Let's Get Physical - Blood Sugar Uncertainty!

Yesterday I attended TCOYD with a group of friends.  And it involved lots of walking, my pedometer counted nearly 10,000 steps and I walked up a quite a few stairs as well.  And I felt really good that the exercise helped me have good blood sugars all day.  And exercise can have a beneficial effect for up to 48 hours and so after exercise I try to keep an eye on my blood sugars not only during exercise but in the day afterward.  I will make some adjustments by slightly reducing my basal and even at times reducing my mealtime boluses.   Exercise is one of those things that require me to depend on my meter more critically and as many of us know all to well we can only have so much faith in our meters.

My Day in Food - Being Resilient

When I am not traveling and am able to most of my meals at home or in controlled situations I generally find things much easier.  But I travel and often eat at places where I don't have great control over the food.  Today was basically one of those.  I attended TCOYD in Washington, DC and then immediately attended a retirement party.  And while I ate breakfast at home I had a morning snack and lunch at TCOYD and then ate at the retirement party.  This is about how I dealt with food for my day.

Tips and Tricks - Making it MY Doctors Appointment

I'm sure many of us have endured countless doctors’ appointments where we are shuttled into the room, the doctor looks over our test results and then tells us our diabetes is doing "great" or "not so great" and tells us what to do. Frankly, this doesn't serve me as a patient. If my blood sugar isn't great, I basically know what I have to do. I have to do it all day every day. What I really want out of my interaction with my doctor is for them to look to me as a patient for guidance about what I think the issues are and how I wish to proceed. So I use a simple approach to bring the conversation back to me. To both be a good patient and to be a patient clearly at the center of my care.

My approach?

My HealthCare Experience - Danger Wil Robinson, Danger!

I have to say, I have not had the best experience with healthcare as it relates to my diabetes.  I have variously run into incompetent professionals, medical mistakes, corruption and just general attitudes that are more focused on business and making money than the patient.   Medical errors are in fact the third leading cause of death in the US.  And that doesn't even account for many of the things I have run into.  I consider the healthcare system to actually be a safety hazard to me as a patient.  I'll relate just a few anecdotes of my experience below, but before that I think it is important that we all protect ourselves against being harmed by healthcare.  That is why I think it is useful before walking through the door to your doctors office to watch this video or remind yourself about the danger.  Danger Wil Robinson, Danger!

Why Words Matter To Me - A Lot!

I've written before about how words are used by society and the medical community in relationship to type 2 diabetes.  I feel strongly that the words that are used are often poorly chosen, hurtful, deceptive and discriminatory.   If this were just some fringe part of society using these words it would be one thing.  But it isn't some fringe hate group, it is the pillars of our society, the medical community and government propagating these words.  In particular I really think the words "Cure," "Prevent" and "Reverse" should just be banned, at least in the medical and government community when it comes to type 2 diabetes.

I would ask anyone reading this to help me "correct" everyone they come in contact with.  I don't mean to give them a bolus of insulin.  I mean that when you hear someone talk about cure, prevention or reversal of diabetes that you gently remind them that those are not appropriate words.  The proper words are "Managing" and "Remission."

To read more about my rants on these words, check out previous blog posts such as "Words Matter – Why You Can’t Reverse Type 2 Diabetes."

The Other Half? I Don't Think So, Diabetes is 90% Mental.

For me, managing my diabetes is relatively straightforward. I take my basal insulin, I count my carbs (kinda) and I bolus. And my outcomes are basically good relative to what I should expect.  But there are the "other factors."  Unfortunately, my life intervenes.  I travel, I have been home only a couple of days over the last three weeks.  I have disturbed sleep and suffer from sleep apnea.  And then there is my job, just like many of you, I have my job.  And it is a source of stress in my life.  Today I woke at 4:15 am to get ready for my meeting today.  I had a hundred people arrive for the meeting that started at 8 am and all kinds of things went wrong.  I didn't get finished til late tonight.  And then my wife wants to have a talk about "our life." So I am sorry about the tardiness of this post.  Sometimes our lives just overwhelm us.

I have to tell you, in my case, I know how to take care of my diabetes.  I can figure out my bolus insulin, I can figure out my mealtime bolus and correct if necessary.  And I am diligent about taking my medications.   But life just sometimes "kicks my butt" and it is just hard.  It is hard to keep up the mental fortitude to take care of myself and even if I have the fortitude to make the right decisions it is very hard to do that when faced when very complicated personal situations.  My diabetes challenge isn't about the mechanical steps necessary to take care of myself.  It is about the mental discipline to do that in the face of files challenges.  For me, diabetes isn't about the half that is mental, it is about the 90% that is mental.

Why Am I Here? Not Because of Me Anymore.

So why did I come here?  I guess you would say "it is complicated."  I originally started reading and becoming active the on-line community because I thought that it was critical to helping myself.  And in the end that was true.  I learned a lot from others and eventually learned to share with others.  I attained better control of my diabetes and achieve (some level) of peace with my diabetes.  But over time things changed.  I changed.  It became more than just peer to peer support.  Eventually it became important to try to effect change.

What is Actually Wrong with UHC choosing a Preferred Insulin Pump Provider?

MiniMed 530G Pump

I have to say, having type 2 I am faced with a generally uphill battle getting insulin pump and CGM technology to manage my diabetes.  With Medicare looming over me the high cost of these technologies are likely to mean that these options will be denied to me.  And what really makes me mad is that I believe that both of these technologies could be made much more affordable.  So when I see changes that might introduce more competition and sensitivity to costs into the system I am both excited and anxious.  The system is so horribly messed up that often these actions are disorganized, ill-conceived and destined for failure.  The latest is the announcement by UnitedHealthCare (UHC) (see page 7) that they are moving to have Medtronic as a their preferred insulin pump provider.