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Posts from the ‘Blood Sugars’ Category

Guest Post: E-Patient Dave Takes on T2D.

Dave deBronkart and I met several years ago through patient advocacy and online connection points, and I’ve followed his health story as he has simultaneously followed mine.  Dave comes from the perspective of a cancer survivor who almost died and has turned his “free replay in life” into a crusade to open healthcare’s minds to the idea of partnering with patients.  So when he messaged me to tell me that his lab results for A1C came back a little elevated, I watched our health stories smash up for the first time.  Nothing like the experience of trying to change an A1C to bring people together.

Today, Dave is guest posting about his experiences toeing line of type 2 diabetes, and his take on patient guidance in the diabetes space.  (And for more from Dave, you can follow his very lively Twitter account or blogOr just Google him and see all the fun that pops up.)

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Dealing with an “increased risk” of T2D
by ePatient Dave

A1c Nov 2014

A year ago this week I got some blood work done and it came back with this great big numeric fart in my face: the number 5.8, followed by “Increased risk for diabetes.”

WHAT?? I. Am. Not. A. Diabetes. Person. Those people are Kerri, or Amy, or Dana, or Manny, or Scott, or Eric, or Dominick. It’s all those people I like and respect and enjoy knowing, but it’s not me. I mean, they’re not me. I’m not them – they’re a special class. What?  I mean, I’m a kidney cancer guy, not an insulin problem guy. I don’t even know what that is, really. And I certainly don’t know how to do it.

In hindsight it feels like it was easier when I was diagnosed in 2007 as almost dead with kidney cancer. And that episode was over in less than a year. Me with a permanent thing? (I know I’m sounding like an uninformed idiot here. That’s what it’s like when you’re in the denial phase.)

What to do? Back then I got it in gear, doing what I could despite bad odds, and I was one of the lucky ones, aided by a great online patient community, which my oncologist said (in the BMJ!) he thinks helped save my life.

So, what to do this time? My PCP told me about a diabetes prevention program run by the YMCA that reduces by 58% the odds of ever developing T2D, if you lose x% of your weight and get 150 minutes of activity every week. I’d have to pay for it – a few hundred bucks – but it seems worth it.

Withings weight curve 2015-08-30And boy has it been effective for me – check the graph from our wifi bathroom scale. (My results were not typical!) I lost 30 pounds in four months (January to May), dropped a few more to 197 in August… I’m back up over 200 now but I’m also a gotta be active guy … first time in my life I’ve felt I have to get outside and move around.

It’s really a lifestyle program – they teach what I’d call food awareness, but it’s really not a diet. They have you count fat grams, with a book or an app or whatever, but that’s no diet. Then later they get into some more detail. But it’s not complicated. And they have you get active – no particular exercise regimen, no in-your-face smiling Sweat Coach.

You know what, though? Effing stupid insurance won’t pay for it.  If the insurance industry wanted to reduce medical spending they’d obviously spend a few hundred on prevention, so I conclude that they’re either stupid or corrupt. (I know I don’t usually talk this way but I honestly can’t figure out any either explanation. Can you?)

Plus, the effing stupid program isn’t available to people who aren’t yet officially pre-diabetes! It’s a good program, and my wife wants to do it too, but they won’t let her in because she’s not almost in trouble! What the !@#@! are these people thinking, not even letting someone buy their way into this course?

And you know what else?  When I measured my A1c again in September, it was up … it was worse. 5.9.

So now I’m in the middle of trying to educate myself about that.  Do you have any idea how hard it is to find out what to do about that??

Well, I imagine you do know. I’m here to say, for sure, that although T2D is different from T1D, it’s clear to me that the system (whatever that is) sure doesn’t make it easy for us to do the right thing.

I do know this: digital tools made (and continue to make) my own work on this a lot more practical … I mean, without important information and without feedback tools, how is anyone supposed to do a good job? As I always say in my speeches – “We perform better when we’re informed better.”

Here’s to a radical acceleration of the tools we need – driven by what patients say they – we – need!

And I’m not even T2D yet – I’m just frickin annoyed at how I can’t even get clear instructions on what I should be doing about it! I believe health goals should be patient-driven, and the C word (“compliance”) should be thought of as achievement. So why can’t I get good guidance on that??

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Health goals should be patient goals, and there needs to be clear guidance on how to achieve them.  Thanks for lending your voice here today, Dave. 

Sleep Number.

I love sleep.

But I did not love sleep while Chris was traveling for work these last few weeks.  Mostly because I did not sleep.

From the middle of September to last week, my husband was away for work. He came home three times for 24 hours apiece, which meant that we missed him terribly. And it also meant that Birdzone and I held down the fort for two months on our own, which, for the most part, went very well. Now that she’s five and a half years old, Birdy is excellent company and we had fun hanging out with friends and playing games. (For the record, she can kick my ass at Uno Attack. And Crazy Mates. If you haven’t played Crazy Mates, look into it. Buccaneer Bob is quite the fella.)

Doing the school routine and maintaining my work schedule was one thing, but getting enough sleep was the most difficult, and somewhat unachievable, goal. The compounded effects of not getting enough sleep took their toll over the last two months.

The first week that Chris was gone, I had a low blood sugar during dinner that was pretty intense. My best friend and another friend were over for dinner, with their kids, so there were people in the house.  I wasn’t afraid that my low was going to leave my daughter unattended.  But this low was long and drawn-out, making my mouth and cheeks numb and leaving my brain unable to formulate anything even close to a coherent thought.  I remember sitting at the dining room table, my Dexcom receiver hollering, and I didn’t respond for a few seconds.  I’d already had a juice box and some glucose tabs and my dinner, for fuck’s sake, but the food wasn’t hitting as fast or as hard as the hypo, so I was floating around on adrenaline and scraps of glucose.

It went on for about 45 minutes, and afterwards, the low hangover was epic.

I didn’t realize this low had scared me so much until a few days later, when I realized that sleep was not happening.  I wasn’t able to fall asleep at night and I woke up several times throughout the night because I was paranoid about experiencing that hypo intensity again.  I decided to share my Dexcom information, usually shared only with my husband and a trusted friend, with my best friend for the duration of my husband’s trip, because she was familiar with what the numbers mean, she knew how to respond in an emergency, and she lives five minutes away (and has a house key), so she could bust in if she needed to.

But even with the safety net of data-watchful eyes and technology that promised to buzz me awake if I fell out of range, shaking that hypo fear was difficult.  It stuck with me for the duration of Chris’s trip, alleviated only when I was either away briefly for work myself or when my daughter was sleeping at my mom’s house.  It wasn’t the actual low that scared me, but the idea that my child could find me low that kept me awake at night.

I wish this wasn’t the case.  I would love to end this blog post with a clever line with advice on how to manage these situations and the best ways to avoid fear of hypoglycemia, but the reality is that I slept through the night again once Chris was home.  And only then.

“It’s Diabetes Month … have you been advocating?” someone asked me in an email this morning.  And I realized I’ve been avoiding it a little, because diabetes has spooked me a little in the last few weeks.  I didn’t want to write about being nervous to go to sleep at night.  That didn’t feel like the “right” kind of advocacy (though there isn’t a “right” kind).

But then I realized that it was the truth.  And as much as I have accomplished despite diabetes, this disease influences my daily life in a way that far exceeds the seconds I spend checking my blood sugar or dosing my insulin.  I had trouble getting any sleep because I was scared.  Plain and simple.

The clever last line of this blog post?  I’m fucking thrilled, for a dozen reasons, that my husband is home.

All Night Long.

It started out innocently enough.  Just a wiggly little drop before bedtime with a bit of insulin on board, so the need for snacking was elevated.

With .8u IOB. Snacktime. #diabetes

A photo posted by Kerri Sparling (@sixuntilme) on

A small handful of raisins and I’m on my merry way.  No worries!

But then 2.30 am hit and I was in the trenches again.  Dexcom alarms were blaring, texts from my Share friends were pinging, and the sweat was beaded up on my brow.

At least my phone is fully charged this time? #diabetes

A photo posted by Kerri Sparling (@sixuntilme) on

But no worries!  All night long lows?  I’ve got this.  Juice box plus temporary basal rate should bring me up juuuuuust fine.

Then Dexcom alarms went off again at 4 am (this time, I was a little high from over-treating the low). Corrected that shit.  No worries.  (Kind of worried.  I am tired.  When do I sleep?  Maybe tonight.  Aw fuck it – let’s dance.)

Diabetes is all night long.

You Don’t Look Like You Should Have Diabetes.

“And this, too, please,” I said, sliding the opened and half-consumed bag of gummy candies across the counter, my hands shaking.

This low was bad.  The symptoms were very visible, with unsteady hands and knees that were buckling out and sweat beading up on my forehead despite the 40 degree weather outside.  I knew I was the color of a cotton ball, with the mental capacity of one as well.

My Dexcom had gone off about ten minutes earlier and I picked around in my purse for the jar of glucose tabs that I soon realized were tucked neatly into the cup holder of my car.  Out in the parking lot.  (Useful.)

Necessity forced my hand to grab the way overpriced bag of candies off the shelf and consume a handful.  “Most expensive low ever,” I muttered, aware that coming up from this 45 mg/dL was going to cost me a pretty penny.  I needed to get out of the store and reassemble my wits, but lows don’t excuse shoplifting, so I made my way to the cashier to check out.

“Are you okay?” the cashier asked, probably because I looked half-removed from the planet.

“Yes, thanks.”

“These candies are open.  Do you want a different bag?  These have been half-eaten,” she said.

“No, it’s okay.  I ate them.”  I smiled in a way that I hoped looked reassuring but probably looked weirdly menacing.  “Low blood sugar.”



She smirked.  “And here you are, buying candy.  Isn’t this part of the problem?  You don’t look like you should have diabetes.  Maybe you should stop eating candy.”

I would have rather been eating a banana, to be honest.  Treating with fruit is my preferred way to upend a low.  Or I would have rather had some measured glucose tabs so I knew how much I was consuming and could avoid the post-low rebound.  Fuck, you know what?  I’d rather not have been low at all, because being low in a public place is embarrassing and makes me feel vulnerable.

Let’s just round it out and say that I’d much prefer not to have diabetes in the first place.

“The candy is to bring my blood sugar up.  It’s to keep me from passing out here at your counter.”  It was hard to make the right words come out, but anger jumped ahead of hypoglycemia.  My voice was sharp, like the plummet on my Dexcom graph. “What does someone who should have diabetes look like, anyway?

She didn’t look at me.   And I was glad she didn’t.  I popped a piece of the candy into my mouth, my attempt at a PWD version of a mic drop.  I don’t look like I should have diabetes?  Maybe that’s the point.  Maybe she needs an education on what diabetes does look like, instead of viewing my disease as a punchline, one that society judges unabashedly.

All of a sudden, I can’t wait for November.

As a Kite.

Woke up to this little gremlin number on my meter:

Gross, gross start to the day. #DOCtober #diabetes

A photo posted by Kerri Sparling (@sixuntilme) on

I pulled my site and immediately blood streamed out, leaving a trail down the side of my hip and actually running onto the bathroom floor (which is DISGUSTING and makes me feel like queen of the macabre).  The site was sore and tender and 12 hours past the “three day” mark, which may explain why it went gross on me.

Regardless of the “why,” the day started with an insistent need to pee and then drink a ton of water from the faucet.  And then change my pump out.  And then rage bolus.  And then start the day determined to have this be the One Thing that Sucks today instead of letting it set the stage for a crappy Tuesday.

Traffic Jam.

Last week, I was up in Boston visiting with Ed Damiano to hear some updates on the bionic pancreas (now known as the iLet – more on that later meeting this week), and our meeting ended late in the afternoon.

Which means I climbed into my car to make the drive home on Route 93 south towards Rhode Island at 6 pm.

For anyone who lives in New England, you know this is a recipe for sitting in the car in maddening traffic for hours.  The drive in and out of Boston is abysmal and unforgiving.  Sitting in traffic for hours on end trying to get to one stupid exit only to have to sit in traffic again for another long while is a waste of time and makes me endlessly grateful for my short commute.

But dude … I was on an iLet high, excited after hearing about how this new technology might help keep me healthy while freeing up brain space previously assigned to diabetes management.  Unfortunately, after peeking at my Dexcom, I was also on a bit of a blood sugar high.

212 mg/dL with an arrow pointing straight up, to be more precise.

“Gosh darn it,” is what I would have said if Birdy was in the car with me.  I was already in traffic.  It was going to be a long, needing-to-pee-because-hyperglycemia.  Time to bolus.

Several boops and beeps later, the correction bolus was en route.


“Oh for pete’s sake,” is another thing I would have said if Birdy was in the car.

I looked at the pump.  I haven’t had an occlusion alarm in ages, so I wasn’t sure what would happen next.  After confirming that none of the insulin had been delivered, I tried it again.


Well okay then.  Time for Plan B.

Plan B is always an option because I am painfully prepared for all kinds of crap things to happen at the most crap of times.  (Except that one time.)  My family mocks me for my giant purse, but when someone needs a bandaid or an insulin set or a t-shirt or a 3 lb bag of coffee or a brick or a small (small) weasel, I am their go-to girl.

Which explains why the contents of my purse often paint me as some kind of drug lord, because I thankfully had a syringe in my meter bag and a back-up insulin pen in my purse, just for moments like these when I’m in Boston traffic and need to shoot up quickly.  I disconnected my pump, uncapped my pen, and took my correction bolus old school style.  Nineteen and a half hours (read: two) later, I was back in my diabetes supply closet safety zone, where I could swap for a new pump set up.

This is exactly why I carry an insulin pen with me at all times. Even when it seems like overkill.

Which also reminds me – I need to update my stash of small (small) weasels.

Guest Post: “KITTY!!” and Other Low Tales.

Mindy was diagnosed with type 1 diabetes during the age of NPH (not the actor) and Regular when she was 7 years old. She’s been involved in the diabetes community since she was diagnosed and got involved in the online community when she started her blog (Telling Type 1 Diabetes Who’s Boss – which she recently changed to There’s More to the Story after getting diagnosed with ADHD, anxiety, and OCD.)  Today, Mindy is guest posting about how her low blood sugars can go from goofy to goat cheese in a matter of seconds.  Read on to see what I mean.

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When I’m low, I get extra chatty and very loopy. I’m already chatty without outside (well inside) factors and loopy- hello ADHD! Add the low blood sugar, and it becomes quite entertaining. After fighting with lows for four days, I’ll take the entertaining because well … the little things, right?

No seriously. Blood sugar, what in the world is going on? I actually still don’t know (even called the endo!)

I made changes; lowered Lantus, lowered basals, changed ratios and corrections, lots of juice, lots of snacks (should I be truthful and mention the Chinese food, fried food, red velvet cake, chocolate covered pretzels, gummi-bears, and beyond I have consumed this week? Most were related to lows- but a few- I was in a bad mood and wanted it).

Some of the nights I woke up high. Needless to say, I was exhausted. The lack of sleep, emotions of the entire thing, and how my body was feeling (plus the heat wave that hit the Northeast)-led for a very fun Mindy. I am so grateful for the understanding people I have in my life who read my texts and tweets, saw my snaps, and stayed with me on the phone during lows (even during a bad mood).

I got the loopy thing going for me, right? I’ll go ahead and say that makes me absolutely adorable.

Everything is hilarious at this point and once the giggle fest starts, nothing can stop me.

You can find me screaming “KITTY” everywhere I go and the cat is terrified. I chase him for love that he doesn’t want to be a part of.
I have a knack for getting lost and being clumsy and low BG makes it even worse. I’ve been walking around with my arms extended ready for a fall and extra time for the navigation purposes.

My new favorite low moment? Thursday night (not the fact that I couldn’t get my blood sugar up until 1AM and not the fact that I couldn’t enjoy my delicious cupcake because nothing tasted delicious and my stomach was a mess).

After my third juice and complaining while giggling, I SHOT up and screamed “GOAT CHEESE.”  I immediately ran to the fridge grabbed a container and a spoon. Ran back to the living room. Kept standing in the middle of the room (because that’s how I roll. There’s something about a low blood sugar that wants me to keep moving- at camp people chased me to sit down to treat a low and eventually get a mini-glucagon). Enjoying the delicious goat cheese (and remembering to take a Lactaid!). I also added some awkward low-infused dancing (to some silent music or maybe very quiet music?). In between spoons of goat cheese, I used the spoon as a wand or pretended to be a conductor.

Yes. That all happened.

I also embrace my child-like sass and blame my endo for bringing up the low blood sugar conversation – about how we don’t want lows – Which makes me gawk every time and ask how? I’m trying to decide if I would rather go the endo while it’s my period and trying to discover the magic formula for not being high during it (like I did last week) or in the middle of constant lows like this week.

Gosh, I thought the “real world” would make blood sugar management easier. You can take the college out of the girl but not the T1D, unfortunately.

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In addition to telling her story here today on SUM, Mindy is the Program Assistant at the College Diabetes Network, CDN, in Boston, MA.  She graduated Cum Laude from the University of Georgia in May of 2015 with a Bachelor’s in Social Work and minor in Sociology (which throws her immediately into that aforementioned “real world.”)  

After living in Georgia in a small town, her whole life and being Pre-Law since she was 14, she decide law school wasn’t right for her and moved to Boston. In addition to the diabetes bits and pieces, she thoroughly enjoys diabetes camp, travel, crafts, running, quotes, reading, binge-watching Netflix, and being awkward. You can follow her on twitter and Instagram @mindy_bartleson.  Thanks for sharing your story today, Mindy!


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