To commemorate National Diabetes Awareness Month (which is every November) the Berrie Center asked an expert on the topic what living with type 1 diabetes is really like. Here is what he wrote—including what he calls, his “top 10 tips to beat the betes.”
My name is Will and I am a 14-year-old boy who lives in Connecticut. I was diagnosed with type 1 diabetes exactly 2 weeks before my 4th birthday. (Great present, right?) At first, my parents did everything to manage my blood sugars. They tested me, changed pump sets, counted my carbs and even monitored my sugars all night long. I figured I had it easy, as they were the ones doing all the work.
As I got older, I began managing my diabetes more and more on my own. I became a wizard with carb counting (math is now my best subject), found comfortable spots on my fingers to test, and can even put on my own site. My parents still help me insert my Dexcom CGM as I wear it on the back of my arm, and it is nearly impossible to reach that spot on my own.
Being diagnosed with diabetes at such a young age has had its benefits. Firstly, I really don’t remember my life without it. It also forced me to be good with numbers, as my whole day revolves around controlling them. It has also caused me to be extremely organized. Everything I do requires a few extra steps, so I am constantly thinking ahead. This has translated over to my schoolwork.
I feel I live a fairly normal life even though I have diabetes. I pride myself on the fact that I have had less sick days than the majority of my classmates. I play squash, tennis, and soccer both as a hobby and for my school team. (Exercising an hour daily is very important to me). I have traveled all over the world, eaten all types of food, and have many great friends. As my mother once told me “nobody is perfect and everybody has something.” The way I look at is at least my “something” can be managed, so I am grateful for that.
Over the past 10 years, I have maintained great A1C’s. I see my endocrinologist every quarter and always listen to her advice. One of the most important things I have learned is that saturated fat, eaten in large amounts, causes blood sugars to rise several hours (for me 5) after being consumed. I try to limit my intake to 3 grams per meal. It may sound difficult but it is actually not a big deal. (Three Oreos only have 1 ½ grams!) That being said, I am a kid so on weekends I splurge on pizza or chicken wings. The trick is to know when that fat will release in the blood stream and use an extended bolus or temp basal to fight it off. (Ask your doctor.)
I wanted to share some of my tips that have helped me over the past 10 years in managing my diabetes. I hope you find them as useful as I do.
Will’s Top 10 Tips to Beat the Betes
1) Always wash hands before testing. If you have touched food or something sticky, you can get a false high reading and there is nothing scarier than that!
2) Try to exercise 30 minutes every day. I play squash and tennis but it could be as easy as a brisk walk, shooting some hoops, jumping rope or running around with your dog. The key is to get your circulation going and move your muscles. Insulin works much better under these circumstances.
3) Don’t have insulin on board when exercising. It becomes very difficult to keep your blood sugar up which leads to eating sugar, which is counterproductive. That’s where you need to think ahead. If you know you will be going for a run at 5:00 pm, try to have your last bolus no later that 3:00pm. This way the majority of your insulin is no longer active.
4) If you ever need to give an injection due to a high blood sugar because you feel your site might not be working, it is important that you keep track of that insulin. After you change the site, disconnect it from your body and bolus the injection amount over the sink. This way your pump knows you have that insulin on board and you can keep better track of it.
5) Use a logbook! It is so much easier to figure out numbers when they are right in front of you. I keep a CVS binder in the kitchen and fill it in daily. This way I can look and easily spot patterns. If you see the same high number at 3 pm, you can call your doctor so changes can be made. If it is not written in front of you it is not that easy to recognize.
6) Keep your old site on until you know the new one is working. I’ve always done this and although most of my sites are good if I happen to hit a blood vessel or any area that isn’t getting good absorption it makes it easier to clip it back in the one that was working until the issue is resolved.
7) Night time lows are always scary. Whether you use them or not, always keep juice boxes by your bed. This way if you are low, they are right there for you to drink. I just leave mine there for weeks at a time if I don’t need them. Always replace them when they are done.
8) Don’t leave the house without fast acting sugar. Being a 14-year-old boy, I carry my Under Armour backpack with me wherever I go. It is filled with candy, (Smarties, Starbursts and Jolly Ranchers as they enter the bloodstream quickly), a juice box, testing kit and a water bottle (useful to drink or to dip a finger in to make sure it is clean before testing). Always replenish the bag when your supplies are running low.
9) Don’t forget to use your temporary basals. If you use a pump like me, temporary basals are the best feature! I use them every day. It is important that you recognize patterns (hint, hint logbook). Everybody is different but for me, sports and activity bring my blood sugar down, while stress (exams) causes it to rise. I always reduce my basal (ask your doctor) while I am playing sports. I reduce to 50% for twice the time I am being active. For example, if I am playing tennis for 1 hour I will reduce for 2 to 2 ½ hours depending on how active I am. This helps me not crash later in the day as the benefits of exercise can last for hours after completion.
10) Relax. Diabetes is a lot of work and at times can seem overwhelming but try to relax and not judge yourself too harshly. The most important thing for me is to feel good and I always feel better when my numbers are in range. That is why I work so hard to keep them there. That being said I too can get low or high numbers, but I don’t let them discourage me. I correct them and move on. It is important to remember as my parents say, “diabetes is a marathon, not a sprint.”
Will Berkley is a patient at the Naomi Berrie Diabetes Center and a Freshman at the Brunswick school in Greenwich, CT.