Contributed by Diane Bajalia
Diabetes is not easy and we don’t all manage it in the same way. I admit that I am a bit neurotic — as my local Jacksonville DiabetesSisters know! I am always trying the new toys on the market such as inhaled insulin and I don’t mind being the first to test out a new pump or cgm. After 26 years with Type 1, I find that I am always looking for something to keep me motivated. DiabetesSisters does that for me; meeting friends monthly and being able to reach out to them anytime has been a terrific diabetes management tool!
For me, having diabetes involves monitoring minute by minute activities, watching hour by hour blood sugar trends, and tracking food and exercise. I need help with this. The March TCOYD Sacramento Conference proved to be another tool in my tool bucket for managing this ever changing challenge in my life called diabetes. Taking Control of Your Diabetes (TCOYD) is a terrific non-profit organization for people with diabetes with conferences throughout the country. If you are not familiar with this group, spearheaded by Dr. Steven Edelman, check out his website (https://tcoyd.org/) and his YouTube videos (https://www.tcoyd.org/videos/the-edelman-report.html)! This guy knows how to tackle diabetes and he does it well - with charm, with motivation and with humor!
At TCOYD Sacramento, where many of the speakers had diabetes, these are the five points that I heard emphasized throughout the day. Please remember to ask your doctor or your diabetes educator to help you incorporate these concepts into your diabetes care.
1. CGMs (continuous glucose monitors) are the single best discovery since insulin!
2. Basal rates (or long acting insulin ratios) need to be set correctly in order to have in range post prandial (after meal) blood glucose levels.
3. It is important to try to pre-bolus (wait for the bend in your CGM or wait for insulin to begin working) before meals with carbohydrates. If blood sugars are low, wait less time and if they are high wait a longer amount of time.
4. Carb counting is hard and it is even harder when eating at friends’ houses or restaurants. Try eating “less carbs” instead of “carb counting” for two weeks, you may like the results on your meter.
5. Fats and proteins cannot be ignored when dosing insulin. Everything counts!
Number 6 was mentioned by Dr. Edelman’s co-worker, Dr. Jeremy Pettus, and the laughter in the room was overwhelming …. When all else fails in trying to manage the diabetes roller coaster make a SWAG (Sophisticated Wild Attempt Guess). My apologies to Dr. Pettus since I couldn’t actually use his exact “A word” for this blog post but I loved his humor in tackling his own diabetes! Dr. Pettus also presented information on a topic that many of us are too intimidated to ask about — “Alcohol and Diabetes: Do They Mix?” There are, of course, many risks in drinking alcohol in general. Add to that all of the things that can affect blood glucose levels (carbohydrates, protein, fat, stress, exercise, medications, infusion sets, air bubbles in insulin, scar tissues, etcetera…) and then mix it with a cocktail. This could be a dangerous situation. While the liver is working on breaking down the alcohol (a foreign drug substance in the body) it may miss the fact that blood sugars are dropping. Dr. Pettus’ advice was to be very aware of current blood glucose levels and trends. Are you 160 going up? Or 160 going down? Or have you been steady at 160 for a while?
If you know where your numbers are, choose your drink wisely. Check online for specific carbohydrate amounts and calories but this rule of thumb can be helpful … Beer (approximately 20 carbs), light beer (approximately 5-10 carbs), wine (approximately 5 carbs) and hard liquor or alcohol (usually 0 carbs without a mixer). Remember to always eat something before drinking and avoid sugary mixed drinks; try mixing alcohol with water, club soda or diet soft drinks instead. Effects from alcohol can linger into the night and even into the next day causing unexpected low blood sugar levels. The takeaway from this session was that one or two drinks can be manageable but make sure your diabetes is well controlled and test often!
Diane has been living with diabetes for 26 years. She currently leads a PODS Meetup in Jacksonville, FL, where women with diabetes gather monthly to share Sisterhood, learn and support one another. While Diane received a DiabetesSisters' scholarship to attend TCOYD in Sacramento, the thoughts and opinions expressed here are solely her own.