Accu-Chek Diabetes Link

Choosing The Right Infusion Set

Thu, 24 May 2012 06:00:00 GMT

Part 2 in a series about the beauty of living with an insulin pump.

Infusion sets are designed to carry insulin from your insulin pump to your body as comfortably and effectively as possible, so there are a variety of cannula designs and tubing lengths for different body types, lifestyles and activity levels.

Choosing an infusion set that works for you is one of the most important aspects of successful pumping. Here are some of the options you'll want to consider.

Steel or soft cannula?
Soft cannula infusion sets are more popular than steel ones and are generally considered more comfortable. They may cause less trauma to the tissue and are a good choice if you've had allergic reactions to nickel. The soft cannula set is inserted with a steel introducer needle that is removed after insertion is complete. You can also wear them longer—these infusion sets should be changed every 48 to 72 hours.

Steel cannula infusion sets are a good choice for anyone with an allergy to the materials in the soft cannula, or if you've had problems with soft cannula sets becoming kinked or dislodged. They may also be a better option for people with high muscle mass and low body fat. This type of infusion set should be changed every 24 to 48 hours.

90º or angled insertion?
90º infusion sets are inserted straight into the skin at a 90º angle and have a shorter introducer needle. This type is good for quick insertion or for people who have needle phobia.¹ You can use 90º insertion with steel and soft cannulas.

Angled infusion sets are inserted at a 20º to 45º angle to the skin, using a longer introducer needle. These are good for slow insertion. What's more, they can accommodate a wider range of body types because they allow greater variety in infusion depths. Only soft infusion sets can be inserted at an angle.

What cannula length?
The proper cannula length is based on your body mass index (BMI).¹ This is just a general recommendation—working closely with your healthcare provider will ensure that you identify the proper cannula length for you.

For more insights on infusion sets and all things under the insulin pumping sun, we recommend a visit to the team at Diabetes Mine or Mike Hoskins' The Corner Booth blog.

¹_{ACCU-CHEK infusion set selection tool. Available at: https://www.accu-chekinsulinpumps.com/multimedia/tools/infusionselector/index.htm. Accessed January 20, 2012.}

_{(author: Beverly Fox Hawkins RN, MS, CDE, Roche Regional Clinical Specialist)}

Driven To Distraction—The Reality Of Managing Diabetes Every Day

Tue, 22 May 2012 06:00:00 GMT

Part 1 in a series about the beauty of living with an insulin pump.

For those of us who take care of diabetes every day, life can be complicated—a lot more complicated than a person who doesn't have diabetes. Every item we eat, every activity we perform, or even just vegging in front of the TV requires consideration, foresight and decisions—all of the time.

Fortunately, you're in good company. Spend some time in the Tu Diabetes insulin pump forum to see what we mean.

Let's put it this way. Imagine a couple about to head out on a nice Sunday afternoon walk. Just before the walk, the person who doesn't have diabetes might think, "I wonder if it's chilly. Should I wear my jacket?"

But for the person who uses insulin to manage diabetes, heading out on that same walk requires a slightly more complex internal conversation:

"What is my blood sugar right now? It's a little high...good...I have room to drop during my walk. Of course, my insulin bolus from lunch is still mostly in me, so I could actually plummet while I walk. Better make sure I have a good supply of glucose tablets in my fanny pack. I also need to make sure I have my meter and strips in there. Maybe I should just eat a few peanut butter crackers before we go. But then I'll defeat the purpose of this walk! I had 30 grams of carbs with a decent amount of fat not long ago, that should do it. Do I need a jacket?"

Like it or not, if you're on insulin—or you care for a child or another person on insulin—diabetes re-orders your priorities.

With that in mind, forgive yourself if you're occasionally forgetful—the brain can only handle so much at one time. The mental hoops you jump through as you manage diabetes may overshadow everything else. Don't beat yourself up if you show up at your tennis match and realize you forgot the balls, or if you left your sunglasses in a restaurant 20 minutes away. Let the people closest to you know about the constant mental workout you go through. They may be more understanding the next time you forget to turn off the lights before leaving home.

_{author: Meredith Rivers, MS, RD, LD, CDE, Roche Regional Clinical Specialist}

Got Questions About the Big Picture?

Thu, 17 May 2012 06:00:00 GMT

An addition to the series about the ABCs of Testing

Regular Bg testing is a very important part of diabetes management. Over the last couple weeks we have focused on providing good, basic information to be a primer to some, and a good refresher to others.

From the feedback we received, once thing is clear: you can never have too much information when it comes to good diabetes care and management. The question is, where can you find reliable resources?

One of our main goals here is to be helpful in pointing out such resources. Here are a few we found to be valuable additions, or good next steps for this series:

Of course, this short list just scratches the surface of the great resources available online. Down the right-hand side of this page, in the "What We're Reading" section, is a great collection of excellent diabetes resources, blogs and communities that are there to help answer questions, offer solutions or maybe simply provide comfort.

Thanks for dropping by today.

Checking Beyond The Fingertip

Tue, 15 May 2012 06:00:00 GMT

This is the final post in the series the ABCs of Testing

Nothing has improved the quality of life for people with diabetes as much as the ability to check and control blood sugar. Still, over time, finger pricks can get pretty tiresome. That's why there's been a lot of discussion of the value of testing blood glucose levels at other parts of the body.

What sites can be checked?
If your doctor says it's okay, you may be able to take a blood sample from your palm, forearm, upper arm, thigh or calf.¹ Because these can be less painful,² doctors hope people will test more often and, ultimately, gain better control.

Is alternate site testing for everyone?
AST, as it's known for short, is best for people who have fairly consistent blood sugar levels. If that describes you, talk to your doctor. If using another site is a good fit for you, it's only suited to routine tests when your blood sugar is stable, such as before eating, after fasting or before bed.

When is it NOT a good idea?
Testing another site should never be used when your blood sugar may be rising or falling rapidly. Studies suggest that, because there are fewer capillaries in the other sites, test results may lag by as much as 15 or 30 minutes behind a fingertip test. If you're headed for a blood sugar low, you know those 15 minutes can be critical.³

To recap, don't test from an alternate site...

Following a meal
After exercising
When you're sick
If you think you might have low blood sugar

Can I use my current meter?
AST is approved for use with a variety of blood sugar meters, but check with the manufacturer to be sure.

Are AST checks different?
A little.

Our lancing devices require a different cap for alternate site testing, so check the owner's manual for yours before you start. You may also find that you need to prick a little deeper, since the skin may be thicker than on your fingers.
Try different sites on your body until you find one that comfortably provides a large enough drop of blood to run a test. Remember to rub the skin first to get things moving in there.³
Then, once you choose a site, stay with it. You can't rotate sites like you switch from finger to finger. If you test your forearm, you should always test your forearm.

Finally, if your alternative site test doesn't match the way you feel, double-check with a fingertip test. It's still the most reliable result you can find. For more detail, read Children with Diabetes' deep dive into AST.

¹_{Talk with your doctor before deciding if alternate site testing is right for you.}

²_{Freitas RA. Nanomedicine, volume I: basic capabilities. Georgetown, TX: Landes Bioscience; 1999. Available at: www.nanomedicine.com/NMI/7.4.6.1.htm. Accessed January 23, 2012.}

³_{Bina DM, et. al. Clinical impact of prandial state, exercise, and site preparation on the equivalence of alternative-site blood glucose testing. Diabetes Care. 2003; 26:981-985. Available at: care.diabetesjournals.org/cgi/content/full/26/4/981. Accessed January 23, 2012.}

Knowing How To Bend-Without Breaking

Thu, 10 May 2012 06:00:00 GMT

Part 5 in a series about the ABCs of testing.

It's Murphy's Law. Just when you get your schedule down pat, something's going to come along to test you. Want proof? Here's an example of Murphy's Law in action. And here's another one. One more? Okay, here.

Well, if people with diabetes need to be anything, it's flexible. In addition to general equipment breakdowns and supplies running out, here are 3 big challenges you need to be ready for:

Travel
Illness
Stress

Travel Tips
Whether it's by plane, train, or car, travel can be stressful in itself. Skip a few time zones, and it gets a little complicated. Talk to your doctor about how to adjust insulin and blood glucose tests if you cross time zones, because as you travel east you're shortening your day, and when you travel west it gets longer.

Waiting to reset your watch until the first morning in your new time zone will help you stick to your doctor's recommendations. And testing more than usual will let you know if your adjustments are working.¹

Whether you're driving or flying, make sure you bring along a substantial snack in case food isn't available at mealtime, as well as double the necessary medication and testing supplies. And always test before you get behind the wheel of the car for a long trip—just in case.²

Illness Info
When you're sick or if you've had surgery, your body kicks into overdrive to help combat whatever ails you. As part of that response, extra sugar is pumped into your bloodstream. That's why it's important to stick as closely to your meal and medication plan as possible. Even if you don't feel up to eating, regular (not diet) ginger ale or mild starches can help you get the necessary carbohydrates.

Frequent testing, especially if you're vomiting or if your blood sugar is high, will help you regain control. Every couple hours, you should also check your urine for ketones, the harmful byproducts of the body's energy consumption. If your ketones are moderate to high or if you're sick for more than a day, make sure you talk to your doctor about what to do next.³

Stress Strategies
Any kind of emotional stress can undermine your self care, by making your blood sugar less predictable and making good control seem like less of a priority.

Those surprisingly high or low blood sugar readings can be caused by the hormones released when you're stressed. The answer isn't to stop testing—it's to test more regularly so you'll be able to take steps to bring your blood sugar back in line.⁴ Testing puts you in control, and that sense of independence is your best weapon in fighting stress.

¹_{American Diabetes Association. When you travel. Available at: www.diabetes.org/living-with-diabetes/treatment-and-care/medication/when-you-travel.html. Accessed January 23, 2012.}

²_{American Diabetes Association. Driving. Available at: www.diabetes.org/living-with-diabetes/parents-and-kids/everyday-life/driving.html. Accessed January 23, 2012.}

³_{American Diabetes Association. When you're sick. Available at: www.diabetes.org/living-with-diabetes/treatment-and-care/who-is-on-your-healthcare-team/when-youre-sick.html. Accessed January 23, 2012.}

⁴_{American Diabetes Association. Stress. Available at: www.diabetes.org/living-with-diabetes/complications/stress.html. Accessed January 23, 2012.}

Getting The Most Out Of Your Insurance Benefits

Tue, 08 May 2012 06:00:00 GMT

Part 4 in a series about the ABCs of testing.

"Look out for number one." It may sound a bit selfish, but when it comes to insurance benefits for diabetes management , you need to take the lead to make sure you get everything that's coming to you. Here are a few tips:

Talk the talk. You've already learned to speak diabet-ese, so making sense of insurance policies will be a piece of cake (with time and persistence). Get your policy out and read it from cover to cover until it makes sense. That way, you know exactly what you're entitled to.

Be the squeaky wheel. If your insurance doesn't cover all the blood sugar testing supplies, equipment and education you need—or even an insulin pump—put up a fight. Things don't change on their own. If your coverage is through your job, talk to your human resources department—not just once, but regularly to check the status of new coverage. Even if your state doesn't require coverage, companies can still choose to offer it. And your human resources department has a lot of influence over what gets insured.

Go over their heads. Fortunately, new healthcare acts ensure greater protections for people with diabetes. But there's still work to be done. Write letters to your senators and representatives to help keep diabetes management on the front burner.

Use your healthcare team. Be up-front with your doctor, diabetes educator and any specialists you see. Tell them you're concerned about costs and coverage. They may be more familiar with local resources and, chances are, they'll have some creative ideas to help out. For example, if you need to save on prescriptions, your doctor may have free samples on hand. Perhaps pills can be ordered in larger sizes and split into two doses (often thirty 50 mg pills and thirty 100 mg pills cost about the same).¹

Take full advantage. Discussions of insurance coverage and diabetes often come down to testing supplies. But are there other health-enhancing benefits you could be using? For example, many companies (and Medicare and Medicaid) will cover diabetes education, nutrition counseling and an annual foot exam. Don't let these covered benefits go to waste.

Remember who has to live with it. You're the one at risk for complications—not your insurance company. When it comes to your health, you always have the last word.

¹_{WebMD. Pill splitting: When is it safe? When is it unsafe? Available at: www.webmd.com/a-to-z-guides/features/pill-splitting-when-is-it-safe-when-is-it-unsafe. Accessed January 23, 2012.}

What's Your Excuse?

Thu, 03 May 2012 06:00:00 GMT

Part 3 in a series about the ABCs of testing.

Ask 100 people with diabetes why they skip blood sugar tests and you'll only come up with a handful of different answers.

Sure, the cost of testing supplies comes up. But if you need more test strips than your insurance allows, your doctor may write a letter to request coverage. If you don't have insurance, many manufacturers offer strips to people who need them. Whatever your situation, blood glucose checks aren't a luxury—they're necessary for keeping your numbers in range and avoiding more costly long-term complications or hospital stays.

Next, finger pain is a pretty common excuse. But using a current lancing device and taking a few steps to reduce the pain can make this less daunting.

What may come as a surprise, though, are the other reasons people skip tests.¹ See yourself below?

"I don't like to check in public."
It's true. People can be nosy and even rude. Family members may want to add their 2 cents. Strangers may know very little about diabetes, but that won't stop them. Still, you can't let someone else's ignorance or attitudes get in the way of your health. If a passerby seems interested, explain what you're doing and why. Don't be embarrassed or ashamed. Instead, feel proud that you're taking good care of yourself.

"My meter makes me feel bad."
Repeat this aloud: "blood sugar test results are data, not a judgment." It's personal information that doesn't need to be shared with anyone but your doctor, and it's nothing to feel guilty about. Even if you know your results will be higher than normal, it might be worthwhile to see how high it's going. That way, you'll know whether you need to increase fluids, test for ketones or call the doctor.

"I'm feeling fine—I'll check if I sense trouble."
Not everyone can feel a blood sugar high or low coming on—in fact, if it happens often enough, it may start feeling "normal" to you. Plus, frequent testing can help you avoid these problems altogether. Even people with excellent control can count on a few curve balls from time to time. You'll never know how stress, unfamiliar foods, new medications or activity might affect you if you don't watch for patterns when you're at your best.

"I know I'm going to get complications, so what's the use?"
Good blood sugar control is like money in the bank. If you can make a deposit every day, excellent. But even if you start depositing money later in life or if you can't make it to the bank every day, what you can do is still worthwhile. Every single day that you manage your blood sugar well makes a little bit more difference in your long-term health.

Want more insight? Read this article, Ten Good Reasons to Hate Blood Glucose Monitoring (And What to Do about Them) from our friend and diabetes educator, Dr. William Polonsky.

¹_{Polonsky WH. Diabetes Burnout: What to Do When You Can't Take It Anymore. Alexandria, VA: American Diabetes Association; 1999.}

Squeezing Everything You Can Out Of That Tiny Drop

Tue, 01 May 2012 06:00:00 GMT

Part 2 of a series about the ABCs of testing.

A game of tennis. That last little sliver of pie. Your wedding. Certain things are bound to make your blood sugar behave erratically. But thanks to your ability to self-monitor, it takes less than a minute to find out just how much.

Blood sugar testing isn't just for people who use insulin. Even if you have type 2 diabetes and treat it with oral medication or a diet and exercise regimen, blood sugar monitoring can tell you how changes to your lifestyle are working. But if you are using insulin, you're probably performing blood glucose checks at least 4 times a day in your quest for blood sugar nirvana.¹

Of course, it's not just testing your blood sugar that's important. You have to understand what the results mean, and when they should alert you to get your team involved. Make sure you've had a clear discussion with your doctor or certified diabetes educator about your target blood sugar ranges. Then decide when they want you to give them a ring. For example, they may want to know if...

Your blood sugar is higher than a certain number or drops below a predetermined limit
You experience highs or lows 2 or more times within 24 hours
You've been experiencing any patterns that may need adjustment, such as an after-dinner or before-breakfast high 3 or more days in a row

In addition to routine testing, your doctor may want you to perform structured tests to problem-solve—to see why you're having highs and lows, to identify blood sugar patterns or to help you and your healthcare team decide if any adjustments are needed in your insulin therapy or other areas of your diabetes management.

We don't usually like to beat our own drum in these posts, but we've created some great tools for this, including the ACCU-CHEK Testing in Pairs tool for comparing before-and-after test results and the ACCU-CHEK 360o View tool, which provides a quick snapshot of patterns in your numbers. They're both free, so you can print them out any time you want to give them a try.

For the past few years, we've also partnered with the Diabetes Hands Foundation on the Big Blue Test, which simply encourages people to test their Bg level, do some sort of physical activity, then test again to see the impact that exercise can make.

Give 'em a try and see what you can see!

¹_{American Diabetes Association. Standards of medical care in diabetes—2011 [position statement]. Diabetes Care. 2010;34(1): S11-S61. Available at: care.diabetesjournals.org/content/34/Supplement_1/S11.full. Accessed January 23, 2012.}

Finger Pricks And The Big Picture

Thu, 26 Apr 2012 06:00:00 GMT

Part 1 in a series on the ABCs of testing.

If you've got type 1 diabetes—whether you use an insulin pump or multiple daily injections—you've already connected the dots (so to speak) between those tiny drops of blood and how you care for yourself throughout the day.

But if you're a normal human being, you can grow weary of monitoring your numbers all of the time. On the other hand, checking blood sugar is a key part of tight blood glucose control. That's why we thought we'd take a minute and talk about the benefits of blood sugar checks and tight control,¹ beyond helping you avoid high and low blood sugar levels today.

You may be familiar with the Diabetes Control and Complications Trial (DCCT) which studied more than 1,400 people with type 1 diabetes over 10 years. After that, a follow-up study called Epidemiology of Diabetes Interventions and Complications (EDIC) continued to track more than 90 percent of the DCCT participants.

Here's what the researchers learned—by tightening up your blood sugar levels you can:²

Reduce your risk of eye disease by a whopping 76%!
Cut your risk of kidney disease in half
Lower your risk of nerve damage by 60%—so you're less likely to lose sensation in your feet or legs, or have problems with your heart rate, digestion or sexual function
Reduce your risk of cardiovascular disease, including heart attack and stroke, by 42%

Since at-home blood sugar monitoring has only been around since the early 1980s, this generation is the first that's really been able to take an aggressive approach to preventing short- and long-term complications.

You've probably already figured out that you can't measure your blood sugar just by the way you feel. Self-monitoring gives you a heads-up when your blood sugar is on the rise or dropping, and it's the only way to see how different foods, exercise, medications and other factors affect your blood sugar levels.

If that isn't motivating you, maybe this will. Reach out to others who really understand your highs and lows (emotionally and glucose-ally). Join the next Diabetes Social Media Advocacy tweet-up hang out in the Diabetes Daily Testing Blood Sugar Forum, or, if you're a girl, meet your sister match at Diabetes Sisters.

¹_{American Diabetes Association. Tight diabetes control. Available at: www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/tight-diabetes-control.html. Accessed January 23, 2012.}

²_{National Diabetes Information Clearinghouse. DCCT and EDIC: The Diabetes Control and Complications Trial and follow-up study. Available at: diabetes.niddk.nih.gov/dm/pubs/control/. Accessed January 23, 2012.}

Nothing Keeps Blogger Sara Knicks from Her Passion to Travel

Tue, 24 Apr 2012 06:00:00 GMT

Sara Knicks of the Moments of Wonderful blog and Diabetes Daily shares some thoughts to close out our series on people traveling with diabetes

The summer before I was diagnosed with diabetes, I spent a semester studying in England and traveling to the surrounding regions during the long weekends. In the days before I was hospitalized with DKA at my diagnosis, I was planning a road trip with a few of my college friends. One of the first questions that I asked the doctor, while still in the hospital, was whether or not I would still be able to go on my trip.

Less than two weeks after I was given my first instructions on how to use insulin and was finally discharged from the hospital, my friends and I packed our bags, put on our favorite playlist, and hit the road. I made some big mistakes on that trip – most importantly, don't take your insulin unless you know how long the line is for the buffet. But I also learned something great on that trip; diabetes was not going to stop me from living the wandering life I enjoyed.

I love adventure and I love to travel. Being diagnosed later in life, I worried that diabetes would affect my ability to explore the world. However, since my diagnosis I have traveled around Israel, floated in the Dead Sea and snorkeled in the Red Sea. I have ridden a donkey in Jordan to the site where they filmed scenes from an Indiana Jones movie. I have spent a week driving across the country in my car with my mom. I have worked in Haiti twice, the first time six weeks after the devastating earthquake, and a second time one year later. I have traveled the world using different types of diabetes management and have realized one lesson is true for every type of diabetes and every type of travel.

I cannot be too prepared for my trips and I cannot over pack.

I figure out how much supplies (insulin, medications, syringes, tape, dressings, etc) I will need for the days of my trip and then pack double, assuming that everything that could go wrong will go wrong. It won't, but I don't want to be without something I need. Speaking of being without – my over-packed bag is always my carry-on bag when I'm flying so it's not affected by temperature or lost during a layover.

I pack extra test strips, extra meters, extra glucose tablets and snacks. I work and play hard when I travel, so I usually need to test more and eat more. Eating unexpected food can lead to unexpected blood glucose checks. I make sure to always wear my medical identification and bring supplies with me to keep my medications at the right temperature, keep my devices safe in the water, and test discretely when necessary.

There are many great companies and products available to make traveling with diabetes so much easier. With a little research and planning, and a big enough bag, I know that I can continue to explore the world and my own backyard while continuing to successfully manage my diabetes.

The last time I was in Haiti, I playfully picked up a toddler on my first night there. In one quick motion he managed to reach up for my glasses, rip them off my face, and throw them into the nearby gravel where one of the lenses promptly popped out. Who other than someone with diabetes would have thought to pack a second pair of glasses?

Getting Into The Travel Routine

Thu, 19 Apr 2012 06:00:00 GMT

The final message in a series for people traveling with diabetes.

If you're successful in self-care, it's probably because you have it down to a pretty clear routine. You know when you're going to be eating. When you're most active. What may lead to low blood sugar levels. And when you should check your blood glucose.

Taking a vacation from your everyday life is also a vacation from your routine—in fact it's anything but routine.

Instead of going to work every day, you may just lie around with a book in a hammock. You may (gasp!) sleep in. You may find yourself walking from one end of an old city to the other. And it may all be happening in a climate you're unaccustomed to.

Those are good reasons to increase your blood glucose monitoring. Because when you can see exactly what's happening with your blood sugar, there isn't anything (within reason) you can't do.

Like anything related to diabetes, planning ahead will have you ready for anything. You'll be able to:

Test as often as you'd like, without worrying about running out of supplies
Take on appropriate challenges, knowing that your healthcare team has given you the green light
Adjust to new time zones with confidence
Try new foods and be prepared for the effects
Look great in your well-packed wardrobe and have a great time

No matter how exciting it is to travel, when it comes to diabetes, you want an utterly uneventful trip.

Still have questions? Take a look at VoyageMD, or ask the Diabetes Daily community. You know someone's been there.

A Seasoned T1 Traveler's Advice for Vacation Planning with Diabetes in Mind

Wed, 18 Apr 2012 06:00:00 GMT

An addition to our series on traveling from Chris Stocker

Planning travel and going on a vacation can be pretty stressful, but they can become even more taxing when doing so with diabetes. I am not a big planner when it comes to packing, nor does it take me a long time. I usually pack my bags about a half hour before my trip, but I do make a checklist for my diabetes stuff.

When beginning my checklist, my first task is to sit down and just start listing everything that I will need to take. I'll worry about quantities later. For a typical trip or vacation, a checklist would look like this:

Meter
Test Strips
Lancets
Infusion Sets
Reservoirs
Insulin
CGM
CGM Sensors
Candy

Now it's time to decide how many or how much of each I am going to take with me. Of course, it all depends on the length of the trip, so I have a simple rule of thumb that I use for myself. I always bring 3 times the amount that I would normally use. Why? Because you never know when flights will be cancelled, bad weather will come along, or whatever other possible delay might keep you from getting back home.

For a normal 7 day vacation/travel, I will grab a full box of infusion sets, and a full box of reservoirs for the pump. For my testing supplies, I typically just grab a box of 100 test strips because, whether I am wearing a CGM or not, 100 strips will get me through the week with some extra left over.

For my CGM, I typically only bring 1-2 sensors with me. Insulin is the most important, and since I go through a lot of insulin on a normal day, I tend to go through a lot more when I am traveling. One vial of insulin typically lasts 5 days, so I will bring 3-4 vials of insulin with me as a precaution.

Most importantly, all of these items go in my carry-on. I do not put anything in my checked baggage because I cannot take the chance of it getting lost or damaged.

These are just the steps I take before getting to the airport, or into the car to travel. The traveling part and the vacation part are two totally different stories. When flying, I try to test my sugar right before I get on the plane because I don't like to take my meter out while in the air (there's just something about germs on airplanes that creeps me out, and I don't want to test my sugar on a plane).

While on vacation, I try to test my sugar a little more often than I would on an average day at home. It's primarily due to my eating habits while on vacation. It is nowhere near what I would normally eat, so I have to make sure that my blood sugar levels remain on par.

This is my simple process of preparing for a vacation or travel with diabetes. How do you plan your diabetes travel? Come visit my blog and let me know!

About Chris:
Chris Stocker was diagnosed with diabetes in April of 2004. He has since gone on to create his blog, The Life of a Diabetic, where he writes about living a normal life with diabetes. Chris is also a small business owner and a huge Philadelphia Eagles and Phillies fan!

Olá! Ahoj! Hei! Hello World!

Tue, 17 Apr 2012 06:00:00 GMT

Part 5 of a series for people traveling with diabetes.

When you're in a new place, diabetes shouldn't get in the way of having fun. Go ahead and try the local cuisine. Simply follow up with a blood sugar check to measure its effect. Trundle to the bottom of the Grand Canyon (if you're in shape for it). Just follow up with a blood sugar check to measure its effect. Stay up all night in Iceland in June. Just make follow up with a blood sugar check to measure its effect.

Getting the picture?

(Speaking of pictures, if you think there's anywhere a person with diabetes can't go, check out diabetes advocate and long-time blogger David Mendosa's hiking and photography blog.)

There are a few things you may want to know about vacationing with diabetes as your travel companion.

Insulin is different over there. Many countries use U-40 or U-80 strength insulin, not U-100 as we have in the U.S. So if you run out, be sure you buy new syringes that match the local strength, or you'll be mis-dosing.¹
Keep it cool. Insulin doesn't have to be refrigerated, but it can't be exposed to extreme temperatures, either. So use an insulated bag and keep it out of the car trunk or glove compartment.¹
Leave your shoes on. It's tempting to run barefoot on the beach, but not a great idea. Burning or cutting a foot could come back to haunt you.²
Be careful at altitude. At high or extreme altitudes, you may not feel well and you have more difficulty controlling your blood sugar.³ What's more, the extreme temperatures at very high places can cause trouble for your meter. Wearing your meter close to your body can help keep it in the proper operating temperature range.³
Don't drink the water. If you do get a case of traveler's diarrhea (as 20 to 50% of visitors to developing countries do), make sure you have a antidiarrheal medication with you. Infection and dehydration make it harder to control your blood sugar.³
Keep a snack on you. The farther you go from civilization, the more unpredictable your meals. Always BYOS (bring your own snacks).³
Whatever you do, check your blood sugar to measure the effect.

¹_{American Diabetes Association. When you travel. Available at: www.diabetes.org/living-with-diabetes/treatment-and-care/medication/when-you-travel.html. Accessed January 18, 2012.}

²_{National Diabetes Education Program. Have diabetes. Will travel. Available at: ndep.nih.gov/media/have_diabetes_will_travel_508.pdf. Accessed January 19, 2012.}

³_{American Diabetes Association. Adventure travel with type 1 diabetes. Available at: care.diabetesjournals.org/cgi/reprint/28/10/2563. Accessed January 19, 2012.}

And Away We Go

Thu, 12 Apr 2012 06:00:00 GMT

Part 4 of a series for people traveling with diabetes.

Getting there may be half the fun if you're traveling by car or sleeper coach. But if you're getting on a plane, it can be, well, less than half the fun.

Going through security.
Navigating the security rules alone can be pretty taxing, although a quick look at the Transportation Security Administration site will fill you in on the latest.

Fortunately, the TSA worked directly with the American Diabetes Association to determine the appropriate rules for someone traveling with diabetes. As a result, you can carry onto the airplane...^1,2,3

Insulin and syringes, pens, etc.—insulin must be clearly labeled
Oral medication
Testing supplies
Insulin pump and supplies
Glucagon kit
Ketone test strips
Used syringes, if they're in a hard-surface disposal container
Juice, gel icing tubes or other items needed to treat or prevent hypoglycemia

Explain to the security officer that you're carrying diabetes supplies so they can be properly screened. And if you're wearing a pump, you can ask for a pat-down and visual inspection instead of removing your pump. The TSA site asks that you explain to the security officer that you can't remove the pump because it's inserted under your skin.¹

You might also want to read the Joslin Diabetes Center's post on traveling with an insulin pump, for another perspective. Or get a first-hand, straight-shooting account from blogger, Kelly Kunik.

On the way.
A few tips to keep you feeling your best.

Bring plenty of snacks—for the airport and on the plane. Last year, 20% of all flights were late by 15 minutes or more, with some routes holding the dubious distinction of being late nearly 75% of the time.⁴ What's more, many flights offer no more than in-flight beverage service. You never know when you'll have to provide your own meal.
If there is an on-board meal, wait until you see the food cart coming down the aisle before you take any pre-meal insulin.⁵
Keep your watch set to your home time zone until the morning after you arrive, so you can stick to your regular medication schedule, or the one you and your doctor agreed to before the trip.⁵
Let the flight attendant know you have diabetes, especially if you're traveling alone.⁶
Check your blood sugar often, to make sure the excitement, time zones, or changes in activity and eating aren't throwing off your control.⁶

¹_{Travel Security Administration. Hidden disabilities. Available at: www.tsa.gov/travelers/airtravel/specialneeds/editorial_1374.shtm#3. Accessed January 18, 2012.}

²_{Travel Security Administration. Travelers with disabilities and medical conditions. Available at: www.tsa.gov/travelers/airtravel/specialneeds/index.shtm. Accessed January 18, 2012.}

³_{American Diabetes Association. What can I bring with me? Available at: www.diabetes.org/living-with-diabetes/know-your-rights/discrimination/public-accommodations/air-travel-and-diabetes/what-can-i-bring-with-me.html. Accessed January 18, 2012.}

⁴_{U.S. Department of Transportation. Air travel consumer report: September 2011. Available at: airconsumer.dot.gov/reports/2011/September/2011SeptATCR.PDF Accessed January 18, 2012.}

⁵_{American Diabetes Association. When you travel. Available at: www.diabetes.org/living-with-diabetes/treatment-and-care/medication/when-you-travel.html. Accessed January 18, 2012.}

⁶_{National Diabetes Education Program. Have diabetes. Will travel. Available at: ndep.nih.gov/media/have_diabetes_will_travel_508.pdf. Accessed January 18, 2012.}

Pack Up The Kids, We're Outa Here

Tue, 10 Apr 2012 06:00:00 GMT

Part 3 of a series for people traveling with diabetes

Traveling with kids can definitely stretch the use of the phrase "leisure travel." On the one hand, you get to see everything through the eyes of a child. On the other hand, you'll never have to carry so much, or be so organized, as the day you load up the whole family for a vacation.

Depending on their ages, there's a lot you can do to help get kids involved in the planning. Perhaps they can select destinations for certain days, doing all the background reading to educate the family on their picks. They can help select what to pack, as well as their in-flight and in-car entertainment. And if you're going to another country, they can learn some key phrases in the local language.

If you want to hear from parents who have been in your shoes (and taken them off for screening), head over to the Children with Diabetes site.

Before you fly, the American Society of Travel Agents and Travel Security Administration (TSA) have some ideas for minimizing the getting-there-and-back stress.

Get to the airport early and plan for extra time between connecting flights. Have a meet-up plan in case you get separated.¹
Talk about what's going to happen during security screening.¹ If you're traveling with an infant, divide responsibilities in advance to streamline the process. For example, mom takes the baby through while dad marshals the stroller and carry-ons. (Knowing how many individual items you're toting helps you count them off every time you get up to move.)
If you're traveling with a baby, declare any liquids such as formula, breast milk or juice that are in larger than three-ounce sizes to the security officer.²
Tell the security officer that you are traveling with someone with diabetes, so they will understand why you're transporting self-care supplies. You can carry on insulin, syringes, lancets, your meter—everything you need. If you have any questions, you'll find a complete list of approved items on the TSA site. If your child uses an insulin pump, they can request a pat-down and visual inspection instead of going through the metal detector.³
Have your child carry an Emergency Diabetes Information Card that explains why he or she might be having difficulty, and provides contact information for you on the road.

Be flexible. Older kids will want some time to themselves. Younger kids may be unpredictable. Having a loose schedule will keep you entertained and allow you to see all the sights without getting stressed out.

¹_{TravelSense. Tips on traveling with children. Available at:www.travelsense.org/tips/children.cfm. Accessed January 18, 2012.}

²_{Travel Security Administration. Traveling with children. Available at:www.tsa.gov/travelers/airtravel/children/index.shtm. Accessed January 18, 2012.}

³_{Travel Security Administration. Hidden disabilities: diabetes. Available at:www.tsa.gov/travelers/airtravel/specialneeds/editorial_1374.shtm#3. Accessed January 18, 2012.}

Kitchen Sink? Check!

Thu, 05 Apr 2012 06:00:00 GMT

Part 2 of a series for people traveling with diabetes

So you're going on a trip. We'll try to control our envy long enough to help you make some smart decisions about what to take, what to leave home and what to deal with when you get there.

Before you get started, let's think about what type of trip this will be. Theatre tickets and fine dining? (Sounds like fun.) Llama trekking? (Wow.) A week on the beach? (Lucky!) Naturally, that's going to drive the way you pack—as will the latest weather forecast and a little insight into local customs. For example, you wouldn't want to get all the way to the Vatican to find out you can't tour St. Peter's in shorts.

Once you know what you're doing and where you're going, make a packing list. A short one. Then stick to it. Because wherever you're going, too much luggage is too much luggage. And more to lose if your bags go missing.

See what Six Until Me blogger and insulin pumper Kerri Sparling has to say about packing diabetes supplies.

The American Society of Travel Agents has some other tips:¹

Try to pack clothing that can be worn in multiple combinations, and weed out anything you can only wear once.
Don't take any jewelry you don't want to lose—and avoid flashy items that can make you a target for thieves.
See where you can cut down: take photocopies of guidebook pages instead of the whole book; use one type of lotion on your hands, face and body; include a Swiss army knife in your checked luggage and it will perform a range of duties.
Button and zip up clothes, then nest and fold them carefully to minimize wrinkles; packing tightly will also help.
Label your luggage inside and out.

In addition, make sure you're covered on the self-care front.²

Pack twice the amount of insulin, blood glucose testing supplies and ketone test strips than you'd normally need, just to be safe.
Take enough syringes, infusion sets or other supplies for the whole trip—don't plan on getting more at your destination.
Throw in extra batteries for your meter and pump.
Bring glucagon, snacks and glucose tabs or hard candy to treat low blood sugar.
Don't forget a first aid kit of antidiarrheal medication, antibiotic ointment, etc., as well as your medical ID tag or bracelet.
Consider an insulated bag for insulin, if you're going to a very hot or cold climate.

Keep your diabetes-related supplies in your carry on, so you won't have to worry about losing them, and you'll be set for a great trip. Oh yeah. One more question—can we come, too?

¹_{TravelSense. Packing lists and packing tips. Available at:}www.travelsense.org/tips/packingtips.cfm_{. Accessed January 18, 2012.}

²_{American Diabetes Association. When you travel. Available at:}www.diabetes.org/living-with-diabetes/treatment-and-care/medication/when-you-travel.html_{. Accessed January 18, 2012.}

Planning For Paradise

Tue, 03 Apr 2012 06:00:00 GMT

Part 1 of a series for people traveling with diabetes

Bartering for batik in Bali. Cruising to Alaska. Stopping at a roadside motel for free TV and air conditioning. Whatever "travel," means to you, diabetes management should never get in the way.

You can find great diabetes-friendly travel tips and tales on the web, like Bennet Dunlap's Disney recommendations at AllEars.net and Sara Nicastro's Haiti diary at Moments of Wonderful.

Before you set out on your own adventure, consider adding a few things to your pre-trip checklist:

If you're taking a long, exotic or strenuous trip, see your doc at least a month in advance.¹ That way you'll have time to tighten up your blood sugar control, if need be.
Ask your healthcare team to help you determine how to handle time zones.¹ You can even bring along a copy of your itinerary so you can work out a schedule for blood sugar checks and insulin. It's easier to address this before you arrive bleary-eyed in Sydney.
Start looking into your destination to get an idea of dishes you'd like to try, carbohydrate counts and customary mealtimes—perhaps you're not used to eating dinner at 10 pm, as they do in Spain.
Learn to say important phrases in other languages. "Please," "thank you" and "where's the bathroom?" will get you most of the way. But knowing how to say "I have diabetes," and "I need insulin," can be essential in sticky situations.
Ask for a special, diabetes-friendly meal when you book a flight¹ (You might even get served first).
Break in those shoes. Nobody—whether they have diabetes or not—wants to find out the shoes they bought to stomp around the Scottish Highlands or Music City USA are blister makers.

Bon voyage!

¹_{American Diabetes Association. When you travel. Available at: www.diabetes.org/living-with-diabetes/treatment-and-care/medication/when-you-travel.html. Accessed January 18, 2012.}

Diabetes Etiquette For People Who Don't Have Diabetes

Thu, 29 Mar 2012 06:00:00 GMT

Over the past week or so, we've been posting etiquette tips by the Behavioral Diabetes Institute on our Twitter feed. The response has been so positive, we thought we'd make it easy for everyone to read and share by posting them all right here.

Thanks to all for the feedback. Keep it coming!

DON’T offer unsolicited advice about my eating or other aspects of diabetes. You may mean well, but giving advice about someone’s personal habits, especially when it is not requested, isn’t very nice. Besides, many of the popularly held beliefs about diabetes (“you should just stop eating sugar”) are out of date or just plain wrong.
DO realize and appreciate that diabetes is hard work. Diabetes management is a full-time job that I didn’t apply for, didn’t want and can’t quit. It involves thinking about what, when and how much I eat, while also factoring in exercise, medication, stress, blood sugar monitoring and so much more—each and every day.
DON’T tell me horror stories about your grandmother or other people with diabetes you have heard about. Diabetes is scary enough, and stories like these are not reassuring! Besides, we now know that with good management, odds are good you can live a long, healthy and happy life with diabetes.
DO offer to join me in making healthy lifestyle changes. Not having to be alone with efforts to change, like starting an exercise program, is one of the most powerful ways that you can be helpful. After all, healthy lifestyle changes can benefit everyone!
DON’T look so horrified when I check my blood sugars or give myself an injection. It is not a lot of fun for me either. Checking blood sugars and taking medications are things I must do to manage diabetes well. If I have to hide while I do so, it makes it much harder for me.
DO ask how you might be helpful. If you want to be supportive, there may be lots of little things I would probably appreciate your help with. However, what I really need may be very different than what you think I need, so please ask first.
DON’T offer thoughtless reassurances. When you first learn about my diabetes, you may want to reassure me by saying things like, “Hey, it could be worse; you could have cancer!” This won’t make me feel better. And the implicit message seems to be that diabetes is no big deal. However, diabetes (like cancer) IS a big deal.
DO be supportive of my efforts for self-care. Help me set up an environment for success by supporting healthy food choices. Please honor my decision to decline a particular food, even when you really want me to try it. You are most helpful when you are not being a source of unnecessary temptation.
DON’T peek at or comment on my blood sugar numbers without asking me first. These numbers are private unless I choose to share them. It is normal to have numbers that are sometimes too low or too high. Your unsolicited comments about these numbers can add to the disappointment, frustration and anger I already feel.
DO offer your love and encouragement. As I work hard to manage diabetes successfully, sometimes just knowing that you care can be very helpful and motivating.

Be A Blood Sugar Control Freak

Tue, 27 Mar 2012 06:00:00 GMT

The final message in a series for people recently diagnosed with diabetes

Like saving for your retirement, sometimes it can be hard to imagine that time in the future when your diabetes management efforts will pay off. But the truth is, good blood sugar control will make it easier to live with diabetes right now, as well as down the road.

For the short term, good blood glucose control may mean:¹

More energy, a better mood and better sleep
Less chance of high or low blood sugar interfering
with your daily life
More effective use of insulin through exercise
The ability to be as active and spontaneous as you like

So start taking charge now. Here are a few ways we think might help.

Make friends online. Be sure to get involved the diabetes online community. Start by speaking up at TuDiabetes, Children with Diabetes, Diabetes Sisters or the @DiabetesSocMed Twitter chat community.

Seek out support. You'll meet people who have been there—they'll know what you're going through and can listen and give advice. Your doctor or local hospital can point you to a group in your area.

Stay in the loop. Read everything you can about living with diabetes. Here are some of our favorite information sources:

And, of course:

Manage your stress. Get a pet (a great excuse to go for walks and built-in unconditional love). Do something nice for yourself each day. What are some other ways you could brighten your outlook?

Laugh about it. Stay connected with your friends and tell them about the things you're learning. Don't treat the subject as taboo.

The bottom line is, if you welcome changes instead of resisting them, before long you won't even have to think about them anymore. They'll become second nature, and you may feel better than you ever have before.

_{1Polonsky WH. Diabetes Burnout: What to Do When You Can't Take It Anymore. Alexandria, VA: American Diabetes Association; 1999}.

More Tips for the Newly Diagnosed from Health Coach, Ginger Vieira

Fri, 23 Mar 2012 06:00:00 GMT

Ginger is back with more advice for people recently diagnosed with diabetes

We had such a great response from Wednesday's post, we are happy to provide more links to encourage those newly diagnosed with diabetes from advocate and health coach, Ginger Vieira.

If you've ever read Ginger's posts or watched her vlogs, you know she is all about inspiring people to lead their lives to the fullest. Below, she has recommended some stories about athletes living with diabetes, and you can click the image above to see her brand new vlog on living half her live with diabetes. You don't want to miss it!

Ballet & Diabetes

BMX racing & Diabetes

Triathlons & Diabetes

For more information about Ginger, please visit her site, Living in Progress.

Make A Plan Before You Catch A Bug

Thu, 22 Mar 2012 06:00:00 GMT

Part 5 of a series for people recently diagnosed with diabetes

That tickle in the back of your throat. A little chill when you don't expect it. That's right, you've got a bug coming on. With diabetes, taking care of yourself when you're sick takes advance planning. And since you don't know when you're going to come down with something, the time to make that plan is now—before you catch a cold or flu.

Sit down with your doctor and answer these questions together. Then keep your notes and your doctor's phone numbers handy so you can refer to them when the time comes.

When should you call your doctor? A high fever? A specific blood sugar level? After a number of days has passed and you're not feeling better? Who can you call when your doctor isn't available? What about nights and weekends?
How often does your doctor want you to test blood sugar and check for ketoacidosis when you're sick? Illness may call for more frequent blood glucose monitoring, and you'll want to keep tabs on your ketone levels as well, since ketone levels can rise when you're ill.¹
What remedies can you take without adversely affecting your blood sugar control or causing an interaction with your prescribed medicines?

Then remember...

Keep checking your blood sugar levels and ketones. It's the only way to know how you're really doing.¹
Keep taking your meds. Even if you're throwing up, don't quit your insulin or other medications. You may actually need more insulin when you're ill.¹
Keep drinking. It's tough when you're sick, but it's crucial. And it's especially important if you're vomiting or have diarrhea. Plus, the extra liquid can help flush out ketones and extra sugar in your system.¹
Keep eating. Stay as close to your normal routine as possible. If your stomach is upset and you can't hold anything down, sip liquids to take the place of the carbohydrates you usually eat. Don't go sugar-free. Drink ginger ale with sugar, regular soda or sweetened tea. Eat popsicles. Try saltines, dry toast (on regular bread), hot cereal, regular ice cream, mashed potatoes or regular pudding.¹
Keep a notebook. Jot down your symptoms, temperature, test results, drugs and over-the-counter remedies, and anything you eat. Don't forget to keep track of your calls to the doctor and their instructions, too. You may not feel like it, but keeping a journal is the best way to learn from your experience and plan for the next bout of bed rest.

_{1American Diabetes Association. When you're sick. Available at: http://www.diabetes.org/living-with-diabetes/treatment-and-care/who-is-on-your-healthcare-team/when-youre-sick.html. Accessed October 17, 2011.}

Ginger Vieira: Words of Advice for the Newly Diagnosed

Wed, 21 Mar 2012 06:00:00 GMT

An addition to our series for people recently diagnosed with diabetes

Ginger Vieira is a powerhouse. Read her blog, or watch her vlogs, and in very short order you will reach the same conclusion.

Sure, she's a world-record-holding powerlifter, but that's not all we mean by powerhouse; she's powerfully funny, powerfully insightful and powerfully relatable, real and inspirational.

As we have been posting a series for people recently diagnosed with diabetes, we thought it would be a good idea to ask her what resources she has that might help them. Here is a collection of her video posts that she recommends (and we do too!):

Diabetic Perfection -- understanding that you don't have to be perfect; when people experience their first true high BGs, they feel very guilty and don't realize it's normal

Diabetics Are Awesome -- Ginger takes a lighter look with some teens, laughing about the many aspects of living with 'betes

Your Diabetes Pizza Restaurant -- Useful for kids and families in trying to explain what diabetes is

DKA - Diabetic Ketoacidosis -- Many newly diagnosed folks don't know about this beyond diagnosis of the acronym DKA

For more information about Ginger, please visit her site, Living in Progress.

Stay tuned! Tomorrow we will continue with part 5 of our series, and Friday we will be posting more of Ginger's links.

Hyperglycemia Vs. Hypoglycemia And How To Beat Them Both

Tue, 20 Mar 2012 06:00:00 GMT

Part 4 of a series for people recently diagnosed with diabetes

When people talk about short-term complications, hyperglycemia and hypoglycemia head the list. But which one's which? And how can you wrangle them into control?

Well, "hyper" means too much of something (think hyperactive, hypertension, hypercritical, etc.). So hyperglycemia means high blood sugar. And "hypo" is Greek for "under," but it's probably easier to just remember that "hypo" rhymes with "low."

Hyperglycemia/high blood sugar
Of course—in the broadest sense—hyperglycemia is the definition of diabetes. So if you're having a spike in blood sugar, you may notice symptoms similar to the ones you saw before you were diagnosed, such as frequent urination and increased thirst.¹

High blood sugar levels can occur when you eat too much food, don't get enough exercise, are stressed out or get sick.¹

The solution: Don't guess at the cause or the problem. Run a blood glucose check. If it's above 240 mg/dL, test for ketones. Don't exercise if ketones are present.¹ If your blood sugar is high, follow your doctor's recommendations for what to do next.

Hypoglycemia/low blood sugar
Also known as a hypo or low, hypoglycemia means your blood sugar has fallen below 70 mg/dL² (although your number may be a bit higher or lower, based on what your doctor recommends). You'll probably start to recognize a low blood sugar level coming on, but it's often a weird feeling of shakiness, dizziness, sweating, moodiness, confusion or clumsiness. Left untreated, low blood sugar can lead to seizure or passing out, so please don't ignore these symptoms.³

Keep fast-acting carbohydrates in the car, your office, next to your bed and in your pocket or purse. Doctors recommend the 15-15 rule: 15 grams of carbohydrates followed by a blood sugar check 15 minutes later, repeated until your blood sugar returns to normal.⁴ Even the most easily absorbed sugars can take 15 or 20 minutes to start working, so don't overcompensate. Eat the recommended amount and relax to give it time to take effect.

Click here for a list of foods and drinks that can be used to treat low blood sugar, compliments of the American Diabetes Association.

¹_{American Diabetes Association. Hyperglycemia. Available at: http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/hyperglycemia.html. Accessed October 17, 2011.}

²_{American Diabetes Association. Common terms: F-K. Available at: http://www.diabetes.org/diabetes-basics/common-terms/common-terms-f-k.html. Accessed October 17, 2011.}

³_{American Diabetes Association. Hypoglycemia. Available at: http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/hypoglycemia-low-blood.html. Accessed October 17, 2011.}

⁴_{Medline Plus. 15/15 rule. Available at: http://www.nlm.nih.gov/medlineplus/ency/imagepages/19815.htm. Accessed October 17, 2011.}

Eating Food And Burning Food: Your Blood Sugar Control Tools

Thu, 15 Mar 2012 06:00:00 GMT

Part 3 of a series for people recently diagnosed with diabetes

Why is it that people who live on the Japanese island of Okinawa are incredibly healthy, even when they're 100 years old?¹ Why don't the French die of heart attacks nearly as often as Americans?²

When it comes to living a long, healthy life, diet and physical activity make all the difference. If you have diabetes, food and exercise mean even more to you. For more than 80 years, the core treatment for diabetes has remained the same: diet, exercise and, if needed, medication.

By now, you've realized that nothing happens in a vacuum. Everything you do affects everything else. Food raises your blood sugar. Exercise lowers it. Plus, exercise can make you more sensitive to insulin, so the better shape you're in, the less insulin you may need.³

In addition to helping prevent long-term health problems, researchers have found that effective blood sugar control can actually translate into a more positive perception of quality of life.⁴

So how can you make food and activity work harder for you?

Ask your doctor to recommend a registered dietitian who can help you craft a meal plan that reflects your personal tastes and routines. Learn how to be flexible, incorporating new foods and allowing yourself to enjoy dining out and attending events
Find ways to exercise that you truly enjoy and stick with them. It's not just people with diabetes—just about everyone tends to start exercise programs, only to abandon them when they get boring. Sign up for a class, hire a trainer or enlist a friend to keep it interesting

See how other people with diabetes stay on target with food and exercise. Let them inspire you to take control of your diabetes. After all, how good you feel is—in large part—up to you.

Check out:

Living in Progress, Ginger Viera's blog about living with diabetes and being a record-setting powerlifter
Recipes at Diabetes Daily, crafted by Elizabeth Edelman. You can even download her free cookbook

¹_{Okinawa Centenarian Study. Home page. Available at: http://okicent.org/. Accessed October 17, 2011.}

²_{NationMaster.com. Health statistics: heart disease deaths (most recent) by country. Available at: http://www.nationmaster.com/graph/hea_hea_dis_dea-health-heart-disease-deaths. Accessed October 17, 2011.}

³_{American Diabetes Association. Top 10 benefits of being active. Available at: http://www.diabetes.org/food-and-fitness/fitness/fitness-management/top-10-benefits-of-being.html. Accessed October 17, 2011.}

⁴_{American Medical Association. Health economic benefits and quality of life during improved glycemic control in patients with type 2 diabetes mellitus: a randomized, controlled, double-blind trial. JAMA. 1998;280:1490-1496. Available at: http://jama.ama-assn.org/cgi/content/abstract/280/17/1490. Accessed October 17, 2011.}

What's Your Type?

Tue, 13 Mar 2012 06:00:00 GMT

Part 2 of a series for people recently diagnosed with diabetes

When people talk about diabetes, they're always referring to the "type." Unfortunately, they don't often explain what those types are and why they're important. So we thought we'd describe the two most common types here, in English, to help make it all a little clearer. (And if you already know all this, forward it to friends and family who don't.)

Type 1 diabetes
Developing most often in children and young adults, only 5-10% of people with diabetes have type 1.¹ Type 1 diabetes means your pancreas doesn't manufacture the insulin necessary for helping the body use blood sugar for energy. That's why people with type 1 diabetes have to "take" insulin through injections or an insulin pump.

Type 2 diabetes
Accounting for the majority of those with diabetes, type 2 occurs when a person's pancreas creates some insulin, but their body doesn't respond to it correctly.¹ Normally, insulin is the key that lets glucose into cells for energy. In type 2 diabetes, not enough insulin is available to unlock the cells, so sugar remains in the bloodstream.

People are at higher risk for diabetes if they are older, overweight, don't get enough physical activity, have a close relative with diabetes, or are members of certain ethnic groups, such as African Americans, Latinos, Native Americans, Asian Americans or Pacific Islanders.¹

Two types—same upshot
No matter which type of diabetes a person has, it's all one disease with the same risks of short- and long-term complications. Even if the specifics of your treatment vary from someone else's, everyone with diabetes has to be especially cautious about cardiovascular health, potential foot problems, ongoing eye care and more.

Good day-to-day control of your blood sugar levels is the key. After all, complications are just a possibility—they're not inevitable. It's all up to you.

_{1National Diabetes Information Clearinghouse. Diabetes overview. Available at: http://diabetes.niddk.nih.gov/dm/pubs/overview/. Accessed October 17, 2011.}