One of my first few posts on captainsrest back in November was titled, Worst Diabetic Fear. In that post, I expressed that my biggest fear is that my three year old daughter (or on-the-way baby) will develop diabetes. This fear is even more heightened because she is so young. I truly can’t imagine her being on a pump or injections and having to test all day long at such a young age. Since before she was born I’ve been asking my doctor and now hers about how often she should be tested, what are the odds she may have diabetes and so on.
Just recently, she was not herself. After a few days of being “off” I started to think the worst. I thought, “She’s drinking a ton of juice and water, she’s going to the bathroom a lot and has been pretty cranky”. I got that sunken feeling in my chest and dropped my head, thinking – oh no. Please no. Don’t be right on this one Tony.
I went and grabbed my meter and brought it to the kitchen. My wife saw what I had in my hand and said, “No, you think it could be” (the word “diabetes” was never said and didn’t need to be). I replied, “There’s only one way to be sure”.
First, I checked my own “number”, which is what my daughter calls it. “Hey, daddy, what’s your number, she says”. I told her what I was doing and that it may pinch for a second, but that the pain goes away quick. Next, I said, “Now we’re going to check your number”. She got excited because it was something new and fun for her. I picked her biggest finger and was visibly shaking as I pushed the button. I was certain she was going to flip out and start screaming. To my astonishment, not even a flinch, whine, tear…nothing. She got big props from us for being a “big” girl.
Now the worst part; the five seconds that took an eternity 5…….4…….3…….2 (Tony thinking, please God let me be wrong)……..1……..ERR (just joking). The number was 98. I was so relived and let out a huge sigh. Phew.
As a parent, the fear will ALWAYS be with me until there’s a cure. It’s just another thing I need to deal with as a parent with diabetes. Until the next time I notice her going to the bathroom a little more often than normal, ciao.…
I was diagnosed with Type 1 Diabetes in the fall of 2002 at the age of 28. I wear a Minimed pump with the Minimed CGM. Since starting to run in September of 2009, I have participated in two 10Ks, two 10 mile races, a 200 mile relay with 11 other Type 1 Diabetics, the GO! St. Louis Half Marathon and will run the Chicago Marathon later this year. I am not a doctor and don’t have a medical background, but I like to share my experiences to help and inspire others with T1.
Tony asked me to write about my experiences with the before, during and after care that goes with extraneous physical activity, like running with T1 diabetes. What follows is what I *try* to do every time I run. I am far from perfect, but I have a good plan. Most days everything will go just fine , but others… well, let’s just say every day is a learning experience.
Preparation and planning is the key to a good run. Having T1, I can’t simply go out for a run at anytime. I need to be aware of what I have eaten and how much insulin I have on board (IOB). An hour before a run I will set my basal down to 10% of the normal level and depending on the distance I’m planning to run, I will leave it at 10% for another 30 minutes to an hour. I like to start my runs with my BG around 120-150 and trending upwards. To do this, I’ll eat 15-20 grams of carbs about 15 minutes before heading out. I’ve found that eating right before starting has little or no affect on my BG, so 15 minutes seems to be the right length of time for me. A lot of other Type 1 Diabetic runners that I know prefer to start with fairly high BG levels. I perform much better with a lower BG level, so I like to be in the normal range. If I am high before my run (220+) , I will do a correction that is equal to about 50% of a normal correction. Having too much IOB is a sure way to have a nasty low while running. If my BG is in the 200-220+ range, I would skip the 15-20 grams of carbs before the run and naturally let my BG levels come down
During runs I will eat 25 grams of carbs approximating every 30 minutes. I prefer GU Energy Gels, because they are easy to carry and easy swallow while running. I NEVER, repeat NEVER, go out for a run without at least 2 GUs. They literally keep me going and out of trouble. I’ll have a GU after my first 2 miles and if my BG is holding steady, as a result of BG testing or keeping an eye on my CGM, I will delay the second and subsequent GUs as long as I can. I like to keep my BG numbers between 120 and 150 during my runs. My CGM really helps me with this, but as soon as I see it start to trend down I will eat a GU. Since the CGM has a bit of a delay compared to a BG meter, a low can occur faster than the CGM will react to it, so keeping a close eye on the graph is critical.
In case of emergencies I wear a wrist Road ID with my contact information and the fact that I have T1. I also try to carry a cell phone. But the main thing is staying out of trouble in the first place. This can be done with proper preparation and just being smart about the situation.
If you have a the luxury of running with a friend, make sure they know what to do in the case of emergency. I have a friend that I run the majority of my long runs with. We talk a lot about T1 and he knows what to do in case of an emergency.
After running I have two scenarios to deal with. The first is going high soon after finishing. Right after a run, my body is low on insulin and potentially high on carbs. In some cases, I have had my basal set at 10% of my normal level for nearly 2 hours while also eating 50 – 75 grams of carbs. My practice is to bolus the amount of basal I have missed during my run. Typically, this would be about 2 units for an hour long run. I also try to eat at least 30 grams of carbs afterwards to help my body recover more quickly. I will simply bolus the normal amount to cover these carbs. The second issue is going low later in the day. About 5 hours after a run, I will set my basal down to 50% of the normal level for 3 hours and also try to remember to eat a carb/protein snack to prevent late afternoon lows.
Running a marathon has been a life-long goal of mine and I’m not going to let diabetes stand in my way. Sure, there are a lot of challenges that I have to deal with to be safe, but in the long run better overall health and improved control is worth it. So, get out there, have fun and enjoy life to its fullest!…
For about 4 years now my doctor has been checking my vitamin D level and has me on supplementation to keep my level as close to optimal as possible. For those that spend the majority of our day indoors, there is typically a vitamin D deficiency. My doctor wants my level between his preferred range of 40-70 ng/ml. I find my levels are best during the summer months when I tend to get more sun – obviously. I’m not a doctor, but would recommend you discuss this area with your regular physician because it could help you too.
Here are some recent articles that support optimal vitamin D levels:
[men’s health] According to the July/Aug issue of Men’s Health, a study suggested that people with low blood levels of vitamin D are 47% more likely to develop prediabetes.
[Reuters] “Lower levels of vitamin D circulating in the bloodstream are tied to a higher risk of developing diabetes…[type 2]”
[Yahoo News] “For every 5 nanograms per milliliter (ng/mL) increase in vitamin D levels, the risk of developing diabetes [type 2] dropped by 8%.”
Some Possible Benefits of Vitamin D
- Improved balance
- Stronger & healthy bones
- Improved muscle strength
- May lower risk of some cancers
- Decreased risk of osteoporosis
- Less tooth loss
- Better thinking
- Boosts immunity
- Improved Insulin sensitivity
Some of these claims may be stronger than others, but there is evidence of each to some extent. Do a simple Google search and you will see for yourself. With all of these possible benefits and almost no downside, why not take vitamin D supplements? I simply take 1 pill twice a week and it brought my level from the 20s to 50. With an Rx from my doctor I get a strong dose that is a generic and very low cost. Seriously, I can’t afford to NOT take more vitamin D.
Tip: Vitamin D supplements are much better than ultraviolet rays (sunshine/tanning booth)
Blood Test: You can suggest to your doctor to test your vitamin D, by checking your 25-hydroxy D…
I know I’m a little behind the news flash on this one, but I want to make sure that all my readers know about this recall. Medtronic announced a voluntary product recall for all of the Paradigm Quick Set (mostly in U.S.) infusion sets that have a reference number of MMT-396 to MMT-399 along with a lot number starting with an 8. I checked the 5 boxes I had on hand and every one of them are part of the recall. Here is part of the press release from Medtronic.
“Medtronic, Inc. (NYSE:MDT) said today that it has initiated a recall of specific lots of Quick-set® infusion sets that are used with MiniMed Paradigm insulin pumps. An infusion set is a thin plastic tube used to deliver insulin from an insulin pump to a diabetes patient, and is typically replaced by the patient every three days. Affected infusion sets are reference numbers MMT-396, MMT-397, MMT-398 and MMT-399 with lot numbers starting with the number “8.” Medtronic recently discovered that approximately two percent of “Lot 8” Quick-set infusion sets (which represents approximately 60,000 infusion sets out of an estimated 3 million infusion sets currently with customers) may not work properly. The affected infusion sets may not allow the insulin pump to vent air pressure properly. This could potentially result in the device delivering too much or too little insulin and may lead to serious injury or death.”
Click here to access Medtronic’s web page regarding the recall with instructions on what to do. It got a little fuzzy when I tried to figure out how to exchange my sets for new ones. I called my supplier and they said I should be receiving something from Medtronic or getting a call back from them with further instructions. It seems that Medtronic is pointing to the suppliers and the supplier is saying they are awaiting more instructions from Medtronic.…
Type 2 diabetes is a disease in which either the body does not produce enough insulin or the cells ignore the insulin. Type 2 diabetes is the more common form of diabetes. Although there is no cure for diabetes, there are many means like diet control and exercises, by which the blood sugar levels can be kept in check.
If diabetes is not kept in control, it can lead to different complications. Most of these complications are a result of the effect of diabetes on the nerves and arteries. Here are some of the health problems that Type 2 diabetes can cause.
- Cardiovascular disease and stroke. Type 2 diabetics have two to four times the risk of suffering a heart attack or a stroke. People with diabetes are more likely to have high blood pressure, obesity and high cholesterol. These together with the artery damage caused by diabetes can lead to heart diseases.
- Kidney disease. Diabetes is the most common cause of kidney failure. Type 2 diabetes can take away the ability of the kidneys to filter waste products. Kidney failure is the last stage of chronic kidney disease and it may require dialysis, artificial blood-cleaning process or kidney transplantation from a healthy donor. 40 % of those who need dialysis have kidney failure from diabetes.
- Foot Problems. The nerve damage caused by diabetes results in a loss of feeling in the feet. This is called neuropathy. The feet become numb and are not able to feel pain, heat or cold and you may not notice injury until the skin becomes infected. Diabetes also causes the skin at the feet to become very dry. Foot ulcers and calluses may form at the feet and if neglected, these could lead to infection. Poor blood circulation to the feet makes infections difficult to heal. In severe cases, this may lead to amputation.
- Eye disorders. Diabetes causes many eye disorders by damaging the blood vessels in the retina. The major eye disorders are glaucoma, cataracts and retinopathy. Non-proliferative retinopathy is common and does not require much treatment but in proliferative retinopathy, the blood vessels are so damaged that there is leakage of blood. This condition may lead to blindness if not treated properly.
- Gum Disease. Diabetics have a higher risk of gum problems. People get gum disease when plaque destroys the gums and bone around the teeth. People with diabetes can get gum disease from having high blood glucose levels for a long time.
Other health problems that Type 2 diabetics risk facing are stomach and bowel problems, where the nerves that trigger normal functioning can become less active causing constipation or diarrhea, and sexual function problems. The nerve and artery damage could lead to impotence. It is very important that diabetics be aware of the health issues that they face. There is nothing to worry, as taking steps to keep diabetes in control will take care of most of these health issues. If you are a Type 2 diabetic, make sure that you take those precautionary measures to keep these health problems at bay.…