Humana project: second question!

Hi Lloyd! This is Meghan from Humana. Thanks so much for sharing your insights! I'm interested in learning more about how you have learned to managed your medications so that you can double check them. Could you tell me more about your system?

Hi Gary! This is Meghan from Humana! Thanks so much for sharing with us - we really appreciate your feedback! How did you learn to link your exercise with your diabetes care?

So many great suggestions! Judith, I would love to learn more about how you found exercise options that work for you - trial and error? Or did you have help? Also would love to learn more about how you educated your family and friends - this seems like a great way to create support around you! (Meghan from Humana)

Hi! This is Meghan from Humana! What carbs are easiest to keep on hand and keep well in your purse? Thanks!!

Thanks, David! Do you have any tips that helped you get comfortable with the idea of insulin? It is so true that insulin may be the best option for people but we hear frequently that people are afraid to start, or feel like shifting to insulin is a sign of failure. Thanks (Meghan from Humana)

Hahahhahaha. Sometimes it isn't the patient. Read about how I started insulin. My view is that we fear the unknown and that actually being able to hear from others who use insulin really helps.

I use a pill box, 4 compartments per day, 7 days. I have 10 prescriptions, I distribute the pills ahead of time. I use an insulin pump, I can look at the data to see if I forgot a bolus, if in question.

Oh my. Anyone who knows me will tell you that this is one of my biggest hot buttons, and one I can lecture on for hours. :-)

I'll try to be as succinct as possible. Here goes.

One of the hardest hurdles to overcome is the traditional attitude, common in health care and therefore among the public at large, that insulin is a "last resort" to be used only when the situation is desperate, or an admission of "failure", both of which are absurd when viewed objectively.

Everyone can tell you a horror story about their aunt or uncle who was put on insulin and passed away not long after. When that happens, it's nearly always because insulin was prescribed too late to make a difference, instead of early enough to actually do some good.

Think of it this way: if you had a broken leg, would you consider a cast a "last resort", and put it off as long as you possibly could? Insulin is the most powerful tool there is for controlling blood sugar. Where is the logic in eschewing it until it's too late to matter?

There's another factor at work, and it too stems from an erroneous belief commonly held by doctors. Often a doctor will hesitate to prescribe insulin because of the belief that patients are afraid of injections. While it is certainly true that some people are needle phobic, that turns out to be much less of a factor than doctors think it is.

A while back I saw the results of a study that surveyed both doctors and their patients. About two-thirds of the doctors said they refrained from prescribing insulin because their patients were afraid of injections. But only about one-third of the patients themselves expressed the same reservation! Which means that thousands (possibly millions) of people are being needlessly denied the therapy that could make a life-changing difference and result in a dramatically different outcome.

I'll just end this by saying that I wish I had asked for insulin a decade earlier than I did; I would almost certainly have many more working beta cells today than I actually do.

So the bottom line, as it so often is, is the need for a change in attitudes; a paradigm shift, if you like. The only solution I know of is education. And that has to begin within the health care professions themselves because it is from them that the media and the public take their lead.

Well said. Me too, after stalling 5 months after it was suggested, and showing little improvement, I asked for insulin. I had mediocre glucose management for 12 years on oral medications.

-Lloyd

Re. exercise, doing the Big Blue Test convinced me that exercise is good for my blood sugar levels. Put it down to experience and testing.

While I am still controlling with diet and exercise, one of the most important things I learned here at TuD was not to fear insulin---in fact, if my numbers start to go all whacky, I probably won't bother with oral medication, which has its own list of side effects, but will go right to insulin.

The mingling of T1 and T2 and LADA here at TuD, is vitally important to all of us as we learn from each other!...Blessings...

Thanks for asking, Meghan.....I was a professional dancer/teacher/choreographer for 40 years and by the time I was diagnosed with fibromyalgia in 1996, I had been feeling extreme fatigue and reactive hypoglycemia (it mimics diabetic hypoglycemia, but your blood sugar is not necessarily low) and fibro fogs for a couple years off and on. The aches and pains of fibromyalgia that everyone focuses on didn't actually bother me that much---as a dancer, I hadn't known a day without some kind of aches and pains since I was 7 years old. BUT it took me years to figure out a Sustainable menu of exercise---important for my arthritis, fibromyalgia and, eventually, Diabetes.

I first just started walking, not something I had ever done much of on purpose (as a devoted user of mass transit, I did plenty of work-related walking). Lo and behold, my little neighborhood is full of wonderful gardens and interesting people to chat with, plus pets to give treats to. In other words, walking was fun, so that was sustainable.

Then I methodically experimented with several kinds of workouts: grunt work drawing on the grunt work of being a dancer plus PT exercises from my various knee surgeries and other injuries of 40 years pushing the limits physically (weights and resistance bands). I chose a reasonable selection that allows for variations that can make it run for 60" or just 45" depending on how much energy I have. And there is a very "dancey" section, too, that I can enjoy with or without music. Sometimes I do it all while listening to a calming retreat talk by the Buddhist nun, Pema Chodrun (meditation helps it all, too).

And, since 1991, there is my garden. I always say it saved my soul when I had to stop dancing. Our old house is on a large double lot and everything that isn't house is garden. The last couple years, since knee replacement surgery, I have needed a helper to maintain it, but that's ok. I still gets me out in the fresh air with purposeful movement for an hour or so a day in season---and in Oregon that is sometimes 8-9 months/year.

I also learned that for working off carbs, housework can do the trick--vacuuming, up and down the stairs a bunch to do laundry, etc. Working off calories may require more, but as a diabetic, it helps to know there are a myriad of ways to deal with carbs--particularly if one has figured out the "law of small numbers.".....Blessings

Oh--the sitting workout is still evolving as my joints get worse. So far there are things from my standing workout that can be adapted plus I'm finding examples online aimed at folks with arthritis.....

Hi Meghan. I find unsweetened dried fruit bars (Safari, Just Fruit) the easiest. They don't cause too rapid a sugar rise and one can eat just half if required. For for drastic lows I generally carry a Slim Slab which has 8.8 g of carbohydrate per bar most of it sugar.

Hi. Just remember that a lot of Type 2s have sufficient insulin of their own and it is all dependent on cellular resistance. I have recently been taken off the minimal amount of sulfonylureas (Glycomin) that I was taking as even the lowest dosage was sending me too low. My levels are now far more stable.

  1. Conquer frsr. I have never liked needles thus never wanted diabetes. Once I accepted that I could become diabetic I was able to.learn when I became diabetic

  2. Learn. I became smrmic and had to learn how to give B,12 injecions. I still don’t like needled but I learned so I could use that knowledge for insulin.

  3. Read. When I can I go to Barnes & Nobles to see what is available in the discount section. Each book I buy has a different perspective.

  4. Reread
    Every time I pick up a book and reread it I gain a new insight or remember something I have forgotten. There is a lot of information to learn and keep accessible.

Misspelled fear (1) and anemic (3)

Thanks so much for sharing! I love the phrase "the law of small numbers!" It really is true that its all about taking small steps. Plus I love the way that you've managed to make exercise and physical activity a little more fun and more like an adventure(exploring the neighborhood). All the best,
Meghan

I am getting a whole education on Dr. Bernstein thanks to all the shout outs on the blog! Thanks to all for sharing! (Meghan @ Humana)

In the beginning I was desperate for someone to talk to about my condition and I obviously overdid it because after the first couple of months my family didn't want to hear a word about how I was feeling or coping. I recently went through a bad dose of depression to which nobody paid any attention at all so I would dearly love to hear how you educated your family and friends. Although my husband knows the symptoms of a low he never spots when I am having one.

That - contrary to what some dieticians told me - all carbs are not created equal. Barley is an excellent carb, based on its very low GI rating, while Kelloggs Cornflakes problably is at the top of the to avoid list. Do your research on the Glycemic Index, it makes a HUGE difference which carbs you eat.