Diabetes Community Advocacy Foundation

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DSMA Live: ‘Rents Afterthoughts | Sara: Growing up and Parenting with Diabetes

Sara joined us in our April edition of DSMA Live: ‘Rents. Our conversation included various insulin pump options, parenting and pregnancy with diabetes and how Sara came to decide to pump as a teenager after years of injections. You may be surprised at what influenced her decision.

Please listen in to this fun and informative show:

 

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Get me off the roller coaster!

Ever been on a roller coaster?  Sure you have.  You know once that seat strap comes down, and you’re off there is no backing out – you are on this ride.  You also know when it’s coming to an end because it s-l-o-w-s down and becomes less exciting.  This is functional so that you can  come to a safe stop.  What if I told you the same was true about wild glucose swings in diabetes?  You have to slow down before you can stop them?  Would you believe me?

The roller coaster that can be diabetes management is HARD.  You’re 300 then you are 30, and then someone labels you as “brittle.”  The term “brittle” gets on my nerves because when you think of something being brittle, you think of it being fragile and breakable.  Why is this?  Well for starters, just like buckling up for that roller coaster, once you are swinging widely from the tree tops to the basement it’s harder to stop.

How do you get off the #$%@ ride?  Well, first I would recommend finding a good person on your diabetes team.  The person from your diabetes care team can be your Endocrinologist, your CDE (certified diabetes educator), or your primary care physician (if well versed in diabetes).  You need someone to monitor your work to make sure you are safe.

First, do some basal rate testing.  You can do this on multiple daily injections (MDI) or on a pump (see info below on how to do this). This will establish how accurate your rates are.  I usually encourage people to break it up into smaller increments rather than one whole day.  You will need to test, test and test your blood sugars.  Follow the instructions on the basal rate testing.  Make sure your meter (and/ or pump and CGM) has the correct time and date stamp so your device can be downloaded or referenced with accurate data points.

Second, after basal rate testing, present your data to your care provider, and sit down and look at it.  Did you dip low or go high at a certain point in time?  Discuss any changes you are considering with a care provider.  If you don’t know how to download your data, contact your device company (meter, CGM, pump to find out how – or ask your educator).

The next step after this is looking at correction factors and insulin to carb ratios – which we’ll do in our next two posts.  This month, your challenge, if you chose to accept is to do the basal rate test with me.  Yes, I will be doing this too, after all CDE’s with T1D may have a lot of knowledge, but we’re not Jedi’s with perfect control.

So let’s start the work to get off the roller coaster!

 

*Basal Testing Instructions

Basal rate testing is used to optimize your basal rates with your Diabetes Educator or Physician.  Having optimized basal rates is the first step in taming the glycemic variability monster (the blood sugar roller coaster).  Basal Rate testing can be done in increments of time.  It does not matter where you start, but it does matter that you complete all time periods.  If during the basal rate testing you are hypoglycemic (have a low blood sugar) please treat it as you normally would.  When your blood glucose stabilizes, you will stop basal rate testing for that time period.  Don’t get discouraged, this may happen before a time period is completed.

Overnight basal rate testing:

  • Test your blood sugar, dose your insulin and eat at your normal dinner time.  Try to choose carbs that are easily counted, and avoid a high fat or restaurant meal before testing.
  • Test your blood sugar 4 hours later -  this is the start of your basal testing
  • You may drink water and sugar-free beverages
  • Do not consume a snack or dessert after dinner
  • Set an alarm and test your blood sugar at 3:00 AM
  • Set an alarm to test your blood sugar at 7:00 AM
  • IF at ANY time you have a low blood sugar, please treat it and reschedule the rest of this basal testing.

Morning basal rate testing (assumes no overnight snacking):

  • Set an alarm and check your blood sugar when you wake up – this is the start of your basal testing assuming you did not snack overnight
  • Test your blood sugar every 2 hours
  • Do not eat your normal breakfast
  • You may drink water and sugar-free beverages
  • IF at ANY time you have a low blood sugar, please treat it and reschedule the rest of this basal testing.
  • Test ends 4 hours after start (if you wake at 7AM then last test is at 12PM)

Afternoon basal rate testing:

  • Test your blood sugar at lunchtime – 4 hours post breakfast or last snack
  • Do not consume your regular lunch
  • You may drink water and sugar-free beverages
  • Test your blood sugar every two hours
  • Test ends 4 hours after start (if you started at 12:00 PM then last test is at 4:00 PM)
  • IF at ANY time you have a low blood sugar, please treat it and reschedule the rest of this basal testing.

Evening basal rate testing:

  • Test your blood sugar and eat your normal lunch
  • Test your blood sugar 4 hours later – this is the start of your basal rate testing
  • Do not eat your regular dinner
  • You may drink water and sugar-free beverages
  • Test your blood sugar every two hours and stop after four hours  (if your basal testing started at 4pm it would end at 8pm)
  • IF at ANY time you have a low blood sugar, please treat it and reschedule the rest of this basal testing.

Just like a snowflake, everyone’s diabetes is different!  You will need to upload your meter and pump, CGM, app (whatever you are using to collect data) and review the data with your care team.

Remember that at any point in time you have a low blood sugar you must take care of it and disregard the rest of the basal test.  This may take a few attempts, but your patience will pay off in the end.

 

* All views expressed here are solely belonging to the author and are not associated with any institution. This website and post are intended for informational and educational purposes only and not for the purpose of rendering medical advice. The contents of this website are not intended to substitute for professional medical advice, diagnosis or treatment.  Please consult your physician for personalized medical advice. Always seek the advice of a physician or other qualified healthcare provider with any questions regarding a medical condition.  If you are experiencing a medical emergency, please call 911.  

Special Edition of #DSMA

Jane contacted our team a few months ago to ask if she could conduct a virtual focus group during DSMA’s Twitter chat.  We thought it was a great idea and hope that you feel the same. Jane take it away…..

My name is Jane and I’ve had type 1 diabetes for 40 years in June. I’ve been helping others live well with diabetes, as a nurse and certified diabetes educator, for 20 years. My personal and professional experiences in diabetes care have shaped my feelings about words and diabetes. A couple years ago I came across my notes from a talk I gave in 1993. It was a presentationfor nurses about the impact of words on people and their health, and I still find this topic both intriguing and an ongoing challenge. 

live in a rural resort town in northwestern Colorado, where Iwork remotely teaching and overseeing the Master of Science in Diabetes Education and Management for Teachers College Columbia University (which is in NYC!). I make it my mission to help diabetes professionals use words that put people first and focus on their strengths, not weaknesses. This year I amembarking on a research program which will look at the words we hear, see, and use in diabetes care (and diabetes life), and the impact those words have. I am excited to host a virtual focus group on DSMA’s live Twitter Chat on Wednesday, March 25, 2015. It will proceed like a usual weekly chat, except that it will be a focus group and the questions will be about diabetes-related words and the feelings they bring up.

Conversations, observations, and reading have made it clear to me that some of the words and phrases used in diabetes care are upsetting to those who live with diabetes. So I decided to get together with people who have diabetes and ask them about it directly. Through a total of four focus groups (two web-basedand two in-person) I hope to gather information about what those words are and how they make people feel. In other words, what diabetes-related words bother you?

I hope you will join me in the DSMA virtual focus group on Wednesday night at 9 pm Eastern. Your contributions to this discussion are very valuable. If you would like to read the full explanation and informed consent for the study, please visit here. You are welcome to leave a comment and ask any questions you may have. You can also contact me directly with questions by emailing me at janekdickinson@gmail.com.

#DSMA ‘Rents Twitter Chat | Monday, March 16 9PM EST

DSMA 'Rents EditionWe’re trying something different in our DSMA Live: ‘Rents programming. This coming Monday we will conduct a special twitter chat during our normal Live show time slot! We’re picking a topic from our most recent show with Katy Killilea of “Bigfoot Child Have Diabetes.”

We covered a lot in this show, but one thing kept popping up throughout the hour: guilt.

Our chat will focus on feelings of guilt. Do you feel it? How do you cope with it? How do you counsel others who experience it?

We’re excited to be conducting our first show carryover Twitter chat! We hope you will join us!! Just follow #DSMA on Monday, March 16 at 9PM EST and join in the chat!

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Afterthoughts DSMA Live: ‘Rents | Katy Killilea of Bigfoot Child Have Diabetes

Katy and FamilyKaty Killilea of Bigfoot Child Have Diabetes joined us on last night’s DSMA Live: ‘Rents.

Katy’s son, Briggs, was eight years old when he was diagnosed with type 1 diabetes. That first night in the hospital, she started writing her blog.

Since Briggs was diagnosed, Katy discovered through Trial Net that both she and her other son have markers for T1D. Listen to their experiences, including how her son was treated and can now pass the glucose tolerance test that he previously failed.

We touch upon so much in this show, including our admiration for Mr. Mike Lawson’s video series. We all want to know which is your favorite. Head over to Bigfoot’s blog and let us all know!

Please mark your calendars: we will be holding a special Twitter chat on Monday, March 16 focusing on a topic just from this show. Join us at 9PM EST and follow #DSMA!

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