Customizing hypoglycemia treatment

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Nobody likes being low.  Not only does it feel lousy, it can impair your thinking and make it hard to come up with a plan without “overshooting” and winding up way above target.  Lows impair your performance and can lead to accidents.  At best, they might leave you feeling a little bit awkward and embarrassed.

Over time, many people lose the ability to feel their lows.  The symptoms are your friend; they let you know that there is a problem that you need to fix.    Untreated lows are incredibly dangerous, to say the least.  Some people allow themselves to consistently run too high, preferring to risk complications rather than risk having lows.  Even if you don’t over-treat a low, you may wind up with high blood sugar due to the effect of counter-regulatory hormones.  Lows can also cause your stomach to empty faster than usual, resulting in a BG (blood glucose) spike.  And the extra calories it takes to treat a low…that can lead to weight gain.  It can be quite the juggling act!

Let’s start with the basics.  Insulin (and some oral medications) and exercise lower BG.  In larger quantities, alcoholic beverages eventually lower BG, although they may initially raise it.  Food and counter-regulatory hormones raise BG.  It’s important that basal insulin be well-set, so that it keeps BG at a reasonable level rather than allowing it to rise or fall.  Generally a BG under 70 mg/dl is considered hypoglycemia, although in pregnancy this number changes to 60, and we often use 80 in those who have hypoglycemia unawareness and for whom lows are more dangerous.    While it is not realistic to have tight BG control without ever experiencing a low, we do want to make sure lows occur fewer than three times per week, and that there are no severe lows.  It becomes a big problem when a low BG cannot be treated without the assistance of someone else.  Severe lows need to be treated with an injection of Glucagon.  Lilly even has an app for Glucagon injection to make it easier for someone to help in an emergency: .

Preventing lows is an important first step.

Keep the following in mind:

  • If you are taking glargine or detemir, there may be a time of the day where it’s necessary to have a few uncovered carbs to prevent lows–this is often the late afternoon.
  • Know how to navigate the effects of alcoholic beverages and exercise.
  • Make sure your correction factor/sensitivity is set properly, and realize that most people are more insulin sensitive in the overnight hours.  Set the I:C so the BG lands near your target 3-4 hours after the last bolus.  Typically different meals require different I:C ratios.
  • Have your BG targets set appropriately.
  • Account for Insulin on Board; pumps do this automatically, but with injections you must do this on your own (a good App is: RapidCalc Diabetes Manager
  • Make sure your carb counting is accurate.  Learn to use the extended bolus for slow-digesting foods or long duration meals (holiday time/picnics, etc).
  • Test frequently, or use a CGM.  Keep records that you can analyze for trends.
  • Pay attention to trends!  Repeated lows at the same time of day means that something isn’t working, and it needs to be changed.

Assuming that you have taken reasonable steps to avoid lows and the inevitable happens, what’s the best course of action to take?  That “Rule of 15″ where you are told to eat 15 gm of carb, wait 15 minutes, test BG, and treat again if still low…that’s not for Type 1s!  It’s more of a one-size-fits-all, and this is about customizing treatment.  So…

First, check the BG with a fingerstick (if possible) to verify the low and see how low you really are.  Then treat with a fast-acting, high glycemic index food, such as glucose tablets or gel, or a dextrose-based candy like Smarties or Sweet Tarts.  If you don’t have access to that, dry breakfast cereals, saltines and pretzels make for some of the better choices.  Milk and apple juice are actually lower on the glycemic index table and take longer to bring the BG up, despite what you may have been taught.  But…how many grams of carb do you need to use?  That’s the million dollar question!  The more you weigh, the less a gram of carb will raise your BG, thus a larger amount of carb will be needed.  The less you weigh, the more a gram of carb will raise your BG, and so a smaller amount will do the trick.  And the lower you are, the more carb you will need.

In general,

  • If you weigh 60 lbs or less, a gram of carb will raise the BG about 6-10 mg/dl
  • For 60-100 lbs, a gram of carb will raise the BG about 5 points
  • For 100-160 lbs., a gram of carb is good for about 4 points
  • For 160-220 lbs., it’s 3 points
  • If you are more than 220 lbs, assume 2 points

Remember, though, if you have insulin on board or have recently exercised, you will need to increase the treatment.  If you are low and are about to have a meal, simply enter the amount of carbs into your pump (preferably after the meal) along with the pre-meal BG value.  The pump will recommend an appropriate bolus, with adjustment made for the low BG.  The same holds true if you overtreat a low.  Collect all the empty food wrappers, count up all the carbs, and enter it into your pump along with the pre-treatment BG value to determine an appropriate bolus.

Checking your BG 15 minutes after treatment is a good idea, but don’t expect your BG to have returned to normal.  Even dextrose takes time to digest and absorb completely.  As long as your BG has begun to rise after 15 minutes, you should be fine.  No need to re-treat, as this will lead to overtreatment.

If you have a CGM (continuous glucose monitor), be sure to look at the trend.  If you are coming down slowly and not yet low, you can use a medium glycemic index food (which will digest slower, but prevent a further drop in BG), and use less of it.  On the other hand, a fast drop warrants aggressive treatment, so use the highest glycemic index food you can find, and make sure you take the full amount of carbs.

One more thing – don’t wait until you’re low to figure all this out.  Plan and prepare your treatments ahead of time so that it’s ready, willing and able to do the job when the time comes!

NOTE: Information posted on Suite D is not intended to be taken as medical advice. Always consult with your healthcare provider for questions and guidance on managing any health-related issues.

Reflecting On A Winter Of Up And Down Sugars And Emotions In The Wilderness

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(Note: Rachel Hemond, an 18-year-old from Acton, Mass., with Type 1 diabetes, spent five months in the Vermont wilderness, managing her blood sugar using the OmniPod System and with the support from a network of doctors, family, and friends. This is the last of a 10-part series of blogs Rachel wrote about her experiences.)

The Kroka Expedition canoes glide onto Lake Champlain, dwarfed by an expanse of water whose far side is nearly invisible. Our canoes, which carried us safely for many miles, seem suddenly inadequate and frail in the vast open water. We trade them for five-person rowboats made by the Lake Champlain Maritime Museum, beautifully crafted by one of their high school programs.

I am the captain of the Resilience, an apt name considering all it has taken to get me to this point. Good weather follows us along the lake, where I rise each morning as early as I can, watching the sun transform the waters from the deep blue-black of night to fiery red and orange to a cool, sweet blue. Long days of open water melt into one another in a sweet haze of sun and endless rowing. About halfway through the leg, we find harbor at Barn Rock, a camp perched high on a ridge that overlooks one of the narrowest parts of the lake.

Barn Rock is where we are to go out on our solos with only our sleeping bag and water bottle. We set off into the woods leaving behind food so that in emptiness we may fill our minds, leaving behind friends so that in silence we may find truth, leaving behind comfort so that in hardship we may find peace.

One by one, we step off the path and settle into the 10 feet that becomes home for the next 36 hours. I make my way down to the side of the water, sheltered in a little bay. Settling my sleeping bag into a small gap in the rocks, I take my journal down to the waterside, writing and relaxing in the warm sunlight. Checking my blood sugar hourly, I write everything down on a page of my journal, going back to the trail a few times to leave the notes so that my teachers can see them.

Because this is a fasting solo, I decide not to bring sugar tabs; instead, I set progressively lower temporary basal rates until, 24 hours in, I turn off all insulin delivery. I rely on the graphs that my PDM provided, watching for any sharp declines that would force me to break my fast.

But I stay in control, hovering around 90 for the majority of the second day and into the next morning. I could fast, despite my diabetes. No, not despite it. I can fast and be diabetic. I can row four six hours a day and be diabetic. I can survive in the frigid winter snows and be diabetic. Being diabetic does not keep me from doing anything, and having the time and space to search within myself by fasting emphasized what I have known all along; diabetes does not, and will never, define me.

We break our fast with a feast prepared by our teachers and accompanied by a sudden outpouring of stories and laughter. We’re happy to be together again after so long in solitude. Along with our new knowledge, we have a newfound appreciation for each other.
From rowing to biking, we move slowly back into civilization. Though biking is another weakness of mine, I am learning to love the crunch of tires over dirt roads, the smooth hum of rubber on concrete. Traveling from farm to farm, I keep my PDM in that same Pelican case that has accompanied me since we left Sky Meadow, though now it is more useful for its shock-absorbing capabilities, tied down with a mass of bungee cords to my bike rack.

I tailor my basal rates to each day of biking, using temp basals to account for sections that I know will be all uphill or, conversely, all glorious downhill. I find that, as I have adjusted to this way of travel, so have my blood sugars, and I am seldom out of my target range.

One last hill and we turn into Kroka. Six hundred miles and four months later, we are home. Our expedition is over, but a mad scramble of a week fat basecamp follows, with all of us working on independent projects. I’m clearing and mapping and blazing trails in Kroka’s woods to help others follow the paths that I did.

As the end of semester approaches, my semester mates and I cling together despite the increasing chaos as we try to pull together academics and crafts and all the other unfinished odds and ends. Our final night of semester is spent in the yurt where we first began. We have grown both as individuals and as a community. I could not have completed this semester without the knowledge that these 12 people supported me fully. Every time that I had to leave, every time that my blood sugars dove and soared and made me want to scream, I knew that they would hold me. They reminded me to test my blood sugar, mimicked my beeping pod so I wouldn’t ignore it, and carried my pods. They are what made the semester possible, more than any strength that I can claim.

Semester and we have scattered. The list of things I have learned from winter semester is endless. I can start a fire in the snow using a single match and a mountain of birch bark. I can sharpen an axe or a knife by hand. I can carry a canoe on my shoulders for miles, then paddle a network of rocks and branches that strive to overturn me. I can ski the length of Vermont.

But most importantly, I can find my own way through life. Semester has created a sort of internal compass to guides me through all that life can throw at me. As I step out into the world, it’s with confidence that I can navigate my future of blood sugars and mountaintops, pods and paths. I don’t yet know where my feet will take me, but it’s sure to be an incredible journey.

Carb counting beaver soup and learning to love early spring ‘swims’

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(Note: Rachel Hemond, an 18-year-old from Acton, Mass., with Type 1 diabetes, spent five months in the Vermont wilderness, managing her blood sugar using the OmniPod System and with the support from a network of doctors, family, and friends. This is the ninth of a 10-part series of blogs Rachel wrote about her experiences.)

The Sky Meadow Retreat Center at the end of the Kroka Expedition’s winter trail is heaven to us; beds and showers and warmth after a winter spent in the cold. We de-issue everything from winter trail, leaving behind skis and poles then joyously taking off the ever-cramping ski boots for the final time. The snow is slowly beginning to melt, but we aren’t ready to leave winter behind. Instead, we chase it up to northern Quebec, driving 14 hours up to the Cree cultural village of Oujé Bougamou.

In Cree, Oujé Bougoumou means “the place where people gather.” Appearing suddenly out of the vast tracts of spruce and jack pine, the community embodies its name. We are welcomed warmly, staying briefly in the town before traveling out into the bush with two elders who have agreed to share their lives with us.

Though we don’t change camp, we are always learning by watching our guides as they move about the camp scraping a moose hide or the gutting the fish we catch. On our first day, a few of us pluck and prepare six ptarmigan, a small white bird native to the area. We eat moose, goose, fish and beavers – even their tails – and stretch and dry the beavers’ pelts. Fishing is a central part of our life. We set nets under the ice catching pike, whitefish, and sucker fish.

Luckily for me, all meats are fairly similar in terms of carb-counting, but managing my diabetes in a culture different from mine is challenging. Beaver soup isn’t listed in the PDM’s food library.

Our life is relaxed, full of crafting and exploration by snow shoe. I spend a portion of my time running through my blood sugars and programs, making a few minor adjustments and allowing myself some degree of satisfaction that everything seems to be working. After 10 days, we say goodbye to Oujé and drive down through Quebec. Where, for the first time on expedition, I get very, very sick.

Almost everyone else in the group had been sick up in our bush camp. Through luck and some pretty stellar isolation tactics, a few other students and I escaped what we affectionately called the plague. Somewhat smugly, we occupied the back of the van on the drive to Quebec City. Then, one of us started throwing up and a sense of doom settled upon us like a shroud.

It hits me just as we enter a museum. I will spare you the details, but I was quickly reminded of how important it is to keep an eye on my blood sugars when I’m vomiting and feverishly burning carbs from my body. I set a lower temp basal, making sure I won’t have to force down glucose tabs when my stomach can’t even handle a few sips of water. Luckily for me, it is only a 24-hour bug so I am never all that concerned about ketones. I recover enough that the next day I don’t have to drive back to Sky Meadow with my head in a garbage bag.

Our return marks a transition symbolized by muddy roads and crocus blossoms; spring is coming to Vermont. With it come new jobs. I trade in my sewing machine for my pencil; I am the new storyteller (aka blogger) and take charge of logistics for our spring expedition.

In the midst of a whirlwind of preparation, we see our families and friends for the first time since early February. Well, I’ve seen mine more recently of course, when I went to visit my endocrinologist, but having them up at Sky Meadow with us enlivens our community and reminds us of the incredible support network that allows us to continue on our journey.

Too soon, we bid our families goodbye and plunge into the next phase of our trip. And I mean plunge in the literal sense; every day at Sky Meadow we jump into the nearby pond, which still has a few chunks of ice floating in it. The frigid water instantly and dramatically increases heart rate and breathing. It quickly becomes difficult to swim as muscles numb. We must learn to overcome the discomfort since our next leg is whitewater paddling. Some of the water is at least class-three rapids, so flipping is inevitable.

We had some trepidation as we arrived at our put-in near the head of the Lamoille River. A quick review of paddling techniques and we’re in the boats for a full day. My canoe flips within seconds of leaving the shore, dumping me unceremoniously into the ice melt. I swim the canoe to shore and my partner and I bail her out.

Fortunately, I assumed that I would be going for a swim and had taken precautions. My PDM and sugar tabs were in a water-proof Pelican case tied securely to the canoe. When we flipped her back over, everything was still there.

The day was very long and very cold. But it was exhilarating running a rapid too fast to think as rocks appear and disappear in the white spray. Everything is snapping into place just in time to guide your paddle as you bounce and roll down the white water. The split second between safety and flipping, the way that breath catches when dropping into a hole of recirculating water – these are the moments that I live for and the reason that, even though I am mildly hypothermic after a few more dunkings, I have a wide grin on my face. The water has energy that was missing in the long, frozen winter.

As we continue down the river, I am struck by the freedom of the spring. We are no longer immobile under layers of clothing, separated from our world by a mass of wool and down. We feel the sun on our faces, our world becomes the almost garish green of new growth. Our delight at the first green grass we see is surpassed only by the emergence of the first leaves, no bigger than a fingernail when we see them first, dew-covered and delicate. Free from worries of highs and lows, I float down the river with good blood sugars and good friends for company.

 (Next: Lake Champlain, end of the journey, and reflections.)



Highs on the Trail, Just Not the Right Kind

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(Note: Rachel Hemond, an 18-year-old from Acton, MA with Type 1 diabetes, spent five months in the Vermont wilderness, managing her blood sugar using the OmniPod System and with the support from a network of doctors, family, and friends. This is the eighth of a 10-part series of blogs Rachel wrote about her experiences.) 

Thanks to the habits I picked up on the trail, I am never still over the course of the 10 days back at the Kroka winter expedition’s basecamp.

I go into Boston to see a wonderful endocrinologist who helps me adjust every possible setting on my PDM.   It turns out the guesses I had made back in January about how my metabolism would adjust were completely off, so everything from basal rates to correction factors has to change.

When I return to Kroka the next day, it is with a mind buzzing with ways to tweak the programming on my PDM on the trail if the highs continued. I have to put these into effect sooner than I expected, since for three or four days after that I still can’t get below 200. And since every day of high blood sugars is another day stuck at basecamp, I can’t help but hate my diabetes.

It is so easy to give in to that, to blame it for all of the problems and despise it for keeping me from the trail, from my friends, and from experiencing semester fully. But this anger isn’t productive, any more than the distracting “what ifs”: What if I weren’t diabetic? What if my blood sugar were just a little lower? What if I could be like everyone else? That line of thought is satisfying in its bitterness. I could have hidden in it forever. It isn’t hard to do – feeling like the world has wronged you and that diabetes is keeping you from achieving your dreams.

But as I think of it, what has diabetes kept me from doing? I have climbed mountains – crawled up them, in fact – with skis strapped to my back. I have crossed the Connecticut River on treacherous ice. I have skied down a waterfall, hearing the water run just inches away from the tips of my skis. I have cared for hypothermic friends on nights that dipped below -25°F; built a shelter in the woods with nothing but an ax and the forest around me; stayed awake an entire night feeding a fire so my companions could sleep warmly. I have sung, laughed and danced without diabetes stopping me. If anything, the knowledge that I have an excuse close at hand – I can’t do that, my blood sugar is low, so sorry – has made me determined never to use it and to go farther than everyone else because I have to prove to myself that diabetes doesn’t slow me down.

So, as I watch the sun sink below the horizon on my sixth day back at basecamp, I let all of my anger disappear with it. Even though it had felt good, for a time, to blame everything on my diabetes, I realize that to do so would be futile. I am diabetic. There is no separating me and my disease, but it doesn’t define me. I must learn to work with it and accept the challenge a doctor laid out for me all those years ago: “Don’t let diabetes take over; you still choose the direction of your life.”

Rachel smiling

I took the right direction by leaving trail and taking time for my personal care. Paths are seldom straight or perfect, and if it’s worth taking, it’s probably not easy.  Soon, I feel the joy of my first actual low blood sugar; hands shaking, stomach doing that lovely low-sugar samba. I can’t stop smiling. I go one day without being above 200. Two days. Then, at long last, I repack all of my gear and set back out into the wild.

The trail welcomes me back with the energy of movement and progress that comes from living with only what your carry on your back. When my group and I walk into Sky Meadow Retreat Center, the end of winter trail, I feel like flying.

I did it. Months after I left from basecamp, unsure and unaware of the challenges that I would face, I have learned to navigate my diabetes, and to love the mountains and twists and turns that make life worth living.

(Next: A change to the Quebec wilderness and a brush with non-diabetes-related illness.)

The Importance of the Diabetes Community Part 4: Believing and Improving

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Join Scott Benner, author of the award-winning parenting memoir, “Life Is Short, Laundry Is Eternal: Confessions of a Stay-At-Home Dad,” for a five-part series on how the diabetes community can help save, support, teach, improve and transform lives.

Support from the diabetes community did more for me than initially I expected it could. Not only did it help my family to live well, but it also gave my daughter better outcomes. And somewhere along the way my heart was remade. I was suddenly able to move on from the fear and anger that diagnosis brought, finally believing that I possessed the knowledge, support and fortitude to conquer our roadblocks. With my uncertainty lifted I was able to take what the community taught me and begin to use those tools to support a healthy life for my daughter and my family.

Please don’t get me wrong, we weren’t doing badly with what the doctor ordered, but when we mixed their guidance with peer support, more than a few wonderful things happened – a much lower A1c, the elimination of random highs and lows, more freedom and less stress are but a few of them.

There was a time that I wouldn’t pre bolus insulin, I would always underestimate carbs to be on “the safe side” and sleeping seemed like a luxury that I could not afford. The thought of leaving Arden, even for a moment felt ludicrous and I was certain that our lives were always going to be informed by fear. But then I found the diabetes community and they supported me in a way that taught me how to live again. Once I could believe that what they showed me was real, I was able to trust the idea that fear shouldn’t rule us and then I put that lesson into practice. Like in a fairy tale the darkness was lifted, diabetes and fear didn’t have to go together anymore and we were saved. Saved by the generosity of people who were willing to share their lives so we could live ours.

But as they say, the devil is in the details and this is the toughest step of your journey to take. It’s easy to tell someone to be bold when they manage diabetes and even comforting to witness another take that advice, but how do you make the leap in your own life? The answer is carefully and only when you are comfortable. But when that time comes, it’s about the best thing that you can imagine. It’s the difference between digging a pit with your hands and someone bringing you a backhoe and showing you how to use it. Relief doesn’t get sweeter than the kind that comes when you look diabetes in the face and say, “That’s enough, I’ll be taking our life back now!”

A diabetes diagnosis is shocking and being knocked over by it is understandable. Needing help getting up is human, taking time to learn the ropes makes sense and being apprehensive about fighting back is just part of the journey but it is a fight that when properly prepared for – you will win every time.

When I witnessed first-hand the possibilities that community support offered, I wanted very much to get past the part of our life where I was scared to try, because I was excited to get to the part where I would be able to thoughtfully offer my support to others. Sometimes I think that the desire to help others in the way that I was helped is what gave me the courage to meet diabetes head on without fear.

Costa Rica – a T1D reality check

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This past winter, my wife, Mollie, announced that we had been invited to her friend’s wedding in Costa Rica. Although I don’t typically jump at the opportunity to go to warm places, I knew my skimboard was begging to be utilized and I agreed.

One of the hardest parts was, for me, was dealing with sleeveless shirts and my insertion sites. It was so hot – so tank tops and board shorts were my uniform for the week. I’m normally all about educating others on T1D, but this wedding atmosphere wasn’t one filled with other diabetics like I’m used to… contrasting to say, a Riding On Insulin camp. And while most places I go, I’m able to cover up my sites and no one knows any different, there were a lot of questions about my OmniPod and my CGM site on this trip.

A particularly memorable comment:

[Girl in the wedding party points to the pod on my arm] “Is that one of those locater beacons?”

At first I was angry. Why didn’t this person realize that my Pod is a serious medical device that keeps me alive? It didn’t take too long to remember that moments like this are not unique to me. We – as T1Ds – deal with these instances all the time. Although that didn’t change the fact that I wished for a minute I didn’t have to deal with it, I took an ego check and took to educating whoever inquired about my “strange devices” at the wedding. Mollie was great at doing the same, while she was with me, and without me. After a few days, the group was accustomed to T1D just like any other place I go.

Highs on the Trail, Just Not the Right Kind

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 (Note: Rachel Hemond, an 18-year-old from Acton, MA with Type 1 diabetes, spent five months in the Vermont wilderness, managing her blood sugar using the OmniPod System and with the support from a network of doctors, family, and friends. This is the seventh in a 10-part series of blogs Rachel wrote about her experiences.)

Layover: a delightful, warm, clean indoor place where a bunch of cold, dirty, hungry semester students take up residence for a day and two nights and frantically organize everything for the next leg of the Kroka winter semester journey. For me, this means checking all my diabetes supplies, sewing four more holders for my OmniPod insulin pumps, and pressing four more of my semester mates into service carrying them for me. When we leave on March 1, my 18th birthday, I am full of excitement for a leg of our trek through the Vermont wilderness free from diabetic-related worry.

But the best laid plans tend to go awry. The problem started innocuously enough. Even though everyone had lost weight on our first leg, most leveled out on this second leg of the expedition. With the exception of myself and three boys, everyone else was putting on muscle.

Snowshoeing (1)

I wouldn’t care all that much, except for the fact that losing weight on winter trail is a serious strength sapper. The four of us are given chunks of raw butter every now and then to add to meals that already totaled between 5,000 and 6,000 calories per day. But it is soon evident that in my case, at least, calories are not the problem.; instead, my blood sugars are to blame. It is my blood sugar.

Absently flicking through my records about halfway through the leg, I notice an alarming trend; my blood sugars had not been within my target, 120-150, for weeks.

Though this may not seem all that terrible, let me give this a bit of context. At home and ever since diagnosis, I have been in excellent control of my blood sugars. My A1C has been 5.9 at its best, and always below 6.2, rarely above 6.5.  My blood sugars are almost always in range, tending to be low if anything. Before expedition, a single reading above 200 would have sent me into a vague but very real panic. And now, stuck in the middle of the remote Vermont wilderness with no way to call in to my doctors and nobody in the group who knew enough to help me, I can’t seem to get my blood sugar below 200.

I change my basals first, then start to experiment with my carb-to-insulin ratios and correction factors. But at the same time, I know I can’t afford to be low while we’re on trail. It would mean 15 minutes of sitting still in the cold, holding up the group, and being shaky for the next half hour or so. Even worse was the idea that, in the fatigue of going up a hill or the adrenalin of going down one, I wouldn’t notice a low until it was too late.

In short, I am so afraid of going low that my attempts to decrease the high blood sugars are crippled from the start. Worrying about my blood sugars consumes more and more of my day, to the extent that I nearly have a panic attack one morning. I have to take off my backpack, sit down and drink hot water from a thermos before I can breathe again. It is clear that something has to change.

I need to break the cycle of fear that has begun to take over my life – fear of my own body and the blood sugars that I just can’t seem to get a handle on. The anxiety and highs are clouding my mind and slowing down my body. I know that I have to leave trail for a second time.

I corner teachers and friends, talking through all of my options and searching for one that doesn’t involve leaving trail. I try checking my blood sugar every hour for a few days, monitoring ups and, well, more ups. I adjust settings, but to no avail.

Finally, I am forced to look at my position logically. I read and re-read the graphs of blood sugars on my PDM, check the statistics it spits out, realize that everything except my ego is telling me to go back to basecamp a second time. In the end, it is a competition between logic and ego. My entire life has centered on beating my diabetes, controlling it, not letting it take over my life and yet here I am in a potentially life threatening situation where such an attitude is no longer viable. I mope around for the last few days, knowing the decision I must make.

And so, after our second leg is completed, I go home to Kroka, leaving my semester behind for a second time.

(Next: Adjusting sugars and attitude pays off.)


The Mystery of the Freezing Pods

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(Note: Rachel Hemond, an 18-year-old from Acton, MA with Type 1 diabetes, spent five months in the Vermont wilderness, managing her blood sugar using the OmniPod System and with the support from a network of doctors, family, and friends. This is the sixth in a 10-part series of blogs Rachel wrote about her experiences.)

Though my diabetes seems to be ready to head out on my winter expedition with the Kroka program, my body is not.


Skiing quickly becomes my greatest foe. I can’t get the hang of it, despite days spent at the local cross country and downhill ski areas. Uphills I can do relatively well, though they are of course relatively exhausting. Wide, flat tracks are friendly too. But stick me on a downhill and I go into an intense snowplow position, sliding down the hill at what feels to me like a tremendous speed, but is in fact an inchworm’s pace. Add a backpack and most of my time on the hill is spent tumbling, sliding and bruising.


In spite of my skiing difficulties, everything else is in order to start the expedition. Backpacks are packed, sitting in an expectant row. Food has been divvied up, skis waxed one last time, final preparations made and remade.

We wake on the morning of our departure to the wing-soft sound of falling snow and churn into motion. We say goodbye to Kroka basecamp and turn to the fresh snow.

The days on winter trails are endless at first, a blur of exhaustion and frozen fingers. Even though my pack is lighter than nearly everyone else’s, I can’t keep up. Skiing is still a challenge, but slowly, ever so slowly, I begin to find it familiar.

My effort pays off. It is impossible not to love the Vermont wilderness in deep snow and I immersed wrong tense myself in it. We sleep in an oval tent staked down with our skis and floored with boughs of spruce, hemlock, or fir. We rely on our surroundings for wood, water, and comfort. The cold is like another member of our group. Life becomes motion; we have no other option, surrounded as we are by bitter chill. I grow used to the cold, as one can become accustomed to the sound of a highway or the smell of a farm. It is just a part of life: unavoidable and, in the end, not all that terrible.

Perhaps it is this mentality of acceptance and ease that led me into a trap, or maybe I just lacked foresight. Whichever it was, I soon learned that although humans can adapt to the cold, machines cannot. After my first OmniPod change on trail, huddled next to the stove, switching my pod to the other arm as fast as I could before I got too cold, my pods begin to die, one a day.

I start playing ridiculous mind games: If I make it up this hill without falling, my pod won’t die today. Or: If I gather firewood in this much time, my pod won’t die today. Of course, it’s futile. Sometimes a pod fails while we are skiing, sometimes while I am setting up camp. After the first failure I realize that to change my pod outside the warmth of the tent is to invite hypothermia; being still in below zero temperatures is not a risk worth taking. So I put off changing pods for hours, knowing that my blood sugar is rising but that there is nothing I can do.

Soon, the skin on my arms begins to show the wear of having adhesive ripped off every day and of unhealed cannula marks. There is nowhere else I can put the pods other than on my arms. The massive backpacks that we wear make it impossible to put anything on my hips and stomach, since the waist-strap rides exactly where I would place a pod. About halfway through the first leg, I realize that I cannot stay on trail. I have to return to basecamp to figure out the mystery of the dying pods.

And so I leave, return to Kroka for a few days. Placing call after call, I talk with Insulet, my doctors, everyone I can think of. I order an entirely new set of pods that get to me the next day, suspecting that the last lot is bad. But while out skiing one afternoon, I realize my error.

Even though the pod on my body is warm, the rest were sitting in my backpack in subzero temperatures for days on end, then put right to work with no re-warming. I decide to try an experiment since I’m sick of being off-trail. Finding a few scraps of an old sweater, I sew a pod holder.

The idea is fairly simple; I need to carry all of my pods on my body, not just the one I’m actually using so that their circuitry never gets below freezing. My body heat would keep them from getting too cold during the day, and I could sleep with the bag of pods at night just as I already did with my PDM and insulin. The problem was not with the pods themselves, but with my own folly in leaving them out and unprotected.

There is only one problem; I have to assume that my pods would continue to die every day, since a little bit of pessimism is required in wilderness medicine. This means that I would need to carry a minimum of six pods with me for the rest of the leg, and anywhere from fourteen to eighteen on the next two.

There is no way to carry that many pods and still be able to move. Also, the fact that I cannot ski for more than half an hour without falling made me decide that it is best not to put all my eggs in one basket – or in my case, all my pods on one tumble-prone skier.

So I sew another pod carrier, this one out of a scrap of sweater. Podholder 2.0 has no tougher exterior like my earlier prototype; I realized the only thing the rougher fabric did was make the package scratchy and annoying to wear directly on my skin. It holds three pods, four in a pinch.

After just a few days I rejoin my group, conning a few of my unwitting friends into agreeing to be pod-carriers. Lo and behold, the ridiculous-looking contraption works and we make it to our first layover, pods happily functional once more.

(Next: More sugar management challenges and another hiatus from the trail.)



Preparing to Hit the Trail with Skis and Syrup

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(Note: Rachel Hemond, an 18-year-old from Acton, MA with Type 1 diabetes, spent five months in the Vermont wilderness, managing her blood sugar using the OmniPod System and with the support from a network of doctors, family, and friends. This is the fifth in a 10-part series of blogs Rachel wrote about her experiences.)

I pick my way along the path, headed for the glowing warmth of the yurt that is to become the classroom, living space, and kitchen at the Kroka Expedition basecamp for the next five months of winter. A few other students have arrived and we are given small tasks to keep us busy for the two hours before lunch. I help lay hemlock boughs on the floor of our dwelling until we are called back to the yurt for a final meal with our families before they leave and we move on, walking into the snow-dusted forest.

Our lives settle into a rhythm, but not so much that we grow bored or restless. Mornings begin with a song from the teachers to wake us up. We don’t have watches, but from the sun’s position on the edge of the horizon we know it’s about 5:30 or 6:00 a.m. We trundle from our dwellings – nicknamed hobbit holes – to the yurt, breath freezing on hair and eyelashes like droplets of crystal. The woodstove in the yurt is lit and we gnaw drowsily on apple and cheese to tide us over until breakfast. I warm my hands before testing my blood sugar since circulation to my hands decreases overnight due to the cold.

We head out to do chores, which range from splitting wood to taking care of the farm to cooking our meals for the day. An hour later, we return to the yurt to eat and plan for the rest of our day to prepare for our expedition. On one day, we’re in the basement, pinning and cutting to the hum of sewing machines as anoraks slowly take shape beneath the needles while other days might find us deep in the woods, felling hemlock trees to re-floor our dwelling and learn forestry. Knife making in the workshop, math classes in the yurt, setting up the tent and lighting fires in snowdrifts and dehydrating the mountains of necessary food make up our days.

We also have big jobs that center around some aspect of the expedition. Food managers dehydrate vegetables and fruit and jerkies and make menus. The navigator pencils our route onto the maps. I, the sewing manager, make endless pairs of mitten shells. Not exactly the most thrilling of jobs, but there is a beautiful, simple satisfaction about making something useful and practical with nothing but a pattern and a needle.

Lunch is followed by another block of preparing for the expedition followed by “Push-ups and Poetry,” a combination of calisthenics and literature where we read a poem or essay, do a round of push-ups or jumping jacks or sit ups, discuss the aforementioned writing, do more crunches or leg-lifts or squats, write our response to the reading, and so on and so forth.

The end of the day is for evening meeting, where we check in on individual and group health before returning to our dwellings as the ice-crusted snow glitters in the moonlight. Our day’s work leaves us exhausted yet satisfied.

For the most part basecamp is a time of relative inactivity, which means I have little trouble with my blood sugars. A few nights in, however, I notice that I’m low in the mornings. This is not a problem when I’m home and eat breakfast right after waking up, but at Kroka it means that I am late for chores because I’m stuck in the yurt waiting for my sugars to climb back up. Soon enough, I realize the reason; I’m “sleeping cold” after an entire life spent sleeping in a house that is always the perfect temperature. Now my body is the heating system and works even while the rest of me is asleep, chewing through my blood.

Once I sort this out, I just fiddle around with my basal rate. First, I set different temp basals of 50 percent decrease, then 70 percent when the former didn’t work as well as I need it to. At last, I get it right and change my basal program. I’ve learned that cold drops my blood sugars and to set lower temp basals whenever I know we would be outside for longer.

I re-do a lot of my earlier pack out as well, recognizing that I had missed a few key concepts when packing in December at home. I hadn’t thought about water, for instance, and if you’ve ever tried to eat a sugar tab when you’re dehydrated, you understand why not having any is a problem.

But I would be in Vermont, and Vermont means maple syrup. Easily carried in Nalgene bottles, and freeze-resistant, it is the ideal substitute for glucose tablets. And of course the small child inside me delights in the idea of drinking maple syrup straight from the jug, so I pack out about twelve ounces per leg of expedition.

I was also using far less insulin than I’d anticipated, and far more test strips. I adjust their numbers accordingly and plan out when I need more pods and other diabetes-related necessities brought to me. I create a little pouch to carry my insulin, an ugly-yet-functional invention I am fairly proud of. It has a wool pocket big enough to hold two vials of insulin, four batteries, and my PDM (personal diabetes manager). A sleeve holds insulin pens in case of apocalyptic pod failure. The wool pocket is inside of a bag that I make out of a tougher fabric, with a long band that allows me to hang the whole thing around my neck. I can carry everything under my long underwear, right next to my body to keep it warm.

Finally, I line my supplies up with the food resupplies and our layovers, put the extra insulin in the fridge and everything else in a storage bay, and breathe a sigh of relief.

(Next: On the trail, discovering the limits of equipment in extreme cold.)

Temperature-Sensitive Stickers and This Blog Help Launch My Vermont Semester

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 (Note: Rachel Hemond, an 18-year-old from Acton, MA with Type 1 diabetes, spent five months in the Vermont wilderness, managing her blood sugar using the OmniPod System and with the support from a network of doctors, family, and friends. This is the fourth of a 10-part series of blogs Rachel wrote about her experiences.) 

rachel smiles 2After weeks of pondering deliberation, I had finally decided to spend the last semester of my senior year in high school at the Kroka winter semester program in Vermont. I convinced my guidance counselor it was a good idea; she helped convince the school administration to let me go and to graduate after spending five months in the winter woods she helped me convince the school administration that I should still graduate after spending five months in the woods instead of a classroom.

Then it was time to prepare for the trip, which included managing my Type 1 diabetes through extreme weather and intense physical activity.

I counted and calculated, collected a mountain of OmniPod insulin pumps, test strips, batteries, and back-up Personal Diabetes managers (PDMs). I packed extras of everything, anticipating that I would tear off pods by accident or lose them.

I knew that the insulin in my pods wouldn’t freeze due to its proximity to my body, but how could I be sure about the vials that I carried inside my many layers? If insulin freezes then thaws, it looks the same but all of the proteins have been denatured. I didn’t want to find out too late that the insulin I was pumping into my body wasn’t working.

My parents and I bought stickers that would indicate whether or not the vials’ temperatures had dipped below 32 degrees F. If they had, a bubble on the stickers would turn opaque and I would know I couldn’t trust the insulin. The labels on the pods said they could be stored below freezing, so I didn’t worry much about them. To keep my PDM and batteries safe, I kept them in my pockets, right up against my body. Finally, I assembled everything into smaller boxes to last me the length of a leg of our journey and labeled them. My diabetes packing was complete, allowing me to start thinking more seriously about what semester really would be; a step into a far more indepentant life, one that centered around my own personal journey.

With that in mind, I realized that I couldn’t let my parents pay for the Kroka semester program. It is intensely transformative and personal, completed only through hard work and focus. A journey like that has to come wholly from my own efforts. Letting my parents cover my tuition would have been easy, comfortable and dull – all of the things I was trying to escape. I needed to find another way.

As soon as I started thinking about how I could possibly raise enough money in two months to fund a $20,000 expedition, I had an idea. After spending a summer educating kids about my diabetes through the lens of my own experience, I knew the effect that sharing personal stories about diabetes could have.

The more I thought about it, the clearer it became. Using the OmniPod Systems had made being diabetic at Kroka possible so much easier. I would ask them to sponsor me; it seemed like the obvious choice. That’s how I ended up here, writing this blog.

And so I found myself standing beneath those same crabapple trees from years ago, back when I had first returned to Kroka after my diagnosis with diabetes. Now, it is winter; the trees are dusted in powdered sugar snow and ice coats the very tips of the branches. Footprints leading from the farmhouse to the camp point me in the right direction, though a biting wind blows snow across the boardwalk, threatening to obscure them.

That pit of anxiety I felt the last time I was under these trees had taken up what felt like a permanent residence in my stomach. I thought about turning around, going home to the warm and sweet comfort of my life. But something deep in my core resisted and I took that first crucial step towards the place and the people that would become my home over the next five months.

(Next: First taste of life in the open during a Vermont winter and adjusting to the elements.)


Deliberation, Decision, Determination

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Boats at sunset copy (1)(Note: Rachel Hemond, an 18-year-old from Acton, MA with Type 1 diabetes, spent five months in the Vermont wilderness, managing her blood sugar using the OmniPod System and with the support from a network of doctors, family, and friends. This is the third of a 10-part series of blogs Rachel wrote about her experiences.)

The second summer of my apprenticeship at the Kroka outdoor education program wound to a close and I returned to the everyday life of a high school senior: applying to colleges, looking for scholarships, balancing mountains of schoolwork with spending time with friends.

But I couldn’t seem to settle back into my life fully. Surrounded by good friends, challenging classes and good stable blood sugars thanks to the OmniPod System, I had grown comfortable. This very sense of ease left me, well, uneasy – and unwilling to resign my senior year to dullness.

In October, a close friend of mine mentioned that he had signed up for Kroka’s Vermont semester. Jokingly, I suggested that I do the program as well to keep an eye on him. We both laughed it off, and I returned to tests and homework and long nights in the library.

But the idea of a semester in Vermont with Kroka stuck in my mind. I’d drift off in the middle of physics class, imagining skiing down a craggy mountain and feeling the formula for acceleration rather than solving endless equations. In calculus I doodled hillsides covered in sketched-out spruce trees. Even in English, one of my favorite subjects, I would lose track of a lecture on Siddhartha because it reminded me of a discussion I’d had over the summer at Kroka.

So only a few weeks after the seed was planted into my mind, I knew I had to try to make the Vermont Semester possible. I set up a meeting with my guidance counselor, laid out a plan, and hoped for the best.

I was told no. No way could I get out of classes after only half a year and still graduate, no way could I skip the AP exams to go whitewater canoeing, no way could I be out in the wilderness when I should be deciding on colleges. No. Absolutely not.

Before getting rejected, I had treated the idea of semester as abstract, a sort of diversion from my more mundane concerns. But being shut down made me realize that Semester was more to me than skiing and heart-stopping, breath-stealing adventures; it represented a freedom that I had tasted in my summers with Kroka. It is the freedom of living simply but well, away from the constant background buzz of media and the superficial concerns that high school often includes. Being told ‘no’ only made the truth clearer to me: I needed this semester, needed fresh air and clean snow and the bite of winter to bring me back to life

But how to move forward? Well, in my case, it was a combination of determination, pig-headed stubbornness, and the hard work of an incredible group of people.

My counselor, seeing how important the winter semester was for me, rallied and convinced the higher-ups to hear me out, accept Kroka’s credits, and let me graduate. I talked to each of my teachers and received responses ranging from questions of my sanity to desire to join me, but all were enthusiastic.

School squared away at last, I filled out my paperwork and began the somewhat insane task of packing out everything that I would need for five months away from civilization.

(Next: Preparations and packing. How to keep insulin from freezing? Packing, preparing, and planning: Freezing insulin, resupply boxes, and Sharpie galore)


Confidence: The Courage of Starting Down the Road Less Traveled

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(Note: Rachel Hemond, an 18-year-old from Acton, MA with Type 1 diabetes, spent five months in the Vermont wilderness, managing her blood sugar using the OmniPod System and with the support from a network of doctors, family, and friends. This is the second of a 10-part series of blogs Rachel wrote about her experiences.)

Since doing a Kroka summer program just after my diagnosis with diabetes, the idea of a Semester-long program with Kroka lodged itself in my mind. After completing the two-week summer program and thriving despite my diabetes, the adventure of a five-month winter expedition seemed daunting yet also appealed to my thirst for challenge.

There was just one problem. In my mind, there was no way that I could ever get out of high school for an entire semester. I had my sights set high, filling my schedule with honors classes and AP exams and a good college so that I could one day pursue a career as a doctor. How could I possibly justify abandoning school for five months to go live in the woods? Moreover, how could I convince my school to let me? But worse than all those logistical questions was that, in the back of my mind, there was a voice whispering that being a Type 1 diabetic in extreme winter conditions would make such an adventure impossible.

For a long time I listened to those doubts and never seriously considered the semester program. Instead I simply returned to Kroka for one more year as a student, this time using the OmniPod System, which made a significant difference in my performance. My teachers, some of whom had seen my entire transition to diabetic life, noticed.

I didn’t go low in the middle of our long hikes because I created a basal program tailored to my activity. If I knew we were in for an especially intense day, I could set a temp basal, ensuring that I would run a little above my 100-120 target for a few hours. No more calculators and Post-it notes to lose and leave littered in every camp, since everything I needed was contained within my PDM device (or Personal Diabetes Manager.)

I didn’t have to rattle around with a sharps container for my discarded needles. This might seem like a small detail – nothing as important as keeping my blood sugars in control – but there is something so disheartening about feeling like a walking biohazard and expecting guys with hazmat suits to drop in on you every time you forget to close it properly. I was free, free to experience the trip without fear or nagging in the back of my mind.

The next two summers found me working as an apprentice at Kroka – a sort of teacher in training. This exposed me to something I’d never expected: questions about diabetes from my students.

For me, testing my blood sugars and changing my pod site and using my PDM were second nature. To them, it seemed foreign, confusing, and a little frightening. I found myself bombarded with questions, especially from the younger students: What are you doing? What’s wrong with you? Why? How does it work? And of course, the innocent yet always somewhat uncomfortable, if you’re diabetic, why aren’t you fat? Or, did you just eat too much sugar when you were little?

Somehow I’d forgotten that when I was diagnosed, I had the exact same misconceptions about Type 1 diabetes, the same biases and judgements. So instead of being upset, I took the opportunity to show my students what being diabetic really means, so that when they returned to their lives they could teach others what they learned.

I decided to just be open about being diabetic, as I was at home and with my friends. I never hid myself away while testing my blood sugars or counting carbs. I had my kit (my lancet, test strips, and PDM) out on my lap during mealtimes. Since we sit in a circle, this meant everyone could see what I was doing. I made it as casual as I could; nah, testing my blood sugar doesn’t hurt. Yeah, 180 is a little high but look, this is what I do to fix it, this is what I do when I eat and yes, I can eat that.

The dialogue varied among age groups. My 11-13 year olds were more immediate with their questions while the older students, 13-15 or 15-18, would watch me for a while before deciding that I wouldn’t be offended by whatever they asked. I was rewarded by their curiosity, the casual way that they’d ask how my blood sugars were that day, and how they explained me and my insulin pump to their parents at the end of the trip.

In hindsight, these informal lectures gave me confidence to talk freely about my diabetes so that I could feel comfortable sharing my experience. That comfort would become more and more important over the coming months as I set my sights on the five-month semester program in the winter woods of Vermont.

(Next: Rachel makes her decision about the winter semester and scrambles to figure out how to make it happen.)


Married with Type 1 Diabetes

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Getting married is a big deal to everyone. But getting married, balancing life as a married couple, and living with type 1 diabetes is even more difficult. We argue about things most newly married couples don’t even have to think about, let alone have to worry about.

I have been a type 1 diabetic since I was 9 years old. I claim to know how to control my blood sugar levels. My husband understands the frustrations I go through on a daily basis. Because he is fortunate enough to live without this disease, it is hard for him to completely comprehend what makes my blood sugars spike and drop so rapidly and so unpredictable.

My husband has always been very supportive in helping to manage my diabetes. When we first started dating, and before I got a CGM, I scared him half to death when I didn’t wake up one morning because of low blood sugar. He had to rush home from work, give me some juice and wait for my sugars to go back up. Ever since then, he has woken me up every morning before leaving for work to make sure I check my blood sugar level in front of him. We also mutually decided that it made sense to set an alarm at 3:00am to check my blood sugar. This way, we could both avoid further frustrations that type 1 diabetes has to offer.

Recently we got into an argument because of my OmniPod meter vibrating. I have an alert set to check my blood sugar for dinner at 6:30pm. By that point, I had already checked my blood sugar, bolused and we had already ate. My meter was tucked away in my purse, and I was in the other room completely oblivious to the vibrating noise. He kept hearing it. He was annoyed, and I told him to just turn it off. He refused.

He didn’t think its ‘right’ to go into a woman’s purse. I told him he had my permission to do so, and being that I am now his wife, he shouldn’t feel that way. Yet he still refused and continued to complain for me to turn it off. Annoyed and irritated, I dropped everything else I was working on and turned off the alert.

Since we are newlyweds, a lot of people surrounding us have asked when we are going to start a family. Neither of us is ready for the full time commitment of a baby right now, but we also know it is going to take a lot extra planning before we can even start trying. I have been trying to get my a1c number down significantly so I can get the green light from my endocrinologist and OBGYN. I have read up on what it takes to plan accordingly. With that being said, I have been testing my blood sugars more often and set the high & low limits on my CGM in tighter control. We have worked together to start eating better and more balanced food. We have worked together to get better blood sugar levels, and he has been on my butt even more about giving myself more insulin to avoid a high blood sugar.

In the last 3 months, my a1c has come down .6% (from a 7.4 to a 6.8). We both know it needs to be even lower before I can even think about stopping my birth control. For now, I am working on getting tighter control of my daily blood sugar levels, while he has become a great assistant in managing them. Without him yelling at me to “turn off my CGM” or to “check my blood sugar,” my blood sugars would still be as bad as they were when I was in college! Being newlyweds while trying to keep a much tighter control of my diabetes has been a positive learning curve for the both of us.


Learning to Accept Diabetes

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Acceptance doesn’t mean resignation; it means understanding that something is what it is and that there’s got to be a way through it.” –Michael J. Fox

Hello. Just to give you a quick background my name is Nicole Gabriela Scola and I am 19 years old. I am from Rhode Island (fun fact: it is the smallest state and has the longest name). I am currently a sophomore at Quinnipiac University where I play Division 1 Women’s golf and am pursuing a Finance degree in the School of Businesses 3+1 MBA program. Some of my favorite hobbies are golf, swimming, hiking, anything adventurous, goofy or fun, and hanging out with friends. Oh and I have type 1 diabetes.

This blog entry has been, I guess, six years in the making, which is about the same amount of time that I have had diabetes. Honestly I delayed writing because I still haven’t figured out how diabetes works in my life, it just appeared one day and I’ve been finding ways to deal with it ever since.

Life is a series of natural and spontaneous changes. Don’t resist them; that only creates sorrow. Let reality be reality. Let things flow naturally forward in whatever way they like.” – Lao Tzu

I was diagnosed during a golf tournament when I was 13 years old. I remember sitting with my babysitter at the doctor’s office when my doctor came out and told me that the tests showed I have diabetes. The first year with diabetes was the worst I have experienced. I withdrew from friends, family, and activities that I enjoyed. I began to feel like an outcast and was labeled as the “sick kid” in school because of my daily trips to the nurse’s office. I began to resent diabetes, and constantly asked myself “Why me?”

Instead of asking the question why me, ask yourself instead why NOT me?” – Dad

When I got my first AIC tested and it came back at a 13 my doctor decided it was time for me to get my priorities in check. She scared me so much that I began checking my blood sugars 6-8 times a day, made anyone I came in contact with aware that I had this disease, and began living my life again.

Beginning high school was nerve wracking because it was the first time I was going to such a big school, with kids that could potentially bully me about my disease. I was pleasantly surprised with the amazing group of friends, faculty members, and nursing staff that surrounded me. Everyone was really accepting and treated me like a normal kid.

Going into the spring I decided to join the men’s golf team. I made it through try-outs and started playing as the number one spot on the team, from the boy’s tees. Boy did some of those guys get jealous! Again I worried about dealing with lows, or ketones, or insulin failure while being on the course. Again I was amazed with the community of people who surrounded and supported me. I created a routine of checking my blood sugar on course, always had tons of snacks (which made me popular with my playing partners), and drank plenty of water. I had not only a great experience on the golf team, but I played varsity all four years, was made captain by my sophomore year, and won girls states four years in a row. With a diligent work ethic to constantly make my health a priority, as well as alerting my parents or coaches if I needed anything, I was very easily able to adjust to the demands of high school.

One thing about championship teams is that they’re resilient. No matter what is thrown at them, no matter how deep the hole is, they find a way to bounce back and overcome adversity”- Nick Saban

Going off to college to play a Division 1 sport also faced its own challenges. A new environment, being away from home and parents, with different living and working schedules all posed their own unique challenges. And honestly freshman year I struggled to keep it all together. As I began playing for the team my game was probably the best it has ever been. I broke school records and was named the conference rookie of the year. At the same time I also had gained twenty pounds, was struggling to keep up with the nineteen credits I was taking, and wasn’t taking care of my diabetes. I constantly felt that wherever I succeeded in my life, there was another part of my life struggling to stay afloat.

I began seeing a therapist to help cope with all of the demands I was under. Working with her has changed my outlook on the obstacles that have formed in my life, and what outlook I should have on them. This year as a sophomore I have learned from my mistakes as a freshman. Shockingly, we cannot do it all! It is not possible to be superhuman! Some of the best advice I was given is that it is not necessary to be better than everyone else, but it is important to be YOUR best. This summer I dropped the weight I had gained. I now have all A’s. My golf game is going well, but will always be a work in progress-just like me! Importantly, my diabetes is back under control. It is amazing when I began to redirect my focus on the things that matter (health, happiness and school) how much better I felt.

Everyone is handed adversity in life. No one’s journey is easy. It’s how they handle it that makes people unique”- Kevin Conroy


Fashion Week with Diabetes

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Attending New York Fashion Week is a completely crazy experience by itself. Add diabetes into the mix, and things get just a little more complicated. But just like managing diabetes in any situation, I had to find a way to work around any potential obstacles while covering several shows for my fashion blog, The Aisle of Style.  The more things you experience with diabetes, the more knowledge you gain to help with future endeavors. My big concerns for this new adventure included when I would be eating, bringing food into venues that didn’t allow it, and of course, storing all my medical supplies in a fashionable bag!

Katie at Fashion Week_Small

A lot of venues don’t allow “outside food and drinks,” which as a diabetic, just isn’t reasonable.  I have found through past experiences that having a note from your doctor is very helpful in this situation.  If there is any hesitation at the door about whether or not you can bring in orange juice or snacks, just ask to speak to a manager. They are usually pretty good about it, and sometimes they have an employee who is a diabetic, so they get it. Honestly, there were no issues at Fashion Week and it was all smooth sailing, thankfully!

Another funny, but important concern to me was fashion and what I would be wearing. Fashion is obviously a huge part of the seven-day event, and I didn’t want to compromise that because I had a bag stuffed full of diabetes supplies and an insulin pump under my clothing.  Thankfully with the OmniPod’s small size, it was not even detectable underneath my sweater and coat, or any of the outfits that I wore inside the venues.

When it came to all of my testing supplies, emergency shots, and orange juice, I specifically picked out a cute and appropriate-sized bag for all of my stuff. I was carrying around a lot of things like passes, a notebook, and business cards, so my bag was fuller and more crowded than usual. I made sure everything I had was organized in my bag before going to each show, so I had a mental note of where my orange juice was located, along with anything else that I might need to find in a hurry.

Speaking of having to do things quickly, another advantage of the OmniPod was that I could test my blood sugar and give myself a bolus with just one device.  I didn’t have to dig a meter out of my bag to test, and then find a syringe to fill and inject my insulin. That would have been much too cumbersome and time-consuming for me.

I have to say that Fashion Week was not only a great experience, but it was an experience that went almost flawlessly, with no major “diabetes issues.” I really believe that you learn different things from every experience you have with diabetes, and my past trips had helped this one go smoothly. This time around I learned to keep higher carb snacks and more orange juice with me, because my blood sugar went low a few times due to all the running around.  Next time I will also cut my insulin ratio to prevent any unwanted lows. When it comes to supplies, I will carry a plastic bag with me to temporarily store test strips, trash, etc. so I can find things in my bag much quicker without granola bar wrappers getting in my way!




True North: Navigating the Diabetes Path

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Note: For a newly diagnosed Type 1 diabetic, learning to manage the disease is a seemingly endless loop of needles, measurements and dietary adjustments. Unwilling to mold her life around her diabetes, Rachel Hemond, now an 18-year-old Acton, MA resident, forged ahead with her dream to spend five months in the Vermont wilderness. Using the OmniPod System, and with the support from a network of doctors, family, and friends, she was able to manage her diabetes despite record low temperatures and a serious dislike of downhill skiing. But even more than that, she was able to strike a balance between accommodating rogue blood sugars and living an adventurous, fast-paced life. This is the first of a 10-part series of blogs Rachel wrote about her experiences with the Kroka Expedition Program. 

Sitting on a bench overlooking the Kroka Expeditions School campus, I tried to focus on the light filtering through the crabapple branches above me, the students moving through the fields, and the feeling of shaded grass against my bare soles. But none of that could untie the knot that had been growing in my stomach over the past few hours.

It was June 2011. Just a little more than a month earlier, I had been diagnosed with Type 1 diabetes at age 14. And ever since then, a terrifying question occupied my mind: can I continue with everything I loved to do, from lacrosse to theatre, if I was always preoccupied with carbs and calculations, shots and sugars? I thought I would have to give up, that my life as I’d known it was over.

But, in the midst of my fear, I recalled something one of my endocrinologists told me: “Don’t let diabetes take over; you still choose the direction of your life.”

A few short weeks after hearing those words, I waited in the early summer heat to talk to my trip leader, to convince her that diabetes wouldn’t be a problem on the expedition. But my words would seem like lies, sour in my mouth; keeping diabetes from interfering with my life seemed like an impossible task. How could I not let diabetes dictate my choices? Especially about Kroka, an intense wilderness summer camp and school. I had gone to Kroka for two years prior to my diagnosis, and I clung to it as a thread of continuity and a source of strength.

The woman who would lead my trip that summer arrived and we started to talk. She listened as I explained my diabetes and the shots and tedious calculations that went with it. When I left a few hours later, my guts had untied themselves and we had a plan for my return a few weeks later on a program called Wild Girls.

The trip went smoothly, with 12 girls and three teachers spending two weeks among trees and rivers, laughing and singing. I thrived, but my diabetes was always in the background. I gave myself shots in the meal circles, pulled out my calculator and Post-it notes to estimate my insulin intake. The long-term insulin’s inflexibility made it challenging to be active –paddling or hiking up to six hours per day – and I was always struggling to keep my blood sugars from dropping.

But the other students didn’t care that I had a broken pancreas, or that my fingers were covered in needle marks. We shared a grounded sense of solidity that comes from living in the woods.

It was on that trip that I heard of Kroka’s five month semester program. The teachers talked about traversing mountains on skis carrying heavy backpacks in the winter and floating home on spring-swollen rivers. My fellow Wild Girls talked about students becoming hypothermic and eating frozen sticks of butter to stay alive in the dead of winter.

It sounded perfect; I was hooked. Many obstacles lay before me, ranging from grades to managing my diabetes. But in the coming years, I pushed forward, finding technology and resources that allowed me to conquer the other peaks that lay between me and five months in the wilderness.

(Next: As Rachel grows more comfortable with her diabetes, the path to further adventures begins to clear.)



OmniPod Welcomes Asante Snap Patients

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Scott Benner, diabetes advocate and author of Arden’s Day, provides coverage of the OmniPod Welcome Program available to Asante Snap insulin pump users. See below for more information on the program.

Asante 1

The recent and unexpected closing of insulin pump manufacturer Asante has left users of their Snap insulin pump in search of a new way to deliver insulin.

In response to the news the makers of OmniPod have announced a welcome program for Snap users that includes a no-cost PDM and ten free pods.

If you are a Snap user who thinks that OmniPod may be the right choice there is no better time to make the move. If you meet the simple requirements listed in the image below, call 888-6-GETPOD to get started.

 Asante 2












Check out Scott’s original post here.

My Journey to Pump Therapy Part 6: The Benefits of Exercising with an Insulin Pump

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Check out the first five parts of Allison Nimlos’ series on her journey to starting on an insulin pump with type 1 diabetes.

Exercising-with-an-Insulin-PumpOne of the most noticeable benefits of using an insulin pump is when I’m exercising. Exercising is not something that comes naturally to me. I’ve never been an athletic person! So it’s easy to want to give up when it’s both hard on the body and hard on the diabetes. Luckily I’ve found that using an insulin pump has helped in many different ways as I try to stay active. Continue reading

Diabetes FingerPricks™: Diabetes Burnout

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Believe me, I’m no stranger to diabetes burnout. I get as tired of counting carbs, calibrating machines, testing blood sugars and evaluating situations as the next person. This is why it’s so strange to admit the following: the smell of insulin has never tired me. Getting sick on cotton candy or candy corn can give a lifelong aversion to even the smell of such foods; too much of a good thing – or bad thing – often puts a negative footprint on our mind. With all the ups and downs I’ve had as a person with diabetes, you’d think smelling insulin would be a gloomy trigger. Instead, the scent of insulin recalls sweet yet medicinal properties – like Band-Aids® – of which I have never wearied. Sure, it’s the associative hallmark of hospitals in general, but instead of making me anxious or panicky as you might expect, it actually soothes me somewhat, as though help is on the way. Funny how the brain works…

The Importance of the Diabetes Community Part 3: Teaching Possibilities

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Join Scott Benner, author of the award-winning parenting memoir, “Life Is Short, Laundry Is Eternal: Confessions of a Stay-At-Home Dad,” for a five-part series on how the diabetes community can help save, support, teach, improve and transform lives.

Scott-Benner-DOC-2Without the support and know-how of the people in the diabetes community, I may never have found OmniPod (the insulin pump my daughter uses), our ketone meter or the courage to best use them.

I look back now and wonder why I couldn’t see it sooner. I thought that the fear I was experiencing in the early days of my daughter’s diagnosis was from the diabetes, but it wasn’t. It was the uncertainty that scared me. Not knowing if I was about to inject too much insulin, count carbs incorrectly or any of the seemingly endless things that I didn’t feel I properly understood. The inability to have confidence in my actions made me afraid. Too many what ifs…

Meeting people who live with diabetes in their lives changed all of that for me. Being able to see others make choices that worked out was a huge relief, but when I saw that they were just as unsure as I was at some point, that was a game changer. I didn’t just not have to be perfect; it was okay not to be. Tomorrow would still come – the community was a glance at our future and our future was bright!

Educating Ourselves on Diabetes Management Options

The possibility that we were going to live well again opened my eyes to all other kinds of new and hopeful considerations. Continue reading

Cooking Diabetes-Friendly Meals

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The paleo recipe I am sharing today, as with most of my recipes, has evolved to include fresh fruits/vegetables, meats, eggs, herbs and spices, and oils in an attempt to replace the standard processed ingredients I used to cook with. Switching everything to almost entirely fresh ingredients has had an eye-opening effect on my blood sugar, lessening the drastic spikes and dips I saw before.

This has also brought a new appreciation of what consuming different foods and ingredients does to my blood sugar. The more I’ve cleaned the ingredients, the more I’ve been able to make a direct connection between the psychological impact of food consumption related to diabetes and blood sugar management.

The following recipe came together upon returning from a long vacation over the holidays to food that needed to be used (and without having to make a trip to buy groceries). The recipe is very comfort-food-like, easy and makes a home smell absolutely wonderful! It also reheated very well throughout the next couple of days. Continue reading

A Mother and Daughter’s Experience at the JDRF’s Children’s Congress

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You may think of the JDRF for their research for a cure for type 1 diabetes, their work with the artificial pancreas and their annual fundraising walks throughout the country. However, they also focus efforts on advocacy in the form of their Promise to Remember Me meetings with congressmen and women and their bi-annual Children’s Congress in Washington, D.C.

According to the JDRF website, “Every two years, more than 150 children living with type 1 diabetes (T1D) gather in Washington, D.C., to meet face-to-face with some of the top decision-makers in the U.S. government. The children, ages 4 to 17, represent all 50 states and the District of Columbia. The delegates in JDRF’s Children’s Congress enjoy a once-in-a-lifetime opportunity to help Members of Congress understand what life with T1D is like and why research to fund life-changing therapies until a cure can be found is so critical. They speak up on behalf of the millions of people living with T1D and the families and friends who love them.”

Hallie-and-AveryAvery Addington and her mom Hallie, author of the website [wp_colorbox_media url="#inline_content1" type="inline" hyperlink="The Princess and the Pump"], were chosen to attend JDRF’s Children’s Congress a few years ago when Avery was seven years old. They share their experience with us below. First we hear from Hallie.

 Leighann:  In what ways, if any, are you active with your local JDRF chapter?

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Hallie:  I am a board member for our local JDRF. In the past, I was the Government Relations person for our chapter. I’m now on our advisory council and am involved in lots of different events like the walks, galas and other outreach events. I’m also a mentor and Avery is a youth ambassador.

Leighann:  What made you and Avery interested in applying for the Children’s Congress?

Hallie:  Avery fell in love with Washington, D.C. when she went to Government Day with me when I was the Government Relations person for our chapter. Continue reading

Sean Busby’s Diabetes Heroes Series: Todd Melinn

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In a series of 12 episodes, Suite D is featuring interviews between professional snowboarder Sean Busby and inspirational people in the diabetes community. In the twelfth episode, Sean interviews Todd Melinn, Sean’s former snowboarding coach who has had diabetes for the last 28 years. If you have a diabetes hero you’d like us to spotlight, please e-mail

Todd Melinn was diagnosed with type 1 diabetes in 1984 and started snowboarding that same year. For 30 years, snowboarding has been connected to Todd’s life in some way. Whether that was moving his way up from working at the first snowboard shop in Wrightwood, California, to being a snow maker, a lift operator, a lift mechanic, the founder/original designer of the Faultine Terrain Parks at Mountain High Ski/Snowboard Resort, co-founder of Active Mail Order and then a coach, Todd has found a way to incorporate snowboarding into his daily routine and job for many years.

The story of Todd comes full circle with Sean Busby. Todd happened to be Sean’s first snowboard coach years before Sean was ever diagnosed with type 1 diabetes. Sean credits Todd and Todd’s friend and co-coach, John, for enabling him to become a professional snowboarder. Continue reading

Things to Consider when Upgrading your Insulin Pump

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- Lisa Foster-McNulty, RN, MSN, CDE

Every four years, we are asked to vote on who will become the next president.  If you wear an insulin pump, every four years your warranty will run. You get to exercise your right to continue with what is familiar – or jump over to something that is different and potentially a better choice for you! Either way, it’s not a decision to be made lightly. You’ll want to start thinking about this at least a few months before your warranty ends so that you have time to do your research. It can be helpful to have some idea of what points you’ll need to consider.

Do your Research

If you are very satisfied with your current pump, it may be a no-brainer to simply continue to use the same product. But what if you think that there may be something else out there that you’d prefer over your current pump? Continue reading

Diabetes and Special Occasions: The Gift of Technology

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Check out 14-year-old Summer Asman’s experiences managing diabetes during special occasions. Do you have an interesting experience you would like to share with Suite D? Reach out to us at

Diabetes-and-Special-OccasionsBefore diabetes, I used to love all of the desserts provided at special occasions, but now I dread eating dessert with people who don’t understand type 1 diabetes. It is hard to eat with people without diabetes. I try not to be jealous when I watch them stuff their faces with hundreds of delicious, sugary carbs (like I used to do) and I have to sit there and refrain from eating as many as them.

Celebrating events with my family is especially hard, because my cousins, uncles and aunts don’t understand. They bake pies and cookies, and they eat with ice cream and pudding. It takes a lot of will power for me to only eat my “sensible” portion of cake! Sometimes I wish my relatives wouldn’t bring so many different kinds of cakes and pies, and eat a little bit of each. They don’t understand how I feel watching them eat. How do I feel? Jealous, frustrated, hurt – and then guilty that I feel that way! Continue reading

Diabetes FingerPricks™: Love for your Insulin Pump

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If only diabetes technology could save us from those awkward situations such as unrequited love! I’ll give credit where credit is due, by all means, but I don’t think we’re there just yet. On this Valentine’s Day let us be thankful for the love we give and love we get (or hope to give or want to get), including that little bundle of parts and batteries that keeps us going.

Click here to try a free Demo of the OmniPod insulin pump.

The Importance of the Diabetes Community Part 2: Finding Support

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Join Scott Benner, author of the award-winning parenting memoir, “Life Is Short, Laundry Is Eternal: Confessions of a Stay-At-Home Dad,” for a five-part series on how the diabetes community can help save, support, teach, improve and transform lives. Check out the first entry here.

My bedroom was pitch black and the house completely silent. It was well after three in the morning and I hadn’t been to sleep. My belief that my daughter Arden’s blood sugar would rise to a safe level was tenuous that evening so I was watching over her even more than usual.

When I fall asleep the likelihood of me waking up when I need to is slim. So on nights like this one I tend to just stay up. This night happened before we became continuous glucose monitor users and I would periodically walk from my room to hers to check her blood sugar. Each time I climbed back into bed, I became a little less certain that I could stay awake. Because my wife was sleeping I was trying to stay still, my eyes were sore from a long day that was getting longer. I had to stop watching television on my laptop, because it felt like there was sand in my eyes. I was exhausted, bleary-eyed and pretty sure that I was about to nod off – so I opened my Twitter app and, perhaps out of desperation to stay awake or maybe in an effort to not fall apart, I told who ever may be out there what was happening.






A few silent minutes later, I received a response from a woman whom I’d never met. Continue reading

My Journey to Pump Therapy Part 5: Why OmniPod?

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Check out the first four parts of Allison Nimlos’ series on her journey to starting on an insulin pump with type 1 diabetes.

The OmniPod was not my first insulin pump. When I first went on a pump in 2000, there were only two options. I was using another pump for about 12 years when I decided to take an impromptu pump vacation. It ended up lasting about 16 months, so perhaps it was more like a pump sabbatical.

I eventually decided to resume life as a pumper, because I knew that my diabetes management would be better and easier for me. I loathed taking frequent insulin injections and I didn’t have the flexibility to increase my background insulin when I needed it, leaving me too high or too low too often. I thought about returning to the original pump I had been on, but I decided to do some investigating into the other pumps that had since come to the market. There were now several popular insulin pumps to choose from. Which one was going to be right for me? Continue reading

Sisterly Support for Women with Diabetes

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When a person is diagnosed with diabetes, they get directives from their endocrinologist and Certified Diabetes Educator (CDE) on how to manage their diabetes. But successfully managing diabetes goes way beyond insulin-to-carb ratios, basal rates and carb counting. Finding support from others who “get it” can help us on levels far beyond what a medical professional can offer. One organization that is helping women of all ages with all types of diabetes find support is DiabetesSisters. Brandy Barnes is the founder of DiabetesSisters and author of the book [wp_colorbox_media url="#inline_content1" type="inline" hyperlink="A Woman’s Guide to Diabetes: A Path to Wellness"], which she co-wrote with Suite D contributor Natalie Strand. Check out my Q&A with Brandy below, as she shares more about DiabetesSisters and how women can find support.

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Leighann:  Why did you start DiabetesSisters and how has it grown?

Brandy-BarnesBrandy:  I started DiabetesSisters in January of 2008 after my own unsuccessful experiences in trying to find other women with diabetes to talk through problems and share life with. Throughout college and early adulthood, I dreamt of a friendship with another female who understood what life was like with diabetes. Unfortunately, I was not able to find it. Continue reading

Sean Busby’s Diabetes Heroes Series: Gavin Deutscher

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In a series of 12 episodes, Suite D is featuring interviews between professional snowboarder Sean Busby and inspirational people in the diabetes community. In the eleventh episode, Sean interviews Gavin Deutscher, an 18-year-old volunteer with Riding On Insulin. If you have a diabetes hero you’d like us to spotlight, please email

Gavin Deutscher is 18 years old and has had type 1 diabetes for seven years. Sean first met Gavin many years ago when he was giving a diabetes presentation in Canada. During that presentation, Gavin recalls Sean speaking about not allowing type 1 diabetes to hold you back and the importance of following your passions and goals. Gavin took that advice and turned his passion for snowboarding into a career. Gavin has now been a snowboarder for 12 years and is going into his fourth year as a snowboard instructor (Canadian Association of Snowboard Instructors Level 2 and Park 1). When not on the mountain, Gavin can also be found studying Information Technology and living in Ontario, Canada.

Since being diagnosed with diabetes, he has never let it hinder or limit him. Continue reading

A Look into the Diabetes Dark Ages

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I’m incredibly grateful to have access to diabetes technology and my current and future health has directly benefited from said technology. Diabetes technology isn’t always perfect and there are moments that I complain about it, LOUDLY, and there have been moments where I’ve come close to throwing my D-technology against the wall or out the window! Do I want quicker turnaround times for diabetes technologies and scientific breakthroughs?  You bet I do and I’ll absolutely fight for those technologies and scientific breakthroughs! BUT, I’ll never take diabetes-related technology/breakthroughs for granted, because I remember when diabetes technology (if you can even call it that) was downright archaic.

I was diagnosed with diabetes 37 years ago, at the tail end of the [wp_colorbox_media url="#inline_content1" type="inline" hyperlink="Diabetes Dark Ages"], and it wasn’t easy. Continue reading

Thriving with Diabetes: Synchronized Swimming

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In Suite D, we like to share inspirational stories of people who are not only living well with diabetes, but also thriving with it. In a “Thriving with Diabetes” series, we will be showcasing people who have turned their diabetes diagnosis into a strength and form of motivation. If you, or someone you know, fit that description, please e-mail to share your story.

My name is Gabriella Sajedi. I am 12 years old and I am in 7th grade. I was diagnosed with type 1 diabetes just three days after my fifth birthday. I wasn’t feeling well for a couple of days and my mom thought I had a virus until she found me asleep on my family room floor. She brought me in to see my pediatrician and he immediately told my mom I had diabetes and that I needed to get to an emergency room as soon as possible.

After being stabilized at our local hospital, I was sent by ambulance to Children’s Hospital in Boston where I fought for my life for six days. I was really sick and in diabetic ketoacidosis. My body was shutting down and I remember being really scared. I didn’t understand what was happening to me and why everyone was so worried about me. In the hospital, my parents learned how to take care of me, how to give me insulin injections, how to count carbohydrates, how to use emergency glucagon and how to check my blood sugars. They told me this would be forever. I remember thinking, “Wow, forever!” I quickly adjusted to my “new life and my new normal.”

Synchronized Swimming with Diabetes

Gabriella-SajediI have been doing synchronized swimming since I was seven years old. I got started with the sport, because my mom was a synchronized swimmer when she was a kid. I like the sport, because I get to be with all my friends and I lose myself in my music. I like the competitions, especially trying out for the 11/12 Age Group National Team. In phase 1 of this competition, I scored 6th in the country for my age group!

Because I have diabetes, I always try to be prepared in case my blood sugar goes too low while I am swimming and competing, which could be very dangerous for me. My mom usually tells the lifeguards about my diabetes. Continue reading

Diabetes FingerPricks™: Keeping your Resolutions throughout the New Year

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You hear from various sources that resolutions at New Years are too difficult to keep. Such resolutions should therefore be avoided, as should all risk of failure, or potential achievement, this time of year. Therefore, these sources are saying, be noncommittal in self improvements and avoid exposure of weaknesses – if only to yourself – in the event something unpleasant should occur. So you don’t follow through.

I say what’s the harm in embracing the possibility of disappointment when the possibility of success (even in its simplest form, perhaps, like walking up a few flights of stairs) is also likely? If it takes a date on the calendar to make a few positive lifestyle changes then friggin’ go for it.

A few of my resolutions from recent years are listed below; I think my success rate on most was about 75%. Continue reading

The Importance of the Diabetes Community Part 1: How it Saved Our Family

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Join Scott Benner, author of the award-winning parenting memoir, “Life Is Short, Laundry Is Eternal: Confessions of a Stay-At-Home Dad,” for a five-part series on how the diabetes community can help save, support, teach, improve and transform lives.

Arden, with her mother Kelly, shortly after being diagnosed with type 1 diabetes at age two.

When my daughter Arden was diagnosed with type 1 diabetes in 2006, our family was violently thrown into a world that we didn’t understand. The days, weeks and months that followed were full of endless sadness, fear and moments that hindsight would later tell us we could have handled much better.

I’m choosing to share my largest diabetes misstep from that time in our lives, because it led me to what may be the most valuable discovery of my adult life. This is part one of my five-part series about community and how it will save, support, teach, improve and transform your life with diabetes. Continue reading

Helpful Tips for Wearing an Insulin Pump

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- Jennifer Smith, RD, LD, CDE

You’ve decided an insulin pump is the best option for precision in your diabetes management. The next big question that virtually every person with diabetes considers once you’ve decided to start pumping is, “How do I wear this thing?” This is of course specific to each and every person with diabetes.

Regardless of the brand of pump you’ve decided to use – one with tubing or a tubeless design – you still need to find that “sweet spot” for wearing it comfortably and possibly discreetly, depending on how comfortable you are showing the pump or wanting to conceal it for safety or personal reasons.

The following is a list of tips on how to wear, where to wear and what to do with a pump once you’ve got it on your body! Continue reading

Ask Tony and Diane Series: A Familiar Diagnosis

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In a series of 12 episodes, diabetes community leaders and husband and wife Tony and Diane Cervati are addressing various topics focusing on relationship and family dynamics with diabetes. Tony, founder of the Type1Rider organization, has been living with type 1 diabetes for 37 years. Diane, founder of the Blue Heel Society, met Tony shortly after her son was diagnosed with type 1 diabetes in 2010.

In the 12th episode, Tony and Diane discuss Tony’s six-year-old son recently being diagnosed with type 1 diabetes. Tune in to learn how the family reacted to the diagnosis and how Tony’s son has been handling his diabetes early on with the help of his family.

Continue reading

A Caregiver’s Journey to Pump Therapy Part 6: Experiences Starting the Pump and How Life Has Changed

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How is the type 1 diabetes journey – from diagnosis, through starting on multiple daily injections, to beginning on an insulin pump and other milestones – viewed and managed from the caregiver perspective? Join D-Mom Leighann Calentine in this 6-part series as she discusses her experiences navigating the diabetes journey as a parent of a child with type 1 diabetes. If you’d like to comment or submit a story, please e-mail

OmniPod-PDMAfter our week-long saline trial with the OmniPod insulin pump, with the help of our endocrinologist, we asked our insurance for approval. The saline trial solidified our decision to begin pumping and we couldn’t wait to go live with actual insulin in the pump. It would be a few more weeks before we could begin pumping, because we had to wait on insurance approval and then we couldn’t schedule our start date until we had her actual pump in hand. Continue reading

My Journey to Pump Therapy Part 4: What I Wish I’d Known about Pumping

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I have learned a lot about insulin pumps over the past 15 years since I first became a pumper. Some things I learned right away, some things took a little longer to catch on. Here are a few insights that I hope will help: Continue reading

FingerPricks™ Cartoons: Sensible Stocking Stuffers from Diabetic Santa

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When I was younger, getting socks as a Christmas present was a total bummer. I wanted – and thought I deserved – gifts I considered fun. The purpose of these gifts was to entertain me and, since it was Christmas, no other purpose was even sought. (I remember the years when Santa wrapped toothbrushes and deodorant for my bothers and me. We reacted as if he’d actually stolen gifts, so unappreciative were we.) As I continue to get older I actually want sensible things – items I can use or actually need. If someone (Santa?) wants to fill my stocking with insulin vials and test strips then – HO! HO! HO! – please do!

Want a free stocking stuffer of your own from Diabetic Santa? Click here to order an OmniPod Demo Kit.

Slam Dunk for Diabetes Basketball Camps Make a Huge Difference

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Joey Balistrieri and friend Jack Borck.

“My daughter cried when we left, because she didn’t want the camp to end!” was how one mom described her daughter’s experience at the Slam Dunk for Diabetes Basketball Camp.

This three-day free camp is offered to any child with diabetes ages 5-18. It’s the only free, not-for-profit basketball camp and relies solely on donations. So a huge “thank you” to all of those companies that helped! My son Joey loves his OmniPod insulin pump, so we were thrilled to learn that the OmniPod was a new sponsor this year.

Monica Joyce, the founder of the not-for-profit camp, is a diabetes educator who had a dream – and thankfully it came true. Monica says: “Slam Dunk for Diabetes is the place where kids with diabetes come for free to have fun and to learn that they’re not alone, how to manage their disease through food, insulin or medication and exercise, and make new friends on and off the basketball court!” Continue reading