I am a walker. What type are you?


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!

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Diabetes Blog Week 2014: A Poem

Diabetes Blog Week 2014 The prompt: Write a poem, rhyme, ballad, haiku, or any other form of poetry about diabetes. (Thanks, Tu Diabetes, for the topic.)

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.

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Diabetes Blog Week 2014: Changing the World

Diabetes Blog Week 2014

The prompt: Today’s topic is Change the World.  (Thanks, Kim of Texting my Pancreas for the topic.)

I ran my first 5k yesterday, thinking it might be an interesting challenge.

I’ve never been much of a runner. So I downloaded a 5k runner 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 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 surprised and 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.
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 the squirrely nature of diabetes to people who don’t live with it every day. The best-laid plans often deliver uncertain results. And yet, my first 5k was rewarding and fun. Diabetes didn’t spoil it. I may not know for sure what was going on yesterday, but I’ll make some adjustments and try another 5k.

So, what do I advocate for? Continuous improvement.

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Thanks, D.O.C.

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!

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Uh-oh, Spaghetti-o

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:


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.

Posted in Food & Nutrition, Living with Diabetes | Tagged , , | 2 Comments

Diabetes Awareness Month

logoJust in time for the holidays, November is National Diabetes Month. Who cares? You might. According to the National Diabetes Education Program:

  • Approx. 26 million Americans have diabetes.
  • An additional 79 million adults in the US have prediabetes.
  • The total direct medical cost of diagnosed diabetes in 2012 was $176 billion.

Two diabetes awareness campaigns caught my attention this year:

  1. Lee Ann Thill created the World Diabetes Day Postcard Exchange to “promote healing through creativity, connection and activism.” Participants in the Exchange send and receive handmade postcards that incorporate the blue circle (the international symbol of diabetes) in their design. Great idea – I’m mailing my cards today.
  2. The Big Blue Test is designed to help people notice the impact of small changes. Through November 14, for every 10 Big Blue Test results that are logged, Diabetes Hands Foundation grants $5 to support people with diabetes.
    You don’t have to have diabetes to participate, and the benefits of exercise are yours to keep. Here’s what to do:

1) Test your blood sugar (if you have diabetes)
2) Move your body (at least 14-20 mins)
3) Test again (if you have diabetes)
4) Share your results on bigbluetest.org

I’ve been logging my big-blue data since the start of the campaign. Each time, my blood glucose has dropped 20-30 points following 60 minutes of moderate-to-vigorous exercise. Plus, I use 15% less basal insulin for the ensuing 4 hours.
That’s some solid motivation right there.


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Carb Cheat Sheet for Halloween Candy

I’m not super-tempted by Halloween candy. (Lucky for me, our neighbors don’t hand out Cadbury milk chocolate.) Still, I keep a carb cheat sheet handy, just in case.

Curious about the carbohydrate count of your favorite Halloween treat? Take a look:

Carbohydrate Content of Popular Halloween Treats

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