The Signs of Diabetes. Do You Know Them?

I sat in the doctor’s office. It was a room that I had sat in many times before but this time was different. My son was laying lifelessly in my arms.  I was terrified.

We had been to the hospital for bloodwork and x-rays. He hadn’t stirred. I looked across the room and saw a poster that had probably been there for the past 10 years or more but I had never noticed it.  It showed the signs of diabetes.  I have never paid attention before.  It was a disease that happened to other people…until it didn’t.

As I waited I read….

warning signs of diabetes Frequent urination

My son did nothing but soak his diapers for weeks. We were going through Pampers in record time and I had blankets on my couch because accidents were happening.

Constant thirst

We had been to the emergency room in the days before and they said that it was a good sign that he was drinking.  Even when he seemed too weak to get up, he could walk to the fridge and drink a carton of apple juice. They assured me that this was a positive thing.

signs of diabetes blurred visionBlurred vision

My son was 2 years old.  He spent most of his time in my arms. I had no idea if his vision was blurred.  He had no way to tell me either.

Fatigue

My son slept all of the time.  He was sick.  I knew that much.  Sleep was a good thing for a little boy who wasn’t feeling well.

Unexplained Weight-loss

My son had always been tiny.  He hadn’t been eating a lot. He was slight but that was to be expected.

Fruity breath

My son had sweet little boy breath.  I didn’t know that there was anything else that could possibly be going on.

Thrush or other yeast infections

This was a warning sign.  Why did a two-year-old have thrush? The emergency room doctor didn’t offer any explanation.  He simply gave us antibiotics.

I didn’t know the symptoms. I didn’t know that warning signs and neither did the ER doctor. It almost cost my son his life.

Know the signs.  Share them with others.  Together we can save lives. signs and symptoms of diabetes

Download a copy of the signs and symptoms of high and low blood sugar levels here.

Hot Tips for Managing Diabetes in the Deep Winter Cold

winter tips with diabetes The weather outside is frightful! The temperatures are dropping and we are in the midst of deep winter cold.  Managing to stay warm can be a challenge on days like these.  How do you manage your diabetes as well? Here are a few things to remember…

Insulin freezes.

Insulin is liquid. It can freeze. Make sure not to leave insulin in your car.  When you are outside, keep it close to your body. This also means that if you are pumping, make sure to tuck your pump close to your body to keep things running properly.

If you think your insulin has been frozen, throw it out! Don’t take any chances.  It will not work as efficiently once the proteins have been frozen.

Keep warm!

That means keeping your diabetes devices warm as well! I just told you to keep the insulin in your pump warm, but did you also know that your pump (like your phone) also needs to stay warm? Keep your pump and CGM under your winter clothing and as close to your body as you can.

If you are using a tSlim pump, watch for the low-temperature warning on the pump.  This will tell you that your pump is not functioning as it should because of the cold.

Check your blood glucose level.

I know, you normally check but when it is cold out make sure that you still check…a lot.  Some people see their bg levels rise in the cold weather while others see it go up.  Don’t guess or go by how you feel–check then adjust with food or insulin.

Before you check, make sure that your meter is warm as well.  Glucometers function poorly below 40F (4C).  If you feel that your glucometer could be too cold, warm it in your armpit for a few minutes. It will quickly return to a functioning state.

Keep your hands warm.

It can be hard to check your blood glucose levels when fingers are cold and blood isn’t circulating properly.  Keep your hands warm and toasty to help making finger sticks a bit easier.  Wear warm gloves. You may want to consider using  mitts that have removable fingers to make it easier to check .

Carry glucose that won’t freeze.

Juice packs are a handy way to treat lows but when you are playing in the snow, glucose tablets and granola bars are probably a better choice.  Also make sure to keep your glucagon warm and safe.  Frozen glucagon will be as useful as frozen insulin.

Winter activities can be fun but make sure you are prepared.  Follow some of these few hot tips and enjoy your time in Mother Nature’s deep freeze!

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Preparing for Disasters with Type 1 Diabetes

This year we have seen many mandatory evacuations because of both hurricanes and fires.  When you live with diabetes in your home, how do you prepare for disasters? Do you have a list of evacuation supplies checked off and ready to go?

People in the hurricane states, often have an emergency tote or bag that they can grab on the way out of the door but remembering everything that you could need can be a challenge.  Over the years, we have come up with a detailed list of evacuation supplies for people with diabetes on the Diabetes Advocacy website.  In lieu of recent events, I thought that it might be a good time to go over some of the items with you.

Download your free emergency supplies checklist here.

Keep a container near the door

As I mentioned, it is important to have all of your supplies in a quick, easy to grab container.  Evacuations can be planned, but sometimes you are only given minutes to have all of your valuables ready to leave.  Make sure your diabetes bag is always in the same place so that you won’t waste valuable time trying to find it.

Packing Basics

Make sure that you have some of the basics like a Frio pack if you live in a warm climate.  You will also want a flashlight and spare batteries in case your area loses power.  Candles and wooden matches can also provide light and heat if need be.

A first aid kit should also be in your emergency container. While you may have a lot of diabetes supplies, other medical emergencies can happen and basic first aid is a must.  Don’t forget to add anti-diarrhea and anti-nausea medication to your kit.  You should also have copies of all prescriptions in case you are away from your home pharmacy and need to access your medication refills.

Food and drink

We have all seen the images of people stocking up on cases of water and in an emergency it is vital.  If you have drinkable tap water, fill up milk jugs, juice jugs, and other items with water to take with you.  Also pack juice packs, tinned food as well as cheese and cracker snacks. If you pack tinned items, don’t forget a hand can-opener as well.

Diabetes Supplies

It is recommended that you pack two weeks worth of diabetes supplies with you during an evacuation.  Consider bringing a spare meter, spare batteries, alcohol wipes, pump supplies, insulin, syringes, ketone strips, and medical tape.

Other items to remember

Don’t forget to bring spare blankets, cash in case bank machines are down, and pet food for your furry family members.

I am sure that I have forgotten a few things but I would suggest that you view the Diabetes Advocacy Emergency page or download the emergency supplies checklist.  This will help you feel a bit more prepared should a disaster hit your community.

Get your free emergency supplies checklist here. 

Back to school with diabetes

Back to school with diabetes

Heading back to school can be stressful.  There are new books to buy.  Every child seems to need classroom shoes, gym shoes, walking to school shoes and then there are the gym clothes, jeans and more! The list is endless but when you are a parent of a child with diabetes, there list is longer.  Thankfully there are a few basics to remember when sending your child with diabetes back to school.

Meet with staff

No matter where you live, you should always make sure that you have a meeting with school staff before your child heads back to school.  If you live in an area that has 501 plans or any sort of diabetes care plans in place, this meeting can be where details are finalized.  If you don’t have any sort of official plans in your district, a meeting with staff is still important.

You want to meet with staff to discuss what they can expect when they have a child with diabetes in their school.  While your child may not be their first child with diabetes, each child’s care needs are different. It is important that they understand your child’s individual treatment plan.

At this meeting you will work together to establish roles.  Carefully outline what do you expect from the teacher and the support staff. Make sure that they understand what they can expect from you.  Finally,  ensure that everyone knows what tasks your child can do on their own.

You should also discuss things like, how will exams be handled?  It is important that school staff understand that  diabetes can cause cognitive impairment when the child is out of range.

You also want to establish a method of communication. The school  should understand that they can contact you and that you would like to be able to stay in touch with them.  Working together will make the year go smoother for everyone.

Click here for a few more ideas of what to take to this meeting.

Gather diabetes supplies.

 

 

Depending on the age of the child, the list of supplies that you require can be different.  A small child will require a change of clothes just in case he/she is high and has an accident in school.  An older child may require access to a phone or cell phone to ask you questions about their care.

Here are a few basic items that can be left in a backpack or put in a safe place at school.

  • juice boxes or glucose tablets
  • granola bars or other carb rich  and carb free snacks
  • spare test strips
  • meter batteries
  • pump batteries
  • a spare glucometer
  • extra needles or pen tips
  • spare insulin vial (to be kept in a fridge)
  • ketone meter and strips
  • spare infusion set
  • spare insulin reservoir
  • alcohol swabs
  • hand wash
  • water bottle
  • sharps disposal container
Other things to remember

If your schedule allows, volunteer to be a part of activities at school.  This will give you a chance to get to know school staff and they will learn a bit more about you.  It will also allow you to discreetly keep an eye on your child’s care without them feeling different.

For younger children, check to see if supports or nurses are available through your district.  The school may be entitled to extra funding that would allow them to have one on one care for your child for all or part of the day.

Make the year fun! Your child is a child first.  Plan ahead with staff regarding things like parties, extra curricular activities, outings and exams so that your child gets the most out of their school year.

For a guide to care policies in many Canadian schools please check out this link.

 

Tips for Managing Diabetes in the Summer

diabetes family summer partyIts summer!! I mean it really is finally summer! Some areas have been enjoying great weather for a bit but where I live–well, I kind of wondered if summer was ever going to show up.   Now that it is really here, let’s talk about a few tips for managing diabetes in the summer months.

Keep your insulin and test strips cool.

Summer heat can literally ruin blood glucose test strips and insulin.  If you are on injections, make sure to keep your insulin stored in a cool place. If you are pumping, again, make sure that your pump doesn’t get overheated.  You may even want to consider changing out your cartridges more often to ensure that your insulin is fresh and hasn’t been compromised by the heat.

Test strips also react to extreme temperatures.  Again also make sure that they are stored in a cool place.  If you are traveling to the beach or theme parks, you may want to invest in a FRIO Insulin Cooling Pump Wallet.  They are convenient little cooling packs that will help to keep things chilled.

If you don’t have access to Frio packs, another great suggestion is to use frozen juice packs.  You can keep your supplies cool and are prepared for lows!

Mastistol and Antiperspirant are pumpers’ new best friends.

Summer often means swimming and swimming can mean chlorine. Chlorine can bring extra headaches for people with diabetes using an insulin pump in the summer. Personally,  the only way for us  to keep sites on in chlorine was by making sure that a product like Mastisol Liquid Adhesive was used on the skin prior to set insertion.

For people using an insulin pump and/or a CGM, you may also want to look at using an antiperspirant on the site.  Apply a light coat of antiperspirant (not deodorant) to the insertion site area.  This will help to keep sites in place when your body begins to sweat!

Have snacks everywhere.

Summer heat can bring its own challenges for managing diabetes. It tends to mean more exertion and rapidly dropping blood glucose levels.  Make sure to carry extra snack foods with you wherever you go.  One parent suggests that you stock up on Freezies.  They are perfect treats for lows and also help ward off dehydration.  Other families have suggested fruit and frozen grapes as must have snacks for on the go.

Drink lots of water.

Dehydration is a real problem in the heat.  It is especially important for people living with diabetes to stay hydrated because dehydration will cause blood glucose levels to spike.

Test often.

Heat, exhaustion and the fun of the sun can really mess with blood glucose levels so make sure that you test often to avoid any serious diabetes related emergencies.

Bring extras!

As I have said, infusion sets can fall out.  Blood sugar levels can go crazy.  It is vital that you carry extras of everything–extra snacks, extra water, extra test strips, extra insulin and extra infusion sets just in case.

Wear sunscreen.

I know, everyone is supposed to wear sunscreen so really is this a diabetes issue? Well no…and yes! It turns out that sunburns have been known to really mess with blood glucose levels.  The moral of the story? Stay hydrated and wear sunscreen to help keep blood glucose levels in check.

Have fun!

Finally, in Canada especially, we just don’t seem to see summer for long enough so plan ahead and enjoy all that this summer has to offer you and your family!

 

Bolus Worthy

Today’s Diabetes Blog Week prompt asks about food.  More specifically it asks us to describe a typical day of eating.  I asked my son at the beginning of the week to do this for one day and send me what he ate.  He told me that yesterday morning he was low so he had some orange juice and around lunch time he ate two cereal bars because he had run out of bread for sandwiches.  This seemed like a pretty light day especially for him.  He said that since I wanted to know what he ate, it was easier to eat less.  So much for that idea!

Like many people with diabetes, my son has heard, “Oh I would offer you one but I know you are a diabetic and can’t have that.”  Of course, like everyone with Type 1 diabetes, the only thing my son can’t eat are poison…and cookies with poison. For every other food, he does his best to balance insulin to what he eats.  And being a teen, he can eat!

I am not sure if it is because of  diabetes and spending a life time educated on nutrition and exercise, if its him or if it is a phase but my son has become very mindful of what he eats.  It is not uncommon for him to sit down to a tin of tuna and a cup of green tea.  He enjoys his fruits and yoghurt.  He can make a mean smoothie (according to him).

He is human however and he is a teen, so he also enjoys certain treats especially when he comes to visit Mom.  He loves his grilled cheese sandwiches. He can eat a pot of boiled eggs for breakfast if given the opportunity. He requests homemade mac and cheese when he arrives.  He enjoys eating snowballs and can demolish a berry pie if allowed.  He can nibble at a tray of cookies or leave an apple with nothing but the stalk.

When he goes to A&W and orders a Grandpa burger meal, does he stay in range? Rarely but he also does not do it every day.  Each time is a challenge to balance the fat, protein and carbs but he does it. He feels it is definitely worth the effort.  Those high effort, high insulin foods are known as “bolus worthy”.  They are the foods whose taste far outweighs any aggravation after the fact.

At 17, my son is very aware of his body.  He lifts weights.  He watches his food intake, not just because he happens to have diabetes but because he wants to stay fit and healthy.  I think he has managed to handle the issue of food very well. Nothing is off-limits–a banana split for lunch? Why not!  Anything in moderation–well his idea of moderation anyway!

Homemade black forest birthday cake...definitely bolus worthy

Homemade black forest birthday cake…definitely bolus worthy

Going to School with Diabetes Has Changed

Today’s prompt for Diabetes Blog Week asks what changes we have seen since diagnosis.

In the past 15+ years, we have seen a lot of changes.  We have seen 5 second glucometer results instead of 30 torturous seconds. We have seen long acting insulin, smart pumps and now sensor augmented pumps.  We have seen Continuous Glucose Monitors go from blinded instruments that you could only get from the hospital to tools that you can wear every day to watch real time trends!

One of the biggest changes that I have seen since my son was diagnosed with diabetes however is how provinces, school boards, and schools are now dealing with children with diabetes here in Canada.

I first began dealing with this issue when my son was 3.  He still had a year to go before he would enter the school system, but the school knew about my knowledge of diabetes care.  They wanted a heads  up on what to expect when a recently diagnosed student returned to school.  Together we were able to explore the roles and needs of both staff and student.

I spent time looking at what was being done in other provinces and other schools.  The results shocked me.  With the exception of New Brunswick, most areas had little to no policies for children with diabetes in schools.  The only thing that they tended to note was whether or not (and usually it was not), they would administer insulin in school and where the insulin was to be kept.

At first I was shocked. Diabetes was not a new disease.  How could it not be dealt with in the school system? Easily…in previous years multiple daily injections, home blood glucose monitoring and insulin pumps were not the norm in diabetes care.  Times were changing and school policies needed to change as well…and they have.

In 2015 provinces such as Newfoundland and Quebec now also have provincial policies in place.  Provinces such as British Columbia are working with their nursing staff to see better protection in place.  In other provinces, people are still working to find something that works for all parties.

The big difference is that today, provinces and parents are talking. Today, school boards are contacting myself, the Canadian Diabetes Association, and parents of children with diabetes to ask what our children’s needs are. There is a willingness to learn and a willingness to create change.

This does not mean that the problem of care for children with diabetes in Canada is solved. It does not mean that parents have no concerns when they send their children with diabetes to schools.  It means that in more places, there are less concerns. It means that in more schools there is already education and policy in place. That is a wonderful thing.  It shows that over time things can change for the better. I am positive that the next 15 years will see many more leaps and bounds for our children with diabetes as they return to school.

diabetes in school
Heading to school with diabetes can be stressful

Luck of the Irish

I am not Irish.  I have never really thought much about St. Patrick’s Day.  As a grade school child, it was a day to make shamrocks and wear green to school.  Over the course of the years, it was just another day.  That was until the year 2000.

That was the year that we all spent wondering if the banks would shut down.  Would the Y2K issue crash everything that we had come to rely on? How would our lives change? Well, Y2K never really seemed to impact much but the year 2000 did forever change my life. It was the year that my two year old son was diagnosed with Type 1 diabetes and was given just 24 hours to live.

For 15 years, March 17 has been a day of sadness and celebration. I grieve for the life my son never got to have–a life without carb counting, injections or blood glucose tests.  Its been a day when I relive every minute of naivety, fear, panic, and gratitude.

Fifteen years later, I live in a city that celebrates St. Patrick’s day with a holiday.  I have had the opportunity to go to Ireland and fall in love with the country’s rich history.  I enjoy listening to many lively Irish tunes.  Its listening to those songs and thinking of this day that led my mind ot wonder if perhaps it was that Irish luck that protected us all of those years ago.

Perhaps it was the whisper of a leprechaun that put my son to the front of the cue in the doctor’s office on that St. Paddy’s day so many years ago.

The doctor who would go on to look after my son from ICU to an independent teen could have been an oversized leprechaun…with a different color beard of course.  He was definitely a stroke of luck.  He was one of the few doctors in that area who were forward thinking with their prescription of insulin regiments. He also believed in allowing us to learn and grow with my son’s diabetes care.

It was definitely the luck of the Irish that led me to make one of my first ever online searches for “parents of children with diabetes”.  It brought me to an online email support group that would become my lifeline.  With the stroke of a few keys, I “met” people from all over the world who would become my family.  I met people who knew exactly what I was dealing with and could help me to find my way.

I found mentors and friends who would be with me through the highs and the lows.  We would stay connected, meet on occasion and always been there for one another.

Through them, I would find the strength to go forward and help other people.  I would find a way to make a mark and hopefully improve the lives of other families living with diabetes.

March 17, 2000 changed our world.  It showed us the insidious nature of type 1 diabetes.  The luck of the Irish has been with us in  many ways however.  We have received  numerous gifts along this bumpy path.

Fifteen years later, my son is on the verge of graduating high school. Type 1 diabetes is just something that he has lived with for as long as he can remember. I would still give anything for him not to have to deal with this but its a part of him that he has come to accept.  March 17 is a day to celebrate the luck of the Irish, the blessing of those tricky little leprechauns, and the day that my son received his first injection of life saving insulin.

from blackberry (10)

 

 

A Bucket of Gratitude

We all have seen how insanely popular the Ice Bucket Challenge has become.  Stories of how much money ALS has raised since this went viral versus how much money it had raised in previous years are astounding.  What is equally moving is the stories of families touched by ALS.  I dare you to watch any of them without a box of Kleenex.


Last week on the Diabetes Advocacy Facebook page, I shared with you Moira McCarthy’s thoughts on this phenomenon and whether diabetes should be doing something similar. Reading about how ALS had touched her family brought tears to my eyes and I was so glad that my son “only has diabetes”.


I have not watched many of the ice bucket videos.  I have seen a few that have auto-started on my Facebook feed but for the most part I simply have said “I hope that they are donating” and “Better them than me but it is for a good cause.”  There are a few from friends who state that they have a personal connections to ALS that I do make sure that I watch .


Maybe that is why I played this next video.    It was from a Facebook Friend who had a child with diabetes who said that ALS had come to call. I was curious.  Would it be her father? Grandmother? I was sure that it would be sad but I had been following the many blessings in their lives. They had recently moved across the country into a dream house. They had enjoyed an amazing summer spent traveling throughout this great country of ours.  Life was very good for them, wasn’t it? After listening to her tell her family’s story, well let’s just say that I was again left very grateful that all my son had to deal with was diabetes.


I know that diabetes kills. I know that diabetes is serious.  I know that things can change in the blink of an eye.  In the past month we have seen depression kill Robin Williams.  We have seen countless stories of how ALS has impacted and destroyed lives.  I have seen a family devastated when a father tried to save his drowning daughter only to be killed instead. Life and death happen. We deal with the cards that we are dealt but some of us have greater challenges to face than others.


In a blink of an eye it could be worse–so much worse. Diabetes can be cruel but life with diabetes is getting better. Highs are still brutal in their destruction of the body.  Lows are still deadly especially when they happen at night or when a person with diabetes is alone. There is hope however. Technology has created major changes.


We have the bionic and artificial pancreas projects.  We have CGMs, rapid insulin, and smart pumps.  We have apps to count carbs and apps to get us out of trouble.  We have a wonderful community of people living with diabetes who get it and support us every day.  Diabetes sucks but after seeing what others live with…well I will take diabetes with a bucket of gratitude.

gratitude bucket

What’s in a Name?

If there is one positive thing to come out of the tragic passing of Robin Williams, its the fact that so many people are talking about depression.  There is a huge effort to help people to understand the dark insidious nature of this disease–and the fact that it is a real disease not just a feeling of melancholy that we all experience now and then.

Clinical depression is a prolong sadness that has a chemical component that most often requires specific medications to begin to improve. It requires the use of a medical doctor and can be physically debilitating.

The most interesting thing that I have read in the past 36 hours or so since I heard about Robin Williams’ passing is a debate that I hear in the world of diabetes all of the time–people would pay more attention to this disease if it had a different name.  People think of depression as fitting things like “rain on your wedding day and a free ride when you already paid” to quote Alanis Morrisette.  These are not exactly issues that lead a person to take their own life…unless they are already experiencing a much deeper pain.  There is a feeling of a need to disassociate the mental illness from the emotion.

In the world of diabetes, we see this same desire often.  People feel that the label Type 1 diabetes does not go far enough. It doesn’t show the true nature of this disease.  It does not remove itself far enough away from another condition that is often associated with poor diet and the ability to be “cured” with diet and exercise.

Personally I am always led back to Shakespeare when this debate is brought up.  “What’s in a name? that which we call a rose By any other name would smell as sweet.”  Okay, diabetes is not as pretty as a rose and when you can smell “sweet” when dealing with diabetes we know that you are in serious trouble but you get the point. A name means nothing. It is all about the awareness.

Type 2 diabetes is not limited to people who are overweight. It is not magically cured by diet and exercising in places like boxing gyms in San Diego, but it is able to be managed that way unlike Type 1 diabetes.  Type 1 diabetes will not be cured with insulin.  Wearing an insulin pump does not mean that you don’t have to think about diabetes ever again.  Misconceptions.  Fallacies. Misinformation.  It happens with every disease.

The general public is ignorant about many things. I knew nothing about diabetes until it tried to steal my son in March of 2000.  I now know more than some medical professionals but I know little about Multiple Sclerosis or other diseases. We educate ourselves to what is important to us. It is our job as people who have become experts is to educate the outside world to the important parts of our conditions.

They do not need to know how to carb count but we must work to teach the general public that there is no known cure for diabetes…unless you are a mouse.  An insulin pump does not mean that you have diabetes “really bad” and it does not cure your diabetes. It is a management tool that requires work and fine-tuning but is preferable by many to help maintain better blood glucose levels.  Myths must be debunked to create better understanding and support.

Much of the same can be said for depression. It is important that the stigma be removed–just as the stigma of diabetes needs to be gone.  No one “caused” either condition.  Both require medical attention and serious work to be able to manage.  Ironically depression is twice as common in people living with diabetes as it is in the general population and if you have depression but don’t currently have diabetes, don’t worry because people living with clinical depression are more likely to develop type 2 diabetes!

Robin Williams is getting people talking about depression. Mary Tyler Moore, Brett Michaels, and Nick Jonahs have all done the same thing in the world of Type 1 diabetes.  Our goal as people who live with these conditions each day is to make sure that the conversations do not end and to take this opportunity to educate people on the realities and dispel the fantasies.
rosePlease remember that if you are experiencing a prolonged sense of sadness that is impacting your daily routine or having thoughts of suicide, please contact a medical professional. If you are having trouble dealing with life with diabetes, a counselor or life coach may help you to find new coping mechanisms.