I Know How To Control My Diabetes but…

Controlling diabetes is always a challenge. Life  so often gets in the way. I know what I have to do to control my diabetes so here it is.

I need to be out of bed by 9am, the absolute latest. This is not difficult during the week but on the weekends it is more difficult. Particularly because I come from a family of dirty stay outs who enjoy sleeping in on weekends. I do not enjoy sleeping in because the later I sleep the less likely I am to have a good glucose control day. But I do enjoy sleeping in because I work ridiculous hours and can always use the extra sleep. Guess which wins on weekends. So if I want to maintain my control I know I need to get up by 9am on weekends. It is up to me…perhaps with consequences at a yet undetermined time in the future.

Once I am up, I need to eat and exercise, period. When I do this I avoid the nasty morning blood sugar spikes that color my entire day when I am not exercising. Exercising regularly is very challenging. It becomes a little easier when you know you have to do it at the same time everyday to accomplish the goal of good control. And, honestly, when I am exercising, I do feel better. Also my numbers are better. My cholesterol drops, my A1c drops, my blood pressure drops, nearly every important marker for good health improves. Only a fool wouldn’t exercise regularly and yet…But I try and I have been succeeding at about a 50% rate and right now I am on a renewed exercise commitment. One of the ways I have found to motivate that commitment is to join the American Diabetes Association’s Tour de Cure – the annual bike tour to support diabetes research. Next spring I am riding 45 miles so I know I have to maintain a training routine.

Throughout the day I need to do multiple blood tests, approximately every 2 to 3 hours. I also need to react to the blood sugar fluctuations that occur. There are times of the day when I am more likely to be low and I have to be in tune to these times because my awareness of my hypoglycemia is marginal. I do feel lows but my brain takes a long time to process this obvious information and respond to it.

I need to eat. If I don’t eat at prescribed lunch and dinner times my blood sugar suffers. If I don’t eat lunch I can maintain a pretty good blood sugar until mid-afternoon when after a cereal bar or two, my sugar reacts with a surge into the mid-200s. That can lead to hypo-glycemia if I over-react. If I skip dinner my blood sugar can (doesn’t always) plummet overnight. This causes me to wake up and over react in the middle of the night, spiking my sugar and causing the following day to be a blood sugar roller coaster.

So yes, I am very in tune to my diabetes. Do I succeed every day? No, but I try and do a pretty damn good job at it, if I do say so myself. But that is the thing, you have to be in tune to the fact that every decision you make throughout the day impacts your blood sugar. I think as long as you know what you need to do to control your diabetes, then you know what you have to do to get back on track. The difficulty is in the doing.

Insane Work Schedules

Diabetes gets interesting when your work schedule turns into a series of 15 – 20 hr days. I work in the television industry and right now I’m working from yesterday through next Wednesday night for a special that airs  on nbc Thanksgiving night at 10pm. The schedule is “as needed” – yesterday was an early night – I started at 10am and left  at 1:30am. I hardly got up from my workstation. The only redeeming factor is that my car is parked far enough away that I get a good brisk 15 minute walk in to and from…so I am able to maintain some exercise in this insane schedule. As for food, I packed a small cooler filled with Chobani yogurts, mozzerella string cheese, a few apple juice boxes and some trail mix. At my work station I have a box of peanut butter crackers and several Nature Valley cereal bars. In order to keep us all working on deadline all meals are delivered directly to us at our work stations. Yesterday I did 10 blood tests and my sugar was running a little low for the entire day. Today and as this schedule moves on, I suspect my sugar will be a little more erratic. This morning I woke up at 244 – rebound from late night low sugars – walked 17 minutes to work and had a pre-breakfast sugar of 202(hello #bigbluetest). I bolused and ate what I eat when I am on this kind of schedule…badly! Scrambled Eggs & cheese on a roll and I have no idea what the rest of the day will bring, food-wise and work-wise but I suspect I will be here late tonight as well. I dual-wave bolused for more Carbs then that meal would be. I did it for 90 Carbs even though that meal is probably less than 60 BUT, there is a fair amount of fat in the cheese. So, I am dealing with the exhaustion, erratic blood sugars and high-pressure deadline work that will culminate in a huge Thanksgiving dinner next Thursday. Big meals are never really too much fun but it will be great fun to spend time with my beautiful family and ugly relatives(kidding). I am looking forward to getting thru this with my sanity in tact and onto a more normal schedule. This may all sound like I’ve got a handle on this but it drives me nuts and I hate that I have this constant nagging, underlying issue that few of my co-workers have to deal with. It takes up mental energy that is very difficult to give, given the circumstances!

I know this much to be true…

This may seem simplistic but sometimes simplicity is all I can handle…

Diets don’t work – if you seriously want to lose weight change your lifestyle, permanently. It’s the only way. Having diabetes makes eating right one of the most important things you can do to control your sugar.

Exercise works – I have exercised and not exercised enough to know that when I am working out my Blood Sugar control is better and I feel better.

Do a blood test – the only way to truly know is to do a blood test. I am famous for saying that I’m fine when in reality my BG could be very low. I can function with an extremely low sugar. I have had to train myself to understand (and I still don’t always ‘get it’) that if my wife is asking me to do a blood test chances are my sugar is low. If I have a little voice in my head telling me “I don’t feel well”, that too, can mean a low blood sugar. I am hypo-glycemic unaware in many cases although I have learned the little abnormalities that make it important to DO A BLOOD TEST!!!

React to the glucometer. If my sugar is high then I should do a bolus. If it is low I should eat something. This may seem like a “DUH” but the mind of this PWD is a pitfall of denials and rationalizations! I don’t always react in a timely manner and that can be dangerous.

more to come…

Snacks and how far we’ve come…

When I was diagnosed I was told that, “1983 is a good year to get diabetes…” Well, forgive me, but the truth is no year is a good year to get diabetes! So I got my training on how to mix and inject insulin. I was put on a mix of Regular and NPH insulin (more on NPH to come!) morning and evening and Regular shots at mealtimes. This was all tied to a pretty strict eating schedule. Mix of insulins in the morning then breakfast a half-hour later; two hours after breakfast a blood test and a snack which consisted of 2 graham cracker boards a slice of cheese and an 8 oz glass of milk – if my sugar was high I would take a shot of Regular insulin but I was never to miss a snack or a meal or a blood test; two hours after that a blood test and lunch with a shot of Regular insulin to cover the meal; two hours after that…well you get the picture, it was a merry-go-round of blood test, shot, snack/meal. But I was thinking snacks when I started this – you see how diabetes commands a lot of attention before you can get to the point?

Snacks – I loved those little snacks! I hadn’t eaten graham crackers since I was a little kid and even though I initially objected vehemently to the skim milk, I eventually embraced that as well. Today whole milk tastes like heavy cream to my “refined palate”. But I had to have those snacks because in 1983 most people weren’t on insulin pumps and there was a whole other way to manage diabetes. My glucometer was huge and the need for a very regular schedule of exercise, food and insulin was extremely demanding! Not the ideal way to live for someone in a high stress, very erratic scheduled career – I’m an editor in broadcast television.

Today I don’t think so much about snacks and I haven’t had a graham cracker in quite some time. Now if I want that graham cracker I just do a blood test and give myself a bolus…or not, depending on my Blood Glucose(BG) at the time. And I can do this at anytime not on a specified schedule, thanks to my pump. These days diabetes takes up a little less time but it is still the overwhelming presence in my life. I don’t leave home without it…or glucose tablets, or cereal bars, or my glucometer, or my pump…

So the snacks are still there but they are less a regular necessity and more a constant emergency plan in case my sugar dips below 70 mg/dl…I don’t miss the schedule of eating every two hours all day long but I do miss those graham crackers. So, guess what, I’m gonna get myself a couple of graham crackers and a nice cold 8 oz glass of skim milk, do a blood test, do a bolus and kick back and be a kid again…

We have come a long way but the fact remains diabetes is a daunting “career” and the only thing that will give me peace is a cure.

The Diabetes Project

Welcome to the Diabetes Project. My name is Gary and I have had type 1 diabetes for 28 years. I have always been an advocate for PWD(people with diabetes) but now I felt it was time to use my experience and talent(?) to really advocate! To that end I am producing short video content that will be featured here and also on my You Tube channel, www.youtube.com/thediabetesproject – there will be new videos uploaded as regularly as I can muster while working for a living!

My conviction is that PWD do not have enough of a community given the difficulty of the task of controlling blood sugar. Type 1 or Type 2 we all have the nagging voice in our heads wondering what our sugar is and what consequences it will have now or 30 years from now. I will tell you that what works for me may not work for you but I think that it is important for us to know the different things that work for different people so we can see for ourselves what works and what doesn’t. After all it is I that lives with this beast 24/7/365 (366 every four years!) so it is I that has to find out what works and what doesn’t and maybe you can help me find those paths! As wonderful as my medical team is, they are just not there every minute of the day.

For example, the thing that works for me is that I do not use any artificial sweetners. I am on an insulin pump – Medtronic Paradigm 523 – and I count carbs. I always use 2 tablespoons of real Maple syrup on my pancakes. 2 tablespoons is 26.5 gms of carbohydrate and I bolus for that. If I had type 2 I would eat those pancakes and then walk home, knowing that the exercise would help bring the sugar down. To see how exercise can bring your sugar down take the Big Blue Test before World Diabetes Day on November 14th – http://www.bigbluetest.org/ –

So there you have my first post…no diet drinks or foods for me. I eat healthy, I exercise and I do many blood tests everyday. I don’t use a CGM(Continuing Glucose Monitor)…yet. My A1c is 6.5 and it comes with a little extra push each day to try and do the right thing…now where’s my margarita?