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Here are my top four strategies for actually prioritizing exercise:

1. Find Your Optimal Workout Time
Mine is 6:15 AM. I like early morning workouts because:

  • The rest of my life generally doesn’t get in the way.
  • If something does interfere, I can often manage to squeeze something in later in the day (e.g. multiple short walks, evening run, etc.).
  • I can dial back on insulin for 2-3 hrs post-exercise. (That, in itself, is hugely motivating!)

2. Leverage Technology
Here’s what I’m using right now:

  • Garmin Connect logo Garmin Vivofit / Connect App – a gift from my family two Christmases ago.
  •  5K Runner App Logo 5kRunner App – this $2.99 investment helped me get in shape for my first 5k.
  •  audible logo Audible.com – I listen to books while I run. Actually, I don’t let myself listen to books unless I’m out for a run. I found a Groupon for a 3-month trial. I liked it so much, I continued the membership. (Did you know you can share a subscription with up to 3 other people? How great is that?)
  • Podcasts – I also listen to podcasts while I run. Current favorites include: The Moth, This American Life, New Yorker Fiction.

3. Invite Friends and Family.
I started with just one thing on this list. Once the habit was formed, I added something else, and so on. Here’s what I did:

  • Challenged my husband, who recently got a pedometer, to a 10,000-steps competition. (I know the 10,000 steps are arbitrary, but I still like having them as a milestone. In fact, those 10,000-steps are what inspired me to start running - because I didn’t have time to walk them all.)
  • Recruited a few friends to walk and/or run with me. It’s good for us all, right? Plus, it’s a great way to keep up with friends!
  • Invited a few other friends to go to Zumba with me. Just $5 a class at our local rec center. Great music, great company.
  • Signed up for a neighborhood 5k. Did I mention that I am was not a runner? (See what I did there? Now I am a runner.)
  • Invited my 11-year old to run with me on the weekends. (We take turns playing favorite songs for each other. I love learning what she’s into!)
  • Realized that my neighbor goes to the same gym I do. (Now we go to the gym together.)

4. Vary the Activities.
Here's what I'm doing now:

  • Cardio and weight lifting (2x/week)
  • Yoga (1x/week)
  • Running (2x/week)
  • Fast-walking (1x/week) or Hiking

How about you? How do you stay committed to exercise?

This post was written for Diabetes Blog Week.
The Prompt:
Diabetes tips and diabetes tricks. 

For more perspectives on this topic, click here.

My Healthcare Wish List (I can dream, right?)

The Doctor-Patient Relationship

  1. At my quarterly endo appointment, I see my actual endocrinologist.
  2. The appointment is scheduled for at least 30 minutes, allowing for thorough discussion and relationship building.
  3. My endocrinologist knows me as a person, and understands my health goals. We co-develop strategies to improve and maintain my health.
  4. All labs and appointments are designed in service to human beings – patients and doctors – rather than in service to the health insurance industry.

The Health and Wellness Center (formerly “Medical Center”)

  1. What used to be known as a "Medical Center" is now called a “Health and Wellness Center” (like this one), reflecting a emphasis on health rather than medicine.
  2. The Health and Wellness Center houses:
    • my primary care doctor's office
    • a gym
    • a nutritionist / dietician / Certified Diabetes Educator
    • a massage therapist
    • a café serving fresh, healthful food (with nutrition info)
  3. The Health and Wellness Center is located near my home so I can walk or bike to it.

Integrated Technology

  1. My BG monitor and insulin pump seamlessly communicate with each other.
  2. I maintain my own Electronic Health Record (EHR) which pulls in information from all my doctor(s).

Insurance Companies

  1. Insurance companies have no place in the perfect world I envision.

This post was written for Diabetes Blog Week.
Today's Prompt:
How would you improve or change your healthcare experience? 

For more perspectives on this topic, click here.

Of all the “hot-button” words around diabetes, the one that rubs me the wrong way is “diabetic,” but only in certain contexts.

I don't mind when it describes a thing – diabetic neuropathy, diabetic glucometer, diabetic low – no problem. But diabetic patient. There’s an eclipsing of the person there that makes me a little twitchy.

But when it becomes a full-on noun, as with the diabetic who lives on my street? That's when I clear my throat and shift uncomfortably in my seat. To me it's reductive – the disease is defining the person. And there’s a connotation of permanence that I find dispiriting. At least “a person who has diabetes” might some day get rid of it...

This post was written for Diabetes Blog Week.
The Prompt:
Many advocate for the importance of using non-stigmatizing, inclusive and non-judgmental language when speaking about or to people with diabetes. Some don't care, others care passionately. Where do you stand?

For more perspectives on this topic, click here.

I was diagnosed with diabetes the summer before my sophomore year of high school. The initial treatment plan? “Take 2.5 mg of Glyburide daily and restrict sugar intake.” Because it was 1987 and glucometers weren’t available yet for home use, I was sent home with Tes-Tape® and instructions to test my urine about once a week or “whenever I felt like my blood sugar might be running high.”

For those who don't know, Tes-Tape® was a roll of litmus paper. You’d tear off an inch or so, pee on it, watch for a change in color, then compare the color to swatches on the back of the container. The darker the the paper, the greater the concentration of glucose in your urine. (For kidneys to spill glucose, your serum glucose level has exceed 180mg/DL, high enough to be causing damage. And by the time it shows up in your urine, it's likely been that way for several hours.) So, any color at all on the test strip indicated some degree of bad news (with no strategy for correction).

Tes-Tape
Image courtesy of perlebioscience.com

I carried the Tes-Tape® with me every day at school, zipped in an interior pocket of my backpack. I was supposed to have it with me, so I did. But I never, ever, would have used it while at school. (If you've ever had to pee on a narrow, inch-long strip of paper, you get it - it's messy!) So, no, I didn't test my urine in a high-school bathroom stall. And I didn't talk about diabetes much at school. None of my friends had diabetes. None of my friends' friends had diabetes. No teenager I had ever heard of had diabetes. And, like many teenagers, I just wanted to be perceived as normal.

Over Spring break that year I visited my friend in upstate New York. At some point during the trip, her aunt asked me, “I hear you’ve been diagnosed with diabetes, how is that going for you?” I answered that it was OK, but that it was kind of drag not to be able to eat everything my friends ate. She listened, and offered this perspective:

Had I ever considered how movie stars ate? She went on to describe that movie stars - who lived lives of luxury and could eat anything they chose, elected to limit their intake of sugar because it was bad for their bodies, bad for their complexions, and contributed to premature aging. She wondered, had I given that any thought?

I had not, and it got my attention. What I heard was not so much the promise of everlasting beauty, but the message that I fit diabetes into a broader, more appealing framework, as long as everything was aligned. I didn’t have to decide that I was deprived of sugar; I could simply bypass it in favor of something better, like ripe, seasonal fruit. I remember this conversation often when I reach for a luscious pear instead of, say, a sugary doughnut. "What would Jennifer Anniston do?" I think.

This post was written for Diabetes Blog Week.
The Prompt:
How does diabetes affect you or your loved one mentally or emotionally?  Any tips, positive phrases, mantras, or ideas to share on getting out of a diabetes funk?

To read more posts on this topic, click here.

Hooray for Diabetes Blog Week! It’s as good an excuse as any for me to resume blogging (ahem), and a great opportunity to discover other diabetes bloggers. (Follow these links to see who else is participating and join in the fun! You can also follow along on Facebook or on Twitter with the hashtag #DBlogWeek.)

Today’s Prompt: Why are you here, in the diabetes blog space? 

In early 2004 I was pregnant with my first child. I had recently switched to insulin therapy since the pills I had been on for years were not FDA-approved for pregnancy. So, I was learning to count carbohydrates, manage multiple daily insulin injections, and minimize the effect of fluctuating hormones on blood sugar. I was excited about the eventual baby, but felt acutely overwhelmed and isolated by diabetes. I pined for someone who understood what I was experiencing.

I searched online and found a diabetes message forum run by the Joslin Diabetes Center. I drafted a short post describing my situation and asked if anyone could relate. When I logged on later that day I found FIVE friendly, supportive responses. One that I found especially encouraging was signed "Type 1 Mom of two grown sons, 20 & 23."

Years later I came across Kerri Morrone Sparling's highly relatable blog Six Until Me, and was again inspired by (wait for it...) a person with diabetes talking about what it's like to have diabetes. When I had trouble finding blogs specific to MODY (my form of diabetes), I realized I should start a blog of my own and contribute something to the conversations!

***

To learn why other people blog about diabetes, click here.

 

OscarBanner

Have you heard about Oscar? Oscar is a “start-up” health insurer that launched in 2013 and serves consumers in New York and New Jersey. The company aspires to leverage technology, data and design to improve customers' engagement and experience with health care. I like these goals, so when Oscar invited me to write post to help spread awareness about diabetes, I was happy to oblige. Oscar’s campaign is designed to highlight how people live unique lives through common approaches to diabetes.

What type am I? I'm a walker…

I have had diabetes for over 25 years. I’m an active person - I jog, swim, life weights, practice yoga and Pilates, play volleyball, etc. But hands-down, what works best for me for staying healthy is walking. Among the known benefits for people with diabetes, walking:

  • Lowers blood glucose levels
  • Improves the body's ability to use insulin
  • Lowers stress levels
  • Raises “good” (HDL) cholesterol levels while lowering “bad” (LDL) levels
  • Reduces risk of heart disease and stroke

I aim to walk 12,000 steps a day (roughly 6 miles). Finding time for those 12,000 steps takes some planning. Here’s what works for me:

  • Instead of catching up with friends at a coffee shop, we get our coffees to go and walk around a park.
  • Whenever possible, I schedule “walking meetings” during the workday. (Not a good option for meetings with lots of note taking, but this format works great for strategy and big-picture planning meetings.)
  • I do a lot of walking errands. Since I happen to live close to a grocery store (6,500 steps) and a library (5,000 steps), these errands contribute significantly to my daily goal.
  • I opt for the stairs instead of the elevator.
  • When really pressed for time, I jog some of my steps. (The efficiency of jogging is hard to beat.)

The best news? The benefits of walking are good for everyone - not just people with diabetes. So, it’s pretty easy to recruit others to join in the fun!

Since yesterday would have been Edward Lear's birthday, how about a limerick?

The guest – we’ll call her Amalia –
Stood chatting amongst the regalia.
On hearing it squeal
She dared not reveal
The pump in between her mammalia.

Diabetes Blog Week 2014

This post was written for Diabetes Blog Week.
The prompt
(suggested by Tu Diabetes): Write a poem, rhyme, ballad, haiku, or any other form of poetry about diabetes.

I ran my first 5k yesterday.

I've never been much of a runner. So I downloaded a running app and started training the next day. I registered for a local race (Denver’s Adelante! 5k). Then I recruited a few pals to run with me once a week. The other days I ran on my own. In time, I began to look forward to the trainings as a way to spend time with people I don’t see often enough or to just zone out and listen to music.

With 7 weeks of training under my belt, I was feeling reasonably prepared on the day of the race. I ate an apple, drank some water, and stashed a juice box in my jacket pocket, just in case. My family came with me to cheer me on (it being Mothers’ Day, what choice had they?). I ran most of the way. And since I wasn’t running for any particular time, I was happy to complete the course in 36:12.

The numbers I care more about are the ones on my meter. And I was less happy with those yesterday. Given that I’d been testing and adjusting for weeks to determine a sensible strategy for the run, I was vexed by my body's response. Here’s what the day looked like in diabetes terms:

7:15 Test: 89mg/DL
8:15 Test: 81mg/DL
Eat apple (skip bolus) Preventively, to avoid mid-race low.
8:45 Decrease basal rate by 20% Again, preventively.
9:00 Run (mostly) for 36 min.
9:55 Test: 176mg/DL Woah…
Check site (it’s fine).
Bolus 2.5 units Hope that’s not too aggressive.
Hydrate.
10:10 Test: 172mg/DL Really?
Ponder test strip inaccuracy.
Verify recent changes to pump settings.
Second-guess skipping the apple bolus.
Second-guess the 20% basal decrease.
10:20 Test: 164mg/DL Still?
Bolus 1 more unit.
Head home.
Change site.
Spot a few air bubbles in line. Maybe?
Open new vial of insulin. It’s time anyway.
Continue to bolus against a stubborn high for most of the day. Sheesh.

It’s difficult to convey how damn squirrely diabetes is to people who don’t live with it every day. The best-laid plans often deliver uncertain results. It can be super frustrating. And yet, diabetes didn’t spoil yesterday; my first 5k was rewarding and fun.

Diabetes Blog Week 2014

This post was written for Diabetes Blog Week.
The prompt
(suggested by Kim of Texting my Pancreas): Change the World.  

By all accounts, participatory medicine is a growing movement. And The Pew Internet and American Life Project, which studies such trends, reports that people with chronic conditions (e.g., diabetes) are more likely than our peers to consume and share health information. The Diabetes Online Community (DOC) doesn’t replace my professional care, but I increasingly rely on its vast network of diabetes patient-experts for general support and practical advice.

I&D marks its first anniversary this January. Looking back on a year of blogging, it's clear to me that being part of the DOC has engaged me in new ways. I participated in Diabetes Blog Week, World Diabetes Postcard Exchange, and the Big Blue Test. I learned practical tips from fellow bloggers (e.g., the best sticky tape for securing a port; how to keep insulin cool in hot weather). I found new blogs to read like Karmel Allison's Where Is My Robot Pancreas and Kim Vlasnik's Texting My Pancreas.

Even when the DOC doesn’t have the answers, it’s reassuring just knowing that others are asking the same questions.

We don't usually exchange Christmas presents, but I got you one anyway - this clip from a favorite episode of The West Wing (No. 32, Noel.) Enjoy!

2

Pasta doesn’t do my blood sugar any favors, so I don’t eat a lot of it. At roughly 55g of carbohydrate per serving, I’d rather eat this:

bagelor a generous slice of this:

chez_panisse_pizza

But the rest of my family loves pasta, so I was happy when a friend turned me onto Dreamfields pasta. dreamfieldsIt tastes exactly like regular boxed pasta, but contains only 5g of “digestible carbohydrates.” It's a pretty amazing feeling to eat a bowl of pasta, dose for only 5-10g of carbs, do a post-meal BS check and find that I am perfectly in range.

There is one important caveat: over-cooking, re-heating, or letting Dreamfields pasta sit in cooking liquid/sauce breaks it down and raises the digestible carbs. So, on the rare occasions I make a pre-sauced pasta dish, I use “regular” pasta. To offset the ginormous carb hit, I also flip the typical pasta-to-vegetable ratio so the bowl is filled mostly with vegetables and accented with pasta.

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