I'll Take "Rude Comments" for $500...

In my previous post, I wrote about my latest blood sugar emergency and the judgment I faced from a store employee during my low. I don't know what it is about diabetes, but for some reason it makes people feel like they have license to comment on your health.  I realize that most people know someone with diabetes, but it's still a very misunderstood illness, so most of what people think they know about the disease just isn't accurate.

I've experienced judgment, both outright and unspoken, due to my diabetes countless times since my diagnosis in 2010. Usually, you can read it in people's expressions as they eye what you're eating/doing, but sometimes others are more outspoken in regards to many aspects of your life, all because you have a disease you never asked for. Sometimes, like the Target employee I had to deal with recently, people will even imply-or tell you in no uncertain terms-that it's your "fault" that you have this disease, regardless of the fact that T1 is unrelated to lifestyle choices and can affect anyone indiscriminate of age, weight, or diet. I realize that the majority of these people confuse T1 with T2, which is more tied to poor lifestyle decisions (though you don't have to be overweight to get T2, and even someone who is 500 lbs and doesn't exercise won't develop it if they don't have the gene), but even so, what gives them the right to comment on someone else's health? They wouldn't admonish someone for having breast cancer, for example. I don't know about you, but when someone says they have breast cancer, I'm not inclined to tell them that they should have lived their life differently.

[[On a related note, check out this post on Diabetes Daily about the rude remarks we receive due to having diabetes (be sure to read the comment section). It's shocking to me that people can be so blatantly hurtful when it comes to this disease...even though 99% of what they say is based on incorrect myths, it's still hard to face in the moment.]]

Recently, I've encountered a lot of questions about my ability to have children. One instance was at a family reunion a few weeks ago (the same one where I had to use glucagon for the first time), when an older relative asked me (with a very serious expression on her face) how I was doing and if I'd be able to have more children since I have diabetes. Even though I've dealt with these questions before, it never ceases to amaze me (a) how uneducated people are about diabetes (hello, this isn't the Diabetes Dark Ages of the Steel Magnolia era!) and (b) how open people are with their judgment of your life decisions when you have this disease. Yes, I can (and did!) have a perfectly healthy pregnancy and baby despite my diabetes, as long as I keep my health and blood sugars in check before and during the nine months of baby creation.

ecards...they say everything you can't say to someone's face.

Because I choose to devote myself to advocacy and outreach for T1, I make sure to at least try and educate people in these instances, because if I don't, they may never get correct information. If I can change someone's ideas about this disease, hopefully the next person they encounter with T1 won't have to deal with the judgment and rudeness I regularly experience.

A couple of weeks after the reunion, my mom and I were at a sandwich shop for lunch when a lady that goes to church with my dad commented (while I was holding my sweet baby, nonetheless), "Oh, I didn't know you had a baby...I didn't think you could because of your diabetes." Even though I have pretty thick skin when it comes to this stuff, I'm still hurt by the implication that I shouldn't have children, especially since I worked so hard before and during my pregnancy to keep my blood sugars in a normal person's (without diabetes) normal range and have no complications related to the disease. Even with the stresses of new motherhood, my latest A1c was 5.5%, well within the normal person's normal of 4.0-6.0%...Therefore, my blood sugar average is actually better than some people who don't have diabetes.

Even though the JDRF and other diabetes advocates are working to change the perception of the disease in the public eye, we still obviously have a lot of work to do. There are times when I want to tell people, "Excuse me, but don't you think I know more about a disease that I live with 24/7 than you ever will?"...but I don't, because that would make me (almost) as rude as they are. Please don't misunderstand-I never harbor bad feelings toward anyone who is truly interested in learning more about the disease; I only take offense when it's obvious that someone is judging my decisions without the medical knowledge (or even basic common sense/courtesy) to do so! Unfortunately, those of us who manage all of the challenges that T1 comes with also have to deal with others' misconceived notions of the disease on a regular basis, so all we can do is take the time to try and educate other people when the opportunity arises. I just hope that by the time the kiddos with T1 are grown ups, they won't have to justify their ability to have children-or whatever else they want to do. In the meanwhile, I'm trying to make sure that they have to deal with this discrimination as little as possible!

(Off) Target...& Under Attack

Two weeks ago, I wrote about my first experience with glucagon. In it, I said that although I was very glad I had access to the emergency injection, I hoped I wouldn't have to use it again anytime in the near future...well, it turns out that although I didn't have to use it at all during the first year and a half since my diagnosis, I've had to use it twice now within a month. I'm not usually one for cussing, general pessimism, or texting acronyms, but this is one time I have to say WTH/FML!

It started yesterday afternoon while I was grabbing a few things at Target. My mom was waiting in the car with my sweet baby, feeding her bottle to her. I was about ready to check out when I started feeling very, very faint-like I could pass out at any moment. I'd taken a few glucose tabs a few minutes before because I could feel a low coming on, but when I checked my BG at the front of the store, it was 69...so really not that low, relatively speaking. I couldn't shake the faintness, though, so I figured I must have been dropping fast or something...thanks to my lovely luck, my CGM sensor had just timed out that morning, so I had no way of knowing for sure.

I grabbed a Coke from the fridge, but even after downing most of it I felt like I was going to hit the floor at any moment. In the meanwhile, my mom had texted me that the baby was "making me a present." I texted her back "SOS." Since I was by myself, I stopped an employee and told her that my blood sugar was low and that I was going to give myself an injection to help bring it up...but that if I passed out, to call an ambulance. I mixed up the glucagon and injected it through my jeans into my thigh, then texted my mom again to let her know what was going on. She asked if I needed her to come in, and I said yes...she told me later she didn't know that I needed help when I sent my SOS-she thought I was referring to the little one's diaper situation! When I checked my blood sugar again, it was 82...but I still felt extremely faint. Through all of this, the employee that I had talked to kept checking on me to ensure that I was okay, making sure to keep me in sight until my mom got in the store. By then, my blood sugar was up to 103, but I just couldn't get rid of that dizzy feeling.

My mom took my debit card and went to check my stuff out while I sat on the end of the next lane where they place checked bags. The lady who was running the register in my mom's lane echoed my mom's orders to stay seated until they were sure I was okay, but then followed with, "I kind of feel sorry for you, but then again I kind of don't since you brought this on yourself." At first, I wasn't sure I heard her right, but then she went on to say that her mom has diabetes and eats sweets, then complains of feeling bad. She said she doesn't feel sorry for her then. Even in my sucky, just-about-to-hit-the-floor state, I explained to her that she was referring to high blood sugar, and mine was low right then-that I had too much insulin in my system and I needed sugar to bring things back up. At that point, she told me that one of the other Target employees also had an insulin pump, that she "had to push some buttons sometimes" (Ha!) and that they have to keep an eye on her. My mom told her I took good care of myself, and I informed her that mine was T1 diabetes, an autoimmune disease. Still, you could tell that she was one of those people that just wouldn't "get it", no matter how much you try to explain things, so I gave up. A lady in line behind my mom told me she was diabetic too, and that she knew how much lows sucked...thank you, person who actually knows what's going on.

I found everything I wanted, plus an ignorant employee.

Later, I couldn't believe the employee's audacity. There I was dealing with a blood sugar emergency, and she was lecturing me about how it was my "fault" that I felt that way...seriously, how much ruder can you get? I know that a lot of cases of T2 can be prevented or improved through lifestyle changes, but lifestyle choices have nothing to do with T1. Unfortunately, most people don't know the difference between the two, so we're left to deal with the rude comments and outright judgement of our health. I'm planning on calling or writing the store's manager, not to seek punishment for the employee in question, but to make sure than any other customer with T1 (or T2, or any other health condition) can get the care they need in an emergency without also having to deal with someone's judgmental attitude.

We went ahead and finished up, then went out to the car to change Baby Girl. By that time, my blood sugar was in the low 200s...and still, I felt horrible. We started to head out of town, but I told Mom that I didn't feel comfortable riding the hour and a half home with the way that I was feeling. She turned around and headed back toward the hospital. She called my endocrinologist's office, but he was out of town until next week, so we went to the ER.

After a few hours of waiting, blood work, some fluids and an EKG, they released me with a diagnosis of blood sugar fluctuations combined with the heat. All of my labs were fine, so that made me feel a little better even though I still had a faint feeling. My blood sugar peaked at 405, but came down without issue. By the time we got home, it dawned on me that my dizziness was probably actually from the sinus pressure I've been having in my head lately. Since I'm breastfeeding, there isn't much I can take that won't affect my supply, so the nurse at my OB's office told me to try Sudafed with some Tylenol. It still may cause a drop in milk production, but I can't stand feeling lightheaded any longer.

I've felt pretty bad today, but I've stuck it out at work even though I should be home resting because my dad/boss is out of the office. I think I'll head home early, though, because I have lots of work to catch up on at home too, and let's face it-there isn't anyone else to do it for me! Even though I later realized that what I was feeling probably wasn't a low (after the fact, of course), I'm still thankful for glucagon because it gives you some power over one of the not-so-great effects of this disease...even if you're sometimes powerless over the way people treat you because of it.

Baby Love

Yesterday was the last official day of my maternity leave...and I honestly can't believe six weeks went by so fast.  I know everyone says that once you have a baby they grow up in the blink of an eye, but I've found out that (like many other things, a la the accompanying lack of sleep) you really can't understand this phenomenon until you have one of your own.


Six weeks ago, our lives changed.  Six weeks ago, we brought home a precious baby girl that still seemed like somewhat of a stranger to us (but whom we've since come to understand a little better, thankfully!).  In the time since, I've grown as a person.  I've learned what it truly means to be selfless as I've spent countless hours in a sleepless delirium trying to please a screaming baby, often to no avail.  I've come to understand a different kind of love, one in which the prospect of this tiny person being hurt, sick, or just unhappy brings a sinking feeling to my chest.  I've learned that good enough is, in fact, good enough when it comes to many things that I was a perfectionist about in the past.  Not only is it very difficult to get much accomplished when you're at the mercy of a newborn's crazy "schedule;" it's also incredibly easy to pass the hours and days entirely just holding her in my arms.


Then there's the sheer awesomeness of watching her grow and change before our very eyes...My husband was quickly amazed by the fact that such a tiny little girl could be so strong, and I love to take pictures of her (sometimes several a day) and look back to see how different she looks a short time later.  Around her one month "birthday," she started smiling...#ohmygoodness!  Her adorable toothless grins never cease to put a smile on my face, even if it is just while she's carrying on one of her "conversations" with the ceiling fan!  Last night, I had finally managed to calm her down after she'd been crying when she sighed dramatically.  I mimicked her, and got a huge smile in return!  It's true when they say that you'll do anything you can to get those priceless grins =)


She's also starting to interact more with the world around her.  There is a canopy on her Pack 'N Play that has giraffes hanging from it, and the other day while I was getting ready in the bathroom a short distance away, I could hear her cooing at them...and now they're within arm's reach!  I also finally ordered the Skip Hop activity gym I'd been wanting to get for her--it's a little pricey, but it's much cuter than any of the others I've seen.  The first time I laid her on it after it came in, I propped her up on her tummy on the miniature Boppy-style pillow it comes with so she could look at herself in the mirror, and I was amazed at how much head control she has!  It didn't take long for her to topple over the front of it, though, because her little legs never stop moving...if I lay her on my stomach, she quickly ends up by my face/shoulder as the result of her pushing off with them.  Of course, I knew when I was pregnant with her that she was going to be a little wiggle worm...she never stopped moving!  I didn't even bother doing the prescribed "kick counts" at the end because she moved so much...in that way, she's definitely her daddy's child!


To shift gears a little, I was reading a post on SixUntilMe the other day about Kerri checking her daughter's blood sugar and the fear that comes with being a parent with T1.  As Kerri says, it's a thought that creeps up on you, either during (or before) pregnancy or when a harmless symptom (such as a wetter-than-normal diaper or an extra-thirsty baby) pops up later on: the big "What if?".  As a PWD, we're very familiar with the subtle symptoms that accompany this disease, and sometimes we're a little over-vigilant when we see them in those around us.  The thing is, just like Kerri said in her post, there's no need to sit around fearing that our children will suffer the same fate we did in the autoimmune/genetic pool.


When I was pregnant with our little girl, the question of whether or not she would "get it" (T1) too came up fairly often.  I tried to use these instances as education opportunities as I informed people that my children would have about the same chance as anyone else of ending up with this disease.  Although their risk is somewhat elevated (4% versus 1%), there's still a very small chance that they'll have Type 1 as a result of my having it.  In fact, as stated on the JDRF website, "only 15 percent of people with type 1 diabetes have an affected first-degree relative - a sibling, parent, or offspring."  Therefore, that my sister and I both have it makes us an anomaly among anomalies...We're part of the 5-10% of people with diabetes who have Type 1, as well as the 15% of the aforementioned group!


Even though the chance of our children developing T1 is very slim, I'm still going to do everything in my power to decrease that possibility as much as possible.  Because of the (loose) link between the protein in cow's milk and T1, I chose to use soy formula when we were forced to start supplementing.  Of course, the original plan was to breastfeed exclusively for the first six months; however, we had to start supplementing with formula when she wasn't gaining weight like she was supposed to (which I still believe is possibly due to gastro esophageal reflux, because she will do fine for a minute or two, then arch her back away screaming...her two-month checkup is about two and a half weeks away, so I guess we'll find out then).  Because not much is known about the cause of T1 (and because it's an autoimmune disease, and therefore extremely complicated), it's so hard to know what to do to prevent it...I suppose all we can do is raise our kids with a healthy lifestyle and hope for the best!


What many people do not understand is the autoimmune aspect of T1.  Thanks in part to the media and popular (mis)conception of diabetes, they assume that age is the only difference between the types.  I'll be the first to admit that before I was diagnosed, I didn't understand the difference--and my younger sister was diagnosed years before me!  Since my diagnosis, it's become very clear that we need to put more effort into educating the general public about diabetes, but especially T1.  It would make life much easier for those of us living with it!  I've tried to use every opportunity I get to educate people in everyday conversations, and in November I wrote an article addressing many of the misconceptions about the disease for our local newspaper.  However, it seems like for every person who "gets it," there are 10 more who don't.  Sometimes it seems like a losing battle, but I refuse to give up.  Until there's a cure for Type 1, the next best thing is making living with it easier, and that's something I--and you--can be a part of.

Basal Rates, Artificial Pancreata, and D-Judgment

Oh, how quickly time seems to get away from me these days...I intend to write a blog post, then other things come up, and before you know it it's been another two weeks since I last posted!  I have to say, I really admire those in the DOC who are able to consistently update their blogs on a daily basis.  Between managing diabetes (which, of course, is another full-time job) and life in general, I have a hard time keeping up with mine at times.  Sometimes I wonder how I'm going to manage it all once the baby is here, but I know it'll work out...somehow!

At least life according to the D-monster has been better lately.  I was getting frustrated with my numbers and my apparent inability to control them despite all of my effort, so I finally (FINALLY!) took a step back to evaluate the situation.  Duh.  My basal rate patterns didn't make sense at all, and it took me a couple of months to figure that little piece of information out!  I suppose with everything going on, I was just increasing the rates themselves over time without looking at how my overall pattern was functioning (not well, by the way).  The day that I realized this, I decided to start from square one and recalculate everything based on the total daily dose of insulin I'd been using.  To do so, I had to pull out my trusty "Think Like a Pancreas" book by Gary Scheiner and review how to calculate all of the basal/bolus rates and ratios.  With a little math (which I always enjoy--seriously, because I'm a nerd), I had a basal/bolus pattern that was a little more sane looking:

 

Before

After

It had been so long since I'd done such a complete overhaul that I was a little worried about highs and lows the next day, but everything worked out surprisingly well.  It's amazing what a little perspective can do...I was just metaphorically kicking myself for not doing it sooner!  My numbers have been much more even, and I haven't had near as many out-of-range results as I was having before.  Not that they were horrible before; it's just that I'm kind of a perfectionist and like for all of them to be as close to "normal" as possible--is that so much to ask?!

In other D-news, how about that Artificial Pancreas Project?!  I'm so excited that the FDA has started the process that will hopefully lead to approval in a timely fashion.  It's such a major step in the right direction for those of us living with T1, and although it's not a cure, it does represent a major advancement in treatment technology.  For more on what this means for us, please read this article:  Interpreting the FDA Guidance for the Artificial Pancreas

This morning I got a blog update from Jacquie Wojcik at Typical Type 1 in my email, and it was an awesome one.  You can read the full post here, but the general gist of the post was about how judgmental people without diabetes can be at times.  If you deal with this disease, no matter the type, you've no doubt encountered it at some point--if not more frequently.  Even when people don't make rude comments or say anything out loud, sometimes you can feel their judgment anyway.  It can make eating in public a psychologically difficult experience, because you know that if you split a dessert with your lunch buddy, there will probably be somebody who is thinking, "She has diabetes, she shouldn't be eating that!"  It's not that I mind talking about my disease or correcting misconceptions when people are genuinely interested; it's the ones that try to impress their diabetes "knowledge" and horror stories upon you that can be irritating at times.

I like to think I generally have a good, positive attitude and outlook on life, but even that can be challenged when dealing with this type of thing on a regular basis.  I've thought before about printing some of these diabetes etiquette cards for people who don't have diabetes to keep on hand for such situations, but I don't know how well received or effective that would be.  Instead, the action I've taken is one I'm super comfortable with: I wrote.  I mentioned it in my last post, but for American Diabetes Month I wrote an article for our local newspaper about the myths and misconceptions surrounding the disease so that maybe-just maybe-it will reach those that need to know these things.  Like I've said before, even though it's hard, I can deal with the negativity...it's the kiddos who live with diabetes that I worry about.  Life with this disease is hard enough without having to defend yourself and your decisions all the time.  We already have to micromanage ourselves, so it's no fun when others try to do it for us as well.  Like one person in the comments said of Jacquie's post,  "It’s amazing how much more people care about/watch what I eat since I was diagnosed Type 1. They didn’t give a crap about what was on my plate before."  So very true.  The not-so-nice part of me sometimes wants to ask these people, "So just because you don't have diabetes, it's okay for you to eat that third piece of cake?!"  But I don't, because I could never actually say that to anyone, no matter how rude they've been to me.  In the end, I have to realize that there are some people who just don't get it.  I can try to change their perceptions, but sometimes their ideas are so long-held and concrete that there's not much anyone could do or say to fix the situation.  So instead, I just try to do the best I can and educate the ones who are willing to learn.

Update Time!

I honestly can't believe it's been so long since I last posted!  Suffice it to say, it's been an incredibly busy one, especially because it's American Diabetes Month...It seems like I've had something diabetes-related to do since the beginning of November.  I'm not complaining, though--I am a very willing participant in all of the awareness activities I've done, and truly believe that all of our efforts are making a difference for the people who benefit from them!

I was contacted last month by Laura from Extreme Southern Couponing.  She has a 9 year old daughter who was diagnosed with type 1 diabetes two years ago, so she was putting together guest posts to feature on her blog throughout the month of November.  She had come across my blog and asked me to share my story with her readers.  Many of you already know most of the details of my diagnosis and journey thus far with T1, but if you're interested you can read it on her site here.

On November 15th, I had an OB appointment and ultrasound in Amarillo, so my mom, sister, and I met my aunt and cousin at Beef O'Brady's for their second "Dining for Diabetes" fundraiser.  They donated a portion of their ticket sales that night to the JDRF, so we got to eat some good food for an awesome cause!  I also got to meet the Branch Manager for the Panhandle JDRF in person, as well as some of the other board members.  They are all incredibly nice, welcoming people, and I can't wait to work with them.

The next day, the article I wrote for the local paper on diabetes awareness was published.  I was incredibly excited to see it happen, because it's something I've wanted to do for a while.  I decided to focus on the myths related to diabetes, because there are so many misconceptions surrounding the disease.  For those of us living with it, having to clear up these myths on a regular basis adds to an already challenging life, so my hope was that by reaching people in our community on a larger scale, things would be a little easier for people with diabetes--especially the kids and young adults who have to deal with it.  It turned out to be a long article, so I'll save it for another post!

I *think* that covers everything diabetes-month related thus far, but I could be missing something.  I was reading "Do Chocolate Lovers Have Sweeter Babies? The Surprising Science of Pregnancy" a few nights ago, and it said that a woman's brain shrinks by 4-6% during the nine months of pregnancy in order to build the baby's brain (at least according to one theory)...my husband says I'm definitely on the 6% end of the range!  Either way, my brain power has been somewhat diminished for the past several months...it's a strange feeling, being in a constant fog.  Then there are the days that I'm convinced I'm losing it, like the day I posted this on Facebook:

I've come to the conclusion that I'm losing my mind! I had to call Mom to ask her a question, but when I dialed her number on my cell phone, the office phone started ringing, so I had to hang up on her. I then picked up the office phone, and no one was there, so I tried Mom's number again. About that time, the office phone started ringing again, so I had to hang up to answer it...And once again, there was nobody there. This went on about five times and I was starting to get extremely frustrated before I realized that *I* was actually calling the office instead of Mom's cell phone number and hanging up on MYSELF. I think I need a break...♥

The diminished mental status and achy hips and back, though, I can deal with.  They're constant reminders that my body is on a higher level of functioning right now to make sure our baby gets everything it needs, and I'm completely okay with that.  When I had my ultrasound on the 15th, I was nervous once again--though not quite as nervous as I was before our first big one in September.  I suppose the worry that everything is developing as it should never quite goes away, but I'm glad that things were still on track with our little one!  She's in the 60th percentile even though I'm measuring smaller, and although she was breech, everything else was where it should be.  As it is in diabetes, "normal" is an amazing thing when it comes to your baby's development!  I'm just hoping she decides to head south sometime in the next 9-10 weeks...=)

My sister also had her baby a month ago after she developed preeclampsia and had to have a c-section at 34 weeks.  Her baby is still in the NICU-she had some breathing problems in the beginning and digestive issues after that, but she's stabilized and is doing better.  She just has to meet all of her milestones before they'll let her go home!  My relationship with my sister has been better since her baby was born, and I'm glad that we've been able to put most of the anguish of the past several months behind us.  The selfish part of me still finds it hard that everything is revolving around her and her baby at this point, but that's just because everyone is so focused on all of that that I sometimes forget we're having a baby soon.  I hear about it so often that I sometimes think of our little one by her baby's name, and that frustrates me!

It's also been hard having my parents gone so often, because it leaves me to take care of the office by myself--something that isn't out of the ordinary, but that can be incredibly stressful at times...and right now, I need to start slowing down rather than taking on more than my share.  We don't have much longer until she'll be here, and we still have so much to do!  I know it will all get finished, but it's still hard sitting at the office when I know there's so much I could be doing at home.  Hopefully I'll have enough time off in the end to get a few things done that I haven't been able to work on, like the quilt that I started over a year ago...The quilting part is not far from being finished, and then I have to bind it, but I never have a solid chunk of time to get it done.

Then I still need to get in touch with a pediatrician, work on my birth plan (/wish list), and about a million other things to prepare for the actual labor and delivery part of things...I try to not let it all stress me out, but sometimes the amount of things I have left to do hits me like a ton of bricks--or at least with the force with which our little girl kicks me sometimes!  Oh-speaking of her kicks, my hubby finally got to feel her kick for the first time about a week ago...I'd been able to feel it from the outside for about a month, but she never would cooperate when he was around!

Well, I think that pretty much covers what's happened over the past few weeks, so I guess I better get back to work!

Diabetes Article in Health Magazine--Another Setback

I was initially excited when I saw an article in the November 2011 issue of Health magazine about diabetes—after all, November is American Diabetes Month!  However, once I started actually reading the article, I was appalled.  Not only was it filled with misinformation and incorrect but rampant diabetes stereotypes, it was completely insensitive.  No wonder people like the woman in the article are “embarrassed” to let others know they have diabetes!  What disappoints me the most is to see such a great opportunity for public education and awareness turned into such a misrepresentation of the disease…a misrepresentation that people with diabetes, like myself, have to fight every day to correct.

I was diagnosed last year with type 1 diabetes.  My younger sister also has type 1, and my dad (along with a lot of my extended family) has type 2.  When I was diagnosed, I made it a point to learn as much as I could about the disease, and have read countless books on the subject.  I also keep up with diabetes news and research and follow others’ diabetes blogs on a daily basis in addition to hosting my own.  In addition, I was recently appointed as a board member for the local branch of the JDRF.  Even though it’s not my paying job, diabetes advocacy is incredibly important to me.  The biggest problem I encounter, however, is not that people don’t know about the disease; it’s that what they think they know is usually incorrect—and usually, it’s due to years of exposure to myths and half-truths about the disease, thanks at least in part to media publications such as this one that further reinforce its falsehoods.

Although it is true that being overweight or obese is a risk factor for developing diabetes (at least for type 2, that is), it isn’t the be all and end all of the disease.  First of all, not everyone with diabetes is overweight.  Type 1 diabetes develops irrespective of weight or health status, and there are many people with type 2 who are of normal weight.  Furthermore, what many sources neglect to point out is that you have to have the genetic predisposition and other risk factors to develop the disease—therefore, not all people who are overweight will develop diabetes.  Secondly, losing weight is not a magical “cure” for the disease.  I have a real problem with people using the word “reverse” in relation to the disease, because “reversing” diabetes is simply not possible.  Remission is a better word, because it at least acknowledges that if you gain the weight back, change your activity level, or become ill, the symptoms of the disease will return.  What is most important to note, however, that even in symptom “remission,” the disease is still very much there.  Diabetes is a progressive disease, and insulin resistance (the main disease mechanism of type 2 diabetes) increases with age.  Even those who are initially able to completely manage their diabetes with weight loss might eventually have to pursue more aggressive treatment options as the natural progress of the disease occurs.  Failing to recognize this is simply dangerous, because it leads people to believe that once their disease is well-managed, it will never be a problem for them again.  I truly believe that this leads a lot of people with type 2 diabetes to not get the proper care and treatment that they need, because they then fail to give their disease the attention it requires.  Therefore, to call weight loss a “groundbreaking new way” to treat diabetes is not only ignorant (weight loss has been used as a part of treatment plans for type 2 diabetes for years), it is also incredibly irresponsible—and to call the woman in the article a “former diabetic” only serves to reinforce this dangerous fallacy.

Articles like this one are responsible for supporting incorrect and negative ideas about diabetes that those of us living with the disease are forced to combat on a daily basis.  The statement that “Most people with type 2 diabetes could actually reverse it if they lose enough weight” is especially harmful, because it bolsters the notion that diabetes is a “fat, lazy person’s” disease that could be controlled if only they would work hard enough.  This stereotype is not only hurtful and extremely insensitive; it also has the potential for damaging fundraising efforts…after all, why contribute to diabetes research if it’s something people can “cure” themselves if only they’d work hard enough?  For those of us with type 1, especially children, this typecast is particularly harmful.  Many people do not understand the differences between the two types of diabetes, and all of these ideas could lead to dangerous non-management of the disease.  There is also a growing problem among adolescents with type 1 in which patients will purposefully withhold insulin in order to lose weight.  This leads to dangerously high blood sugars that force the breakdown of muscle and fat, but can also cause diabetic ketoacidosis and other complications.

These are the reasons I felt compelled to write such a lengthy, detailed letter...a letter that was too long to actually send to the editor, of course!  Articles on disease awareness (especially in major publications) are wonderful, but only if they contain accurate information.  In the future, I beg all magazines to please keep this in mind when undertaking such ventures!  Diabetes awareness and education is achieved one person at a time, but so are harmful setbacks.  I hope that from now on, all publications will make an effort to be part of the former.

For those of you who are interested in reading the article in its entirety, it begins on page 95 of the November 2011 issue of Health.  I couldn't find it online, otherwise I would have linked to it here!

The Great Vaccine Debate

I decided yesterday that it was time for a change, so I revised the design of my blog and even got a new profile picture to match-and it actually looks kind of like me, so I thought that was pretty cool!  Every time I decide to embark on a blog makeover, I end up all tense with achy-shoulders from trying so hard to find the right html code to change in order to get the look I want, because the templates rarely work 100% for me.  Anyway, I somehow managed to get it decent-looking, so now I can finally relax!

I had another OB appointment on Tuesday, mainly to do the blood work for the quad screen prenatal testing that we decided to go ahead with.  Long before I was pregnant, I was undecided on the issue of finding out the risk level of having a child with a genetic defect or disorder (like Down's Syndrome or Trisomy 18), but since then I came to the conclusion that IF there was something wrong with our child, I would want to know before birth so I could be prepared for the challenges we'd have to face and get somewhat more mentally/emotionally adjusted to the fact, if that's possible.  A big needle stick (like I'm not used to that...), and 10 days later we should have our results.  They said no news is good news, so that's what I'm hoping for!

Prenatal testing, as I've discovered, is just one of the many difficult parenting decisions you have to make before your child is even born.  From breast/bottle feeding to the circumcision issue for little boys and even pacifier use (or not), there is plenty of controversy surrounding all of these choices.  People on both sides of every issue are passionate about their position, and few are willing to modify their ideas.  None of these debates, however, is quite so polarizing as the issue of vaccines.

Every time I come across an interesting article on vaccines, I post it to Facebook.  I am absolutely pro-vaccine, and passionately so...therefore, whenever I encounter these articles online, I opt to share it with my friends because I think everyone should have the best information possible to base parenting decisions on.  The first was an article about pediatricians who refer kids that aren't vaccinated to other physicians--as the article says, "no shots, no service."  The American Academy of Pediatrics stated that by instating policies like this, these pediatricians might be preventing unvaccinated children from receiving proper health care.  The bigger issue in my eyes, though, is that these children aren't being vaccinated in the first place-is that not considered "proper health care" too?  After all, babies can't decide whether or not they receive vaccines; it's the parent's choice.  And with so many rampant rumors and misinformation on vaccines, more and more parents are making the decision to not vaccinate their children or to delay their shots based on invalid information and anecdotal evidence from parents who claim that their children were injured by vaccines.  The thing that saddens me most is that these children aren't receiving the recommended health care because their parents either do not have access to accurate information, or simply choose to believe that the vaccine schedule is part of a big government/pharmaceutical conspiracy.  What they fail to realize, though, is that vaccines offer very little profit for the manufacturers (especially compared to other pharmaceutical drugs), and that the government has little to gain from children being vaccinated other than an assurance that the threat of disease outbreaks in the country is reduced.  I am not saying that politics do not influence medical issues and vice versa; I am just saying that given the current situation, I do not believe the vaccine conspiracy theory that anti-vaccine advocates are so quick to force.

In all honesty, I think that vaccines should be required by law in all children who aren't allergic to them or have compromised immunity for whatever reason.  The reason I believe this is very simple: the more children who aren't vaccinated, the greater the threat to herd immunity.  The second article I posted regarding vaccines on Facebook was a story about a little boy with leukemia who could not be sent to day care because his parents could not find one in which all of the children had been vaccinated.  The reason this was of such great importance was because this little boy, whose immune system was compromised due to chemotherapy, could not receive vaccines during his treatment--therefore, he (like many others, including young infants and other immunocompromised individuals) relies on herd immunity to protect him from the diseases that vaccines would ordinarily offer protection against.  The problem that scientists and doctors are seeing, though, is that in communities where so many parents are making the choice to not vaccinate their children, herd immunity is compromised so much that diseases that were once thought to be basically eliminated from the modern world are gaining a foothold once again.  As a result, children (both those who are too young or cannot receive vaccinations due to compromised immunity and those whose parents choose not to vaccinate them) are dying of preventable diseases.

Regardless of your views on vaccines, you only have to look at recent news stories to know that this is true.  Last year, the pertussis outbreaks in several states were devastating.  The numbers of children affected by the disease were disproportionately higher than previous years, and many investigators believe that it is at least partially due to the anti-vaccine movement.  It's pretty simple, really: the more unvaccinated children in a given population, the lower the percentage of vaccinated individuals; the lower the level of herd immunity, the greater the chance of disease outbreak.  What scares me the most about this is that the diseases that are emerging in epidemic proportions again are so threatening to babies who are too young to receive the vaccines that would protect them.  The first shot for pertussis, for example, isn't given until 2 months as part of the DTaP vaccine.  Before then, babies are vulnerable to the disease, which can kill an infant in a very short amount of time.

What I've encountered in posting these articles is that anti-vaccine proponents are quick to say, "Well if vaccines do such a great job of protecting your child, you shouldn't be worried about my unimmunized child making them sick."  No matter how often I get this reaction (and it happens surprisingly frequently), it still frustrates me to no end.  First of all, who are you to tell me that I shouldn't be worried about my child's health?  Of course I'm going to worry about my little one getting sick, and I absolutely worry about them being exposed to unvaccinated children for this very reason.  Secondly, if you know ANYTHING about vaccines, you know that they aren't all given on day one...so until they're given the vaccination for a particular disease (which may be months down the road), they're vulnerable to it--it really is that simple and obvious.  The more I've thought about it, the more I realize that this reaction is just part of anti-vaccine advocates' self-affirmation toolkit--the more that they can convince themselves that their children aren't going to be infected with and/or spread diseases, the more they believe they're making the right decision in not vaccinating them. 

I've also found that anti-vaccine supporters tend to surround themselves with people who think the same way they do.  My husband was raised Mennonite, and although he received all of his vaccines and believes the same way I do, there are a lot of people within that group who are part of the anti-vaccine movement due to all the popular horror stories and rumors of vaccine injury.  As Seth Mnookin points out in his book "The Panic Virus", being around other people who support your way of thinking seems to validate your decision: "[...]sustained encounters with a small group of like-minded people almost inevitably lead to the conclusion that everyone thinks the way you do." (pg. 141, Nook version)  Never mind that 90-95% of the population in almost any given area of the country vaccinate their children; being around other anti-vaccine advocates (who are part of the other 5-10%, mind you) confirms that you're making the "right" decision, even if it goes against what the majority of the general public does.  I'm not saying that the majority way is always the right way; it's simply that on this particular health issue, it's logical to assume that if virtually everyone else is vaccinating their children without ill effect, you can be reasonably confident that your child is not going to suffer any adverse reaction from being vaccinated as well.  In fact, the chance of contracting one of the vaccine-preventable diseases is about 20 times greater than being injured in any way from the vaccine.  To further break those numbers down, if the risk of being infected with disease X is 1 in 1,000, the risk of having any ill effects from the X vaccine would be 1 in 20,000.  Furthermore, the transmission rate of most of these diseases is anywhere from 80-100%, so that gives you a 0-20% chance of NOT contracting the disease if you're not vaccinated against it.  Given those odds, I don't see how anyone would willingly not vaccinate their children without a valid medical reason.

Anti-vaxers also like to make the argument that if their child is sick, they're not going to expose them to others.  However, this is a simple statement to refute as well.  Many of these vaccine-preventable diseases have incubation times that are such that you could go days or weeks without realizing your child has been infected before they start to have obvious symptoms.  Pertussis, for example, first appears as a normal cough/cold before turning into full-blown whooping cough.  What parent keeps their child home from school (or any public place) every time they have a simple cough or cold?  I'd wager that it's not many. 

I've had this debate several times on Facebook, and one person even asked me point blank what the chance was of their unimmunized child giving a vaccinated child one of these diseases.  Never mind that the point of the article at hand (the one about the boy with cancer) was the danger posed to children who couldn't be vaccinated (yet), or that the occasional immunized child who for whatever reason does not get full protection from the vaccine(s) they receive also relies on herd immunity; this is what I replied:

[...]Therefore, the disease transmission rates (percentage of susceptible individuals who will become infected by an infected individual, where the susceptible individual is a person with a compromised immune system or one who has yet to receive the vaccine due to being too young) vary based on the particular disease. For pertussis, the transmission rate is 80%+. For measles, it's nearly 100%. This means that when a non-immunized child becomes infected with one of these diseases, the chance that they will infect a susceptible child they come into contact with is 80-100%.

As mentioned previously, there have been many recent cases in which a non-vaccinated child contracts a disease and in turn causes an outbreak. Most notably, there were 21 cases of measles outbreaks in Minnesota in April this year, of which 85% or more were linked to one unvaccinated child. In Utah, another child may have exposed up to 1,000 different people in two different events to the disease. The pertussis outbreaks last year have been linked to the large percentage of children who were nonimmunized, infecting infants who were too young to receive the vaccine and for whom the disease is often fatal. So clearly, it's a very real issue, especially when it comes to the recent epidemics of vaccine-preventable diseases in the U.S.

I also linked to two more articles (here and here) about how recent disease outbreaks have been linked to the anti-vaccine movement and how it is fast becoming a social health issue.  Never mind that the original "study" linking vaccines to autism, conducted by Andrew Wakefield in 1998, has been found to be fraudulent (and, in fact, clearly should have never been published if you read chapters eight and nine of Seth Mnookin's "The Panic Virus") and completely baseless, emerging from his illogical connection between the measles part of the MMR vaccine and bowel disease (yes, bowel disease), leading ultimately to autism.  Even after hearing about the Wakefield study being invalidated, I never realized the full ridiculousness of his claims until reading Mnookin's book.  No matter how crazy and unfounded, however, it is easy to see how claims like Wakefield's can so quickly influence the public's perception and how difficult it can be to undo the damage once it is done.  The media loves a good public health scare, and articles confirming vaccine safety aren't as newsworthy or attention-provoking.  Therefore, once the public is sufficiently enraged over a perceived issue, the retraction or correction barely registers in the collective psyche.

More recently, a review of the current literature on vaccines was completed by the Institute of Medicine (a division of the National Academy of Sciences) and confirmed that vaccines are generally safe.  Before anti-vaccine advocates can shout bias or conspiracy, it is important to point out that this study is unique because it reviewed over 1,000 existing studies on vaccines.  So unless thousands of scientists are publishing falsified research in legitimate, peer-reviewed journals (unlike the some other "scientific" publications, which will admittedly publish any article, even those that appear to be questionable at the onset), it would be hard to refute these findings.  On a Facebook page for Pregnancy and Newborn Magazine, which posted a link to this article after I did, Organic Baby University commented on the link that "I would love in just one article or news piece from someone to provide the actual studies they used to determine no correlation. Never seen a link or attachment or anything to provide the public with the ability to read those studies that prove it. Just that they exist. As educators we would love to read the scientific studies!"  Another person and I both replied with the link to the bibliography from the study.  Perhaps after reviewing 1,000+ research articles, some anti-vaccine advocates will feel more comfortable with the conclusion that vaccines are, in fact, safe. However, there will always be those that dismiss any evidence in favor of vaccines as part of a conspiracy, even though this review was completed by an 18-member committee and included research by thousands of scientists!

That's the thing that has been the most striking about this debate for me--no matter what evidence you provide to anti-vaccine proponents, they would rather believe anecdotal "evidence" from people who have no medical background (not that I claim to have any medical training; I simply rely on facts from those who do to guide my decisions) over scientific fact.  Controlling for any potential biases, I just can't understand why anyone would believe that every single study confirming vaccine safety and neccessity is somehow "not real," or not to be trusted, or that peer-reviewed studies should not be used as a legitimate basis for decision-making.  Just last week, one of my closer friends (who does not vaccinate her child) deleted me as a friend on Facebook because she and her husband were offended by my posts on the subject.  She also took issue with the fact that my husband and I are choosing to not expose our baby (which will be born in February, the height of cold/flu/RSV season) to unvaccinated children until he/she can be immunized, because once again, she posed the question "If vaccines do what they say they do, why should you be concerned about our child?".  After I refuted this claim (again), I told her that my husband and I have every right to do what we feel is needed in order to protect our child.  I would rather take extra precautions to protect him/her and risk stepping on some toes rather than our little one getting sick when we could have prevented it.  I will choose protecting our baby over hurting someone's feelings any day, end of story.  I also told her that while I agreed that being a mom is a job that takes heart, I didn't see how my making educated decisions based on facts would make me any less of one.  I told her that if she chooses to believe other things over scientific fact, that's her decision-but it certainly isn't mine, and never will be. I simply could not make a decision about my child's health that goes against everything I know, simple as that.

I know that all of these people who choose not to vaccinate their children do so out of legitimate concern for their child's wellbeing and feel that they're doing what is best for their children, but it saddens me to know that they do so without accurate information to base their decisions on.  I believe that parenting decisions should be left to the parents until those choices affect my child's wellbeing-or theirs.  There is a reason why you can't get a religious or philisophical exemption for drunk driving or illegal drug use-it's an issue of public health and safety...The thing is, I don't know how many more children are going to have to die from preventable diseases until something is done about the issue.

Diabetes Terminology: It's Time for a Change [Awareness Series #1]

Words have the power to build people up or tear people down.  Unfortunately, a lot of people don't know how hurtful and harmful their words can be to others, especially when it comes to diseases or disabilities.  These are often sensitive subjects for people affected by them, and cause a lot of personal turmoil on their own.  This anxiety is compounded when others (either intentionally or not) use terminology that is at best politically incorrect and extremely hurtful at worst.

Before I was diagnosed with diabetes, I did not think twice when I referred to someone as "diabetic."  Even when my sister was diagnosed with type 1 diabetes at age 16, I didn't realize how some people are affected by the term.  My sister often complained about our family bringing up her diabetes to everyone, because it was something that she wanted to keep private at that age.  By describing her as "diabetic," we were defining her first and foremost by her disease.  I truly didn't understand how much that could hurt until I personally was diagnosed with type 1 diabetes in August. 

I've written several times about how being referred to as "a diabetic" (with a capital 'D') irritates me.  Some people, especially those who have been dealing with the disease for many years, aren't bothered by this term.  However, a lot of people (myself and my sister included) would rather be referred to as PWD.  In the DOC (diabetes online community), this abbreviation is used to refer to "a person/people with diabetes."  This may seem like an argument of semantics, but it's really an important distinction for those of us that are affected by the term.  The reason being that this distinguishes us as people first...people who happen to have diabetes. 

I would almost guarantee that anyone who has any form of disease or disability does not want it to define their lives or who they are.  Yes, many times these things do tend to take over a large percentage of our time and attention, but we still don't like to be defined by them.  These terms put our diseases or disabilities (which, by the way, no one asks for) at the forefront, while most would prefer they be left as part of the background of our lives.  I am very open and forthcoming about my diabetes with those who are genuinely interested in learning more about the disease, but I get frustrated with people who assume they know everything about my life just because they know someone who is "a diabetic". 

For example, I was at a fundraiser meal with my husband one Sunday a few weeks ago and was wearing my insulin pump on a belt over my skirt suit.  When we got to the end of the line, a lady I used to go to church with asked me, "What is that on your belt?" I told her it was my insulin pump, and she replied, "Oh, I didn't know you were A DIABETIC."  I let that one slide, and told her that I was diagnosed as type 1 six months before.  She said, "Oh, I didn't know that.  I guess you can't have dessert then, huh?!"  I informed her that since I was on insulin, I had more flexibility with my diet and could simply cover the occasional dessert with insulin.  I'm almost positive, though, that she was thinking I didn't know what I was talking about, and that I should only be eating sugar-free desserts.  When I told my sister about our conversation, she said that lady had given her a lot of grief in the past as well over what she ate. (Also see: "the D-Police" in this post)

Then, just the other day, my mom and I were talking to another lady who seemed to believe she knew it all about diabetes because her neighbor and preacher (and her grandmother and son, who had both passed away) were "bad diabetics."  She told me she would bring me some sugar-free (but not carb free, of course) cookies next time she made some.  Obviously, she meant well; however, it is difficult to explain to people like this who have long-standing beliefs about the disease that what they think they know is oftentimes incorrect.  Clearly, the only way to fix this problem is to raise awareness and educate people at every opportunity.

"Bad Diabetics"
What's almost as bad (and just as frustrating) as people referring to me as "A Diabetic" is to hear people talk about others they know who are "[a] bad diabetic[s]" when diabetes comes up in the conversation.  This bothers me for two reasons: first, what in the world is a "bad diabetic"? (and would that person enjoy being called that to their face?).  Is it someone who truly doesn't take care of themselves, or just that diabetes is something they have to give a lot of attention to?  In the first case, you would be better off giving them some much-needed encouragement and support to take care of themselves better rather than discussing their bad health with others.  In the latter case, of course diabetes takes a lot of time and attention to control.  I suppose in that case I have it really "bad", because managing it often feels like another full-time job.  Furthermore, in some people's eyes, the fact that I use an insulin pump must mean that my diabetes is really bad, because otherwise I would just be able to diet and exercise or use pills like the other "Diabetics" they know. 

They often don't realize that the two types of diabetes are very different in terms of cause and treatment, and that just because I'll have to use insulin for the rest of my life doesn't mean I have the disease any "worse" than someone who is able to manage it with diet and exercise...it's just a difference in type.  In fact, it's important to point out that the two types of diabetes are actually two very different diseases even though the end result (high blood sugar) is the same.  Type 2 is caused by insulin resistence (a condition in which your body doesn't use the insulin it makes efficiently), while type 1 is an autoimmune disease in which your own body attacks your pancreas (which it sees as a foreign body), causing it to stop producing insulin.

Secondly, talking about "bad diabetics" further reinforces the notion that we're all condemned to this one big category of people who don't take care of themselves and are destined for horrible health.  I don't know about you, but I try my best to have a positive outlook on life (including my diabetes management), and work very hard to keep my blood sugars within normal range.  Just because I have this disease doesn't mean that I'm automatically resigned to having amputations or other health issues in the future.  In fact, many people don't know that with tight control, your risk for having any diabetes-related complications is greatly reduced or can sometimes be eliminated. 

Furthermore, I believe that referring to people as "bad diabetics" may lead to situations of self-fulfilling prophecies in people who do not have the social support they need to manage their disease.  After all, if you always heard what horrible health you were in and already had problems with your disease, what motivation would there be to make the effort needed to change your situation?  I am a very motivated person when it comes to managing my diabetes, but a lot of people have trouble finding the desire or getting the help they need to adequately manage their health.  These are the people that are often referred to as "bad diabetics," and they're the ones that stand to be hurt the most by the term.

This phrase may seem harmless enough to people without diabetes, but it hurts every time I have to hear it.  It underlines the perception that diabetes is something you somehow caused or brought upon yourself for not living a healthy lifestyle, and that you can "cure" it by becoming more healthy.  Very few people know that type 1 is actually an autoimmune disorder, for which the causes are largely unknown at this point.  Type 2 has a huge genetic component, so even though lifestyle choices can affect its prevention/development or prognosis, it still isn't the person's "fault" for having it.

"Fault"
The notion of fault in diabetes is sad and hugely detrimental for several reasons.  First, it contributes to the general apathy towards diabetes and people who have it, which in turn prevents people from donating to diabetes research.  After all, why contribute money to research for a disease that (they think) people could prevent if only they'd lose weight/eat healthier/exercise more?  It's a vicious circle: lack of research and awareness, more people with diabetes, apathy towards the disease...it needs to stop, but how?  I certainly don't have the answer, but I do believe that more could be done in the area of awareness at very least.  If we could educate the general public on the realities of the disease and combat the common myths surrounding it, there might be more interest in funding diabetes research.

The idea of fault also makes it harder for those of us living with the disease to cope with the realities of having a chronic illness.  Having diabetes is hard enough to deal with without having to feel guilty for having it.  As I've already mentioned, it often feels like a second (or third, or fourth) job; and it's draining physically, emotionally, psychologically, and financially.  It's no surprise, then, that depression has a high comorbidity rate in people with diabetes.  It's obviously a challenging disease to deal with even under the best and most supportive situations, so it can be downright impossible to manage for those who receive little or no support.  The bottom line is that the perception of fault associated with diabetes is clearly detrimental to the people that have it and to the research that could possibly find a cure someday.  It's not fair, but it's part of our collective reality.

"The Cure"
The issue of a cure is also a controversial one.  I've had some heated exchanges with people over the subject, and it just goes to show how hard it is to educate people on a disease that is surrounded by so many myths.  Despite what you may hear from people or in the media, there is currently no cure for either type 1 or type 2 diabetes.  Even with cases of type 2 diabetes, in which many people are able to control the disease through diet and exercise alone, the underlying disease is still there; and since insulin resistence gets worse with age, it will become progressively harder to control for many people over the years. 
The belief that diabetes has a cure is obviously another hit for diabetes research funding, and sadly it's a common one.  One of my next diabetes awareness posts focuses on the need for diabetes education, and will provide some startling statistics on the general public's knowledge of the disease.  The study featured in my future post found that of the people surveyed:

• 67% believed (mistakenly) that there is a cure for type 1 diabetes
• 25% believed that the proper diet could "cure" the disease
• 32% believed that exercise could be a "cure"

Just as insulin is not truly a "cure" for type 1 (it's more like life support, really), diet and exercise and/or pills treat the symptoms of the disease (high blood sugar), not the root of the disease itself.  Therefore, I am extremely hesitant to call them a "cure".  For me, a cure is something that completely and permanently erradicates a disease, not a temporary elimination of symptoms.

The bottom line...
Clearly, the words we use in relation to diabetes (and other disease/disabilities) can have an immense impact on both the people affected by it and the funding for research to find a cure.  Each of us has the power to change this, at least in our own families and communities.  Next time you hear someone use these words, please take the opportunity to educate them in a way that is firm, but not rude or defensive.  Some of these ideas and terms have been around for decades, so it's not going to be an easy or quick change, but it can happen. 

In addition, I've posted this "Diabetes Etiquette [for people who DON'T have diabetes]" handout before, but I thought it appropriate to share it with you again.  I first came across it in my diabetes education class, and think it's a great collection of advice for anyone who doesn't have diabetes on how to treat those they know who are affected by the disease.

Challenges in My D-Life

Help! I'm on the D-Rollercoaster again and I can't get off...
The last couple of days have been pretty tough for me.  I've had some ups and downs with my numbers, and my after-breakfast BGs have still not improved.  It seems like no matter what I do, they're always in the 140-200 range while my lunch and supper postprandials are perfect.  It's frustrating simply because I've tried so many things in an effort to change the trend, but haven't succeeded yet.  Actually, I was following my CGM pretty closely yesterday morning and bolusing accordingly as my BG went up...and up, and up.  I bolused about 8.0 units to cover 24 grams of carbohydrate (a Glucerna mini snack bar and a SF Jello Pudding snack) and ended up at 119 at the two hour mark...so a success, but wow.  Will I really have to take that much insulin every morning?  Today I thought I did everything right--I ate a Jimmy Dean D-lights whole grain bagel w/turkey sausage, egg whites, and cheese.  31g carbohydrate, 18g protein, bolused with ~40% given immediately and the other 60% over 30 minutes (to accommodate the protein content), and no caffeine.  Then an hour and a half later, I was at 192.  Ugh...So. Incredibly. Frustrating.

In Other Not-So-Great D-News...
Other than those post-breakfast highs, I also had to deal with one of the other challenging aspects of diabetes again yesterday.  Over the course of conversations with people about my diabetes, I encounter a lot of frustrating ignorance about the disease.  The way a lot of people perceive those of us with diabetes is often hurtful, and leaves me feeling helpless as to how to correct them in a way that will change their way of thinking without pushing them away or letting my feelings get the best of me. 

I have a lot to say on the subject, so I've decided to break it down into a serious of posts focused on raising diabetes awareness and correcting the common myths and misperceptions associated with the disease.  I completely realize that most people don't mean to be hurtful with their comments, and that they simply come from a place of ignorance regarding the disease.  I'll be the first to admit that I had some of the same ideas before I was diagnosed, even though my sister had been diagnosed with type 1 about four years before me and my dad had had type 2 for a couple of years before.  I've been on both sides of the fence and know that the general public just has very little accurate information when it comes to diabetes, and it's natural for people to want to relate to one another.  For this reason, I think a lot of people are simply trying to empathyze with you and show you that they know there are things that are more difficult for a person with diabetes when they bring these things up in conversation...At least that's what the optimist in me wants to believe.  Some people, though, can be downright rude and mean when it comes down to it.

What is it about diabetes that makes people feel like it's their personal responsibility to make sure you know everything they think they know about your disease?  When people find out you have diabetes, they almost automatically tend to comment on, instruct you, or judge you when it comes to your disease, and they don't always have to use words to do it.  I've come to the conclusion that pregnant women and new mothers must feel the same way, because having that belly or baby somehow makes people believe that you're somehow public property open for comment.  (Not that I am or have been pregnant, but I've had plenty of friends that this has happened to!)  Whatever the reason for this, it happens; and it happens often.  I don't understand it, mainly because you wouldn't tell someone who has cancer or some other disease that they should just "____[insert genius medical advice here]" and all their problems would be solved, so why is it people feel they have the right to do this when it comes to diabetes?

In the end, the only solution is to raise awareness and educate people on the subject.  I'm tempted to create a brochure or booklet on diabetes that I can hand to the people I have these conversations with.  It would make things a lot simpler, and maybe then the information would stick.  I've also thought about writing a column for our local newspaper to raise awareness on a bigger scale and educate people that I may not reach otherwise.  Stay tuned for developments in that area, and for future posts in my awareness series!