Humana project: fourth question!

Humana provides health insurance to nearly 1 million people with type 2 diabetes. In an effort to better understand and support these Humana members, they have partnered with Diabetes Hands Foundation and TuDiabetes to sponsor a 10-day series of discussions about “tips and tricks” for life with diabetes. Information gained through these conversations will help Humana to better serve people with type 2 diabetes, so please join the conversations, and share as much as you can!

Here is the fourth question in this series:
What are the top three things you discovered through personal experience that most helped your ability to manage your diabetes?
Answer question ONE
Answer question TWO
Answer question THREE
Answer question FIVE

In my experience the three things that have helped the most is a psychologist that specializes in diabetics, a nutritionist that is nonjudgmental and informative and an endocrinologist who cheers me on with small victories and helps me think through the tough times. The blame and shame needs to stop.

1. It was not my fault I got diabetes, there are many and varied reasons for diagnosis.

2. Eating low carb helps keep my blood sugars at a reasonable level. A T2 on tablets has no other method of controlling their blood sugars.

3. Testing and exercise are also other tools in the fight to stay in control.

Everything has a positive side and I discovered that I had a great deal more willpower than I ever thought possible. It enabled me to switch to a low carb diet and really exercise and has kept me going for the past ten years.

That there was an algorithm to follow for the data collection and insulin delivery. I never heard of such a think until I was an adult. It increased my quality of life dramatically because it gave me a tool to manage my illness.

2. What it means to be a 'good' and 'healthy' person with chronic illness.
3. Talking with/interacting with people who have other chronic illnesses, or none at all, because it showed me how we are unique as a community of diabetics. People from other illness communities taught me how lucky we are to have an illness with a name and treatment.

The three main things that were instrumental in my control of this chronic affliction include (but are not limited to) the following:
1. Pursuit of knowledge and self-education (this is an ongoing, never-ending quest). Diabetes is one of the few diseases that is 100% controllable but requires maintaining blood glucose levels at normal or near-normal ranges. Learning from the experiences of other diabetics and adapting those ideas, suggestions and techniques that have (or have not) worked for me has aided in fine-tuning what I needed to do. This includes a healthy combination of activity/exercise, proper nutrition, and meds. My two most valuable publications are Diabetes Solution (Dr. Richard K. Bernstein) and Blood Sugar 101 (Jenny Ruhl).
2. Self-management. My “health care team members” can only provide me with generalized guidance and prescription meds. Unfortunately, far too many of them provide advice that is overly stereotyped, misguided (even though it may be unintentional), and/or is too frequently based on the “continuing education” that they have received from drug manufacturers’ reps, headline “studies,” or symposiums that have been sponsored by Big Pharma. To say that their information is heavily biased towards the self-interests of the drug manufacturer is similar to relying on a snake to guard the chicken coop.
3. Trial and Error/Personal Experimentation. Each of us must find our own path in terms of discovering what works (and doesn’t work) for us individually. I make it a practice not to rely solely on the advice from others; especially recommendations that are heavily stereotyped. I prefer/insist on seeing if the advice dispensed actually produces the promised or desired outcome (after all, it is the end result that counts). If something (food, drug or exercise) works for me, I retain it. If it does not, I dismiss and discard it. This has resulted in the exclusion of all processed and GMO foods from my diet and my overall health is better than most in my age bracket (my Endo says that I am in the one percent [1%] of ALL his patients)!

My own A1c has been in the 4% club over the past three years (generally 4.8/4.9 but rising to 5.0 during an experiment with a high protein diet). I am currently back down to 4.8 with very few lows (none of which were serious or required intervention). During my journey, I was successful in overcoming my foot drop syndrome affliction and completely reversed the neuropathy that caused it (at least inasmuch as any tests or symptoms can reveal). My last meter dump at my Endo’s office showed no readings below the 60’s with the vast majority of my meter readings in the upper end of the 70’s through 110 range.

1-I discovered a low carb diet is superior to a low fat diet when it comes to controlling blood sugars.

2-I discovered that I am the captian of this ship and that no one else can keep it on course but me.

3-Learned that for me insulin is much superior to oral medications. With it I found I have the tool manage my BG instead of the oral meds managing me. .

I have Type 1, but all D types have to manage their Diabetes; maybe my experiences would be helpful.

1. We all need knowledge about this disease and it's management. I've read my share of D books, but my daily go-to is TuDiabetes. When I first started insulin, I was so clueless that it's a wonder that I didn't accidentally kill myself! It was finding TuD that saved me.

2. I have both D and Celiac Disease. Eating foods that are both D- and Celiac-friendly is necessary for me to have stable blood sugars. A low carb diet, or moderately low carb, as well as being gluten-free works for me.

3. I have been so lucky to have good doctors and a supportive family, esp. my husband. I know I couldn't manage very well without them.

1. Search for a happy medium between my RA and my Diabetes--the steroids that help my RA also increase my BGs which harm my diabetes.
2. The joys of low-carb dieting
3. You Diabetes Will Vary. My mom can eat carbs like my maternal grandmother without her blood glucose going crazy; however, I am like my maternal grandfather and must abstain from all carbs in order to keep my blood glucose within a manageable range.

Hi fayebella! The idea of a psychologist that specializes in diabetes is really interesting! How did you identify this person? What special understanding did this person have? There are nutritionists and educators who specialize in diabetes, so why not other medical specializations, right? Thanks, (Meghan from Humana)

NutriJoy - thanks so much for your response! We hear you on the overly stereotyped education and the need for personal experimentation. One of the things that we are trying to figure out is how we can change the game here by (1) making education less general and more personalized or at least contextual, and (2) support people with diabetes through the trial and error process. Do you think that having a someone like a coach to support you and provide you with the "right thing at the right time" would have been beneficial? Other ideas for how to make the personal learning journey more smooth? Thanks!! (Meghan from Humana)

I love that positive attitude! Where did you find your willpower came from? Do you have anything that you read or look at when you feel like giving up? (Meghan from Humana)

There are people who focus specifically on the mental aspects of dealing with diabetes. Probably the most well known is Bill Polonsky, author of "Diabetes Burnout". Riva Greenberg, who has written several books and is on the board of advisors of TuDiabetes, is another.

In no particular order--

  1. Constant learning and study. I read everything I can find on diabetes. There are some truly excellent books out there. I read and reread the good ones.
  2. Getting involved with the DOC (Diabetes Online Community). The DOC is an inexhaustible source of shared knowledge and experience. As such, it is a resource beyond price. For example, TuDiabetes is a community of over 35,000 people touched by diabetes who between them have experienced just about every possible nuance and wrinkle in this disease, and who are eager to share. No doctor, nurse or clinic can even begin to duplicate that deep well of experience.
  3. Dealing with everything empirically. Try things. Test, test, test. Keep records. Drop what doesn't work and do more of what does. [ Did I mention "test"? :-) ]
  4. A low carb diet. Low carb is one of the principal keys to nearly every good result I've achieved. When I went low carb, my A1c, lipids and weight all dropped dramatically.
I estimate that about 97% of what I have learned about diabetes management came from #1 and #2 above, about 3% from the medical professions.

Dawn phenomenon can best be managed via insulin pump.
Good carbohydrate counting skills are necessary.
Carbohydrate limiting provides both weight loss and tight glucose control, for me.


My garden is my restorative. Whenever I feel like giving up I do some really hard gardening and work it all out of my system. I have an enormous garden which I handle all alone and trimming hedges and digging over vegetable beds does wonders!

I think I will mostly just underline what others have said:

1. Diabetes brought out my OCD tendencies: I hate it when my numbers run high so figuring out delicious and sustainable ways of eating lo-carb really does work for me---emotionally, as well as physically.

2. A new level of understanding just what support means. For instance: while my family was somewhat bemused by my early obsessive focus on getting control, they tried hard to understand and, in the cases of my husband and my sister in particular, never wavered in helping me make dietary and exercise changes---learning to make lo-carb recipes, accompanying me on walks, etc.

3. The DOC is an incredible resource that I never knew existed. Can't do it without these amazing online families to this day. Once, just a year or two ago, I grew really depressed and withdrew from the DOC completely, including here. It only lasted a few weeks. I missed everyone too much. I missed being able to seek help and understanding from here. This was not anything I even imagined when I was first diagnosed in 2007.

1. Find and use a tracking app. In my case I use OnTrack for Android.
2. Be kind of obsessive about using the tracking app.
2. Make changes based on what the data in the tracking app shows.

Learn to know and trust your blood glucose meter - it truly is your best friend. Test after eating especially if trying out new foods, before and after exercising, when you wake up in the morning and when ever you have symptoms you think might be caused by high or low blood sugars.