGM and pay attention to its warnings of lows.  My meter is easily accessible on my belt and I am proficient at testing while on the go.  Third, I use temporary basals as much as possible to minimize insulin on board.  Fourth, I carry a Glucagon kit and my hiking companions know its location and how to use it.

It is unlikely that I will have a problem with my insulin delivery, but this could become catastrophic very quickly.  As a pumper using short-acting insulin, I start feeling sick if I go without insulin for 3-4 hours.  Periodically on diabetes forums someone asks how long a person with Type 1 can survive without insulin.  Will Dubois at Diabetes Mine has a good post on the subject and concludes with the answer of a few days to 1 or 2 weeks.  How quickly would I feel so sick that I could not longer hike?  Probably 5 to 8 hours.

To prevent an insulin emergency, I always start my adventures with a full or nearly-full reservoir in my pump.  Secondly, if the battery level on my pump is not 100%, I put in a new battery and always carry a spare.  Third, I carry syringes in both my meter case and backpack.  I always pack back-up infusion sets, a reservoir, and a vial of insulin.

Kate mentioned her concern about the proper storage for insulin if and when it becomes part of her diabetes regimen.  Frio cases are the easy solution.  The soft pouches work with evaporation and only need a soaking in water every few days to provide adequate cooling for insulin.  They puff up when “charged” with water and their Pillsbury Doughboy chubbiness helps protect insulin vials from breakage.  They also come in sizes for pens, pumps, and other supplies.

Those of us with Type 1 have to be more neurotic in our preparations for life than those with Type 2.  I don’t complain about diabetes very often, but sometimes I wish that I didn’t have to be so darn prepared all of the time.  At the same time I am thankful for my pump, meter, and CGM that allow me to experience the Great Outdoors in relative safety.

Kate_photo_RKate:  I’m humbled.  I’m impressed!  Laddie, your preparations for a day of hiking are astounding.  I always knew, intellectually, how much preparation is involved for going anywhere with type 1.  I’ve read other blogs and Facebook comments about packing for a trip and needing to take multiple sets of this and that.  I just never transitioned that over to being on a hike or camping.  You always have to be prepared!

One thing that stands out to me is the fact that type 1 carries with it an immediate threat of serious issues.  Someone like me who has type 2 and does not use insulin (or any medication that can cause severe lows) doesn’t have those worries.  I’ve always known this, but this conversation has really brought it to the forefront for me.  There is no “worse” type of diabetes but, in my opinion, type 1 is a lot more serious in the short run.  Your need to control your blood glucose cannot be ignored.  I am not someone who ignores my diabetes control but if I ever do I’m not going to die.  That’s serious stuff.  In the long run, we aren’t much different.  People with all types of diabetes need to be aware of the fact that poor glucose control will most likely lead to serious complications. (It’s important to remember that even if we do control our diabetes the best we can, we may still experience complications and that is not our fault!)  As a type 2 I intend to continue to pay attention and do everything I can to keep my bg as close to normal as I can.  I’m afraid that many type 2s don’t do that.  It’s easy to forget what can happen when we aren’t faced with the immediacy of type 1.

I think it’s so cool that both of us love the outdoors, that we have fishing pictures that are nearly identical and that we do the things we love despite our diabetes.  We are different but we are the same.

Laddie_Head SquareLaddie:  Well said, Kate.  I don’t think that I have anything to add to our discussion except visual proof that people with Type 1 or Type 2 diabetes can look equally goofy in fishing hats!  (If we were men, we would also have to argue about whose fish was bigger….)


Gone Fishing_2

Kate_photo_RKate:  One last thought: I think it’s important to point out that neither Laddie nor I hesitate to get out there and do the things we love to do, despite our diabetes.  Don’t let diabetes keep you from living your life.  It can be difficult and frustrating but it’s worth the effort.

Be sure to come back next week when our conversation will be about Friends and Family.  If you missed our first conversation about weight, check it out here.


This post was originally published on July 15, 2014 on Kate’s blog, Sweet Success: My Life with Type 2 Diabetes.