#and also pay me for the test strips so you can check your blood sugar

[houndpitspub]

yes, yes, insulin should be free, but needles need to also be free. like fuck I should not have to pay to GIVE myself the medication I need to survive

#its like pay me for you insulin #now pay me for the thing you need to GIVE yourself the insulin #and also pay me for the test strips so you can check your blood sugar #oh and you one of those continuous glucose monitors? pay me for that too #FUCK

[quixoticanarchy]

Hi can I pick ur brain about how u have some kinda control without carb counting and micro managing, so I am seriously out of control I'm often just 'hi' I hardly do anything because I seriously struggle to even think about management anymore cozz it's just sends me into a spiral where I end up a depressed mess with serious mortality issues and I think it stems from having to micro manage, if there's another way I would love to know, I've got a daughter and I wanna be here for a long time for here but if I carry on like this I'm not gonna be

Okay I can try to give an answer - first, that’s a horrible spiral to be in and i'm so sorry. I hope this response doesn’t sound fake optimistic or trite; i had to learn it all the hard way, and it is hard. But i think it’s better than the alternatives. The goal here is just, i guess, to stay alive and live your life the least painful way you can.

It’s long so I’ll list my main points/concepts and then explain them below the cut (if my phone lets me). Take what’s helpful or doable to you, leave what’s not, etc.

Perfect control is impossible

Doing a little bit is better than nothing

Learn to know yourself, your needs, your intuition

Care for yourself, don’t punish yourself

The body is not the enemy

[Caveats: i currently have access to the insulin, test strips, pump supplies, syringes, sugar, etc. that i need. If you are also struggling with getting basic supplies, that’s of course an additional level of stress because it might not be possible to give yourself the care you need. I’m also speaking as someone who’s been type 1 diabetic for 17 years; this is all just my own experience and thoughts]

1: this is of course easier said than done, but i think one step in making diabetes management less impossible and spiral-inducing is to accept that it will go wrong, and forgive yourself when it does. Really: there is no way to avoid some bad sugars and bad days. I don’t know what your access to insulin situation looks like, but it helps me yo remember blood sugars are never permanent - that's their blessing and their curse. They can be fixed. If it makes you horribly stressed or guilty or upset when you’re constantly high, i would say: try to step back. It is just a number.

I spent a long time where whenever my sugar went really high i would overcorrect on purpose with a ton of insulin, as if to punish myself by making my sugar drop as fast as possible. This of course just led to me then chasing lows instead, and it never made me less likely to go high again.

2: better to do a little bit than nothing. I know it doesn't fix the feeling of spiraling, but checking your sugar even once or twice a day is better than none. Treating a high sugar late is still better than never. Ask yourself what feels within your power. What care can you give yourself. Ymmv but again, something is better than nothing. I also believe that it becomes easier with practice.

Also, appreciate yourself for small things: if you bring your sugar from ‘hi’ down to a number reading, good job! That’s something! If at first you don’t treat a sugar but do it later - still helps! If you haven’t checked your sugar in a while and when you do, it’s high - good job for checking! The temptation to spiral is so strong, but the spiral will only ever tell you you’re wrong, you’re doing it wrong, you’re failing. That’s never helped anyone and usually isn’t even true. You’re doing what you can for today.

3: know yourself. Intuition takes practice, but this is where the getting away from micromanaging comes in. I don't think you need a food diary or a scale or an app or even a calculator (if it helps, use it, but don’t force it). I don't think you can form a better relationship with your body and its conditions by trying desperately to control it. What i do recommend is paying attention: what makes your sugars go high? What doses of insulin work for what meals or sugar levels? What doesn’t work? This is really hard to separate from the impulse to judge - feeling like you’ve messed up, you guessed wrong, you forgot, you were too tired to bother. But no rules can teach you exactly what you need. It’s incredibly subjective. The same things won’t always work, which is eternally frustrating - there is no magic formula. But you can learn to recognize what you need, in the moment, not according to ironclad rules.

When i say i don’t count carbs, this is how it looks: let’s say i have toast and eggs for breakfast. I've had toast lots of times. I know roughly how i’ll react to it. If my sugar is higher when i eat I’ll also need more insulin to deal with that. I might think: so, i gave 4 units yesterday for a similar meal and came out a little high later, and maybe my sugar is higher today than yesterday morning. Maybe today i give 5 units. I don’t use official carb ratios; I use my past experience of what usually works. I try to pay attention to how i feel in the hours after - am i thirsty? Am i tired or foggy? Shaky? I have a lot of practice at this kind of intuition, so i can make a decent guess as to whether my insulin dose was too much or too little. If it’s hard to sense where your levels are at, maybe recheck your sugar in a bit to see how it went. And I can still be wrong sometimes - that’s ok, i just respond to wherever I find myself now.

Like - it’s stressful to tell yourself you can’t eat certain foods. It’s stressful to have to do lots of math any time you eat. It’s stressful to constantly feel like you should be doing better and if you’re not, then something’s wrong with you. If you feel restricted and hounded by rules, or are angry at yourself for breaking them, it becomes harder to care for yourself.

4: care, not control. I think a lot of the stress and the fear and the depression does come from the control mindset; specifically, feeling like we’re failing at it. Control implies that there’s a right way to do something and a wrong way that will/should be punished. Care is more of a negotiation: try something. See how you respond. It builds off intuition - knowing what you need rather than trying to follow a rule or achieve a given number. A little bit of control may seem pretty worthless if your goal is total control - but a little bit of care is clearly better than no care. It’s a matter of keeping yourself alive, yes, but also trying to make that life livable. “Control” might be an impossible target; “care” isn't a target, it’s a practice, and shouldn’t be impossible.

If you ‘mess up’ or have a bad day - or lots of them - you still deserve care from yourself. Even if it feels hopeless. Even if nothing seems to be working. Even if your sugars aren't where you want them. In my experience, I feel less anger or shame or exhaustion if I change my goal from needing to control/punish/fix myself, to taking care of myself however much i can.

5: the body is not the enemy. This is just a reminder I have for myself that builds off the principle of care. I hate the idea of ‘bad diabetics.’ It’s not a moral failing to be diabetic and it’s not a moral failing to struggle with it. “Good control” and “good” numbers do not make you a more virtuous person. This is a hard thing to live with, and being tired or frustrated or feeling defeated makes sense. Why in the world shouldn’t you feel that! The idea of failing at control implies you need more control / to punish yourself to fix it - but you don’t. I don't say all this as if i'm going along happily observing every high sugar i have or being kind to myself all the time. But I’ve tried to stop seeing my body as the enemy. We might be unhappy teammates but we’re on the same team, and it’ll go better for me if i accept whatever current situation I'm in, and do what i can to make it better, without judging or hating myself in the meantime.

This is not to say it’s not hard. It’s hard and it’s overwhelming and it’s tiring. But the way that we’re told is the right way to live with it makes it harder, in my view. If you’re here and you’re trying to care for yourself - even just a little at a time - that’s something. It counts. It counts for your daughter, too. And i'm wishing you the best, and a little peace with yourself. Strength & solidarity ❤️

#this is long but I hope it helps or clarifies how I think about things #I hold these principles for stuff beyond diabetes too #also im still learning all this I promise I haven’t got it all figured out #nor is it easy. but it can be less hard & the typical frameworks you get taught make it harder. imo #diabetes #actually diabetic #type 1 diabetes #chronic illness #skravler

[autisticeducator]

Dear body,

I know I can be scarily accurate about what is potentially going on with us. I didn’t want to be so dead on about low blood sugar being a migraine trigger that I got a glucose meter that plugs into my iPhone (of course) and started tracking my blood glucose levels to find that I wake up hypoglycemic Every Single Morning.

*Quick note, I’m not diabetic, my A1c has been tested recently and came back 4.6 but both my parents are diabetic and I have a genetic predisposition to develop diabetes.

I didn’t want to be so incredibly right about this to stun multiple doctors by the fact that I even thought of doing this without being told to. There are diabetics that can’t remember to test regularly (I live with two of them). I’m using this as a tool to get my migraines in check. If it helps prevent diabetes, then even better. I got enough going on to deal with that.

*So for those who don’t mind paying out of pocket, paying absurd prices for test strips anyway, or have terrible insurance that covers pretty much nothing, Center Health makes two glucose meters. The Nano works via the headphone jack (will work via Lightning to headphone or USB-C to headphone adapters but must be the Apple or Google ones). The Duo is a Lightning meter (USB-C version should be coming at some point) that uses two enzymes rather than just one for better accuracy. The meter you pick is provided with your test strip subscription. They will also send free control solution upon request. Shipping is included in the subscription price.

$16/month for 50 strips

$20/month for 100 strips

$29/month for unlimited

Test strip prices out of pocket are horrifying when bought at a traditional pharmacy. I went this route because I need the technology to track for me or I’m not going to remember anything (the incorporation of other data like sleep and exercise from Apple Health is incredibly helpful for pattern tracking). I don’t like relying on what my insurance is willing to pay for (especially since I’m not diabetic, that would be nothing at all).

#too accurate #i know myself too well #migraine #diabetes #test strips #center health

[helpingmaster]

Smart Blood Sugar   {Imagine… No restrictive diet. No crazy exercise program.}

Hi, I am helpingmaster. Although this seems incredible. But imagine...no restrictive diet. There is no crazy exercise plan. How does a 59-year-old diabetic chop 80 points from fasting blood sugar-in fact overnight? And after three days, he stopped taking insulin!

he key is to say “no” to restrictive diets. They’re impossible for most people to stick with.

Instead…  revolutionary “Diabetes Reversal Recipe” enables you to enjoy the food you and your body crave… food that flips your blood sugar “switch” back ON… so your body quickly and efficiently burns up all the sugar in your blood stream… like striking a match to gasoline!

Just ask 59-year-old John Hiatt…

John’s a Type II Diabetic whose blood sugar had been rising for years… so his doctor put him on 3 different blood sugar meds and 2 kinds of insulin.

But even with all that churning in his body, his fasting glucose soared to dangerously high levels — bouncing between 200 and 275.

That’s organ-failure territory!

All that roaming sugar thickened his blood and slowed his circulation. As a result, his vision got blurrier each day. His organs, hands, and feet were slowly starving to death, robbed of the nutrients they needed.

No wonder he lived in fear of the day — a day he prayed would never come — when his doctor would put a hand on his shoulder and break the bad news…

“Sorry, John… you’re going to lose that foot.”

Then, one Sunday night, alone at his computer, John stumbled upon my “Diabetes Reversal Recipe.” He learned he could still eat delicious foods that automatically turned his blood sugar “switch” back ON.

He had nothing to lose. So he put it to work that very night.

The next morning, John checked his blood sugar and was shocked — his blood sugar had dropped 80 points!

He wondered if it was a fluke — would his blood sugar bounce back up again? To test this, he continued the plan that day and the next morning…

His blood sugar dropped again — 40 more points!

He was astonished: a drop of 120 points in just 2 days? He had never seen anything like it before.

But the amazing part was when he decided to stop taking insulin that very night. Understandably, his wife was worried — what if John’s blood sugar shot up during the night? What if he slipped into a diabetic coma?

Well, when he woke on the third day of following the Diabetes Reversal Recipe, both he and his wife were shocked to see that his numbers had stayed at their all-new low!

As a result,

John hasn’t taken a drop of insulin since!

This means he pockets an extra $400 a month — that’s how much he used to pay for insulin out of his own money. That’s $5 grand a year for him to keep; as he calls it, “it’s a vacation in Hawaii 。

Plus, as an added “bonus”, John lost 25 pounds — without trying. He says his gut is “almost gone.” His friends do a double-take when they see him for the first time.

John says, “This was an epiphany.I thank god。

I am truly humbled to hear from people like John… people who were desperate for a way to lower their high blood sugar… who hated taking a fistful of pills and injecting insulin every day…

…but who felt they had no other choice:

Eat brown rice, tofu and carrots for the rest of my life? No thank you! I’d rather — I’d rather be sick

So their eyes light up like a Christmas tree when they discover they can feast on delicious food… and…

…watch their blood sugar numbers sink like a stone!

That’s why you can eat this way for the rest of your life! Because it’s easy! This is the key. Everyone is different, so of course some folks take longer than others to lower their blood sugar. But because I’m not asking you to “tough it out” or rely on willpower, you get to enjoy eating while your body heals.

Because while you savor each mouth-watering bite, the specific nutrients in the Diabetes Reversal Recipe go to work, invisibly repairing your blood sugar “machinery.” Here’s how: Essentially,

Each cell in our bodies has a blood sugar “switch”…

When the switch is “ON”, our cells burn the sugar from meals… just as soon as we eat.

That means you can eat ice cream, a candy bar, whatever — and all that sugar gets burned up as energy.

Maybe you’ve even known people like that… people who can eat whatever they want without worry. Lucky devils.

Well, this is why — their Blood Sugar Switch is “ON.”

But for many of us, our switch turns “OFF.” What does this?

   The hormone Insulin.

That might sound odd, because as you may know, insulin is the hormone that stores sugar into your cells. Without insulin, sugar can’t get inside. You definitely need it.

But here’s the strange thing…

Too much insulin over time is the same as having too little — both cause your blood sugar switch to turn OFF. Here’s why:

Think of insulin as the “key” that opens the “lock” on your cells. When insulin works properly, it opens the cell doors, and sugar races inside to be burned as energy.

But over time, too much insulin exposure damages these locks: they get “stripped” from over-use.

When this happens, you have insulin resistance. Your cells resist insulin, and so you don’t efficiently burn sugar. Your switch turns OFF.

With nowhere to go, that sugar gets stored as fat — ballooning your waistline!

Worse, it piles up dangerously in your body. It thickens your blood, slows your circulation, and can permanently damage your eyes, organs, and feet.

But here’s where the Diabetes Reversal Recipe works its cellular magic. With a precise calibration of nutrients, it works to flip the blood sugar switch in your body back “ON” — reversing even years of insulin resistance — so you can burn up sugar again and rush it from your bloodstream.

That means lower blood sugar numbers than you’ve seen in years!

Just like Robert C. from Canton, NC saw: “My A1C was 6.9… down from previous visit’s 7.4. Weight down 6 pounds. My doctor took me off Lantus. Blood Glucose readings are mostly within normal range… all from using the Diabetes Reversal Recipe.”

Now, you can put in the diabetes reversal recipe to change your life!

The method is as follows: Put a simple step-by-step instruction book called "Diabetes Reversal Recipe" into...

  Smart Blood Sugar!

This handy guide is the product of natural medicine training conducted at the Health Center in Austin, Texas and years of perfecting diabetes reversal recipes.

There’s no fluff or technical jargon to wade through. Just practical, real-world help. This means you get to the “good stuff” you can use today.

So now you can lower your blood sugar and reverse your diabetes… in the fastest, easiest, and tastiest way possible!

You won’t have to tear out your hair counting calories or deciphering complex plans, like with the “low-glycemic index”…

…and you can ignore restrictive “rabbit diets” — the kind of diet you find on the American Diabetes Association website…

In fact, there’s one ADA guideline that can ruin your chance of ever reversing diabetes — I’ll tell you what it is and why you can safely ignore it!

Instead of all the hassle, you get my simple blueprint for lowering blood sugar: The Diabetes Reversal Recipe.

And as powerful as this is, there’s even more in Smart Blood Sugar.

You’ll also get extra “bonus material”…

You see, I’ve picked up a handful of “quick tricks” that shortcut the healing process and make it even easier… and I want you to have these shortcuts in your back pocket when you need them…

Shortcuts like…

…How to eliminate sugar cravings — without will power.

It’s actually simple when you discover what drives a “sweet tooth” — it’s not something you’re born with. Sugar cravings come from specific “programming” in the brain, but I’ll show you the easy way to “Feed your brain”, so the cravings disappear.

You can still enjoy sugar, by the way — you just won’t be a slave to it. You will be in control.

In fact…

You Can Lower Blood Sugar While Eating Sugar!

t may sound too good to be true, but I’ll show you a 60-Second “Cheat trick” that forces your body’s cells — even if they’re “insulin resistant” — to instantly gobble up sugar from your blood stream… even when you indulge in that slice of chocolate cake. (Your lab results will still impress your doc — he’ll never know you “cheated.”)

Plus, you’ll see what you should have in your fridge at all times to keep hunger away…

he bite-sized snacks to keep in your pocket for an instant pick-me-up…

Personal story: These tiny energizers kept me going when I pedaled my bike across the country. These treats worked like magic to give me long-lasting energy without a crash, unlike energy bars. If they could keep me pedaling for 20 miles a day, imagine what they’ll do for you. I now keep a few in my purse at all times.

Plus more helpful “tricks”…

How to order at a restaurant like a normal person… Just by requesting THIS at the start of the meal. Then order whatever you want.

Do you crave cola? You’ll see the easy way to kick a soda habit, even if you currently guzzle it by the case. This sneaky trick will fool your taste buds so you don’t miss the cola…

How to enjoy healthy sweeteners: Most sweeteners spike your blood sugar and are toxic for your body (like aspartame). But it’s easy to pick the right kind when you shop — you just have to spot three specific letters on the label.

The Japanese “miracle noodles” that don’t raise blood sugar one iota. You’ll love their mild flavor and soft, chewy texture. Please your pasta cravings without spiking your blood sugar…

My “Heavy Artillery” For Lowering Blood Sugar!

These 2 blood sugar busters can reset your blood sugar switch in the shortest time possible.

I do have to warn you: these 2 “big guns” take a bit of effort, and they may not be for everyone. But if you choose to use them, they work like magic.

The first is the fastest way to reverse insulin resistance. What is it? A specific form of movement that vacuums up extra glucose in your blood stream.

But don’t worry — this isn’t the same old “exercise for 30 minutes a day” boring advice you may have heard. In fact, this takes just a few minutes.

(Forget wasting your mornings like those poor souls stuck on a treadmill — you’ll be done before they’ve even warmed up!)

And the second “Big Gun” is actually a secret found in Scripture.

This religious practice (which anyone can use, no matter your denomination) almost miraculously resets blood sugar. In fact, you can do this just once a month and enjoy lower blood sugar for days.

True story — I’ve even read of one doctor who does this faithfully every other day… and then on the other days, she eats whatever she wants… we’re talking all the McDonalds and candy bars she feels like — and she still remains healthy. She’s slim as a rail.

(Not that I’m recommending you do this, but it does show how effective this ancient technique can lower blood sugar and drop extra weight.)

Put all this together, and Smart Blood Sugar delivers everything you need to know to get your blood sugar under control… faster and easier than you thought possible — even if you feel like you’ve seen it all.

Now, I can’t promise you’ll achieve the exact results you’ve heard today. Your results depend on several factors, including how closely you follow the Diabetes Reversal Recipe. Your blood sugar may take longer to heal… or… it may heal even faster. That’s why I strongly recommend you wait for your doctor’s blessing before you stop taking any medication.

But this is the only method I know of that safely and naturally gets your blood sugar under control.

So if you’re sick and tired of “feeling sick and tired”… of living with unpleasant drug side effects…

…if you’ve tried “dieting” before and it hasn’t worked… then give Smart Blood Sugar a try. Just click the big button below to get started.

And you risk nothing when you act today…

You’re protected with an extremely generous 60-day, 100% money-back guarantee. You have a full two months to decide if Smart Blood Sugar is right for you. If you’re not completely thrilled with Smart Blood Sugar — for any reason — then you get a no-hassle refund anytime in the next two months.

To get started, all you need to do is click the big order button below. Next, you’ll see a secure ordering page. After your order is processed, you’ll be able to download your digital copy of Smart Blood Sugar without delay.

You can also receive a physical copy of the book for a small shipping and handling fee.

As soon as you download your copy of Smart Blood Sugar on to your computer or other device, you’ll be able to put the Diabetes Reversal Recipe into action. It’s that simple. At your very next meal — today — you can begin turning your blood sugar switch back “ON.”

And it’s easy to get started today with the low price I’ve reserved for you.

Now, I’m sure you’ll agree that this kind of potentially life-saving information is extremely valuable…

Many of my patients pay several hundred dollars, starting with a $150 fee for their first visit. That’s when I share the Diabetes Reversal Recipe and explain how it works.

But I want to make sure as many people as possible avoid the horrors of uncontrolled diabetes. I don’t want price to keep you from that. So I’ve arranged with my publisher to price Smart Blood Sugar at half this starting price — just $67.

But WAIT!

That’s not the price YOU will pay today.

By watching this entire presentation to the end, you’ve proven you’re committed to improving your health. You’re the kind of person willing to take action.

When I see a patient like you, I get a big smile on my face — because it means my job is halfway done.

So as a thank you, you can have Smart Blood Sugar for a fraction of its value…

For only $67… $27!

And remember you don’t risk a penny of that. You have an entire two months to check out the plan and still get your money back, hassle free.

But wait — it gets better.

When you order today, I have something really special for you…

Five FREE Gifts!

…that make the Diabetes Reversal Recipe even easier!

FREE GIFT #1:

“7 Day Meal Plan”

This is a deal: "Diabetes Reversal Recipe" was given to a professional chef and asked her to design a simple and easy-to-use recipe...,

She created months of these delicious, precisely calibrated recipes that are easy to make — most take 20 to 30 minutes, and many can be made in advance and frozen for the week. (Especially nice when you come home and just want to eat!)

And you get 7 days of these recipes for free — with Breakfast, Lunch, and Dinner for the next week. Bar none, this is the easiest way to put the Diabetes Reversal Recipe into action.

And to make these recipes even more of a no-brainer, you also get a complete “Grab it ‘n’ Go” Ingredient Shopping List for every ingredient you’ll need for the meals. Just take the Shopping List with you to the grocery store, and you’ll be in and out in under an hour. Ready for the whole week. It couldn’t be simpler.

Plus, you’ll enjoy what happens when your family digs in to these dishes…

As Susan C. from Franklin, TX discovered…

FREE GIFT #2:

“99 Foods for Diabetics”

These 99 foods have been shown in several studies to reduce insulin resistance, lower blood glucose levels, strengthen your immune system, and prevent diabetes-related complications like neuropathy, kidney failure, and blindness.

Plus, you’ll see why these 99 foods work: each food comes with a list of its key macronutrients, vitamins, and minerals and a concise explanation of how these specific nutrients lower high blood sugar.

And you’ll see these foods do a lot more than just battle high blood sugar…

Like the fruit that wards off gout attacks … the food that prevents bruising… the mild type of lettuce that can save your eyesight… the spice that soothes joints and calms upset stomach… plus dozens more health bonuses.

Of course, you don’t need to read the details — you can just select a food that gets your mouth watering and dig in.

Plus, you get three more bonus guides…

FREE GIFT #3:

“How To Read a Food Label”

Food companies have invented all sorts of sly ways to sneak in junk ingredients… but they won’t make a fool out of you! With this handy guide, you’ll be able to spot blood sugar-raising ingredients at a glance.

FREE GIFT #4:

“Carb Count Cheat Sheet”

This list of over 40 restaurant and packaged foods shows how you can safely eat yummy treats from Krispy Kreme, Subway, Olive Garden, and others. Enjoy eating out without missing out.

And last (and maybe most popular)…

FREE GIFT #5:

“Alcohol That Works”

You’ll see how you can lower your blood sugar and still enjoy alcohol — even everyday if you choose. (Plus you get a bartender’s guide to 5 decadent, blood sugar-safe cocktails — including whiskey sours, cosmopolitans, and margaritas.)

Picture yourself waking up and feeling more alive…

…more focused, and more hopeful than you have in years.

No more worries about blood sugar, like losing a limb to amputation.

Instead you’ll feel excited about the future. You’ll have the strength and energy to enjoy each day to the fullest. And you’ll enjoy the peace of mind that comes from knowing you’ll be around for your family.

You can do this. The book and the bonus gifts show you every simple step to take. All that’s left is for you to take that first step and click the button below.

And remember that I’m taking all the risk — you get every penny back if you wish.

click the link。↓

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So click the button below to lock in the ultra-low $27 price.

On the order page, you’ll see the 5 bonuses added automatically to your order — at no extra charge, of course. You will get immediate access to the digital book and the 5 digital bonuses — with simple, clear explanations for how to download them to your computer. And your physical copy will ship right away if you choose.

Again, you are completely covered with a very generous 60-day money back guarantee, so you don’t risk anything. Just order now, while you’re determined to get your health back today.

#blood sugar #lower blood sugar #recipe #healthy #Kitchen witchcraft #diabetes

[ayehatethis]

Niall the Nurse

Warning: blood and needles, mild vomiting

I've been type 1 diabetic for 25 years and so I sort of wrote this cause I wanted one and it's more for me than anything. I wrote this based on my experiences, my symptoms, how I handle them and how my doctors have advised me to. I am not a medical professional, just a T1D (for longer than Niall has even been alive) and this is based on that. If you have questions regarding anything I talk about here, please don't hesitate to ask.

Also, I know Niall is scared as fuck at these types of things but I 100% believe if his girl had something like this he'd learn all he could to help her.

Here

It's the sixth glass of water she's ordered when I notice her face looking a little paler than usual. She usually drinks whiskey or some type of cocktail but tonight she insisted she only wanted water and I didn’t think anything of it till now. She is diabetic and I wonder if she’s checked her sugar lately. Someone calls my name and startles me from my thoughts and I forget to ask her.

I made her go to this stupid dinner for some golf event she didn't care about and she told me earlier in the day she hasn't been feeling well but she said she'd still go cause she knew it was important. I tried to tell her she didn't have to suffer through if she didn't want to. We could keep the babysitter and she could just relax in the hotel room the company booked me and if she felt better she could come down, but she insisted.

She's wearing a simple black dress and it's stunning on her. It comes down to her knees with a slight slit up the side. It has a soft neckline trimmed with a hint of lace and it shows just enough of her chest that it makes my heart beat faster. I know she's uncomfortable in dresses and she for some reason felt the need to wear some sort of contraption under it that sucked in her waist a little more. I thought it looked better without. I like her curves. I like the stretch marks and the baby weight she hasn't lost. It's a mark of how strong she is and how she gave life to my little girl. She’s too self conscious. Especially in this business I’m in, which is why I guess she felt the need for it.

The waiter just brings her an entire pitcher this time and leaves it on a side table behind us so she can get more when she needs it. If she's feeling too bad she'll tell me, I hope. I'm trying to pay attention to the other dinner attendees but keeping an eye on her, when I see her put an ice cube in her napkin and rub it on her forehead. She puts her head in her hands and she’s trying to be inconspicuous about it to not alert the other dinner guests.

"Baby, are you okay?" I lean over and whisper.

She shakes her head no before grabbing her purse and excusing herself to the ladies room. I follow her with my eyes as she starts to walk faster the closer she gets. I see a few of my colleagues notice as well and I stand up, throwing my napkin on the table and follow her, ignoring the ‘LADIES’ sign on the door and the dirty looks from the older lady walking out. 

 My princess is sitting on the bench in the ladies room and she feels so ill she doesn't even ask why I'm in here. She just hands me her purse and it clicks in my head what she needs. I should have asked her earlier.

I pull out her meter and wipe her finger with an alcohol wipe. I hold the lancing device (she calls it a pricker and I always thought that was strange) to her balmy hands and press the button to release the lancet into her delicate finger. A small drop of blood appears and I place it onto the test strip.

"HIGH" is all it reads once it counts down. "Babe, you're over 600. It won't even give a number. Is your site in?" She shrugs and mumbles something incoherent. I make sure there's no one else in here before I lock the door and then help her lift up her dress. I pull off the waist control thing and see that in fact her insulin pump site had been pulled out and started bleeding. 

"Babe, it came out. Do you have any syringes with you?" She nods. I clean up the site and the blood and fix her dress. Without the waist control. I throw it in the trash and I dig out the syringe and tiny bottle of insulin from her purse.

"20 units" she mumbles and I fill the syringe with the insulin. I wipe the skin on her exposed arm with another alcohol wipe before pinching a small section of fat, inject the needle and push the plunger in. I pull it back out and she looks up at me with sweet doe eyes and I'm about to help her back to the table when she flashes off the bench and into a stall. I can hear her losing everything she had eaten that day and I rub small circles on her back with one hand and hold her hair back with the other.

Someone starts knocking on the door and I forget for a moment where I am, but then run over and open the door to find the wife of one of my golfers. She looks startled that I’m in the ladies room and we’ve locked the door, but when I explain, she looks relieved that we weren't just in the bathroom messing around.

"Her blood sugar is really high and she's sick and I gotta take care of her. Can you just stay with her for a minute so I can go explain?" She nods and I kiss my wife's head before ducking out of the ladies room. 

When I walk back to the table, they’ve moved on to dessert. A few ask if she’s okay and where she is.

“She’s not feeling too well. I’m gonna take her back to the hotel. Thanks for a great dinner guys. I’ll see ya tomorrow”

A few of them snicker under their breath thinking they know why were leaving early. I mean her dress was amazing, but that’s not why. I ignore them and grab our food that the waiter had wrapped up. I walk back to the ladies room and knock on the door before peeking my head in. The woman whose name I can’t remember is sitting with her on the bench again, wiping a cold towel on her forehead and cleaning up her makeup. I thank her and she gets up to leave.

“Do you want me to take her to the hotel so you can stay?” she asks. “I don’t mind, I really hate these long dinners.”

“I’d rather go, in case she needs me to help her get her site back in. I’d rather make sure she’s okay, but thank you.” She nods and leaves the room. I call my driver to pull the car around and I don't care where we are, she's my princess and she needs me so I scoop her up into my arms and carry her out of the restaurant and to my car. I get a lot of strange looks and I'm sure this will be in the press tomorrow but I don't care. Morgan or Megan, whatever her name was can explain to everyone what was wrong. I know I’m overreacting, but I don’t think in how long I’ve known her I’ve ever seen her get sick from a high blood sugar. I wonder how high it actually was.

My driver looks surprised to see us out so soon and that I'm carrying her and helps me open the door and get her in. I explain to him on the way back to the hotel. It's a short drive, but her insulin is fast acting and she's starting to feel a little better when we pull up.

"I can walk Ni." she says, but she’s wobbling a little.

"Are you sure? I can still carry you."

"It's just a high blood sugar because my site got pulled out. It's not that big of a deal. Although I am sorry you had to leave early. I should have known it came out. Once I get my site back in, do you want to go back alone? I feel I wouldn't be good company tonight. Mel can come keep me company.” So that’s her name, I mentally note.

I walk her to the elevator and push the button for our floor. She leans on my shoulder and I put my arms around her waist to stabilize her. "We'll see how you're feeling. I don't wanna leave ya."

The elevator dings and we get out and walk to our room. I help her into one of my old  T shirts and some sleep shorts and she sits on the bed and starts to put her site back in.

"Do ya need help?”

She shakes her head no and I watch her as she puts the insulin inside the reservoir and connects it to the tubing before injecting the needle and tube into her stomach. I hate that she has to do this. She's so brave and strong. I don't dare tell her cause she hates when people tell her that for doing something so simple that's just a part of her life. Something that's been a part of her life much longer than I have.

Her mother was insistent on me learning all about it when we got engaged. Y/n said I didn't have to, but I was eager. I wanted to know how to take care of her. I wanted to be prepared in an emergency and so she gave me a crash course on diabetes every time she had to do something new I didn’t know about. I learned all about her symptoms, high and low. I learned how to check her sugar, inject syringes and change her pump site. I learned about sick days and traveling and adjusting depending on time zones and temporary rates. How she didn’t have a degree in mathematics to figure all this out, I don’t know. There’s so much calculating it overwhelms me sometimes.

She finishes up and I'm still in a daze watching her. I know it's not the worst thing that could have happened and I didn’t need to react how I did, but I hate seeing her sick, not feeling well, or like she was tonight.

"What's wrong, Ni?" She breaks me out of my daze as she throws all the trash away and cleans up all her supplies. She lays down in the king size hotel bed eyeing me waiting for me to answer.

"You really scared me. I don't think I've ever seen your blood sugar that high before. I was scared outta my mind. How would Juls react if she had been here to see mommy so sick?" I don’t mean to sound accusing, but if it scared me that much, how would our three year old react?

"I'm sorry. I started feeling crappy early on, I should have tested sooner. I know better. I am sorry I scared you. And I really appreciate you helping me. I’m glad you learned all this shit. I guess mom was right.” she chuckles.

"Babe, please do me a favor?" I ask as I take off my suit leaving me in just my boxers.

"Anything" she says as I hand her a bottle of water from the mini fridge. She downs half the bottle in one shot and puts the rest on the table next to her.

"Don't wear those squeezy waist things anymore. I hate em and they pull at your site and then you get sick. They aren't healthy for ya anyway. I wanna see your curves. I hate when ya hide em. If ya want to get a trainer to help ya feel better, I can call Bres to see about the girl he goes to.”

I climb into the bed next to her and she wraps her arms around my chest instinctively.

"I'll think about it." She says clutching me tighter and I wrap my arms around her.

"So you aren't gonna gonna go back?" She asks a few minutes later.

"Nah, I'll see em all tomorrow. I wanna make sure your blood sugar goes down. You're more important than all that. By the way, check your sugar again. I wanna see if the shot helped.”

She pulls her meter out of her purse and checks it. “413, at least its going down. If you wake up and want to check me during the night, I’ll put it on the side table for you.” and she places it next to the water.

I am totally going to wake up and check her blood while she’s sleeping. 

We have to get up early for the event today and when I check her sugar before I shower, its down to 115. ‘Perfect’ I think to myself as she rolls over and pulls her hand from my grasp. “Ni, you’ve checked me 15 times in 6 hours.” she groans.

“I know babe, I just wanna make sure you’re okay and you are. Go back to sleep for a few minutes. I’ll get you up when I’m out of the shower.”

“Mkay..as long as you promise I can take care of you next time you’re sick. You’re always taking care of me.” she says. I hardly get sick, maybe I’ll pretend to make her feel better next time I have a day off.

“Sure, babe.” I laugh “Oh, make sure to pack an extra set today just in case”  

“OKAY NIALL!” She yells as she tosses a pillow at me.

I laugh and run into the bathroom just in time to miss her toss.

Yeah,she’s definitely feeling better.  

My computer is being shitty today, so thank you for reading and sitting through this mess. Again, if you have questions about any of this, just ask!

#Niall Horan #diabetes #diabetes is stupid #writing

[ampijpers]

I was supposed to finish this project in November of 2015. But I didn’t. I attempted to finish it a year ago, but that also didn’t happen. Life is distracting. The thing is, type 1 diabetes isn’t a project that will ever end for me. It’s an everyday project. It’s a life project. I have this for the rest of my unforeseeable future. What still remains true though, is that every day is different. It’s the only way I can deal with having this illness: one day at a time. If I start to think of the big picture, things get overwhelming & it makes me feel like shit.

What follows is writing I’ve had saved on my computer with all intentions of contributing it to this endeavor. It is organized by a daily format to stay true to it’s original structure. The writing spans anywhere from March 2016 to now. Enjoy, or something:

Day 27: I think my biggest frustration with type 1 diabetes is constantly having to be prepared. You can’t be spontaneous.  I’m envious of friends who quit their jobs whenever they want and go on trips and spend money recklessly. I simply cannot do that. Any time I go on a trip somewhere, I have to plan very, very accordingly. I have to prepare the correct amount of supplies, and by “correct”, I mean twice or four times as much than I would need. Sometimes I have to spend extra money so that I have backstock. You cannot be caught off guard if you have type 1 diabetes. If you don’t have what you need, you are fucked, simply put. I’ve been in situations where I’ve run out of insulin or test strips and it is a type of stress I never want to revisit. Not having what you need to survive can put your head in a twist. I’m at a place where health insurance through my work is vital to my survival, despite it’s awfully high deductible draining my pockets.

I’m currently in Belgium on vacation, where my parents live. To prepare for this trip, I brought an absurd amount of back stock for pump supplies. Because of how much one vial of insulin costs, I didn’t get another vial from the pharmacy. I couldn’t afford it. I decided I would spend my money on test strips instead. I also didn’t want to ask my parents for help. I hate asking them for help. Hate it. I recycle the insulin leftover from my pump cycles. I have two vials of recycled insulin. If my doctors knew this, they would shake their heads. You’re not supposed to recycle insulin. Heat breaks down the effectiveness of insulin. It still works to some degree, but not as well as it should. I personally think it’s a waste to throw usable insulin away. In dire situations like right now, this recycled insulin is helping me. The past two days I’ve been playing tug-of-war with my blood sugars. I have been giving a lot of insulin and not seeing the results I want. I’m only here for another six days, so I’m not too concerned. I mentally prepared myself for this bullshit. During moments like these, I’m frustrated. Irritated. This morning I woke up at 4 am to a low blood sugar. I treated it, fell back asleep. When I woke up four hours later, I was in the 200’s. It just doesn’t make sense. My blood sugar should not have been that high. Why can’t my body just do what I tell it to? Why can’t the buttons I push do what they’re supposed to?

It’s my birthday today. My mom made a cake. But I don’t want to eat it, because I know it’ll fuck my numbers up. Type 1 diabetes is so much fun. Can you tell?

Day 28: Ever since starting insulin pump therapy in 2002, I have used the same part of my body to inject the infusion sites in. Namely, my upper butt. It’s a good area- out of the way, out of sight, you name it. The past few months I struggled, though. Some spots in the area were still good, but more often than not, I’d have to cut a cycle short and inject a new place because things weren’t working like they should have. Or it would start hurting. Repeatedly injecting in the same part of your body for at least decade apparently fucks up your skin. Whodathunk!?

Last week, I decided to start injecting my pump sites in a new place. My legs! Whoa! Since this change, things are looking up. Injecting barely hurts and I’m still adjusting to this thing being on the front of my body now. When I was still injecting around my old sites, it wasn’t pleasant. Sometimes it’d be sharply, physically painful. That has never bothered me much about the disease though, the physical pain. The difference is stunning, however. I am currently experiencing phantom pump sites. Makes sense, but I never thought about it. It’s amazing how your body moves and adjusts to stuff. I had to relearn how to pull pants on and off without hitting the site. I can only imagine what it’s like for people who lose limbs.

The photograph above is the result of my first site injection into my leg, directly after I removed it. I look at it and it doesn’t gross me out. Or make me sad. Or anything. It’s just part of my body and life and a constant reminder to those reading this that you should never, ever take your health for granted. I would not wish type 1 diabetes upon anyone. Except Donald Trump.

Day 29: I wake up and the sadness is present and inexplicable. I just feel sludge weighing my body down. Depression is something I live with. More often than not, it hides in the back of my brain, and only emerges at the most selective, unpredictable times. Type 1 diabetes is undoubtedly the cause of this, as well as celiac disease. This so-called sludge, I’ve felt it since I was young. I remember being ten or eleven and feeling this. I couldn’t put it to words back then and it manifested into something that got extreme at points. But now that I’m older and have more perspective and have seen a number of professionals, I can put it into terms humans created. It is the number one thing that stops me from taking care of myself. And I hate to admit it, but it’s true a lot of the times. There’s an avoidant attitude; I don’t check my blood sugar enough. I half-remember to give insulin sometimes. Why is this still happening to me? After all these years of having this? Why isn’t there any part of my soul that wants to put effort into this thing I live with? How is it so easy for me to ignore it for large chunks of time? At work, when I’m out with friends, fucking anything. It’s frustrating, because I’m at a point where I’m fed up by my laziness, by my lack of motivation. I want so badly to be better; to be good; to be awesome at taking care of myself. Maybe it’s because I know I can’t beat it for good. I’ll never defeat it. It’s something I’ll live with until I die. And after a while, what’s the point anyways? We’re all going to die. I just have to stay motivated. And the way I do that is by creating things and occupying myself with projects.

Day 30: This is the end of the project. For you, at least. This isn’t the first time I’ve done a project about this illness I live with. I feel like it’s going to be a thing I constantly revisit. The first time around, I made paintings. This time around, I drew and wrote and took photographs. I don’t know what it will be next time around. Something. Maybe dancing or performance art? I’m joking. I’m a strictly two-dimensional art/music nerd. “This is a dance piece about how my pancreas doesn’t work”. I’d love to see that in the flesh some day.

Insulin is not a drug. It’s something your body naturally makes. That’s why I have so many frustrations with health insurance and the cost of this tiny little vial of fluid. We should not be paying hundreds of dollars simply to survive on a basic level. If you’re reading this, please consider signing this petition to make the cost of insulin go down. Myself and millions of other people living in America have to pay an absurd amount of money to simply survive. Change starts with us. The moment you become active, the more you are helping. Same goes for all the protesting against Donald Trump and his evil fucking ways. We’re all in this together. If you sign this petition, you are helping me. You’re helping all of us with this shitty illness we live with. Thank you.

#Aimée Pijpers #type 1 diabetes

[mercadosadaf]

The HVMN Ketone Triathlete Project: Part 4

Before I get into the gritty details of the results, I would recommend checking out part 2 and part 3 of this project to familiarize yourself with the science and reason behind doing such a (some might call stupid, but I prefer, fun) experiment. In this final installment, I am going to go over the results, “findings,” and future recommendations.  

I should also first note that HVMN kindly provided me with ketone esters and ketone blood strips for this project. I paid for import fees and duties.

All future purchases (SPOILER Alert: I will be definitely be making more purchases) will be on my own dollar without any discounts or kickbacks. I had complete autonomy and control over the content of the blogs, the personal research that I did, the structure of the workout, and the results (that is, they did not pay me to sandbag the workouts).  Alright, with that out of the way, let’s get into what happened…

The workout that I have labeled the “Tetris Brick” consisted of 4 hours of:

1000 m on the SwimErg as 4 rounds of 50 m hard above threshold, 200m cruise at 85-90% of my swim critical power or CP.

45 min on TrainerRoad doing the Deerhorn -4 workout which consists of 2 rounds of 4 x 4 min at 92-94% FTP with two 30s surges in the mix.

To see what this looked like in real time check out the video I created (Part 2 of the videos):

So how did it go? First, let’s look at the big picture then get into more of the details to see what happened. And, don’t worry: I will discuss the obvious limitations of this experiment and some final thoughts.

Overall Results

Overall, the whole workout went better than expected. When designing this workout, I knew it was going to be tough, and the first hour certainly was. I think I needed a longer warm up because my perceived exertion and heart rate was slightly higher than expected.  However, after the first round of intervals, I started to feel pretty darn good.

By the second and third hour, I was cruising! My mind and body seemed to be completely in sync and focused. Nothing else mattered but the interval I was on. I even forgot to record some video. Fueling was steady with about 150 calories per hour which is about half of what I typically consume.

At hour 2, I had another bottle of HVMN ketones and hopped right back in. I was going strong until the final hour. At the three hour mark, I began to fade — not mentally but physically. The snap in my arms and legs simply was not there like it was. My mind was saying: “Let’s go. Let’s go. Let’s go” and my legs were saying “F#c$ you!”.

It was a weird feeling to have my body give out before my brain like that. By the middle of the last interval, my body had had enough.

It was a like a power switch had been turned off. I tried reducing the intensity, but even then there was nothing. Despite my mind racing like the Energizer bunny, I knew that it was time to throw in the towel. My body had hit its limits for my current fitness. I stopped the workout and did an easy cooldown.

The Objective Nitty-Gritty

Now, let’s look at the Objective results.

Here are my ketone levels over the course of the four hours:

Reading Number Time Ketone levels 1 Baseline 0.1 2 30 min after bottle 1 1.1 3 60 min into the workout 1 4 Two hours in (2.75 hrs from the first bottle) 0.3 5 15 min after the second bottle 2.2 6 Before the final bike (1 hour before post 2nd bottle) 2 7 After workout 0.6

Phinney and Volek, two researchers on the forefront of low carb fueling, ketones, and ketosis, define ketosis as .5 mmol/L and above.

So you can see that one bottle put me into a state of ketosis and kept me there for roughly two hours. Based on these results, we know that the ketone esters do what they say: put you into ketosis without having to go low carb. Moreover, they keep you in ketosis, while still allowing you to top off and fuel with sugar.

While being in ketosis allows you to spare glycogen stores, meaning you burn less sugar at higher intensities, you are still burning sugar and thus need to replenish them albeit with fewer calories.

It is important to note here that it is hard to say whether my crossover point (where I go to burning almost all sugars) was bumped up because of the ketone esters. I think that will be the next experiment.

Looking at my watts, you can see that they remained steady for all four hours. It is important to note that the IF and NP include the warmup and cooldown on the bike.

When these are spliced out IF and NP goes up. As you can see, each round was almost identical and right in that Olympic race pace zone. When looking at the 30s surges on the bike and swim, my power also remained steady.

Workout Normalized power Intensity Factor (IF) Swim 1 71 0.84* Bike 1 273 0.92 Swim 2 73 0.85 Bike 2 275 0.91 Swim 3 73 0.86 Bike 3 273 0.91 Swim 4 78 .92 Bike 4 269 0.92**

*Including 200m warmup **Denotes the first half IF. .84 for the whole workout.

My third round bike power file

A sample power file of the Vasa SwimErg. Note the ANT+ drop out after the first surge.

The Subjective Experience

Now let’s get a bit more into the fuzzy area of my personal experience. In my Google sleuthing since the experiment, others have had very similar experiences to my own, but keep in mind that your mileage may vary. Some people have said that they experience GI distress when consuming these (see the research paper that I posted in part 3) and this hindered their TT performance. However, I never had an issue even on the sprints. Yes, it is not the most pleasant of beverages.

But it works, which is the important part. It tastes like watts. You also get used to it quickly; after a few swallows of water, I was good.

Regarding recovery, I did not really notice a difference. I was able to hustle off to work without issue and focus through the rest of the day. The next day, I woke up and trained normally. I have no idea though whether this had anything related to the ketones but it was nice not to feel completely gutted afterward.

As I said before, my RPE was high on the first round but dropped in the second and third. Even in the final round, I felt fine despite my muscles not wanting to work. Typically, my brain fails well before my body, or I run into either not fueling enough or too much and have GI distress. I also know what it is like to mentally fail where I just want to quit and throw in the towel.

This was a different type of “wall.” My interpretation of what I felt is that I found the limits of physical fitness, which is a good place to be. When you fuel correctly, your mind and body can push itself further and find your current limitations (or pretty darn close to it).  

 I was not in a flow state nor an endorphin high but more of the feeling of laser-like focus and determination. I bet it’s like how Rocky Balboa felt when he was training to fight Mr. T.

Now I know how long I can go at this intensity and can train to push that a little further next time. With more training and the same fueling strategy, I might be able to go the whole 4 hours or maybe even 5.

Limitations, unanswered questions, and future directions

As you can tell, this was not a fancy laboratory experiment; it was a basic DIY n=1 trial.

I did my best to control the variables that I could, but it was not double-blind (meaning I did not know whether I was consuming the ketones or a placebo beverage). It would be awesome to do something like that but for now, this will have to do. Admittedly, a double-blind test would be tough to design at home given the unique taste of the ketone esters. (Side note/challenge: If you can design a better test, I would gladly conduct it).

Could the performance have been a placebo? Possibly. If it was, the placebo worked really well. What is not a placebo is the fact that my blood ketones rose after consumption.

How much of this was related to my fitness? Would you have been able to go for all four hours if you used HVMN ketones? It all depends. A less fit person might have gone 2 hours before failure and a more fit person most likely would have been able to go 5 or 6 before failure. However, in either scenario, I believe that those athletes would be able to push their upper fitness limits at the same intensity.

Also this was at just under threshold with surges but not sprints, so I am still not sure whether ketones could work for something like a criterium race where your power is relatively low while you are in the draft pack then sprint well over threshold. I would think that it would because you are sparing glycogen throughout the race while drafting so that you can have plenty of sugar to burn when you do sprint. This might be another future test.

Despite it being n=1, I am a typical age group triathlete and not a pro athlete or remarkably strong on the bike or swim. I am just your triathlete next door, so I do think that my experience is reflective of a large group of athletes.

Overall Conclusions and Recommendations

Overall, using the HVMN ketone esters was a huge success. I now know that it works for me on endurance intensities and for extended, near-threshold efforts. I also know that using the ketones plus some Golden Graham cereal bars allowed me to find a whole new level of physical fitness. To be clear, it was not like drinking this bottle magically made me fitter or stronger.

Rather, it allowed me to unleash my fitness without the hindrances of mental fatigue, fueling, or GI issues.

Based on this and my previous test, I do have a few tips:

While the instructions online say that you should take it with your normal breakfast, I found that I felt better with a smaller breakfast of just a cereal bar and protein powder in my coffee instead of my typical bowl of oats. I train better with a semi-empty stomach and I felt that the ketones hit my system faster with less food.

I was able to stop and drink the bottle mid workout, but if I was racing, I would put it into a small gel flask for easier consumption than the nice, twist bottle.

The bottles are small and sleek so can be easily repurposed. They fit snugly into my running fuel belt, so I am going to use them to hold fuel (diluted gels or concentrated hydration mix) for long runs when I am not using ketones.  

Given how this workout went, I would give HVMN ketone esters a strong recommendation for short to long course triathletes. In particular, those who:

Have GI issues or a sensitive stomach so cannot eat as much and therefore need to use alternative fueling sources.

Are looking for a competitive edge. Like I said it will not boost fitness but will allow you to express your current fitness for longer.

Race in a hot climate where consuming a lot of calories could be an issue.

Compete in endurance events.

Are health conscious athletes who do not want to use loads of sugar to fuel.  

These are expensive, but I am still going to use them for priority races as follows:

Distance Fueling strategy Sprint 1 bottle before Olympic 1 bottle before, 1 bottle during at the final 10k of the bike. 1 bottle after for recovery Half Ironman 1 bottle before, 1 bottle at 60 min into the bike, 1 bottle with 6 miles to go on the bike Ironman 1 bottle before, 2-3 bottles on the bike and 1 bottle at the half marathon mark.

I would also do this once before each race during a key workout to be able to finetune the timing and what I will use for other fuel (granola/cereal bars are still my favorite). All other workouts will be fueled as usual. And, as I said before, I will pay for these myself. In my opinion and experience, these would be better a investment than buying a new gadget for my bike, swim skin, overpriced wetsuit, action camera, overpriced tri kit, or recovery compression boots.

With that, thank you for reading. I would love to hear your feedback, questions, and constructive (key word there) criticism. I would love to do a similar test, so please send me your ideas on what I can test next.

If you would like to put HVMN to the test and to find out more about it, click here

We do not do this often, but because I believe in the product and have found that it works if you would like a discount, to order you can go to this link for 5% off.

Coach Chris Tri Swim Coach

The post The HVMN Ketone Triathlete Project: Part 4 appeared first on Triathlon Swim Training.

from Sports https://www.triswimcoach.com/the-hvmn-ketone-triathlete-project-part-4/ via http://www.rssmix.com/

#sports

[kristinkratzer]

I’m often talking about insets and pump sites and tubing, but I had a realization tonight.. a lot of you don’t know diabetes jargon! That’s okay! I didn’t either until I started living it everyday. So, let me introduce you to the things that keep Luke alive each and every day. (And the reason why I had a mild panic when Luke told us he only had three insets left.)

The pump

This is Luke’s insulin pump. He uses the Tandem T-Slim. He chose this one because it looked the most techy & had a touchscreen. Ha ha! Luke switched from MDI (multiple daily injections) to the pump just five months after diagnosis. We knew we wanted to make this switch as soon as we possibly could and he’s done amazing with it!

The insulin

We’ve hopped back and forth between humalog and novolog, but both are fast-acting insulins. When on the insulin pump, Luke only needs one kind of insulin. The pump uses this insulin and gives a constant “drip” throughout the day & night. This is called his basal rate. The basal rate can change as he grows & as hormones change. We’ve been lucky – his basal rate hasn’t changed at all since diagnosis three and a half years ago! Fast-acting insulin is also used when he boluses for what he eats.  This is when we count carbs. For every 15 carbs he eats, he gets 1 unit of insulin. He just plugs his blood sugar and the number of carbs he is eating into his pump and it does all the calculating for him!

The cartridge, syringe & needle

The cartridge

The syringe

The needle

These three things work as a team to get insulin into the pump. The cartridge is a little plastic vessel that holds the life-saving insulin. Every 3-4 days, Luke uses the syringe and needle to pull insulin out of the vial (above) and insert it into the cartridge. He puts about 160 units in at each round – insulin for the constant drip (basal), his boluses (when he eats carbs) and then a little bit to fill the tubing so he isn’t giving himself air for the first few boluses. Once the cartridge is full, he inserts it into the pump.

The infusion set

The infusion set

The needle that inserts the canula

The whole get-up, inset to cartridge

The infusion set (or inset) is what he has to insert into his body – usually his stomach or upper thigh. The needle inserts a small tube, called a canula, under his skin. Attached to the inset is skinny tubing. The tubing connects the pump to the inset, allowing the insulin to get safely into Luke’s body. Luke needs to rotate the pump site (where he insert the needle) so he doesn’t develop scar tissue. If he uses the same spot over and over, scar tissue develops and the insulin can’t work how it’s supposed to work.

The meter, test strips & lancing device

The blood glucose meter

The lancing device (aka poker)

One canister of test strips

Blood glucose meters are something you may have seen before. These can be purchased over the counter at Walmart & usually include a lancing device, which we so officially call a “poker.” I’m pretty sure all of our meters were “complimentary.” We “only” had to pay hospital and doctor bills and for a pump. And we have to pay for the test strips – they cost a little more than a buck each. (Yeah, don’t get me started on the cost of life-saving supplies and medications… again.) Luke uses this little machine 4-6 (sometimes more) times a day. He doesn’t think twice about poking his finger and squeezing out a little blood anymore. Luke should test his blood sugar before each meal and before he goes to bed. Other times to check are when he feels like he’s out of range – either with a low blood sugar or a high blood sugar. For Luke, if his sugar is below 70 or above 150, he’s considered out of range. He is usually pretty good at knowing when he’s low & a finger stick confirms it.

So that’s it… a brand new vocabulary! Ready for your quiz?

Smells Like Insulin | Meet the things that keep Luke alive... I'm often talking about insets and pump sites and tubing, but I had a realization tonight.. a lot of you don't know diabetes jargon!

#jargon #type 1 diabetes #Vocabulary.

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When Paying for Insurance Makes Paying for Diabetes Supplies Impossible

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When Paying for Insurance Makes Paying for Diabetes Supplies Impossible

The Cost of a Chronic Illness – Tuesday 5/16 Insulin and other diabetes medications and supplies can be costly. Here in the US, insurance status and age (as in Medicare eligibility) can impact both the cost and coverage. So today, let’s discuss how cost impacts our diabetes care. Do you have advice to share? For those outside the US, is cost a concern? Are there other factors such as accessibility or education that cause barriers to your diabetes care? (This topic was inspired by suggestions from Rick and Jen.)

Diabetes is one of the most costly conditions in the US. For many of us who depend on life-saving insulin, the cost can be astronomical every month. With insulin ranging from $200-300 per vial (depending on what type and where you get it) to over $500 per pack of insulin pens, it’s hard to understand how any family can make it when they have to not only pay for the insulin but other supplies like test strips.

I have good insurance now through my husband’s employer, however, it wasn’t always that way for me. I worked a job where there were only 5 employees, and my boss was not required to offer benefits. The plan that was offered was group health insurance through the parent company we worked for, but I paid 100% of the cost. The only thing I could afford on my just-above-minimum-wage paycheck was a premium that was $450 (and this was 10 years ago too), but it also carried a deductible of $2500 – and one that absolutely nothing was covered, not even prescriptions – until this deductible was met. So, if I had even paid for the deductible to even get to the 70% co-insurance by December, I I would have paid $7,900 total. So I did the only thing I could do.

I bought my insulin bottle by bottle, and rationed my insulin – running my sugars in the 200-400 range. I can even remember the pharmacy technician asking me if I had insurance to cover any part of the cost. (And what is mindblowing is that the very same insulin I bought then has tripled in price since then.)

I also had an insulin pump, and I would wear the sites for a week or longer if I could – most of which would become infected.

I rarely checked my blood sugar because I couldn’t afford the $80 per box for test strips that I needed.

I didn’t even go to a doctor, let alone an endocrinologist, for an entire year.

So, how does cost affect diabetes care? It affects it directly. If a person is too strapped to afford to even pay for medical coverage, how can they also be expected to pay the exorbitant costs of the supplies that they also need?

It’s not enough for people to have coverage – they need coverage that is both affordable and helps pay for the medications and supplies they need. Otherwise, more and more people will be in the same boat as I was — and so many are now — due to catastrophic plans being the only thing that is remotely affordable: skipping appointments and rationing medications and supplies just to pay for the healthcare they may never be able to use. And with insulin being the highest of all yet most necessary, it’s certainly not something anyone should ever have to ration.

People with diabetes and other costly conditions need better access to the medications and supplies they need, without it costing a literal arm, leg, or eye to get it.

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#Healthy Tips

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The Resolution Revolution

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The Resolution Revolution

By Gary Scheiner MS, CDE

Every year, it’s the same thing. During the month of January, the YMCA where I work out year-round is stuffed to the hilt with new bodies. The basketball courts are packed, the classes fill up early, and there’s often a wait to use the cardio equipment and weight machines.

By the end of the month, the crowd starts to thin a bit (literally and figuratively). And by February, I can pretty much pick & choose my workout without the slightest inconvenience. The reason for this cyclical bump in the fitness business is simple: New Year’s Resolutions don’t work.

That’s not to say we shouldn’t try to improve our lives. Even though the holiday season can be a busy and stressful time, it is also an ideal time to think about aspects of our diabetes that we want to work on in the upcoming year. Maybe you truly want to exercise more regularly. Perhaps you want to get your A1c down, lose weight, or change some aspect of the way you manage your blood sugar on a day-to-day basis.

The difference between pie-in-the-sky New Year’s resolutions and SMART goal-setting is about ten minutes of actual planning. In the SMART system, goals are designed to be Specific, Measurable, Achievable, Relevant and Time-limited. Below is a description of how to use the SMART goal setting system for diabetes self-management

Specific:

Your goals should be clearly defined. Stating that you want better blood sugars is not specific enough. Instead, focus on one or two elements of your diabetes management – such as your post-meal peaks or your fasting (wake-up) glucose readings. If you aren’t sure what to focus on, it may be helpful to talk it over with your diabetes care team. Here are a few other examples:

“General” Goals SPECIFIC Goals I want to eat better. I will limit my nighttime snacks. I need to get in shape. I will improve my cardiovascular fitness. I should pay more attention to my diabetes. I will start to check my blood sugar more.

Measurable:

It is absolutely necessary that you set goals that are quantifiable. You have to be able to look back at some point and be able to say, definitively, whether or not the goal has been met. For instance, rather than vowing to have better blood sugar control, you might set your sights on having at least 75% of your readings within your target range. Of course, it will be necessary to track your data somehow. If you’re not into keeping detailed written logs, there are many software programs, web-based tools and smartphone apps that can help you to organize and quantify your data. Here are a few examples of how to take your specific goals turn them into measureable ones:

Specific Goals Specific, MEASURABLE Goals I will limit my nighttime snacks. I will only have one snack each night. I will improve my cardiovascular fitness. I will walk for 30 minutes after dinner every night. I will start to check my blood sugar more. I will check my blood sugar at least four times every day.

Achievable:

Your goal should be something that you can realistically achieve. Perfect blood sugars all the time would be nice, but when you have diabetes, it’s generally not realistic. If, say, 40% of your readings are currently in-range, achieving at least 60% in-range is within reason. If your A1c is currently above 10%, a goal in the 8s is more realistic than setting your sights on 6. Continuing from our previous examples:

Specific, Measurable Goals Specific, Measurable, ACHIEVABLE Goals I will only have one snack each night. I will only have one snack each night on weeknights. I will walk for 30 minutes after dinner every night. I will walk for 30 minutes before breakfast or after dinner at least 3 times a week. I will check my blood sugar at least four times every day. I will check my blood sugar morning and night every day, and before lunch, dinner and exercise on days off.

Relevant:

Your diabetes management goals should be relevant to your life as a whole.

For example, improved blood sugar control is not just about numbers and lab results. It positively impacts work productivity (which could lead to a raise or promotion), athletic/physical performance (which could enhance your self-esteem and sense of accomplishment), moods (which can boost your social stature) and sleep (enough said!). Adding relevance to the goals in our previous examples:

Specific, Measurable, Achievable Goals Specific, Measurable, Achievable, RELEVANT Goals I will only have one snack each night on weeknights. I will only have one snack each night on weeknights, which will help me control my nighttime blood sugar and sleep better. I will walk for 30 minutes before breakfast or after dinner at least 3 times a week. I will walk for 30 minutes before breakfast or after dinner at least 3 times a week so that I can start to lose weight and lower my risk for heart disease. I will check my blood sugar morning and night every day, and before lunch, dinner and exercise on days off. In order to ward off serious hypoglycemia, I will check my blood sugar morning and night every day, and before lunch, dinner and exercise on days off.

Time-Limited:

Goals should be tangible and concrete, and the action that you take to achieve these goals should also be tangible and concrete. Do not set a goal without including a time element for achieving that goal. Efforts to achieve more in-range blood sugars can start right away, but there needs to be a stated time for evaluation, adjustment, and reaching the stated goal.

Specific, Measurable, Achievable, Relevant Goals Specific, Measurable, Achievable, Relevant, TIME-LIMITED Goals I will only have one snack each night on weeknights, which will help me control my nighttime blood sugar and sleep better. For the entire month of January, I will only have one snack each night on weeknights, which will help me control my nighttime blood sugar and sleep better. I will walk for 30 minutes before breakfast or after dinner at least 3 times a week so that I can start to lose weight and reduce my risk for heart disease. Starting the first of the year, I will walk for 30 minutes before breakfast or after dinner at least 3 times a week so that I can start to lose weight and reduce my risk for heart disease. By March 31, I will have walked at least 40 times. In order to ward off serious hypoglycemia, I will check my blood sugar morning and night every day, and before lunch, dinner and exercise on days off. Starting immediately, in order to ward off serious hypoglycemia, I will check my blood sugar morning and night every day, and before lunch, dinner and exercise on days off. I check my meter memory every Sunday night to measure my progress.

Now What?

Someone much smarter than me once said, “Nobody plans to fail. They just fail to plan.”

To increase your chances for success, creative strategies are needed. Consider what will motivate you and ease the path toward goal attainment, and consider obstacles that might get in the way. A decision to increase the number of times you check your blood sugar might be easier if you have more than one meter at your disposal, and if your insurance will cover the test strips.

If your goal involves walking more often, your chance of success might increase if you have a partner to walk with, and an indoor option in case the weather turns nasty. Cutting out the night snacks is much easier if you have a filling dinner, stay busy at night and don’t bring junk food into the house. Your diabetes clinician/educator should be able to help you develop some effective strategies for meeting your specific goals.

So, there you have it – the SMART goal setting system for diabetes self-management. Hopefully, the wheels are already turning and some ideas are popping into your head. By all means, jot them down! Then set out to make them specific, measurable, achievable, relevant, and tangible.

Editor’s note: Gary Scheiner is owner and clinical director of Integrated Diabetes Services (www.integrateddiabetes.com; 610-642-6055), a private practice specializing in advanced training and management of children and adults on intensive insulin therapy. His team of CDEs (all of whom have Type-1 diabetes) provides consultations worldwide via phone and the internet. Gary is author of several books including “Think Like A Pancreas” and was named 2014 Diabetes Educator of the Year by the American Association of Diabetes Educators. Feel free to submit questions and comments to [email protected]

Photo Credit: David Mark (Pixabay)

Diabetes Type 2 Tips Diabetes Escape Plan Does Diabetes Destroyer Really Work? Original Article

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Don't Be Frightened: It's Just a Teen with Type 1 Diabetes

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Don't Be Frightened: It's Just a Teen with Type 1 Diabetes

If there's one thing harder than raising a teen, it's raising a teen with diabetes! Korey Hood is a family clinical psychologist at the Cleveland Clinic, and as a type 1 diabetic himself since he was 19, he has counseled many families through his practice and also through serving as faculty member at the Children with Diabetes conferences.

Korey is also the author of the new book, Type 1 Teens: A Guide to Managing Your Diabetes. Today, Korey shares some words of wisdom about how to handle the tumultuous teens years and what you — the parent — can do to survive!

A Guest Post by Korey Hood, Professor of Pediatrics

As a parent of a teenager, you probably see or hear any number of the following on a daily basis: eye rolls, "whatever," or sighs as your teen walks out of the room. As a parent of a teenager with type 1 diabetes, you probably get the same treatment, but because you have more interactions due to taking care of diabetes and all those tasks that HAVE to get done, you may get a double-dose of eye rolls and whatevers! If you find yourself frustrated with your teen at times, burned out by all the work that's involved in diabetes management, or just generally feeling like the teen years are never going to end, read on.

I was never a teenager with diabetes myself, as I was diagnosed as a young adult, but I have managed my own type 1 diabetes for more than a decade. Plus, I am a child psychologist and spend a lot of time working with teens with type 1 diabetes and their families. Here are some things that other families have found helpful when attempting to improve communication and decrease conflict about diabetes:

Change the way you think about blood sugars. How many times have you gotten frustrated with a number that pops up on your teen's meter? How many times have you been scared by a number? I bet it happens a lot. And what happens when you're frustrated or scared is that you may ask your teen, "have you been eating something you're not supposed to?" or "why is your number so HIGH?" What usually happens then? The teen may give a short answer or sense your frustration and say "leave me alone!" One way to avoid displaying negative emotions about blood sugars is to start thinking about the number as simply that — a number, a piece of data, information to figure out what to do next. If you start to think about the number just as data, it will help to keep your emotions in check. Once that happens, the teen may be more willing to share numbers and even check more often (keep your fingers crossed on that one!). So, think about the number as a piece of data, keep your emotions in check, and then treat the blood sugar if need be.

Find alternative ways to communicate about diabetes. If you're struggling to get information from your teen or struggling to get your teen to check more or bolus before meals, come up with alternative ways to talk about it. It may just be the verbal interactions about diabetes that are making it harder to get along. Try putting up a white board on the refrigerator and "passing notes." You could write "remember to check before you eat breakfast, and please write your number here." The teen could check, write the number down, and you can come by later and see what it was. The next step could be to have your teen write down what he or she did about the number. You can try this with other things as well, such as taking supplies for sports after school, knowing how many test strips he has left, or reminding him to wear his medic-alert bracelet. This isn't a long-term fix, but may help with rough patches of poor communication.

Find time for a family meeting. Instead of reviewing blood sugars and discussing eating and snacking throughout the day, pick a designated time to discuss these things. That way, everyone can be prepared to discuss trends in blood sugars, potential changes in insulin doses, and plans for activities that require planning about diabetes. Being prepared to discuss these things at a specific time can help avoid making your teen feel that he's being constantly nagged about diabetes throughout the day. Plus, it will give you more information to either problem-solve for the next day or to tell your diabetes team so they can make changes. So try a "family meeting" or check-in for 5 minutes in the evening, or a little longer if it's just once a week.

Hit the RESET button. Wouldn't it be nice if we had a RESET button that we could hit when things go wrong? I definitely would like one. Well, you can use this idea to help you manage your teen's diabetes. Try to think of each day as a new day for managing diabetes and don't let the previous day's problems carry over. This is tough to do, but it will help you keep a fresh perspective and not let frustration about high blood sugars carry over to today's efforts at managing diabetes the best you can.

It is a tricky process being a parent of a teenager, and an even trickier process parenting a teen with type 1 diabetes. Try some of these strategies and keep working hard — your efforts will eventually pay off. And keep taking care of yourself, too, because you'll be a better helper if you've done things to take care of yourself first!

For more from Korey, check out his new book, Type 1 Teens: A Guide to Managing Your Diabetes, now available at bookstores and on Amazon.

Disclaimer: Content created by the Diabetes Mine team. For more details click here.

Disclaimer

This content is created for Diabetes Mine, a consumer health blog focused on the diabetes community. The content is not medically reviewed and doesn't adhere to Healthline's editorial guidelines. For more information about Healthline's partnership with Diabetes Mine, please click here.

Type 2 Diabetes Treatment Type 2 Diabetes Diet Diabetes Destroyer Reviews Original Article

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Ask D'Mine: What to Do When You've Got No Insurance, No Money

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Ask D'Mine: What to Do When You've Got No Insurance, No Money

Got diabetes and need some help? You've come to the right place.

Every week, we take reader questions and do our very best to be informative and helpful (and make you smile a little) here at our diabetes advice column, Ask D'Mine, hosted by veteran type 1, diabetes author and community educator Wil Dubois.

Send us your queries related to life with diabetes — nothing is off-limits here! (except of course specific medical instructions for your own care; that's what doctors are for)

Need help navigating life with diabetes? Email us at [email protected]

It's tough times out there, and for proof, here's a pair of questions from the trenches that'll make you reach for the Kleenex box:

Steve from Minnesota, type 2, writes: I had my diabetes well under control a couple of years ago with an A1C under 6 once, and in the low 6 range typically. Then I lost my insurance and can no longer afford medical care. The critical drug that helped me achieve good numbers was Actos, but it's so expensive I had to stop taking it. Now my blood sugars are screaming high. I finally just quit checking because there's no point in knowing if it's 450 or 500. What to do?

Wil@Ask D'Mine answers: First and foremost, let's all sit down and have a good cry.

There. Anybody feeling better? No? Yeah... it didn't help me as much as I thought it would either. Next time, we'll all try Primal Scream Therapy.

So you're absolutely right: you can't afford your Actos. I checked with Epocrates and they show the "approximate retail price" ranges from a low of $193.48 per month for the 15mg tabs, up to a high of $239.99 for a month's worth of the 45mg tabs. Not exactly chump change. I'd also bet even though this was your "critical" diabetes drug, it probably wasn't your only one.

So what to do?

Naturally, I have a plan.

First, I want you to go on the Akins Diet. (Hey, I said I have a plan, I didn't say you were going to like it.) Don't worry, this won't be forever. But in your case, an as-close-to-zero-carb-as-possible diet is good medicine. For God's sake, your blood sugars were running in the 500s last time you checked! You're at risk for glucose toxicity at this point. Cutting the carbs to the bone is an emergency measure to try and save your kidneys from extinction until we can get your diabetes medicated into submission again.

Second, go here to find the closest Federally Qualified Health Center (FQHC). These are non-profit clinics that are subsidized by the feds and will see you on a "sliding fee" basis. You don't need health insurance. How much you pay depends on how much you earn. You may be able to see one of their docs for free, or for a very small co-pay. Get the next appointment available.

Third, and here's where it gets really good, most FQHCs are really well plugged into Patient Assistance Programs, called PAP in the biz. This is all you need to know about PAP: you can probably get your Actos for exactly zero dollars and zero cents per month. PAP programs are run by the Pharma companies and are actually pretty generous when it comes to helping out those who are uninsured and sorta broke. For instance, Actos is made by Takeda, which uses an annual income of at or below 300% of Federal Poverty Level (around $32K for a single person) to qualify patients for assistance.

Oh... but there's one other little thing I forgot to mention. There's... umm... ah... a dark cloud of sorts over Actos at the moment. Actos may, or may not, be the smoking gun in an increased risk of bladder cancer. The FDA issued heads-up warning about the drug in June of this year and within 5 hours the water was filled with sharks in suits. There're now dozens of law firms licking their lips and trying to line folks up for class action suits against Takeda. Late night TV is full of call us if you took Actos ads and there are gazillions of websites launched by law firms trolling for clients.

So... I dunno. The jury is still out on Actos—literally and figuratively. You'll need to talk to your new doc at the FQHC about whether the Actos is still the best bet for you at this point or not. But if so, remember that it'll take about six weeks to spool up to maximum effectiveness in your body, so keep on the Akins thing until the med is working again.

Bottom line, you'll need to take something for your diabetes, given how high your blood sugar is, and in your circumstances, the FQHC and PAP is the best way to get from where you are back to an A1C in the sixes. Whether you re-start Actos, or start something entirely new really doesn't matter.

So let's reserve the screaming for Primal Therapy and our politicians, rather than your blood sugar altitude.

Note: a fact often missed in the media is that not having insurance is only one problem facing PWDs in our country. Sometimes you can have insurance and still be in the same I-don't-make-enough-f*ing-money-to-pay-the-bills-and-keep-myself-healthy boat. Consider, for instance:

Janet from California, type 1, writes: I am a single mother of three kids in college. I have diabetes, I have insurance, however I can't afford the test strips, needles, and now 4 diabetic medications along with depression, high cholesterol, high triglycerides, and low vitamin D medications. I need to take care of myself but I cannot afford the co-pays. Do you have any suggestions? My A1C is 10. Now the doctor has added more testing and increased my units on Lantus & Apidra. I am ready to give up and just stop taking all medications. HELP!!!

Wil@Ask D'Mine answers: So I looked into it, and the cost of an average funeral in the United States is between $7K and $10K. According the Federal Trade Commission funerals "rank among the most expensive purchase many consumers will ever make." How's that for depressing?

My point?

Oh sorry. I wasn't being clear. I was just letting Janet know that she actually can't afford to "just stop taking all medications." She's a type 1. If she stops her insulin she'll die. And dying is expensive. And her three kids will have to drop out of college and spend the rest of their lives flipping burgers at McDonalds.

Believe it or not, Janet is actually in a worse situation than Steve is. If you have insurance, you can't get PAP. So that route is closed. Being underinsured, or being well-insured with an empty bank account is a special kind of hell.

But not to worry. Again, I have a plan. And again, it's not a great one, but it will do for now. So there are two approaches here, and we can mix and match them. The first is medical triage. Triage is just a way of prioritizing the most urgent needs. Remember in the old M*A*S*H TV show when the helicopters would bring in the wounded soldiers and the docs would dash out and figure out who needed to go into surgery right now and who could wait an hour or two? (Oh crap, now I've got the M*A*S*H theme music stuck in my head where it will haunt me for the next three weeks.)

Well, when times are tough, you can do the same thing with your health care—and I like to say "blood sugar first." Hey, at an A1C of 10 your blood sugar is cytotoxic. You're killing yourself in slow motion and the folks at the dialysis center are getting excited thinking of all the money they'll make off you (at more than $70K per year, that's better than seven funerals!). So in my mind, nothing else really matters if your blood sugar is a train wreck. That means insulin and test strips are the top priority. I wasn't clear if you were on anything other than the two insulins for your diabetes, but in a crunch, you could drop any other diabetes meds because it's more than possible to control your diabetes with the Lantus and Apidra alone. Ya just gotta take enough.

So using triage, you might choose to just take care of your diabetes for a while until you get it on track. Ignore everything else for a time. Will high cholesterol kill you? Yeah. Probably so. But it will take a long time to do it. Eat smart for a while to minimize your risk, but if push comes to shove you could back-burner the cholesterol issue for a year, or until your oldest kid graduates and frees up some cash flow.

Stopping your depression meds cold turkey can be dangerous, so talk to your doc about how to safely get off them if you need to. And so on and so forth. Only treating your most urgent needs during a financial emergency is a valid form of medical treatment called harm reduction. It's not the "standard of care," but desperate times call for desperate measures.

But, wait, maybe you don't need to ignore your other health challenges. Do I hear the thundering hooves of charging horses and the sound of bugles? I do believe the cavalry is coming over the hill to rescue you and it's... it's... Wal-Mart?!

OK, not quite the boys in blue that I was expecting.

Here's the deal. Open your medicine cabinet and look at your cholesterol med. Is it a fancy brand-name drug or an older generic? Rather than stop your cholesterol med altogether, talk to your doc about getting a prescription for a generic that you can get on the $4 formulary at Wal-Mart, or one of the other big-box stores. Meds for your depression and trigs are also available as generics. You can also get vitamin D supplements over-the-counter in bottles that are the size of rain barrels. And even if the generics aren't quite as effective as the fancy-pants name brand ones (and many are much closer than we've been lead to believe), it's still better to have some control over your cholesterol than none at all.

Now, on to diabetes penny pinching: One thing to check is whether your insurance has a preferred insulin brand. On the fast-acting front we have Apidra, Humalog, and Novolog. Frankly, it's the same as Tide, Cheer, and Gain. Hey, they really all work pretty much the same, and if one insulin brand carries a lower co-pay, so much the better for your wallet. Similarly, the basal insulins Lantus and Levemir are more-or-less interchangeable (there's more of a difference between them than there is with the fast-acting juice, but if you can save a bundle of money, then you can adjust).

Next, let's look at delivery devices. We all love pens, but many insurance companies will give you a lower co-pay on vials and syringes. If you're out-and-about a lot, it's hard to beat a pen of fast-acting to cover meals in public, but most of us take our basal in the privacy of our homes anyway, so using a syringe once or twice a day really isn't that big of a deal if it will help you keep the lights on, food on the table, gas in the car, and the kids in college.

And if push really comes to shove, depending on how high your insulin co-pays are, you can buy old fashioned Humulin-R, 70/30 mix, and NPH insulins at Wal-Mart under the ReliOn label for $24.88 per vial. That may be less than your co-pay. Speaking of ReliOn, I've been playing with their Micro meter recently and have found it to be remarkably accurate. The strips run twenty bucks for 50. Again, if this beats your co-pay, switch over. You should also Google your favorite test stip. You might be surprised. I saw Presto strips online at Amazon for only $14. Crazy!

Bottom line: just because you have insurance doesn't mean you always have to use it. Sometimes just getting out your wallet is cheaper than going through your insurance.

So shop smart. Stop (some meds) smart, if you must.

But don't stop all your meds. Oh, and my apologies to the funeral industry. I know times are tough for you guys, too.

This is not a medical advice column. We are PWDs freely and openly sharing the wisdom of our collected experiences — our been-there-done-that knowledge from the trenches. But we are not MDs, RNs, NPs, PAs, CDEs, or partridges in pear trees. Bottom line: we are only a small part of your total prescription. You still need the professional advice, treatment, and care of a licensed medical professional.

Disclaimer: Content created by the Diabetes Mine team. For more details click here.

Disclaimer

This content is created for Diabetes Mine, a consumer health blog focused on the diabetes community. The content is not medically reviewed and doesn't adhere to Healthline's editorial guidelines. For more information about Healthline's partnership with Diabetes Mine, please click here.

Type 2 Diabetes Treatment Type 2 Diabetes Diet Diabetes Destroyer Reviews Original Article

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D-Blog Week: "What They Should Know"

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D-Blog Week: "What They Should Know"

The Diabetes Blog Week prompt today asks us to ponder the question "What They Should Know," i.e. what we in the Diabetes Community would tell someone who doesn't have diabetes, given the chance. Our hostess Karen Graffeo encourages us to use this chance to do a little advocating ...

I've been around the block a couple times since being diagnosed with type 1 diabetes as a kid, so I'll warn you: my list isn't short. People don't know enough about diabetes. I wish they did. That's my view in a nutshell. Looking back, these are the points I'd share with a handful of specific non-PWDs whom I've encountered at some point in my life, who should have known a little more.

To the McDonald's cashier in Ohio who tried to convince me the "sweet-tasting Diet Coke" was in fact said diet soda, and thought I was mistaken to believe it was regular soda:

1. Customer service, dude. Look it up. Working those customer-focused jobs in my younger years, I learned to go along with the idea that "the customer is always right." Explore that concept.

2. I have diabetes, and while that may not mean much to you, it certainly means a lot to me. That means what I eat and drink is a very key part of my health and survival. Little things, like drinking a regular sugar-saturated soda instead of diet, can be a BAD thing for me. Please respect that, and trust me when I say this isn't diet. I can tell. And all you have to do is check. Embrace the customer service role, and be what you are meant to be in your current position. Otherwise, find another job. Thanks, in advance.

To that reporter writing a story about the "silent killer" that is diabetes, with an editor demanding sources who are overweight or must inject themselves with shots every day:

Facts are important and accuracy is your job. Not everyone with diabetes, of any type, is overweight. Two main types of diabetes exist, and it's important for you to distinguish between them and adequately explain to readers those differences. Many people think those of us taking insulin have the "bad" kind of diabetes, or that our illness is somehow more severe than those who don't take insulin. That helps breed fear and misconceptions, especially among type 2s who sometimes see insulin as a last-resort and sign of failure — which it is NOT. What you write is playing into all of that, so be careful. Please make sure you're getting it right. From one journalist to another. If your editor has a problem with that, send the right sources his or her way. We in the DOC will make sure they get the message.

To the other reporter or columnist who already published a story criticizing any person with diabetes for eating sugar, because that's a recipe for doom:

We CAN eat sugar. You got it wrong. Whether or not we choose to eat sweet things is a personal decision left up to each of us, because it takes a lot of work to manage the consequences, but it's not something we're restricted from enjoying if we choose. Those of us living with diabetes don't have to completely avoid sugar; we just have to make sure we're taking enough insulin to accommodate whatever we're eating. Sure, moderation is important and no one's supposed to constantly eat ice cream or candy. Please make sure you know what you're writing before it's published. There's a whole initiative now run by the Diabetes Advocates group aimed at making sure newspaper and media folk get diabetes right. Do what you need to, in order to get the most accurate information out to your readers. We appreciate it.

To the woman on other end of the phone questioning why I need to check my blood sugar "so many" times a day (6-10), and can't be content with insurance paying for just 3-4 strips per day:

My doctor and I had this discussion and determined that this many blood sugar checks was the best for my health. You are not my doctor. Stop second-guessing those who are supposed to be making the decisions based on health, not a financial bottom-line. We can sit here and argue about why I check X many times a day, in order to keep adequate track of where I'm at... why I'm working to prevent highs and lows that could either leave me in need of paramedic help, an emergency room visit or future complications that will all cost a whole lot more than the additional test strips needed each month. You do the math!

To the nice concerned lady at Target:

You didn't seem too hip on the basics of Diabetes 101, but when I was having a low in the cheese aisle that one day and just seemed a little "off," you found it in your heart to ask if everything was OK. And you saw that it wasn't. And in seeing the insulin pump clipped to my belt, and hearing me talk about needing juice or sugar, you scurried off to the nearby refrigerator and grabbed an OJ box for me to consume. This erratic behavior caused by lows happens to us People With Diabetes sometimes, and often we're confronted by judgmental looks from people who think we're just drunk or overly dramatic wannabe actors. There are also those Diabetes Police who, with all good intentions, ask questions and try to offer us advice or suggestions — even at the most inopportune times. But you didn't go there. So thanks for that, and much thanks goes your way for helping me out.

To the guy at the Kansas City airport in October watching as a couple-dozen members of the Diabetes Online Community gathered to greet a friend visiting from Australia:

We're sane, really. That's not a lie. Even that one girl with the faux marriage proposal sign. We are friends who met online because of diabetes, but we extended those friendships into real life beyond that shared chronic condition. The support, camaraderie, and awesomeness is something I hope you have in your life. We referred to this particular get-together as the Simonpalooza, but to outsiders it may be more simply referred to as good friendship.

To the TSA agent or security officials at courthouse entrances who've hassled me because of the insulin pump and CGM hooked on my belt:

No, these aren't pagers or cell phones. They're more important than that. It should be obvious — I like to pretend I'm Batman with a cool utility belt. What!? You thought these were medical devices or something? Please... That's like saying I thought your screening practices and attitudes actually served a beneficial purpose. But no, seriously, I'd like the non-D screening agents and metal detector agents at government buildings to know that I'm just trying to get where I'm supposed to be going without being overtly harassed and having my medical devices put in danger by your machines and methods, all in the name of security.

To my non-D friend who jokes that People With Diabetes just gather for meetups to "snort Pixy Stix," rather than hang out as friends:

I've not said anything, because I know you're just joking, but this does bother me. I think it's because the phrase hints at the misconception that "sugar causes diabetes." You know the difference, because we've had that conversation and you know better. But this still bugs me, maybe even more because it feels like you're slamming my friends and my D-Community. I may be nearing the point where I'm going to confront you on this.

To my 5-year-old self, just before I was diagnosed with type 1:

I'm bending the rules a little here, but if I could, I'd go back and say to myself: Things are going to get a little crazy and you'll have to start stabbing yourself with needles soon. But don't worry. It will be OK. You are normal. And as much as you might feel "different," you are a person before you are a diabetic. Just live your life, little Mike. Diabetes will change your life for the better and lead to great things, personally and professionally. It will allow you to reach new heights in achieving your dreams. It's not a pure negative, even though it will be tough at times. Just keep your chin up.

To any parent, just before they're thrown into the D-world for the first time:

You may not understand diabetes at this point, but you'll soon become well-versed to the level of being a superhero. There is no cure and you didn't cause this, so don't let other people make you feel guilty. You may not think you have the strength to do what's necessary, but you do. That attitude and ability to manage your child's diagnosis and diabetes life will stick with him or her for the rest of their life, and allow them to grow into the adult they will become. So in advance, thanks for what you're about to do!

A whole bunch of other PWDs are writing on this topic today, too — so go check out their blogs (after leaving a comment below, of course!!)

Disclaimer: Content created by the Diabetes Mine team. For more details click here.

Disclaimer

This content is created for Diabetes Mine, a consumer health blog focused on the diabetes community. The content is not medically reviewed and doesn't adhere to Healthline's editorial guidelines. For more information about Healthline's partnership with Diabetes Mine, please click here.

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