You keep using that word. I don't think it means what you think it means.
You guys. Healthcare News lost its freaking mind last week about Medtronic’s “Artificial Pancreas” getting FDA approval.
It’s always exciting when a new device or device enhancement becomes available to people with diabetes because it usually means that if I can get my hands on said device, I’ll have better blood sugar results.
But I’m concerned that the “breaking news” media reports have caused people to believe that there’s finally a solution that will relieve diabetics of our constant daily struggle to keep our blood sugar in target range.
Medtronic’s new 670G insulin delivery system (“artificial pancreas”) is no such device.
If you look closely at the FDA’s announcement, you’ll notice that the FDA has not called Medtronic’s new device an “artificial pancreas.”
In fact, if you look at Medtronic’s announcement, you’ll notice that Medtronic, the creator of this device, doesn’t even call it an “artificial pancreas.”
Also, the Medtronic Minimed 670G is approved for type 1 diabetics only (1.25 million people in the U.S.), not type 2 diabetics (27.9 million people in the U.S.)
So let’s all hold our damned horses and chill the heck out, here.
You might be wondering whether the new Minimed 670G insulin pump/CGM system is even worth getting excited about? You bet! In fact, the new 670G system has new features that other pumps don’t have, and two of these features are what make the 670G different (and more automated) than other insulin delivery systems.
The two features the 670G has that other systems don’t have:
For some very basic details on insulin delivery systems and the 670G, take a look at the table below.
Based on what I’ve read about the Medtronic 670G and based on what I know about insulin delivery systems and how they work (since I’ve been using them for 16 years) Here’s my quick assessment:
If you are a type 1 diabetic using the Medtronic 670G system, you are still going to have to work just as hard to manage your blood sugar as you always have, but, if the new Medtronic sensor is more accurate than Medtronic’s previous sensors, there’s a non-zero chance you’ll get slightly better blood sugar results from your efforts if you use this system. And a better result, no matter how slight, can make a world of difference for some.
As for me, I'm going to continue to use my old Medtronic pump along with my Dexcom sensor, even though the two devices don't interact with each other. If diabetics using the 670G start raving about the painlessness and accuracy of the new Medtronic sensor, then maybe I'll give the 670G system a try. And if you are using the 670G, I invite you to add your opinion in the comments section below. For now, because I've been scarred (emotionally and physically) by Medtronic's prior sensors, I just can't give up my Dexcom (which, thus far, has been a far superior CGM) anytime soon.
During BootCamp for Betics this week, one of my students asked a really great question about what your A1C should be.
If my goal is to lower my A1C, how do I realistically determine what it could/should be in 3 months or 6 months? How do I figure that out?
That's hard to answer since everyone is so different, but I'll give it a try. As you know, the A1C is a nicely predictive value that tells you and your doctor how well "controlled" your blood sugar is, but it is not a totally accurate data point.
For example, your blood sugar could be 40mg/dL 50% of the time and 240mg/dL the other 50% of the time and your A1C would be 6.5 (control is not great, but A1C is good). Likewise, your blood sugar could be 110mg/dL 50% of the time and 170 the other 50% of the time, and your A1C would still be 6.5 (control is much better, but the same A1C as before).
So while the A1C number is a good reference point, it's only part of the goal. Here's what I'd suggest.
First, choose a baseline target bg (wait, what the heck is a baseline target bg?) that is safe. Let's say, for example, you want your baseline bg to be 110 to start off, just to be on the safe side and avoid hypos (if you're not on insulin or sulfonylureas, your eventual baseline target should be lower than 110). Next, pick a max postprandial bg goal (post-eating for a type 1 can be 140-180, sometimes higher depending on your circumstances. If your A1C is currently above 7, start with 180, which I'll use in this example). Add the two numbers together (baseline goal + postprandial target = 110 + 180 = 290, and divide that total by 2. The answer in this case is 145, and that's your average blood sugar goal. Then, go to this website: http://www.phlaunt.com/diabetes/A1Ccalc.php and type your average blood sugar target into the mg/dL field, which will help you figure out what A1C that corresponds to (it's 6.7).
One thing you (and everyone else) should consider before lowering your A1C, though, is whether or not you have *any* diabetic retinopathy. If you have existing retinopathy (proliferative or not), you can exacerbate your eye issues by lowering your A1C too fast. If you don't have any preexisting retinopathy, this warning doesn't apply to you. But, the faster you can lower your A1C, the more your kidneys, heart and nerves will thank you. It's a total catch 22 if you have any retinopathy at all.
So, if you do have retinopathy, then you need to take your current A1C into account and be careful to lower your A1C slowly. I think a half a percentage every month is slow enough, but you should check with your ophthalmologist about what they recommend. So, let's say your A1C is 9. Try to lower it to 8.5 by next month, then to 8 the month after that, etc., until you can get it to a healthful and attainable target. An A1C of 8.5 corresponds to an average blood sugar of 197 according to the A1C calculator. Multiply this average blood sugar by 2 (197x2 = 394), and then subtract your baseline target bg, which should be on the high side if you're looking to lower your A1C slowly. Let's say it's 130. So 394-130 is 264. 264 becomes your absolute "not to exceed" number for the month that you're trying to get your A1C to 8.5.
As for a *final* A1C goal, well, that's up to you. If you're prone to hypos, an A1C of 6 or even 6.5 may not be realistic for you, and you may want to hover right around 7, which isn't perfect, but again, it's another catch 22. You want to keep your bg low enough to not cause any complications, but you can't keep it so low that you have constant hypos and seizures.
With Betic Love,
I have two quick things to share with you:
Thing #1: Two new insulins coming soon.
One new insulin is called Basaglar. It’s supposed to be a lot like Lantus/Levemir/Tresiba/Toujeo, but it’s going to cost about 75% less than the current long acting analog insulins. So if you have crappy drug coverage, this could be a great option for you. Basaglar should be available in pharmacies mid-December. I haven't tried it yet, so I have no opinion about it's efficacy. Some insurance companies have already replaced their tier 1 long-acting analog with Basaglar on their 2017 formulary, so you might end up taking Basaglar next year whether you want to or not.
The other insulin is called Ryzodeg. It’s a 70/30 mix, meaning it’s 70% Tresiba/Degludec (which is a new long-acting insulin released earlier this year) and 30% apart (which is Novolog). Because Degludec doesn’t have strong peak times, diabetics taking Humalog 75/25, Humulin 70/30, Novolog 70/30 and Novolin 70/30 could consider switching to Ryzodeg. My guess is that Ryzodeg could reduce hypoglycemic events caused by the other mixes as long as you’re using the correct dose. I have contacted Novo Nordisk for the date on which Ryzodeg will be available in U.S. Pharmacies and will update my blog when this information becomes available.
Thing #2: Here's an article on the dismal state of 2017 prescription formularies.
The short version is: check your insurance company's 2017 formulary. A bunch of drugs are getting cut, and you need to have a plan to ensure you don't have a break in drug coverage. This may mean calling your doctor and getting a new script for a new (biosimilar) drug just before January.
Hell yes, insulin prices are skyrocketing. And the trajectory is so much steeper than we thought. Last week's news made a really amazing effort to shed light on the insane costs of being diabetic, and, as a result of last week's reports, a bunch of change.org petitions to lower insulin prices popped up and got passed around on Facebook and other social media.
Which is awesome. It’s really nice to see people caring about insulin prices.
The JAMA study's data from which the news reports got their numbers is entirely correct and you should definitely read it if you get an opportunity (It's a study about type 2 diabetics. It didn't include type 1s). But I am concerned that the news reports have not clearly explained the meaning of JAMA's figures in a way that is relevant to the diabetics who actually take insulin (and their loved ones). So I'd like to set the record straight and help clarify the figures.
Well, I figure if you're gonna be pissed off on behalf of the diabetic(s) you love, I want you to be pissed off based on a more clear interpretation of the data.
The actual average price of insulin per insulin-dependent type 2 diabetic in 2013 was $2661.52, not $736.09, as many believe based on last week's news reports.
Wait, WHAT? Why am I saying the average yearly price of insulin in 2013 was $2661.52 and all the other news articles are saying it was $736.09?
Let me explain.
This JAMA study tells us that insulin cost an average of $736.09 per type 2 diabetic per year in 2013, This average cost is distributed across ALL diabetics, whether they’re taking insulin or not! But, only 29.2% of Type 2 diabetics actually take insulin. Do you know what this means?
It means that 29.2% of type 2 diabetics are absorbing 100% of the insulin cost.
Look, if you're an insulin-dependent type 2 diabetic with a kick-ass health plan, your insurance company might absorb a good portion of this cost on your behalf. But, if you don't have a health plan, or if you have a high deductible before drug coverage kicks in, or if you pay a high coinsurance percentage, or if you're stuck in the donut hole, you might become desperate enough to start thinking about other less healthful options, such as rationing insulin by skipping doses (yes, this is actually happening, and it really shouldn't be) or using the cheaper but less effective insulins.
So sure, the study had numbers in it. And the numbers were correct. But the study didn't calculate the values that are most relevant to people who are going broke thanks to their insulin bill (which wasn't the purpose of the study anyway, so don't be mad at the researchers. They didn't do anything wrong).
So, here’s what’s actually relevant to us: The average cost of insulin for an insulin-dependent type 2 diabetic increased from $742.14 in 2002 to $2661.52 in 2013.
And guess what else. Prices have increased a LOT since 2013. Based on the published cash prices for insulin on GoodRX.com and using the JAMA study’s average figures for yearly insulin consumption in mL, an insulin-dependent diabetic on analog insulin (the good stuff that actually works) can expect their “average” insulin costs in 2016 to be anywhere between $2662 and $5459 or more per year. If you don't have a good health plan to cover these costs, you are screwed.
Here’s some extra math, for those of you who like math:
The JAMA study indicates that in 2002, the average price of insulin was $4.34 per mL, and that in 2013, the average price of insulin was $12.92 per mL. The study also indicates that in 2002, insulin-dependent type 2 diabetics took an average of 171mL per year and in 2013, insulin-dependent type 2 diabetics took an average of 206 mL per year.
So, if you care about a diabetic, and if you've been getting all pissed off about the price of insulin increasing but you haven't yet fully grasped how ridiculous the price increases are, just do the math yourself using the figures above, and then join me in my full blown rage, or cry, or shout expletives, or call someone and cry, or whatever.
And, if you haven't done so yet, go sign one of those change.org petitions! Because for pete's sake, we 'betics can't afford these disgusting insulin price shenanigans.
Nothing makes me madder than having to arduously fight the insurance bureaucracy to stay alive. And the NPR report I read today has my heart racing with indignant rage on behalf of diabetics everywhere who KNOW what a struggle it is to cry, beg and plead with the insurance company in an effort to coerce them into doing the very thing they’re charged with doing: keeping you alive and well.
If you have diabetes, you probably (like me) burst into tears at least three times per year after ending a call with a customer service representative who insists your life-saving diabetes treatment isn’t covered by insurance. Before you continue reading, get your game face on, because this is going to piss you off.
In 2017, diabetics who get their meds through CVS Caremark or Express Scripts are in for some blood boiling adjustments to diabetes (and other) drug coverage.
NPR’s got the full story, and you can read it here. For my part, I’ll summarize the CVS diabetes drug denial list for 2017 (because it’s bigger than the Express Scripts list), and discuss why denying people the drugs they need to stay alive is so awful.
Both companies are choosing to remove brand name drugs from their formulary and instead are choosing to cover generic versions. Fine. We’re all accustomed to that. That isn’t news. Substituting generic for brand name happens ALL the time. I’m not upset about that.
Here’s what I AM upset about: the prescription insurers are choosing to replace some of your current meds with biosimilar medications (this happens from time to time with all insurers, but not to this degree). Replacing a drug with a biosimilar is NOT the same thing as replacing a brand name drug with a generic drug that has the exact same ingredients. In this particular context, biosimilar means, “Drugs that are designed to do the same thing, mostly, but each drug is actually different from the other, and they each have their own interesting side effects, and there are some people who can tolerate a certain drug but CAN’T tolerate its biosimilar competitor drug(s).”
To see the full list of formulary changes for CVS Caremark and Express Scripts, visit these sites:
(Consider taking a xanax before you click, though. Oh, wait. That isn't covered.)
CVS Caremark Full List of Formulary Changes
Express Scripts Full List of Formulary Changes
For the purpose of this article, I’m going to use CVS Caremark as my example. Below is a table of CVS Caremark’s diabetes treatment changes and what should have been considered (see notes/comments) before implementing the restrictions.
(In a relatedly dickish move, United Healthcare decided to stop covering all insulin pumps except the Medtronic pump, which is *really* going to destroy some people’s lives. More on that in another article.)
Look, I see biosimilars as treatment options, and I hope I will always be able to get my hands on the best drugs & treatments that will help me, as an individual, control my diabetes. I want options. I NEED options. And so does every other diabetic.
Unfortunately, the insurers see biosimilars as an opportunity to negotiate lower drug prices, which I can certainly understand (diabetes meds are hella expensive), and I *know* there are factors involved in these decisions that I’m not privy to, but, as a patient on the receiving end of these new restrictions, I feel like I’m being stuffed into a regimented care plan box, which will inevitably result in an uncomfortable and less healthful life. I need the freedom to use the treatment options my doctor and I decide will keep me alive for as long as possible. I don’t know how to solve the myriad of problems insurers face with regard to ever increasing drug prices. But I want prescription insurers to realize that what they’ve devised as a viable solution to THEIR problem has created a BIG problem for ME. And I implore prescription insurers to actually care about this.
Look, you guys. It’s an obnoxious battle to try and keep my blood sugar in target range every single hour of every single day, especially when I’m trying to eat healthy, exercise regularly and still maintain a flat baseline. I use three different pieces of medical equipment to stay alive. I use the test strips and insulin that work best for me, as an individual. And I *really* depend on this stuff to stay healthy. It’s difficult, but I’m not gonna complain, because at least I’m lucky enough to be alive. But. I can’t understand why I constantly have to fight my insurance company for the stuff that keeps me alive. This shit wears me down. Makes a diabetic want to just hold up her hands and say, “I give up.”
So, to CVS Caremark and Express Scripts, for restricting diabetes treatment options, and to United Healthcare, for restricting insulin pump options, and to the drug companies who charge way more for drugs in the US than they charge anyone else, I have a challenge for you. I’d like to invite you to spend a few days with me (or better yet, sign up for my Diabetes Education Course) so that you can better understand how potentially devastating your new 2017 restrictions are.
With as much diabetic love as I can muster in this dire situation,
Did you know there are two types of carbs, only one of which diabetics should be eating? Watch the video below to find out more.
Note: This is my first attempt at a vlog post (a video blog). I promise to improve the sound quality when I make the next one. :)
With Diabetic Love,
I had an appointment with my Endocrinologist last month, and I had a pretty confusing and unfortunate experience. Let me share it with you.
During my diabetes appointment, I saw an Endocrine fellow (a fellow is a doctor who is training to become an expert in a medical specialty) instead of my regular doctor.
I came to the appointment feeling VERY annoyed at my blood sugars. After the birth of my son in December, I’ve had a hard time getting my baseline blood sugar fixed (I’m using insulin). Everytime I’d get my blood sugars under control, my basal (baseline) insulin needs would change and my blood sugars would be all over the place again! I had quite a few blood sugars in the 200s and 300s and I was excited to meet with the doctor to get some help with my insulin dose. I do know how to adjust my insulin rates on my own, but I get burned out pretty quickly with my diabetes, and it’s sometimes nice to have a fresh pair of eyes looking at my blood sugar log.
During my appointment I expressed my disappointment about my blood sugars to the Endocrine fellow, who looked at my log for a few moments and said, “Well, this isn’t that bad. Lots of patients have blood sugars that are way worse than this.”
Maybe he thought he was complimenting me. Or maybe he was trying to make me feel better by comparing me to other patients. Either way, I was gravely disappointed. I felt like I came to my appointment looking for blood sugar help, and I ended up getting dismissed by the doctor because my blood sugars weren’t bad enough to be interesting to him.
Am I reading too much into this?
I’ve been the patient he is comparing me to. I’ve been “worse.” I’ve had blood sugars in the past that were completely off the charts, and I’ve had, in my life, some truly terrible A1Cs. And what I can say is that once you get to that point, once you become “worse,” you stop caring, because it is SO much easier to pretend like you’re not diabetic than it is to address the problem head-on. For me, at that time, knowing that my doctor thought of me as "worse" would have caused me to stop visiting him altogether. And now, having an apathetic doctor who is pleased with “good enough” as defined by his experience with other patients is the least helpful endo consultation I could have experienced.
It is my hope that my BootCamp for Betics offering will provide folks with the motivation they need to fix their blood sugars in a way that doctors can’t. But, how do I reach those people who, like me years ago, have basically given up? I’m looking for suggestions. Have you ever suffered diabetes burnout? What did you do to overcome it? Please, help me figure out how to get BootCamp for Betics in touch with those who really need it.
Click here to share your thoughts and experiences: http://goo.gl/forms/qKCQU8P7Cp9bKXbj1
Thanks in advance for contributing. Also, if you know someone else who has something to say about this, please feel free to forward this to them.
With Diabetic Love,
This article is written for type 2 diabetics who need help coming down from a very high blood sugar during a single, isolated high blood sugar event.
If you want to try an stabilize your baseline, consider signing up for my Baseline Blood Sugar Challenge course.
THIS ARTICLE IS NOT A SUBSTITUTE FOR REAL MEDICAL ADVICE.
If you're a type 2 diabetic and your blood sugar is high right now (greater than 300mg/dL for at least 6 hours), the first thing you should do is call your doctor. So, if you haven't called anyone for help yet, please stop reading this article and call your doctor. If your doctor is able to help, then you need not read on.
Also, if you are having symptoms of Diabetic Ketoacidosis, stop reading this article and go to the hospital immediately. Diabetic Ketoacidosis can kill you if left untreated.
But. If you're in a situation where your blood sugar has been high for an extended period of time, you could perhaps consider taking the following steps to solve your blood sugar problem.
Disclaimer: This is friendly, non-medical advice from a random diabetic person you don't even know, which is a very (very) poor substitute for real, actual medical advice. Use at your own risk.
First, you should try and lower your blood sugar without injectable insulin by completing the following steps:
1. Check your blood sugar. Write down the time and your blood sugar level.
2. Drink water (this doesn't actually lower blood sugar, but it helps flush sugar and ketones from your body, if you have them). Continue drinking water, but please don't make yourself sick.
3. Move. As in, walk. Walk around the block or walk in place or haul your ass up and down the stairs for 30-60 minutes. Walking helps your cells become less insulin resistant, which is what you need right now. Do NOT engage in high-intensity exercise, because strenuous exercise could make your blood sugar higher.
4. Take a warm (not hot) shower for 15 minutes (this helps the insulin flow).
5. Check your blood sugar again. Write down the time and the blood sugar level. Did your blood sugar go down after you walked and showered? Great! Repeat the above steps until your blood sugar is back into your target range.
If your blood sugar didn't go down, and if you can't get access to medical assistance, you could consider taking insulin just this once to lower your blood sugar, as long as you promise to call your doctor when s/he is available to tell them what you did. You'll probably get yelled at for using insulin without your doctor's permission, and for following advice you found on the internet. And your doctor would totally be correct to yell at you for doing this. Also, keep in mind that if you accidentally take too much insulin, you could die. Which would be very bad. So, be careful.
To fix your blood sugar with insulin, complete these steps:
STEP 1: GET THESE SUPPLIES AT WAL-MART
1. 1 bottle of Reli-On Regular Insulin ($26)
*This insulin costs over a hundred dollars at other pharmacies. Wal-mart sells it for $26. It's also not the best insulin for treating highs. There are better insulins out there, but most of the good ones require a prescription. This insulin, in most states, does not require a prescription.
2. 1 bottle of ketone test strips ($10-$20, depending on the brand)
3. 3 or 4 bottles of Powerade ZERO (you MUST get the sugar-free "ZERO" version or your blood sugar will go even higher)
4. 1 box or 1 packet of 30 unit (1/3cc) Syringes (needles)
STEP 2: FIGURE OUT HOW MUCH INSULIN TO TAKE
If your blood sugar is 300: Take 2 units of Regular Insulin
If your blood sugar is 350: Take 3 units of Regular Insulin
If your blood sugar is 400: Take 4 units of Regular Insulin
If your blood sugar is 450: Take 5 units of Regular Insulin
If your blood sugar is 500 or more: Take 6 units of Regular Insulin
STEP 3: CHECK KETONES
Use the ketone test strips (ketostix) to check if you have ketones. Ketones can be bad if they are present with prolonged high blood sugar. After you give yourself insulin and continue to hydrate yourself, your ketones should go away.
STEP 4: GIVE YOURSELF AN INJECTION OF INSULIN
This helpful youtube video will show you how to do it. Remember that on a 30 unit syringe, each line equals one unit. If you are using a 100 unit syringe, each line equals two units. This is why our instructions suggest 30 unit syringes. Less confusion. Please don't take any more than 6 units at a time unless your doctor says its ok.
STEP 5: MOVE, MONITOR, HYDRATE
1. Continue to move (walking is great!).
2. Continue to check your blood sugar every 2 hours for the next 8 hours. You may not see any results for about 4 hours. You have to be patient.
3. Do not eat anything that contains carbohydrates.
4. Drink Powerade Zero to help replace any electrolytes you may have lost.
5. Take a warm (not hot) shower about 30-60 minutes after taking the injection. This will help the insulin flow.
6. Continue checking ketones every 4 hours.
7. If you start to feel worse, or if you start having symptoms of diabetic ketoacidosis, get yourself to the hospital right away!
8. After 7 hours, if your blood sugar still isn't below 300, call your doctor or repeat the above steps again. Do NOT take another dose if you haven't waited the full 7 hours.
Remember, insulin is very dangerous and can cause severe low blood sugars if not used correctly. If you have a low blood sugar episode, treat it immediately with quick acting sugar.
Also remember that everyone processes insulin differently. Some people might find that the above dose worked really well to lower blood sugar, while others (more insulin resistant diabetics) may have blood sugar that won't budge with this amount of insulin.
I hope this helps you solve your single, isolated high blood sugar problem. And again, if you are looking for more help and support with blood sugar management (and if you need some motivation to get out of your diabetic rut), sign up for one of my BootCamp for Betics courses!
With Diabetic Love,
Once you learn that someone you know has diabetes, you probably want to say and do things that are helpful and supportive. Your desire to help and support actually means a lot to those of us who have diabetes, and we appreciate it! I've heard it can be challenging and sometimes even awkward to interact with someone who has diabetes, because it's hard to know what to say in certain situations. Sometimes your efforts to be helpful and supportive can come off as insensitive and foolish, which, typically, is the exact opposite of your intentions. To assist you in your efforts to be helpful, I've listed below some situational phrases that you can use to ensure you're being supportive of (and not accidentally hurtful toward) your local diabetic.
-Someone tells you that they have diabetes
Don't say this:
-Oh wow, that's awful. My grandmother died from diabetes.
-So, that means you can't have any sugar, right?
-I see. Are you sure you're supposed to be eating that?
-Did you get diabetes from eating too much sugar?
-Well, at least it's not cancer!
-My Aunt Tilly is in kidney failure because she never took care of her diabetes.
-Huh. I thought only fat people got diabetes. You're not fat.
-I've heard that cinnamon/chromium/okra can cure diabetes. Have you tried it?
Say this instead:
-Thanks for telling me. Please let me know if there's ever anything I can do.
-That's good to know. Please let me know if there's ever anything I can do.
-I've always wanted to learn more about diabetes. Please let me know if there's ever anything I can do.
-You witness a diabetic eating or drinking something that you've heard is "against the rules" for diabetics (the generally accepted belief that there are hard and fast rules for all diabetics is a myth, by the way).
Don't say this:
-Are you allowed to eat that?
-You can't have that, can you?
-Isn't that bad for you?
-You need to take better care of your diabetes.
-Is this going to put you into a coma?
-My aunt ate cake all the time and had to have her foot amputated
Say this instead:
You have deep knowledge about how another friend/family member cares for their diabetes, and you witness someone else managing their diabetes in a way that is different from what you've observed in the past.
Don't say this:
-I'm pretty sure you're not supposed to be doing that.
-My friend/family member manages their diabetes by <enter treatment method here>. Have you tried that?
Say this instead:
You witness a diabetic checking their blood sugar and/or taking insulin. You are squeamish and HATE needles.
Don't say this:
-Oh wow, I would just DIE if I had to prick myself like that every day!
-Can you please go into the bathroom if you're going to do that?
-Can you not do that in front of me?
-You must have the bad kind of diabetes.
-Your diabetes must be really bad.
Say this instead:
You learn that your friend/family member's blood sugar is, at this very moment in time, too high or too low (This occasionally happens to all diabetics. Blood sugars will never be perfect 100% of the time).
Don't say this:
-Wow, isn't that bad?
-Wow, why is it so bad?
-OMG that's really low/high isn't it?
-Is this because you ate something you shouldn't have eaten?
-You need to take better care of yourself.
-But you don't look sick.
Say this instead:
-Let me know if there's anything you need.
-How can I help?
-What can I do to help?
-What can I get you?
You say, "what's that?" and the diabetic responds with "It's an insulin pump" or "It's a glucose monitor."
Don't say this:
-OhMyGosh I'm SO sorry, I shouldn't have asked!
-Wow, your diabetes must be really bad.
-Are you a brittle diabetic?
-My friend was a bad diabetic so that's why they put him on insulin.
-Oh, you have diabetes? I know someone who died from that.
-I heard insulin makes you fat.
Say this instead:
-That is awesome technology!
-Oh neat! That is so fascinating. Mind if I ask some questions about how it works?
A diabetic you know is unconscious or having a seizure (uncommon, but possible)
-If you're trained in blood sugar testing/treatment and/or glucagon administration, follow protocol.
-If you're not trained in blood sugar testing and glucagon administration, call 911.
Diabetes (all types) is a very difficult and confusing disease to manage. Diabetes behaves in extremely inconsistent ways from day to day. Most diabetics are doing the best they can! Things don't always work out perfectly. I understand that most of our supporters really just want to help, especially when they believe a diabetic is struggling. But. Unless you are a diabetes educator or an endocrinologist, it's unlikely that any suggestions you make will add value to a diabetic's life. Always remember that there is a very fine line between curiosity and perceived criticism. When in doubt, just say this: How can I help? If there's a way for you to help, we'll let you know! And, in case we forget to tell you, thank you for caring so much about us.
With Diabetic Love,