Category Archives: Diabetes Blog Week

Siri, Tell Me about the Ultimate Diabetes Device


Diabetes Blog Week is technically over, but I still want to write about one of the topics: my dream diabetes device.

I — In the past I’ve written about wanting an application that integrates all my current diabetes paraphernalia, my Carelink account, and my mobile phone iPod. The goal was to have total diabetes awareness by tagging “interesting” events so that I can go back to the historical record the next time that thing occurs. “When I was sick how much extra insulin did I need to give?” “When I ate Indian food, what was an appropriate amount of insulin and how did I deliver it?” “What basal rates and carb amounts worked well for a triathlon?” Ask one of these questions, and see the BG values, bolus wizard details, and CGM traces for all of the events tagged with those keywords. It wouldn’t be a perfect solution to preventing all lows and highs, but it would surely be better than my own faulty memory.

I actually started writing the application and got all of the data into a MacOS application, but I got frustrated that I wasn’t going to be able to easily get the data from my computer onto my mobile device. So, as usual, I set it aside and got distracted by something else. That was a couple years ago. Since then iCloud came along and makes sharing this kind of data between devices much easier. Maybe someday—after I win the PowerBall lottery, perhaps—when I have limitless time and ambition, I will pick it back up. Or (better yet) I’ll become a venture capitalist whose first project is to fund the development of such an app. That way I can travel the world while other people do most of the coding for me. I’ll show up for design reviews to give insightful commentary and gather information for my TED talks.

II — Recently I’ve started working on another diabetes data project. Now that I have a newer Mac, I can run MATLAB again. Yay! It occurred to me, after reading a coworker’s at-work blog about telling stories with MATLAB, that it should be possible to integrate a lot of the disparate sources of data into one application (MATLAB) and try to reconstruct a day with diabetes and try to figure out a partial model for some of the stuff that currently requires a lot of trial and error. It’s not a perfect solution, but it’s a start.

The thing that makes this all possible is the fact that so many of the devices I use every day record and export data. My cycling GPS and Garmin running watch tell when I exercise, for how long, and at what intensity. My CGM records my blood sugar patterns, while my BG meters record the ground truth. My insulin pump tracks my basal insulin usage and all of my bolus wizard details, along with a host of other details. There’s a lot of data there that I can potentially synthesize and display in one view. And, because it’s MATLAB, I can define every last little thing about how I want the information displayed, what details I want to filter out, and what I want to try to highlight or search for.

III — But even with all of this data there are missing parts of the picture. Diabetes is a difficult disease to manage, in large part, because it’s integrated with almost every other part of life. Unfortunately, daily life is messy. There’s a lot of it that just isn’t easily tracked by devices—well, not yet. I’ve toyed with the idea of getting a FitBit device to keep track of some additional things, such as overall activity and sleep, but that still leaves a lot of things untracked, especially food: food that I don’t bolus for, such as glucose tablets, food during exercise, “just in case” snacks, the things that seem too small to worry about, etc. And then there’s swimming, stress, pain, illness, hydration, weight, and so on. I wish there were a way to keep track of all of that. (At least for a few days or a couple weeks while trying to figure out appropriate baselines or when changing my training load. Paying attention to all of that data every day could be a bit overwhelming.)

So I asked one of my bildr/maker-type friends if there were good hardware or software solutions for keeping track of any of this stuff, especially the food-related bits. There are hundred (if not thousands) of nutrition apps, but all of them I’ve seen are much more heavyweight than I want. Don’t make me select something that says which food I ate in order to give me all of the nutrition info or calorie count when all I really want to record is “At 11:25AM (give or take) I ate 15 grams of carbs that I didn’t bolus for.” The best that we could come up with at the time is a small notepad and pen to record stuff before transferring it manually into whatever computerized, MATLAB-based system that holds all of the other diabetes events.

Thinking about it on a bike ride a couple days later, it seems like it should be possible to have a little nanny app that pops up a few times a day asking questions. How is everything going? What time did you wake up this morning? How much sleep did you get? Feeling stressed? Eaten anything you didn’t bolus for in the last day that we haven’t already talked about? Do any swimming or yard work? How active have you been this afternoon? Any pain? Illness? Have you been drinking water?

Just a few judgment-free yes/no questions and easy-to-answer questions involving time and quantity, and voilà! instant context. I could probably make an iOS app to do that in a weekend (if I didn’t mind it looking crappy). But really that’s all of the data that my devices don’t give me now that I want to capture. Oh, and it should have a one-touch switch that turns it off so that I’m not bothered during the 95% of the year that I don’t want to keep track of all that stuff.

IV — As an aside, wouldn’t it be awesome if someday there were a Siri-like interface for diabetes?

“Hey, Siri. Remind what I did those times that I had barbecue at the office and everything went pretty well?”

“You estimated you ate 100 grams of carbs. You delivered ten units of insulin in a dual-wave pattern with two-thirds up-front and the remaining third over an hour. Here’s what your CGM trace looked like for the next six hours.”

“Thanks, Siri. I love you.”

“Hey, let’s keep things professional. I’m not that kind of robot.”

“Sorry, girl.”

“It’s cool.”

V — But all of this “Total Diabetes Awareness” and data fusion and mindfulness/memory apps got me thinking that the ideal diabetes device system is one that wraps all of this up. It automatically keeps track of activity and food and active insulin and BG/CGM values and all of the other emotional intangibles.

But then I thought, keeping track of all that data in order to make better insulin dosing decisions is 20th century thinking. What I really want is a system that automatically regulates BG levels using two hormones, one that lowers blood glucose (via insulin) and one that raises it (via glucagon). Then the system can reach homeostasis all on its own.

Of course, an artificial pancreas that integrates everything together in a closed loop system needs believable inputs. BG meters and (especially) CGM sensors need to be much more accurate so that the system is given the right data to make the right decisions. It’s a bad thing when my CGM says I’m 40 mg/dL (2.2 mmol/L) when I’m really 140 (7.8) or, worse, vice versa. So obviously, an artificial pancreas that’s actually implanted and uses a semi-permeable membrane that lets more insulin seep out when it’s needed is the way to go.

And that’s when I realized the basic truth of diabetes technology: The ultimate diabetes device is a new pancreas.

Posted in Data-betes, Diabetes, Diabetes Blog Week, Fodder for Techno-weenies, Life Lessons | 1 Comment

Shhh…

I should be writing today’s Diabetes Blog Week post about my ultimate diabetes device, but I really need to go to bed in a few minutes. Tomorrow I’m leaving Milford around 5AM to drive an hour to the start of the North Shore Tour de Cure Gran Fondo. “What’s a gran fondo?” you ask. It’s like a race but not. It’s a mass start event with some timed segments, but it’s not a race, okay?. Okay. I certainly won’t be racing the 100 miles . . . except for the hill climb and the time trial.

But don’t worry. I’ll post about diabetes doodads soon. And the ride of course.

Posted in Cycling, Diabetes Blog Week | 1 Comment

I Want that other Kind of “Diabetes”


Diabetes Blog Week gets a little freaky this Friday . .  and frankly a little uncomfortable if taken seriously. “If you could switch chronic diseases, which one would you choose to deal with instead of diabetes?”

Comparing chronic illnesses and wishing that you had a different one is a fool’s bet. At worst, you show yourself as failing to understand how difficult another person’s illness is. At best, you still have a chronic illness! You will still need to take medication or be watchful and worry about when your illness will turn more serious.

Instead, I’d rather have the kind of diabetes that some people think I have. No, I don’t mean the diabetes that people believe means I can’t eat delicious things with sugar. Nor do I mean the one that leads people to think there are things in my life I can’t or shouldn’t do. And it’s certainly not the kind of diabetes that somebody’s aunt “who didn’t take care of herself” had before she went blind, lost her feet, became impotent, had a heart attack while on dialysis, and died. (All of those things are no laughing matter, of course, and can happen to anyone, no matter their A1c.)

No, I wish I had the “easy” diabetes. That’s the kind of diabetes where insulin is a cure, where having a pump means that I can do and eat whatever I want without worrying about anything, where using CGM lets me test my blood just once a day, and where “following the rules” puts my A1c instantly into the non-diabetic range. It’s the kind where following a low-carb diet, making out with Halle Berry, or eating cinnamon makes your symptoms completely disappear. It’s the kind of diabetes where simply preparing a few recipes from a “diabetic cookbook” is enough to ensure perfect glycemic control. It’s the same kind that is already cured in mice, and the same cure would be ready for me in less than five years. This diabetes uses technology and medication which are so inexpensive, easy-to-use, and reliable that the artificial pancreas is a flawless cure. It the kind of diabetes where islet cells are readily available for transplantation, anti-rejection drugs are foolproof, and medical professionals and drug companies provide everything pro-bono.

Obviously, this “diabetes” doesn’t exist at all, but, believe it or not, I’ve actually heard or read all of these things before. It sure would be nice if any of these were true, though. Some of them may eventually come to pass; I really do hope so. Others—like making out with an Oscar winner—probably will be just as mythical as any kind of “easy diabetes.”

So, I’ll be keeping this chronic illness instead of trading it for another. Besides, I have plenty of work left yet to figure out this one.


p.s. — Just in case you missed it, when talking about a mythical, nonexistent “easy diabetes,” I certainly don’t mean type-2 diabetes. That variety is just as hard in its own way as any other chronic illness. Don’t forget what I said in the first paragraph.

Posted in Diabetes, Diabetes Blog Week | 2 Comments

Biggest accomplishment? No big deal.


Today’s Diabetes Blog Week posts encourage us to “share the greatest accomplishment you’ve made in terms of dealing with your (or your loved one’s) diabetes.”

I won’t lie, my biggest accomplishment with diabetes is still a work in progress. It’s taken a long time to get where I am with being comfortable with insulin, and I could be even more comfortable with seeing a bolus wizard suggestion and just saying, “Okay. I can handle that amount of insulin without worrying.” Nevertheless, where I am now is much better than where I was a year ago . . . or even six months ago.

The results of “doing what I’m supposed to do” are encouraging. My A1c is the lowest I’ve had in quite a while, and I’m seeing fewer big spikes than in the past. I’m snacking less at times when I really don’t want to. Cycling with “normal” BGs is happening more often. Even eating Indian food is easier.

I am, however, having more lows than in the past and needing more (legit) snacks to prevent them, so I have some fine-tuning left to do. However, unlike in the past, I’m not treating those lows as a frustrating justification to do whatever. The changes I need to make are all do-able (By the way, I wasn’t simply flailing in the past; I was actually trying to make things better, but it was just a little hard to do that when I was adding so many other variables into the mix.)

Basically, this accomplishment is all about gaining the confidence I had needed to empower myself to do “scary” things (like taking insulin) and to enable doing more exciting things (like getting CGM no-hitters and doing half-Ironman triathlons).

Posted in Diabetes, Diabetes Blog Week, Life Lessons | 1 Comment

Remembering the Desert


Memories are the focus of today’s Diabetes Blog Week posts.

Until recently, my most memorable day with diabetes would have been the day of my diagnosis 13+ years ago. It was such a life-changing event—cleanly separating my memories into before and after—that it’s going to be hard to ever truly forget much of it. But recently more and more exciting/interesting/unusual things come to mind first when I think about diabetes and my life. On the bizarre side, I called Minimed from a pay-phone in the middle of the outback in Australia when my pump died. Later on that month-long trip, Lisa and I had a fabulous time snorkeling (sans pump), and I barely worried about diabetes at all.

Perhaps my most memorable diabetes event (at least for now) is last year’s JDRF Ride to Cure Diabetes in Death Valley. Diabetes was everywhere on this ride (including some of my favorite people with diabetes) and yet my diabetes was remarkably well behaved. The more time that passes from this event, the more special it becomes. I mean, I rode 105 miles in the desert Death Valley! It was hot and difficult and so meaningful. It’s something I couldn’t have done on my own, and all of the help from the volunteers and donors meant so much to me. That particular ride is not necessarily something I’ll ever do again, but the memory changes how I think about diabetes and what I can do with it.

Posted in Cycling, Diabetes, Diabetes Blog Week | 3 Comments

Cats: The Perfect Diabetes Service Animal


Today, the second day of Diabetes Blog Week, prompts us to think about petitions for diabetes. (For some context on why this is relevant to the community, read the DiabetesMine article.) I’m not really a big fan of petitions, so I’m going to do one of the wildcard topics: “What is the ideal diabetes service animal?”

I’m going to have to go all-in here and say, “Cat.”

Let’s look at all of the reasons:

  • Cats are furry . . . and warm . . . and affectionate. It’s hard to do better than a warm, furry, affectionate critter that wants to be around you.
  • Cats—like diabetes—interrupt what you’re doing to remind you of their existence. This presents a very convenient reminder to test . . . especially at 3:30 in the morning when they pounce on your feet or walk all over your face.
  • They don’t really care what the hell you do as long as you feed them. They give you that look which says, “Hey. That thing looks bolus-worthy. I’m not going to judge you if you eat it.” Or maybe it’s a look of disapproval. Or ennui. It could definitely be ennui. Cats are an emotional Rorschach test.
  • With their constant desire for food, cats provide a reminder to eat that food you pre-bolused for.
  • Cats don’t bark or need baths. They’re pretty self-sufficient.
  • Cats are easily distracted by empty boxes. Need a diabetes break? Just set out an empty box, and voilà!

Well, that’s pretty much it.

Posted in Diabetes, Diabetes Blog Week, Photography | 7 Comments

The Truth Comes Out


It’s here! Diabetes Blog Week has arrived again, and it’s time to let someone else help me figure out what to write about here. Today, we pretend that our health care providers are reading what we write. What would we want them to know (or not know) about our lives with diabetes?

Hey there, Awesome Endo and Awesome CDEs! I think y’all are pretty great. You have a really good sense of what people with diabetes are going through, and I believe you really treat this as a calling to help make our lives better and not just a job. I’ve shared links with you in the past, so there’s an outside chance that you are, in fact, actually reading this right now. But you’re all very busy people with lives outside of the office, so I kinda doubt that you actually are. Anyway.

What I hope you do see is also what kinda wish you wouldn’t see: People with diabetes are constantly doing things and making choices that are contrary to what we talked about in your office. We present you data that often doesn’t have all of the context. “What happened here?” Well, it’s a long complicated story that started earlier in the day . . . or the day before . . . or all of those years ago when I was on NPH. But really, that’s a lot more detail that I suspect you really want—or that I can remember—so I’m going to make an educated guess. (This probably isn’t surprising to you.) So many of the choices we make are “messy” and nothing like the ones that we talk about in the office.

Neither of us is doing anything “wrong”—whether it’s making suggestions based on limited data or living in a way that leads to such choices—but it makes it hard to feel completely honest during the conversations we have where we’re trying to make things better. This is part of the reason why I’m glad that you look the other way at the occasional highs and lows in my logbook. Don’t get me wrong; I’m doing my best to make the right decisions, gather the right data, and do the things we talked about. I’m just really glad that you don’t see the imperfections as failures, because I do enough of that on my own. (Although, I’m getting much better at being okay with those misses.

So, thanks for reading and for helping me be the best human pancreas I can be.

Oh! And I wish I could always show you CGM reports like the first picture below; but, really, they’re more often like the second one.

 


If you are a health care provider, be sure to read Céline’s post today.

Posted in Diabetes, Diabetes Blog Week | 1 Comment

Team of Heroes


Here it is: the last day of this year’s Diabetes Blog Week. It’s been a good selection of topics, and I’ve enjoyed reading everyone’s posts. Today, we talk about heroes.

I’m going to confess that I don’t really have any heroes. Some people do fantastic things that need to be shouted from the rooftops, and there are nonprofit groups and NGOs who do the amazing, selfless work that’s the traditional domain of heroes. But being a “hero” is a big ask for anyone.

With that caveat, I’ll say this: I really admire all the athletes of Team Type 1 and the idea behind the team. The cyclists, runners, and triathletes—some of whom are among my very best friends—are such inspirations. They show that it’s possible to do the same amazing feats of athletic derring-do with diabetes that people without it can do. After I learned about them, I bought one of their (older) jerseys, and I wear it often to represent for my peeps.

In my heart, I want to be one of them.

Posted in Diabetes, Diabetes Blog Week | Leave a comment

Working Out the Highs


Today in Diabetes Blog Week is snapshot day. Last year I had a lot of fun with this when I was in DC. This year, I’m being a little more traditional.

Friends, I have been having the worst period of prolonged high blood glucose that I can remember. All the “rules” are wrong; nothing is working the way it should. Basal rate, bolus ratios, the effects of exercise—they’re all messed up. There could be any number of reasons: ineffective infusion set locations, lower training volume or intensity than before, no longer being overtrained and in glycogen debt, different eating choices, bad insulin, etc. Who knows? The result is that last night my 7-day average of all readings was 199 mg/dL (11 mmol/L). I don’t think it’s been this high since I was discharged from the hospital when I was diagnosed.

I’m working on figuring everything out again, almost from scratch. These snapshots are all from today, which was full of a lot of things that lowered (and occasionally raised) my blood sugar.

(You can click on any picture for a larger version.)


Today started with a interval workout on the track that actually raised my blood sugar. I’ve been using a foam roller to help keep my IT band in check, since it’s starting to feel a little injured.

After my run, a little stretching and the foam roller.

This is how Kitty spends the majority of his day.

Since I was still high, I decided to bolus and mow the lawn. I was wearing my heart rate monitor from my run, and I checked in from time to time. 120 BPM to mow the lawn. Ha!

After my run, it was time to mow the lawn.

Our irises are going gangbusters this year.


After lunch: housecleaning. It always lowers me a bit (supposing I bolused enough for lunch).

The carpets needed a good hoovering.

After vacuuming, it's time to clean the dining room.

Usually the vacuum cleaner makes him run for the hills.


Meanwhile, Lisa was doing battle with the shrubbery.

Lisa needed a tall person.

Different piece of furniture, same result.

Time to take the clippings to the transfer station


It was a warm day. That calls for ice cream before doing more housework! (Of course, we’ve also been known to go to the ice cream shop during a snowstorm.)

A Treat after all that yardwork

The office needs a good going through.

Lots of bike riding recently


I’ve been jonesing for a long bike ride for quite a while. Tomorrow is the day. We’ll see if that can’t knock these highs down a bit.

Tomorrow, I'm going for a little ride. Maybe that will help.

Posted in Diabetes, Diabetes Blog Week, Photography, Reluctant Triathlete, Running | 2 Comments

Blood Glucose Just Is


Wow, time has flown by! Diabetes Blog Week is almost over. Today’s prompt: “What is one thing you would tell someone that doesn’t have diabetes about living with diabetes?”

I feel like I should have something profound to say here, as if after almost thirteen years of diabetes—has it really been that long?—I should be some kind of sage. But when it comes down to it, living everyday with a chronic illness renders it rather banal.

Doing all of the diabetes things (checking the blood, using insulin, changing infusion sets, looking at CGM graphs, being mindful of all the factors that affect blood glucose, and doing so many other activities) becomes just another part of living. It’s an unwanted part, to be sure, but those of us living with the disease integrate it into the fabric and rhythms of our life because we have to. Sartre and Camus would remind us that we’re always making choices, but practically our options are severely constrained when it comes to either accepting this disease and making it part of who we are or deciding to ignore it and face the consequences.

What this means is that we live life in multiple ways. We have the “normal”/”healthy”/non-diabetic portion with jobs, commutes, families, hobbies, and obligations, not to mention anxiety, joy, boredom, failure, and success. And then we have the part where we pick up the slack for our malfunctioning endocrine systems. This brings its own tasks, obligations, diversions, emotions, friendships, and opportunities to be better than yesterday. Diabetes is just another “thing” that we do. And like other things in life, sometimes it’s surprisingly easy, while other times it’s cruelly difficult. Sometimes we use these challenges in life and diabetes as a springboard to transcendence, and other times we just can’t wait for them to be done so that we can say, “Well, that sucked. Let’s never fucking do it again if we can help it.”

Diabetes just is.

It’s an aspect of my life that I manage (or mismanage) like any other part. Could I have better BG numbers and be less afraid of insulin? Yes. Could I also sleep more, floss regularly, and worry less? Yes to all. Do I mostly do alright with the diabetic and nondiabetic parts of my life? Absolutely. Diabetes isn’t a separate thing from me, but it is also not an essential, defining part of who I am. Just as I would never say, “I’m a toothbrusher,” it seems ridiculous to assume that my diabetes shapes the essence of my life any more than my toothbrush. I would rather say that I’m a husband, a software engineer, a triathlete, and an international playboy, and I just happen to do all of these things with diabetes.

That’s what I would say to people with or without diabetes: This illness is just another part of life, so don’t expect it to be our top priority or our defining characteristic. There’s more to us than that. It is, nevertheless, an important part of our lives, and it’s going to have an impact on what we choose to do and how we do it. Occasionally, it’s going to mess everything up. Try to be as Zen and thoughtful in your acceptance of this part of us as we are trying to be ourselves and as you would be of any other aspect of our lives.

Posted in Diabetes, Diabetes Blog Week, Life Lessons, This is who we are | 2 Comments

Diabetes Mind Palace


“Stuff” is one of the evergreen topics of diabetes. What we use, the features we would like from pharma, and why we don’t have the amazing toys yet—we never seem to get tired of discussing it. Today in Diabetes Blog Week is the day that we talk tech, in particular our “fantasy diabetes devices.”

I think you can divide fantasy devices into (at least) two broad categories: (1) things like what we have now, and (2) things that act like an endocrine system. I’d love the latter, with its promise of a system or implant that behaves like a pancreas and gives us back normal glycemic response without any work. It’s going to take a while before we have replacement beta cells that don’t die . . . or CGM sensors that are accurate enough to make life and death decisions without our input . . . or control system algorithms that can handle all of the crazy variables that go into blood glucose.

So I think we’re on our own for a while longer, and we will need devices that help us make better decisions. I’ve said it before: we generate so much data that never gets used, and I’m sure that device manufacturers could build more decision-support, trend-spotting, and CDE-like functionality into our devices. And these devices should all talk to each other using standard, open protocols (like ANT+) so that they can integrate with all kinds of other devices—like my Garmin bike computer or running watch—and third-party software, which I would totally write if it were easier to get at the data.

Ideally, these decision-support systems would remember what’s happened over a long, ever-growing history, know what’s happened earlier in the day, and give suggestions about what to do next. The less work that I have to do the better.

Posted in Data-betes, Diabetes, Diabetes Blog Week | 3 Comments

I’m Noticing a Trend of Procrastination


After starting with the good news yesterday, today in Diabetes Blog Week we look at the flip-side: What could be better? What could we start doing today to make it better?

Friends, I am very good at spotting possible trends in my BG readings. Yesterday, I reported how morning swims are almost always amazingly consistent BG experiences. I have also noticed that I go up most afternoons around 2:00 and then drop a bunch during my afternoon workouts. I’m observant enough to have seen that evenings are higher than mornings. And I believe that I fall slowly overnight before going back up a bit before dawn. Some of these trends are good, others less so, and some just are what they are.

(Recently I’ve also been noticing more trends like the one shown below: awesome trend lines reported by my CGM. That 7:00 bolus there is for pizza, my friends. Half of a large pizza.)


What I’m not good at doing is acting on those hunches. When I suspect a pattern, I could should make detailed observations, adjust a few things, and test whether that made it better. But I don’t. Well, I do, but it takes longer than it should. (I also forget to write down the awesome things that worked, and I sometimes have to start over from scratch.)

“Why?” you might ask.

I believe some might call it “procrastination.”

“But that’s not a reason,” you say. “It’s likely just an effect of some kind of disordered thinking. Why not make the changes?”

Because, my dear friends, it’s hard to make changes to something that (mostly) works, that keeps away the lows and lets me exercise when I want with (mostly) good results. Because it’s hard to fiddle around and possibly make things worse. Because starting to make changes like that requires an active commitment to start, and I just haven’t carved out the time to do the basal testing (again!) or kept up with my BG+food+exercise journaling. Because, despite having done my NPH exorcism almost two years ago, that fear of the lows is still very much with me, and getting closer to the good place means getting closer to the edge of hypo more often. (At least I tell myself that, even though I’m not convinced it’s true.)

But today is a new day, and it’s the day I can stop procrastinating on these trends.

Posted in Diabetes, Diabetes Blog Week, Life Lessons | Leave a comment

So HGH, Epinephrine, and My Liver Walk into a Bar…


Today in Diabetes Blog Week we’re talking about the things we do spectacularly. I’m not a superstitious man—except for throwing spilled salt over my shoulder—but I’m keenly aware of hubris or karma or whatever you call being too sure of yourself. I’ll do my best to get past it for today’s post’s sake.

Yesterday evening on the way back from the grocery store, I asked Lisa what she thinks I do very well when it comes to diabetes. Her answer—after saying that I’m often too hard on myself about diabetes, “which is understandable because it’s difficult”—was this: “You’re really good at exercising with diabetes. You do it a lot, and you’re not hypo all the time afterward. So I guess it’s that.” Then she asked if I’d read the post from Kerri about the elliptical and lows and juice boxes and whatnot. (I admit, I had a moment.)

So, I guess it would have to be that: exercising. In particular, I’d point at swimming. My stupid-high BGs before the triathlon Sunday notwithstanding, swimming is usually the easiest and most predictable thing I do with diabetes.

I get up at 5:00AM. I set a temp basal rate for 0% for 1.5 hours. I swim from 5:45 to whenever (usually 30-40 minutes). I go back to my locker and silence the “OMG!! THE SENSOR SIGNAL IS WEAK. WEAK!!!1!! I’VE LOST MY SENSOR! IT’S SOOOO LOST! WTF AM I GOING TO DO??!!!?” alarm on my Minimed pump. Get ready for work. Test. Deliver 1.0 units of insulin or so. Drive to work. And have a perfect-ish BG morning.

If I’m below 130 beforehand I’ll have a little snack. Otherwise, it’s like a little early morning gift delivered three times a week.

I can only imagine the internal body dialogue that might be causing this night swimming pre-dawn / early morning swim phenomena:

Human Growth Hormone: Yo, Epi, are you awake?

Epinephrine: YES! I’m always awake. And I’m amped and ready to go. What do you have in mind?

HGH: Let’s go wake up Liver and see how much glycogen he can spare.

Epi: YES!

HGH: Hey, Insulin. ‘Sup? Your blood sugar?! Haha. I’m just teasing. Seriously, though, WTF man? You just keep chillin’ for a little while longer. Epi and I have some unfinished business with Liver.

Insulin: Wait . . . what? Oh okay. I guess I’ll just stay here for a little while. Um, guys. Am I disappearing?

Epi: YES!

HGH: Hey, Liver. Wanna go swimming?

Liver: Let me grab my towel.

Epi: SWEET!

Posted in Diabetes, Diabetes Blog Week, Swimming | 10 Comments

Friends with Diabetes


It’s Diabetes Blog Week again . . . yay! The last couple years were great, helping me meet so many wonderful people online with diabetes (POWDs?). Once again, Karen has done a fantastic job creating the topics and organizing the logistics. Kudos to her! Today’s topic invites us to “find a friend”—or rather, to share a friend with you, the reader.

I have met so many wonderful people with diabetes through their websites, Twitter feeds, and Facebook posts, that I don’t feel right naming just a few names. I have been fortunate enough over the last 18 months to meet several of these wonderful people and even call some of them my very best of friends. They’re not just people who really get diabetes and are there to share the triumphs, disappointments, and everyday shenanigans that is blood glucose. No, they’re also wonderful people with lives and interests and passions, and they’re most interesting (to me) when they share those other, “normal people” parts.

There are, however, a few people I read everyday because (a) we’ve met in real life, had a wonderful time, and grown close afterward, (b) they post several times a week, and (c) if I miss a post, I’m missing out on what’s going on in my friends’ lives, the same way that I would if I’m on vacation and cut off from the normal connections that bind friends together. That is to say, there’s no difference between these Internet friends and the ones across town; we just communicate differently. So Céline, Jess, Kim, Scully, and Victoria, here’s hoping others get to know how awesome you are. (And Caroline, I would totally put you in this group, too, if only you posted more often. :^) [Update 23 May 2012: Oh! Here it is!])

There’s someone I’ve never met in person and whom I’ve only just recently started following online. I think y’all should give her posts a look. Scully introduced me to her fellow Team Type 1 rider Becky Furuta’s awesome blog, Avec Délectation. (Don’t worry, ‘Mericans; it’s at least 99.44% English.) She’s smart and funny and thought-provoking. Her posts prompt me to think differently about diabetes . . . more matter-of-factly, more holistically, more—I dunno—post-hippy-Boulderite-like. If that’s not a good enough reason for having the Diabetes Online Community around, I don’t know what is. Oh, she also likes pounding diabetes into the ground as she rides her bike fast. She’s my kinda gal. One day, we will have to meet.

Posted in Diabetes, Diabetes Blog Week, Hoarding, Worthy Feeds | 3 Comments

Diabetes Snapshots: Paint Talks

Day 6 of Diabetes Blog Week: Snapshots!

In case you didn’t know: I’m in DC. I drove down here yesterday (Friday) to see a major Gauguin exhibit at the National Gallery of Art and to see some people from the diabetes community. Both experiences were really great.

I went to a few other museums in addition to the NGA, and it struck me that the people in the paintings and I had a lot of the same things on our minds. (I recommend clicking on the first image so that you can see all of the “What They Were Thinking” captions.)

Posted in Crusty Old Paint, Diabetes, Diabetes Blog Week, General, I am Rembrandt, Photography, Travel, USA | 4 Comments