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If Not Now, When?

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:

🔸Heart Attack
🔸Stroke
🔸Kidney Failure
🔸Blindness
🔸Lower Limb Amputation

What can be done to improve access to diabetes care worldwide? It all starts with our lawmakers. We need to keep our state and federal lawmakers accountable in ensuring that our healthcare system:

🔹Provide basic health care at a reasonable cost to people with diabetes

🔹Develop policies to improve prevention of type 2 diabetes

🔹Enhance screening to ensure timely diagnosis and prevent complications resulting from diabetes

🔹Develop mechanisms to engage people with diabetes in the development of diabetes policies

As we’re voting for newly elected officials today, make sure the candidate you’re voting for is willing to support health equity for all.

Until Next Time,

The Genetic Diabetes

Wellness Wednesday: Latent Autoimmune Diabetes in Adults

Latent autoimmune diabetes in adults (LADA) is known by its unofficial name, type 1.5 diabetes. The body’s own immune system attacks and kills the beta cells that produce insulin in the pancreas. However, the process of destroying all beta cells takes longer in people with LADA than it does in people with type 1 diabetes.

As you lose the ability to make insulin, your body is unable to control your blood sugar levels. You may not need treatment for many months or years after diagnosis like those with type 1 diabetes.

LADA usually begins after you turn 30, and doctors sometimes misdiagnose it as type 2 diabetes.

In fact, up to 15% of people who are diagnosed with type 2 diabetes actually have LADA. Being misdiagnosed puts people at risk for diabetic ketoacidosis (DKA) and other long-term complications.

Furthermore, if the person does not know they have autoimmune diabetes, they will not be screened for other autoimmune diseases, such as thyroid or celiac disease, which are more common in people with LADA than those with type 2 diabetes.

LADA symptoms are similar to those of type 1 or 2 diabetes. Usually if you don’t get better within a few months of taking oral diabetes medications, your doctor might suspect LADA.

LADA is diagnosed with a blood test. Because LADA is an autoimmune disease, individuals with LADA usually test positive for at least one islet autoantibody (a protein produced by the immune system). Tests can be performed on your blood to check for autoantibodies to GAD, IA-2/ICA512, insulin, and ZnT8. These tests vary in cost depending on your insurance coverage.

As soon as oral treatments, exercise, and diet plans fail to control your blood sugar, speak with your healthcare provider about insulin therapy.

Sources: DiaTribe and EnM (Endocrinology and Metabolism)

Until Next Time,

The Genetic Diabetic

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Motivational Monday

Every member of this community is here because they or someone they know is battling diabetes.
Diabetes is a life-long condition that takes work for us to manage. What may work for us one day might not work the next. So many factors contribute to our numbers fluctuating. There’s always a chance that the condition will progress even if you do everything you can.

However, we still have three options for how to approach the way we handle this:

– Giving up and don’t do anything about this condition

– Giving in and doing the least we can to treat this condition

OR

– Giving our best and not only control our condition, but do our best to learn about diabetes and to try and discover ways to stop its progression by doing our best. Additionally, even when treatment fails, you don’t give up or give in.

This week’s Motivational Monday’s Message:

Don’t give up.

Don’t give in.

⭐️Give it all you’ve got⭐️

Until Next Time,

The Genetic Diabetic

Wellness Wednesday: Diabetes and Dehydration

Dehydration can be very dangerous for people living with diabetes

The risk of dehydration increases for individuals with diabetes since high blood glucose levels decrease hydration in the body.

Drinking water helps keep your hydration and blood sugar levels in check. Besides fighting dehydration, it can also help remove excess glucose.

People with diabetes should drink plenty of fluids – 1.6 liters (L) or 6.5 cups a day for women; and 2 L or 8.5 glasses of water per day for men.

In addition to water, there are a number of other drinks that are also effective for preventing dehydration and increasing fluid intake. Examples include caffeine-free herbal teas, sugar-free sparkling water, almond milk, and sugar-free coffee.

Drinking sodas, energy drinks, fruit juices, and sweetened drinks is not recommended since they contain a lot of sugar and will increase your blood sugar levels.

What does your water/liquid intake look like?

A. 8 or more cups

B. 6-7 cups

C. 5-4 cups

D. 3 or less

What is your drink of choice?

Share your answers below in the comments!

Until Next Time,

The Genetic Diabetic

Wellness Wednesday: Ways to Combat Diabetes Distress and Burnout to Prevent Depression

Yesterday, we’ve discussed diabetes distress and diabetes burnout. To recap:

Diabetes distress occurs when someone feels overwhelmed by the daily demands of managing diabetes.

Diabetes burnout occurs when a person becomes tired of managing their condition, and then ignores it for a while, or even permanently.

If diabetes distress and burnout are not taken care of, both could lead to depression.

There are ways to prevent diabetes distress and burnout before they cause serious long-term complications or lead to clinical depression.

  1. Observe your feelings. When you have diabetes, you can experience frustration, stress, and fatigue a lot more than usual. When you experience these feelings for a long period of time, you might need help managing your diabetes.
  2. Speak with your healthcare provider about your feelings. If you are experiencing any difficulties with your diabetes care, talk to your doctor, nurse, diabetes educator, psychologist, or social worker. They can help you with problem-solving your diabetes concerns. They may also suggest that you speak with other health care providers.
  3. Consult your healthcare provider if you are experiencing negative reactions from others. It is important not to feel that you must hide your diabetes from others; your health care provider can help you manage feelings of being judged by others.
  4. Find out if you can receive assistance with the costs of diabetes medicines and supplies. Your pharmacist and health care provider may be able to assist you with the cost of your medication if you are concerned about the cost. Additionally, look into community health centers to see if they offer programs to help people get insulin, medicines for diabetes, and supplies (test trips, syringes, etc.).
  5. Talk to your family and friends. Tell the people around you how you feel about having diabetes. Be honest about the problems you’re having. Just verbalizing how you feel can have a positive effect on reducing stress. However, in some cases, the people around you can add to it. Be clear about how and when you need their help.
  6. Allow your loved ones to help you manage diabetes. The people who are closest to you can help you to take your medicine, monitor your blood sugar levels, participate in physical activity with you, and prepare healthy meals. They can also learn more about diabetes and go with you to appointments. Provide your loved ones with ways to help you manage your diabetes that are useful to you.
  7. Speak to others who suffer from diabetes. It may help to talk with others who have diabetes. They can give you insight into how they manage their diabetes and what works for them. Other people with diabetes can help you feel less alone and overwhelmed. You can find diabetic support groups in your community or online by asking your healthcare provider.
  8. Focus on one thing at a time. Managing your diabetes can be overwhelming. If you are suffering from diabetes distress, make a list of every task that you have to do each day. Try to complete every task one at a time.
  9. Take it one step at a time. You don’t have to meet your fitness goals immediately. You may want to walk for 10 minutes, three times a day, five days a week, but you can do it by walking twice a day or every other day.
  10. Spend time doing what you enjoy. Take time to do something you enjoy; it might be talking to a friend, playing with your children, or working on a project you enjoy. Look for activities around your area that you can do with a friend.

When you address the source of your distress and burnout, you will be able to regain control of your diabetes management with the help and resources you need.

Please don’t wait to get help, you don’t have to suffer diabetes stress or burnout any longer.

Until Next Time,

The Genetic Diabetic

Caretaking With Chronic Illness

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. 

Let’s Talk About Insulin Pt. 2: Supplemental Insulin

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:

  • Humulin R
  • Novolin R
  • Velsulin R

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:

  • Apidra (glulisine)
  • Admelog
  • Humalog (lispro)
  • Fiasp (insulin aspart)
  • Novolog (insulin aspart)

Intermediate-acting Insulin

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:

  • Humulin N
  • Novolin N
  • ReliOn (NPH)

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)
  • Levemir (detemir)
  • Basaglar
  • Lantus (glarine)

Example of ultra long-acting insulin:

  • Tresiba (degludec)

Premixed 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.

Inhaled 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!

Until Next Time,

The Genetic Diabetic

References:

American Diabetes Association: Insulin Basics

https://www.diabetes.org/healthy-living/medication-treatments/insulin-other-injectables/insulin-basics