When I decided five years ago that it was time for me to go on an insulin pump, I shopped around. But I didn’t ask my doctors about which kind the preffered, and I didn’t call my local sales reps for their opinions. Nope, I started right here on my blog and with other areas of the diabetes online community. I’ve always known that other people with diabetes had the best advice to offer about living well with this disease, and pump shopping was no different. The guidance of the DOC led me to the perfect choice in pumps for me, and of course have since provided advice on everything from running half-marathons to traveling in Asia with diabetes. All of us who have been part of the DOC for a while know that when you want the best information, you go right to the end-users. What’s exciting about the diabetes world right now though is that the companies that make our supplies are starting to catch on to this mindset in a big way.
I was invited to be a guest speaker for a big pharmaceutical company this week. On Sunday night, I flew across the country and gave a simple, straighforward talk to over 200 employees on Monday morning. The subject was simple for me: What is it really like to live with diabetes? (Which, as a side note, is kind of like asking a person without diabetes “what did you have for breakfast today?”) My presentation was about 15 minutes and centered around setting straight a common misconception about diabetes: the fact that the burden of this disease has nothing to do with injections and finger-sticks and is in fact so difficult because it takes up so much of our mental space, every single day, to manage it.
The talk itself wasn’t groundbreaking. But what was exciting was the fact that this company was willing to listen. And more and more companies in the diabetes game these days are doing so. After some super-expensive but totally unsuccessful supposed “game changing” products bombed (hello inhalable insulin), companies are starting to realize that if they don’t find out what is important to the patient, they won’t be successful, no matter how many marketing guys tell them they will be. Case in point, everyone thought inhalable insulin would be a blockbuster. They thought not having to inject oneself was the holy grail of innovation. But they didn’t take into account that the device they came up with it to deliver the insulin looked like a giant bong and no one was ever going to be confortable whipping that thing out at a business dinner. Especially when they could discreetly pull out an insulin pen and inject under the table without anyone noticing.
That company didn’t know what it’s end user wanted. They assumed injecting was harder to manage than the social stigma of having diabetes, when they couldn’t have been farther from the truth. But all of that is changing, as evidenced by the patient summits that big companies are regularly calling. Just in the last month I’ve been invited to do the talk I mentioned, as well as sit in on two product devekopment reviews to offer my feedback. All three of these things focus on one question: “What will make the patient’s life better?”
It’s not a perfect system yet, by any means. But the fact that companies are willing to ask these questions and listen thoughtfully to the replies is leaps and bounds beyond where were just a few short years ago. So keeping talkin’ DOC! Important people are listening – finally.
As part of Diabetes Awareness Month and the impending Holiday Season (which we all know involves a LOT of food), I wanted to provide some inspiration in the kitchen for you all (and myself, let’s be honest). When I heard about Chef Jess’ cooking (delicious!) and her goal of helping people with diabetes live better through good nutrition (awesome!), I wanted to know more.
Jessica Swift – better known as Chef Jess – has always had a passion for cooking. She perused this passion, graduating from Johnson and Wales University with a degree in Culinary Arts. But while in cooking school, she watched her father struggle with Type 2 diabetes. After talking with a local dietician, she realized she could use food to help her father – and others – live better with diabetes. She was so inspired by this idea, that she went on to earn a Bachelors’ in Dietetics from Michigan State University and eventually on to Howard University, where she completed her Master’s in Nutritional Sciences and focused on perceptions of the diet as it related to disease.
Chef Jess now provides nutrition and culinary services to groups and individuals including Health Shopping Tours and something she calls the “Cabinet Clean Up,” which involves a house call to whip your food stock into shape! How cool is that to have a Chef RD come to your house and evaluate your cabinets? She also loves to write and blogs frequently on her website, http://www.chef-jess.com/. Chef Jess’ mission of helping people with chronic illnesses live better through good nutrition was inspiring to me, and I’m lucky enough to have interviewed her for today’s post.
Clearly you have always had a passion for cooking and food, but what made you want to also become a Registered Dietitian?
My passion for Dietetics came about from watching family struggles. My father, in particular has struggled with Diabetes and my mother with hypertension. While in culinary school I was able to see how I could successfully incorporate my love for food and nutrition. I was the star student in my culinary nutrition class. At the time my professor, Dr. M, began mentoring me, opening my eyes to a great career of being a Chef RD.
You have dealt with diabetes in your family for several years. What are some of the stereotypes about diabetes that really bug you now that you’ve experienced it directly with your family and understand it better?
One stereotype in particular that bothers me is when others think that all people with Diabetes developed the disease from simply over eating and not taking care of themselves. I use this opportunity to educate on the difference between type 1 and type 2 diabetes.
The holidays are coming up! Any quick and easy substitutions that people can do to their recipes to make holiday favorites more healthy?
When baking, using wheat flour instead of white, I often substitute oil with jarred baby food (i.e. carrots or applesauce). Using baby food is best because there are no added sugars; Lastly, substituting sugar with Splenda and occasionally agave.
You mention in your tips for cooking that sugar is better when it comes from natural sources, but you also mention to always check the total carb count on foods, and things like honey and dried fruit can really pack on the carb count, which drives up the need to cover these foods with more insulin. How many is too many carbs, natural or not?
Yes, sugars that come from natural sources are much better. For example, if eating piece of dried fruit, although high in sugar, you are still getting other nutrients that are great for your body (i.e. phytochemicals, fiber, vitamins). The maximum amount of carbs is very specific. After, reviewing your diet, your dietitian and doctor would have to determine the amount of units appropriate for you. It is very important that you check your blood sugars often and give a very thorough account of usual intake to help aid in blood sugar stabilization.
What is the go-to meal for a busy chef like you do when she has to make a super quick and healthy meal?
I always keep cooked chicken or fish in the fridge. I grab lots of fresh veggies, spinach, tomato, onion, bell, pepper; then sprinkle on 1/8 C. of beans, 1/8 cup of nuts and 1/4 cup of quinoa. Dress it with fresh lemon juice, olive oil, oregano, salt and pepper. And you have an amazing quinoa, vegetable and (chicken or fish) salad. This is packed with protein, complex carbohydrates and vital nutrients. The great thing about this salad is that you can throw anything in and it will still be delicious.
What is the one message you hope that people with diabetes get from your cooking tips?
I would like people to not be afraid to try new dishes or make substitutions. I am an advocate for creating new recipes and often find myself recipe testing. Whenever you eat, make sure you are “eating the rainbow” different colors represent different nutrients and our body’s benefit from all of them.
It was another grueling Wednesday morning class at my gym, and I sweated through box jumps, tricep dips, squat jumps, and a whole host of other torturous exercises in my “I Run on Insulin” t-shirt. When the trainer called for a break, we all gratefully walked to our water bottles. Another regular in the class sidled up to me.
“There’s no way you’re diabetic,” she said, her eyes wide with disbelief.
“I am. Type 1″ I countered right away, my guard already up.
“Oh yes, of course, a Type 1. Incredible.” she said.
“Oh…uh..thanks? I’ve had it 20 years,” I said back.
She shook her head. “Just amazing. Incredible.”
Then she walked away to take a swig from her water. We resumed class and she didn’t say anything else to me for the rest of it other than “do you want to switch medicine ball weights with me?” (which I did, I like the 10 pounders for wall ball squats anyways).
I have no idea what her comment meant, or why she had such disbelief that she was working out right next to a real, live Type 1. But I’ll choose to take it as a compliment. After all, it’s not everyday that someone returns the comment “I have Type 1 diabetes” with the words “amazing” and “incredible.” I’ll take that over the alternative any day.
Look, I know I’m not the best when it comes to being on top of my foot care as a person with diabetes. I get pedicures, I run in toe-shoes, and I grew up surfing and chilling barefoot at the beach. But after feedback from several readers debating the merits of “recommended” foot care for diabetes, I’ve been trying to be better. So when Gold Toe socks sent me a pair of their new SoleUtion socks for sensitive feet in honor of November being Diabetes Awareness Month, I gamely pledged to test-drive ‘em. And also, I don’t live in San Diego anymore and henceforth can’t wear Rainbows flip flops to everything. Which means, I’m gonna need more socks for this winter!
Gold Toe is a popular brand of socks already, but the SoleUtion socks are specifically designed to be what the company calls “non-binding” (i.e. allowing for proper circulation). The socks have reversed toe seams for comfort, moisture control properties to keep your feet drier, cushioned soles, and are made with something called “Freshcare” to control odor-causing bacteria (which sadly, I’m really in need of. The rest of me smells great, I promise!)
When I lived in San Diego, I had so few socks that during the colder months I found myself dipping in to my husband’s work sock stash to find a pair. I don’t have a lot of sock-buying experience, which makes all these features on the Gold Toe pair feel like I’m wearing the Cadillac of socks – and I like that because I immediately feel like I’m doing more for my diabetic feet in one second than I have in 20 years just by slipping these on.
On the practical side, these socks are incredibly comfy and breathable. They worked under sneakers but also with a pair of tighter boots. Plus, they come in two colors and several styles if you want to get all crazy with it. You can get a pair here if you’d like to try them yourself.
The fact that I’m taking a step towards better foot care just by slipping on these socks is the true benefit here. The socks being super-comfy and warm is the added bonus! Thanks for the helpful push in the right direction Gold Toe!
If you’re reading this, then you probably have diabetes or know someone who has diabetes. So I probably don’t need to tell you that it’s Diabetes Awareness Month (which, side note, I’ve always thought it’s kinda funny that Diabetes Awareness Month is the same month as Thanksgiving, a holiday that celebrates heavy food…but maybe it’s a good educational opportunity? Just a thought). But I do need to remind myself that it’s Diabetes Awareness Month. In fact, I’m going to remind myself of it every day, because I’ve actually personally declared this MY Diabetes Awareness Month as well.
I’ll explain. Ever since I got this A1c back, I’ve been trying to fine tune. As we all know, the little stuff with diabetes, the details, and the small changes that make big differences are the hardest ones to make. The diabetes devil is in the details (note to self: Halloween costume idea for next year: Diabetes Devil) and for me to get my 7.2% down into the sixes, I’ve gotta put in some serious work.
I’ve had a ton of distractions in the past six months: moving cities, getting married, my best friend’s wedding – it’s been busy. My focus has not been on my diabetes, and I’ve let a lot of other things dictate my food choices, my exercise routine, and my priorities. So this November, I want to put more focus in on my diabetes management than I have all year. I want to make food choices based on what will be best for my blood sugars. I want to exercise to augment, not complicate, my BG control. And I want to take the time to make those micro-adjustments that really make a difference. It won’t be easy, but it’s time to put my back into it and really push to get the numbers down to where I was pre-Asia. What could be more important than my health? Nothing really, but the past six months wouldn’t support that claim. It’s time make the changes and put in the effort.
So why am I telling all of you this? Well, it’s called accountability. If I write it and put it out there to share with the world, then I’m on the hook for it. And, I know I can count on all of you for support which is why I joined the DOC in the first place. Cheers to a healthy November!
I put my Omnipods through a lot. I sweat on them in the gym and out running, I do sit-ups on ‘em, toss and turn through my sleep. Most of the time, they hold up incredibly well. But ever since I got the new smaller pods, I’ve had several do this weird creep-up thing with the adhesive that ends up forcing the pod to detach and/or causing an occlusion as the cannula pulls out, rendering it useless and making me change sites. It always looks like this when I pull it off.
It’s happened about three times since I started the new pods which was only a month and a half ago. Anyone else having this weird adhesive creep-up on the new pods? Or is it just me over here, the girl in the gym who’s sweating like a linebacker five minutes into the warm up?
I’m so lady-like!
Yesterday, I rolled down to my local Walgreen’s and paid $31 to get a flu shot. It made my arm sore, and I was so tired by 8pm that night that I hit the hay not much longer after that. I don’t love getting a flu shot every year, but I do it.
I used to wonder why people with diabetes were lumped into the same category as the elderly and children in terms of who is recommended to get a flu shot. Don’t we already have pretty iron-clad immune systems, as evidenced by the civil war inside our bodies that left our beta cells useless? Turns out that we don’t fall into the category because of our immune systems. It’s actually recommended that people with diabetes get a flu shot because it’s such a royal pain in the ass when we do get it that we should do everything we can to not contract it in the first place.
The flu can cause vomiting and diarrhea, sniffles, body aches, fevers and coughs, and is generally much worse than your common cold. If you had a head cold last winter and you have diabetes, you already know that it quickly puts your BGs on a roller coaster (mostly highs as your adrenaline kicks in to high gear fighting off the cold), and makes your food intake irregular. If you multiply that annoyance by about 1,000, then you’re about where the issue with the flu lies. If you have diabetes, managing your condition while also having the flu can get real risky, real fast, and it’s not worth it. So, that’s why we’re all told to get a flu shot every year.
Do you guys always get one? And has anyone had the flu with diabetes? Was it as bad to manage as they say? Because I know when I have a regular cold things get really tough. Even with this kick-ass, hyperactive immune system I’ve got over here.
Our furry little skeleton would like you to have a happy and safe Halloween! And remember to bolus early and bolus often with all that candy around.
For me, it actually wasn’t that hard to get my A1c down from 8% (after our return from our Asia trip) to what it is now: 7.2%. This was was accomplished by macro changes, some of them forced due to being back in the United States. For example, I went back on my pump after doing MDI for our three months abroad. I also stopped eating noodles and rice with every single meal (god I miss those days). These changes alone probably slashed my numbers by the .8%.
But trying to go a measly .3% from 7.2% to 6.9% so I can officially say that I’m under 7? Now that is what takes work. There are no more macro changes to make: I’m back to eating a normal, lower carb diet. I exercise most days of the week. I have my pump and my CGM on at all times. Those things are great, but fine tuning is all about the micro changes.
It’s remembering to bolus 20 minutes before a somewhat carby meal.
It’s remembering to cut your basals before your workout but to bolus after to prevent a post-workout spike.
It’s not getting a popcorn at the movies because although Tuesdays are great, they are not a special occasion and don’t really warrant a “treat.”
It’s taking the time and effort to correct a 168mg/dL with half a unit of insulin before bed.
Actually it’s ever bothering to bolus a half unit for anything, really.
It’s not shutting the Dexcom alarm off in the middle of the night but actually getting up, finger-stick confirming and correcting the problem.
It’s telling your friends at happy hour that no, you don’t want to split the chips and guac but could we get an order of the carb-less chicken skewers?
It’s a lot of freaking work is what it is. It’s the extra effort that can take you diabetes management from “pretty good” to “dang, that’s a low A1c!” And it is hard.
But I know that it’s worth it. And after this crazy, blessed, action-packed whirlwind of a year, that effort and focus is just the TLC my body needs.
Sometimes there are things in life that we have always just assumed we’d do, but never realized the way it would feel until it happened. Thursday was a day like that for me. After 30 years of being Alexis Pollak, I went to the social security office and changed my name officially to Alexis Pollak Hauptman, taking my husband’s last name.
I’d always liked the idea of taking my husband’s name, and not only because Pollak is always misspelled and harder than you’d think to pronounce. I also liked the idea of having the same last name as my partner and being a little family unit of two (three if you count our furry, four-legged child). But when it actually came time to sign the document at the downtown social security office, I felt a little pang of sadness along with all my excitement.
It’s a funny thing to give up a name that’s been with you for as long as you’ve existed. That’s the name I grew up with and built a career with, and with a few strokes of the pen, it would change. (And on that note, they really don’t care at all what you’re changing your name to over there at the Social Security office. Like you could really just walk out of there named Rainbow Diamond Princess if you want. Which I am sure has already been done). But it also felt so exciting. That moment really made me feel like I was married. It was an exhilarating feeling to commit to someone so much that you take their name. It also helps to be married to someone that didn’t ever take that commitment for granted. Jacob never asked that I change my name and would have supported me if I had not wanted to. And he was also incredibly excited and flattered when I did.
To celebrate the name change, we made German food that night in honor of the namesake. As it turns out, there’s quite a bit of German fare that’s extremely dia-friendly. We made a red cabbage dish and bratwurst that are both super low-carb (although we did cook spaetzel as well, which is essentially a pasta-like side dish that is loaded with carbs – I kept my serving small). It was all absolutely delicious and a fun way to celebrate.
While I was surprised that I had mixed feelings when I had assumed it would be easy, by the end of the night I was reminded that it doesn’t feel like you’re losing anything at all when you gain so much in return. And as an added bonus, I’ve moved way up on the list of alphabetical order!