World Diabetes Day 2021 theme from the International Diabetes Federation
The availability of insulin and other elements of diabetes care remains out of reach for millions who need them. People with diabetes are at risk of severe and life-threatening complications, especially if they do not receive adequate support or treatment. Complications include:
Caring for yourself while caring for a loved one with a chronic illness or disability
There are many days when it doesn’t matter how you feel, the show must go on. In addition to managing our own conditions, many of us also have to take care of our loved ones, especially those diagnosed with an illness or disability.
I am a mother of a child on the autism spectrum. The diagnosis of my son with autism came five years prior to my diabetes diagnosis. As a result of observing him experiencing sensory issues during preschool, his diagnosis was not entirely surprising. Our son began occupational therapy every week and he received an Individualized Education Plan (IEP) for school.
My son has made amazing progress on his journey. He achieved many fine and gross motor milestones. He is a scholar student and has graduated from an IEP to a 504 Accommodations Plan. He will attend a new school this year and participate in a gifted program for language arts.
He has experienced setbacks, however, over the past couple days. Since then, he has had anxiety attacks, eaten very few foods, feared being alone, and has been having sensory meltdowns. His overwhelming fear is that things around him are moving nonstop and will soon explode. He had just been watching a YouTube video about how the universe would end.
The sudden occurrence has caught the entire family off guard. It is a waiting game in the house, since no one knows when the next episode will arrive. I am in the process of connecting with a therapist and his occupational therapist.
The whole family has been affected, and I personally have been stressed out. Having to manage a chronic illness is difficult enough, but adding caregiving to the mix is extremely stressful. My son has been sitting, eating, and resting with me for the last few days, who is usually energetic but now won’t leave my side. Rarely does he play with his siblings. He hasn’t called his best friend yet. He won’t leave our room.
This is not the same little boy who was having a blast last week on our vacation. He’s not even the same one that was dancing and full of joy two days ago.
Currently, I am managing both my own and his conditions.
It’s extremely hard.
It pierces my heart to hear him scream and cry in agony. We are literally counting the hours until we can call the pediatrician.
In the meantime, I am unable to eat or sleep well because I am so concerned about my son. Nevertheless, a wise psychologist friend I met today gave me some words of encouragement that I want to share with anyone going through similar difficulties: first and foremost, take care of yourself. If you don’t take the time to eat, rest, and manage your own condition, then you won’t be able to provide for those who depend on you.
It’s not easy to deal with chronic illness or caregiving, so when you’re ill and you’re the primary caregiver, it can be overwhelming. As a caregiver, you may be exposed to health risks due to the stress and demands associated with a serious health condition. When you are taking care of yourself and a loved one, consider these things:
While you are not feeling well, find someone to look after your loved one until you feel better. Respite care can also help you rest if the need arises.
If you have older children or adults at home, delegate certain tasks, such as taking your loved one to appointments, making calls, and preparing meals.
Organize a plan to take care of yourself and your loved one if there is no one available to help. Keep it simple:
Consider staying in the same room as your loved one. Ensure that the area is close to a restroom and kitchen for easy access.
Take advantage of the convenience of getting healthy foods delivered.
Have a place where all medications and other medical supplies can be stored.
Take the opportunity to do some work or hobbies while your loved one is resting.
Being constantly responsible for someone’s care can be emotionally and physically draining, but you will do anything for someone you love. Don’t forget to love and care for yourself as well.
An overview of the five types of supplemental insulin
In the previous post, I discussed the role of insulin and glucagon, as well as the two main types of insulin, basal and bolus. In this post, I will discuss supplemental insulin, how each type works and insulin brands.
There are more than 20 brands of supplemental insulin available in the United States. There are five types of brands: rapid acting, short acting, intermediate-acting, long-acting, and ultra long-acting. In addition to these categories, you can get premixed insulin or inhaled insulin as well.
Rapid-acting Insulin & Short-acting Insulin
To replace the natural bolus insulin produced by the pancreas, rapid-acting and short-acting insulins are used. These types of insulin are administered just before a meal or snack to counteract sugar spikes that are caused by eating.
In the medical world, short acting insulin is known as regular bolus insulin. Short-acting insulin begins to work within 30 minutes, reaches its peak between 2 and 3 hours, and lasts for 3 to 6 hours.
Examples of short-acting insulin:
Rapid-acting insulin, however, works the fastest of all types of supplemental insulin. In the case of rapid-acting insulin, onset occurs after 15 minutes, peak within an hour, and then lasts 2-4 hours.
Examples of rapid-acting insulin:
Fiasp (insulin aspart)
Novolog (insulin aspart)
Intermittent-acting insulin replaces basal insulin. Only one type of intermediate insulin exists, Hagedorn or NPH. Within 2-4 hours, the onset occurs. Peak hours are between 4 and 12 hours and the duration varies from 12 to 18 hours. As a result, some people use short-acting or rapid-acting insulin to cover meals.
Examples of intermediate-acting insulin:
Long-acting Insulin & Ultra Long-acting Insulin
The long-acting and ultra-long-acting insulins are used to replace basal insulin by maintaining glucose levels throughout the day and night. They begin around four to six hours apart, but the duration is at least 24 hours. This type of insulin doesn’t have any peak points as it is designed to remain in the system for longer.
Examples of long-acting insulin:
Toujeo (glargine u-300)
Example of ultra long-acting insulin:
In a premixed insulin injection, varying amounts of intermediate-acting insulin are combined with short-acting or rapid acting insulin. Depending on the mix, onset can take between 15 minutes and an hour. It peaks at varying times and lasts for up to 24 hours.
Examples of premixed insulin:
Humulin 70/30, Novolin 70/30 and Humulin 50/50 are mixtures of intermediate and short acting insulin.
Humalog Mix 75/25 and Novolog Mix 70/30 are mixtures of intermediate and rapid-acting insulin.
As far as we know, Afrezza is the only rapid-acting insulin that is inhaled. As soon as Afrezza is inhaled, it begins to take effect within 12 to 15 minutes, peaks in around 30 minutes, and dissipates around 3 hours after taking it.
SOUND OFF: What type of insulin are you currently using? Let’s have a conversation and comment below!
You just returned from your follow up doctor’s appointment, and it didn’t go quite as well as expected. While you’ve followed the recommended diet, exercised, improved your sleep and implemented some stress management strategies, your A1C has increased. Your doctor is strongly considering adding insulin therapy to your treatment plan.
The stigma attached to injecting insulin has caused you to try very hard to avoid using it. However, it seems that there is no alternative for you.
Feelings of guilt and failure begin to creep in. As a result of the failure of your current treatment, you feel that you failed.
Taking insulin is not a sign of failure, my friend.
When insulin therapy is used properly, you can still live a long and healthy life. There is a good deal of planning, organizing and a lot of math skills required (no kidding!), but once you understand the role insulin plays in our bodies, you will discover that insulin therapy is a life-saving tool for managing diabetes.
The Role of Insulin
Insulin is a hormone that aids in lowering the level of glucose in the blood. In response to a rise in glucose level, such as when eating, this hormone is released into the bloodstream. In the body, glucose enters cells where it can be used for energy or stored to use later.
Any excess sugar is stored in the liver, muscles, and fat cells. In the cells, glucose reaches its normal level once it enters the cells.
The presence of low blood glucose stimulates the release of another hormone called glucagon by cells of the pancreas. Glucagon activates the liver to release the stored glucose known as glycogen from the liver into your bloodstream. Throughout the day, insulin and glucagon alternate their release in order to keep blood glucose levels stable.
A person with type 1 diabetes needs insulin therapy to replace the insulin that is not produced by the body.
The insulin therapy is sometimes necessary for people with type 2 diabetes or gestational diabetes when other treatments have not controlled blood glucose levels. Maintaining a target blood glucose level prevents complications.
Basal & Bolus
Insulin comes in two basic forms: basal and bolus.
Basal insulin is a long-acting type of insulin, also known as a “background”. Basal insulin boosts activity for about 24 hours at a time. High resting blood glucose levels can be brought down with basal insulin by providing a continuous supply of throughout the day. Basal insulin is usually taken once or twice a day to maintain consistent levels. By using basal insulin, glucose levels can remain steady even when individuals are not eating, allowing the cells to use energy more efficiently.
Bolus insulin is a more powerful, but shorter-lasting type of insulin. It is commonly taken before meals and during periods of higher blood sugar. Bolus insulin is taken at mealtimes to maintain a healthy level after eating. It is also known as “rapid-acting” insulin because it needs to work fast. Bolus insulin usually works around 15 minutes, peaks after an hour, and lasts for 2-4 hours. Bolus insulin is affected by the amount of food a person eats during a meal; therefore, it’s necessary that a person with diabetes knows how many carbohydrates they consume so that they can adjust how much insulin they need. Many people using bolus insulin use carb counting and carb-to-insulin ratios as tools.
Basal-bolus insulin therapy is an intensive insulin treatment that involves taking basal and bolus insulin simultaneously. This means that some people takes basal insulin once or twice a day and use bolus insulin at mealtime. In addition to insulin, people with type 2 diabetes may need to take oral, non-insulin medications.
Did you know that there are over 20 different types of insulin on the market in the United States? Tomorrow, I will share the five types of supplemental insulin and how each of them work.
It’s easy for us to be concerned about the future with chronic illness. However, we must keep in mind that there is so much life left in us. It may not be the ideal life that we’ve imagined, but it is still life. So instead of worrying about the how our conditions might affect us in the future, let’s just focus on today. Do what you can today.
Diabetic discrimination at the workplace: What you can do
Take a moment to imagine this:
You’ve worked for your employer for several years. It’s a great job and you love the environment. You have just been diagnosed with diabetes. Suddenly, your entire lifestyle has to change. You must take new medications, alter your eating habits, and increase your physical activity. In addition to adjusting to these changes at home, you will also have to adjust to them at your workplace as an employee with diabetes.
During your work hours, you need to monitor your blood sugar twice, have snacks handy, and find creative ways to incorporate physical activity. In addition, you will need to locate a discrete area at your workplace where you can take insulin and other medications.
However, when you tell your immediate manager about your medical condition and accommodations that you request, the manager is nonchalant and doesn’t seem to care. The manager feels that you’re making too much of your condition, and believes that it would be unfair to give you “special preference” over all of the other workers.
This is an example of workplace discrimination based on chronic illness. It’s more common than we realize, especially when it’s a non-visible condition like diabetes. The awareness of diabetes among employers is still relatively low, even though it is one of the fastest growing chronic diseases in the US and worldwide.
Employees with diabetes working in the United States have Federal and State rights. A federal anti-discrimination law, the Americans with Disabilities Act, covers employers and unions with 15 or more employees. It protects people with disabilities from unfair employment practices. An employer may not treat you differently based on the fact that you have diabetes in hiring, firing, discipline, pay, promotion, job training and fringe benefits. You must be a “qualified individual with a disability.” Diabetes has been characterized as a disability due to its detrimental effect on the endocrine system, which regulates bodily functions.
Many states have their own laws against disability discrimination. These laws and the state agencies that enforce them may give employees extra protection and may apply to smaller employers as well.
Providing reasonable accommodations is the way employers can ensure people with disabilities do their jobs and are treated fairly. The majority of people with diabetes only need to make small changes that cost little or nothing.
Asking for accommodations is employee’s responsibility. While not entirely required, it is best to submit a written request for accommodation that explains why diabetes is a disability; specifies the accommodations required; and how the accommodations will enable the employee to carry out job duties effectively. This should be given to the human resources department along with a letter from the physician confirming the request.
There are a number of reasonable accommodations that may be provided. Here are some examples.
• Breaks for blood glucose testing, eating snacks, taking medicine, and going to the bathroom
• Keeping diabetes supplies and food close by
• Leaving for treatment, recovery, or training on managing diabetes
• An alternative work schedule or a standard shift instead of rotating shifts
• People with diabetic neuropathy (a nerve disorder caused by diabetes), for access to a chair or stool;
• People with diabetic retinopathy (a vision disorder caused by diabetes), for access to large-screen computer monitors or other assistive devices
Eligible employees can also take can advantage of the Family and Medical Leave Act (FMLA). Employees with serious health conditions, most private employers with more than 50 employees, and most government employers, must provide a minimum of 12 weeks of leave per year. You can take this leave in small time chunks to attend to short term problems, for example, managing blood glucose levels or to attend doctor’s appointments.
If an employer refuses to accommodate reasonable accommodation requests, conducts illegal medical inquiries or undergo an illegal medical examination, employees are encouraged to contact the Equal Employment Opportunity Commission.
The American Diabetes Association and the Chronic Disease Coalition are two organizations dedicated to assist employees experiencing workplace discrimination due to diabetes.
The American Diabetes Association has created an entire section on workplace discrimination and provides resources for employees and employers.
The Chronic Disease Coalition is a strong advocate for rights for individuals diagnosed with chronic illness. Chronic Disease Coalition Ambassadors have published several stories related to workplace discrimination and has a section that keeps people updated on current legislative efforts.
The fact that we live with an invisible illness does not mean we are not struggling and that we are not exasperating our condition. We remain hardworking, dedicated workers capable of performing our jobs. In order that we can effectively do our jobs and provide for ourselves and our families, we need to be treated with dignity and to be provided with the accommodations we need.
I can no longer watch my family making unhealthy choices
If anyone wants to know why I do what I do, here’s one of those reasons: to be able to see this sweet face everyday.
I want to show him and his siblings the right way to take care of the temple that God gave to them. I want to show them that this diagnosis is not the end of the world, and that we have the power to change the narrative.
Observing their current eating habits solidified that the fact something has got to change. With a family history of diabetes and heart issues on all sides of their families, there’s no reason why my family should not start changing their current lifestyle.
In a couple of weeks, I will be sharing what my husband and I are planning create a new health legacy for our family. Follow my blog to stay updated!
Read how Allison is taking charge of her health and not allowing anything to stop her.
Allison Age: 45 Conditions: Hypothyroidism and allergies to everything outside (biweekly shots) and dust mites and mold.
Year diagnosed? 15 or so years ago for hypothyroidism and maybe 5 years ago I was tested for allergies.
How were you diagnosed? Tested by blood tests for hypothyroidism after demanding bloodwork (doctors said I was fine, I work too hard, maybe I was depressed…I knew something else was wrong but couldn’t figure out what). After bloodwork they were almost surprised, like oh, something IS wrong. This was probably the hardest part and the part that took the longest. It’s hard getting passed doctors who look at you and say you’re fine and disregard what you’re trying to tell them. With allergies, same thing, I had to keep trying to figure out root causes of why I struggled. Life shouldn’t feel so hard. Allergies are one of those things too that doctors can’t see, but the patient feels and knows something isn’t right.
How have the chronic conditions affected your life? I think the mental torment is the worst part. I tried for so long to fix things on my own or worse, thought I wasn’t doing something right. I cried a lot. Conditions like these often go unnoticed or undiagnosed but the symptoms are terrible to live with. I take medicine for hypothyroidism. I have no idea if I could feel better, I don’t know any different. I still want to find a better doctor. Currently where I go the doctor turnover is so high it’s like I have a new primary doctor every year and half to two years. It’s frustrating and honestly, I haven’t put in energy to find a different doctor (I would have to travel more than I already do for doctors and I’ve become complacent. Typing this is convicting me to not be. 😳😶
Your thyroid plays a HUGE role in your overall well-being. I had no idea and still could learn more. Again, just typing this is convicting me to start researching it more and find a doctor who specializes in it. I’ve heard so many say they can get off medications with proper diet. I asked a thyroid specialist and he said, NO! Food doesn’t change anything. I don’t know why I stopped checking. I assumed since he was the specialist on thyroid disorders, he would know. I know I don’t live in area where there are many specialists. I had to drive over 100 miles just to see him (which is probably why I stopped checking. 😔).
How have you grown since diagnosis a d what do you wish people knew about the condition and/or chronic illnesses in general? I will say that learning about what I COULD do enabled me to actually feel like I’m living. I hear so many women give up like it’s a life sentence to be turned an overweight for the rest if their lives. I’m living proof you can be fit and healthy with hypothyroidism. I have to work for it and eat healthy, but it’s possible. 😁💪🏻❤
I hope that Allison’s story resonated with you. Learning more about your condition and researching ways to control the symptoms is the first step in owning your health journey.
You have the power to take charge of your health. Don’t let your illness control you!
We want to hear your story!
If you would like to be included, email me at firstname.lastname@example.org by July 18th with the following information:
First name Age (Optional) Condition Year diagnosed How you were diagnosed? How has your condition affected your life? How have you grown since your diagnosis? What do you wish people knew about your condition or chronic illness in general? Picture of yourself or family (optional)
Your story has the ability to educate, empower and motivate others who might be struggling on their own journey. Telling your story can be freeing and therapeutic, not only for the listener but also for yourself. The more you share your story, you will gain a better understanding of yourself and it will also help build greater self-confidence.
Telling your story has the capacity to change lives, including your own.
I’m excited to announce that illustrations for my first published book, My Diabetic Mama are completed and the images are absolutely gorgeous!
The next steps are editing and proofreading. That process should take no more than a few weeks. In the meantime, we will start our official webpage for our book as well as some pre-ordering information. My plan is to debut the book later this summer.
My Diabetic Mama is a children’s book featuring 8-year-old Mac, whose mom has been diagnosed with type 2 diabetes, along with his family, that supports his newly diagnosed mom adjust to new lifestyle changes. This book is recommended for elementary school students in grades 2-5. This book will cover a basic definition of diabetes, the two major types of diabetes (type 1 and 2) and general symptoms of high and low blood sugar levels.
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