Hello all you lovely WordPress.com readers! This post is just for you. No one else will see it, as I moved my blog to wordpress.org. I hope you decide to keep in touch by following me on facebook and visiting my new site at cyberneticdiabetic.com. And feel free to drop me a line too!
As a mother with T1 diabetes (and Grave’s disease) I can’t help but wonder “Is my child more likely to develop one of these conditions and if so, is there anything, no matter how small, that I can do about it?”
You’ve probably all heard the term “genetically predisposed to diabetes”. What does it mean? Basically it means that you were born with certain genetic markers (that’s just a small piece of your DNA) and research has shown that if you have these certain genetic markers you’re more likely to develop Type 1 diabetes than if you don’t. We have no control over our DNA, so if we have them, we were born with them and that’s that. The same goes for our children. (Read a summary from Joslin Diabetes Center about what you’re child’s genetic risk may be based on relatives with T1).
Outside of the world of genetics though, there are lots of other factors that have been shown to increase (or decrease) your risk of developing T1 diabetes, including environmental factors (like certain things you eat or don’t eat), and your microbiome (that’s the “usually good” bacteria that live inside your body all the time….eww!). Researchers are doing more and more studies on these other factors every day. When factors are shown to increase your risk of developing T1 diabetes they’re called risk factors but when they’re shown to decrease your risk of developing T1, they’re called protective factors. Ahh, as a parent I really like the sound of that…protective factors….
There isn’t anything I can do about my children’s genetic risk factors, or their microbiome (yet), but what about the environmental stuff? Are there any protective factors, even if they’re small, that I can integrate into our daily lives? In short, the answer is yes.
Will they actually help to protect my kids? I’ll probably never know…but turns out most of these small changes, largely related to diet and our environments, are healthier choices for the whole family anyway, so why not try?
Some of the first protective factors we can control as parents are related to infant diet (but there are others that apply post-infancy). Infant diet protective factors include: longer duration of breastfeeding (at least 4-6 months), and waiting longer to introduce cow’s milk products (at least 8 days).
As a T1 diabetic these reasons were some of the most important ones for me when I chose to breastfeed my kids…and the main reason I really pushed myself to continue with it for at least a full year.
psst…I’ll be posting about other risk and protective factors periodically under the tag “Type 1 diabetes pathogenesis”.
- Study to investigate causes of Type 1 diabetes (abc.net.au)
So, like a lot of people, I tend to get higher blood sugars after breakfast (which I rarely eat) or morning coffee (which is a “must have” every day) than after any other bolus in the day. Until about 6-12 months ago my post-meal highs were something like 150-160. Lately, though with all the other variables I’ve introduced (post-pregnancy, nursing, hormones, stress, etc) it was getting to be like 250…even 300 some mornings. I always felt guilty about it but did I give up my morning joe? Heck no! I’ve just been keeping the problem on the back burner for several months knowing I would eventually have to deal with it. Now is the time.
Realistically, I need to reassess my entire insulin regimen including my basal rates (but for me that’s phase 2 after hormone-adjustment phase 1), so for now I’m experimenting with less conventional ways to bolus in the morning that might make the difference. It looks like I may have found one!
For the past several days, I’ve been giving myself a square-wave bolus over 30 minutes and then actually drinking my morning cappuccino starting at minute 45. Look at these CGM results: On this day, I took my bolus about 7:45 and drank my coffee about 8:30. The little bump you see about 9:30 never got over 140.
It’s not the most ideal but it’s working for now so I’ll take it! What do you do for post-breakfast (coffee) highs?
It’s official. I quit nursing my son after 13 months. Part of me wants to celebrate that my body is once again all mine and I have a little more freedom. Part of me is a bit sad because I won’t be having any more children, so this was my last time to experience that special baby-mommy nursing bond.
What does the diabetic part of me think?
Well, research shows T1 mothers are less likely to long-term breastfeed successfully. You read a lot of quotes in scientific journals like this:
I’m sure this isn’t a huge surprise to any of us, as most hard things in life are a bit harder with T1 along for the ride. Nevertheless, I’m proud that I lasted this long (despite the fact that I’m guilty of “down-prioritizing my own needs”).
Research also shows that a longer duration of breastfeeding might help protect my children from potentially developing T1 themselves. So, I’m proud for that reason as well. I really like to think that despite my broken immune system, I was still able to pass on to my little guy what he needed for his tiny immune system to grow big and strong (hopefully strong enough to know not to attack parts of his own little body!).
I’m also nervous. I’ve been telling myself that when I finished nursing I would get back on the trail to emphasizing my own health, which means letting my body adjust to the hormone changes that come with quitting (and premature menopause) and then figuring out where my insulin requirements really stand now. This is daunting. So much has changed! I weigh more. My activity levels are different. My schedule is more erratic. I eat a little differently. I was never afraid of a new variable before. I watched my BG patterns and I made adjustments as needed. But this? This is a LOT of variables that have changed at once. I almost feel like I’m starting from scratch. Then again, I knew it was coming, so the jig is up. I’m on my own once more with no excuses and it’s time to work on stabilizing my BG patterns.
Today on my lunch hour I headed home and loaded up my 6-year old daughter in the car to take her to her first day of lego summer camp (fun!). Normally I would have checked my BG before driving at lunchtime but I’ve gotten kind of reliant on my CGM and it said I was fine at 87, so I didn’t bother with a finger prick. We’re half way there and I start to feel just a little funny, so when we hit a stop sign I whip out my kit just to be sure…53. Grr! Thanks for nothing CGM!
That’s an open container of glucose tabs I’m holding while also shifting gears (no, I didn’t actually take the pic while I was still driving…I’m not crazy!).
Why did I drive-while-tabbing instead of pulling over?
Because in my world a BG of 53 (being treated) isn’t terrifying or dangerous. In my world it’s just another, albeit wearisome, inconvenience. In my world you don’t pull over (literally or metaphorically) for the big D unless you really have to….you just don’t.
Instead you adapt, and learn to overcome new challenges. Dealing with D becomes part of life and you figure out how to get the job done anyway. For me, popping a few tabs in the car occasionally, while not ideal, has become equivalent to opening a box of crackers for my kid while driving or feeling around on the floor of the car for the baby’s pacifier while driving (you know we’ve all done that one!).
You adjust to how your life is different. Like when you have kids and your life changes. It’s still “your life” but now it’s also “your life with kids” and this change brings with it lots of wonderful and not-so-wonderful moments.
My life isn’t only “my life” anymore, now it’s also “my life with diabetes” and my life with diabetes happens at home, at work, on vacation, and yes…sometimes even in the car.
My husband and I were out on date night last night and stopped at the market to pick up a bottle of water for the movies when I remembered I had a prescription of test strips waiting to be picked up.
I get my strips 450 at a time, so it usually comes in a pretty big pharmacy bag but I guess I always either go through the drive through, or have a shopping cart or diaper bag to stash it in…not tonight (on date night).
Tonight my husband and I split up and while I went to get bottles of water, he went to the pharmacy. When we met back in the middle of the store he hands me this giant (obviously pharmacy) bag…sigh.
I know I shouldn’t care what people think, and really I don’t but who wants to walk around with that?! We live in a smallish town and often bump into people we know (or have seen around before) at the market and you just know no one’s thinking
“Hey there’s a type 1 diabetic (not her fault, by the way) who must take really good care of herself because she sure does test a lot!”. Nope, they’re thinking, “What in the world could possibly be in that huge prescription bag? Must be some kind of strange and unpleasant plastic apparatus or a very large vat of mysterious cream….eww!”.
I know, it’s a very small matter in the grand scheme of D-care and all the crap that comes with it…but all the same, even though I like to try to keep “green” by using my own shopping bags, next time I find myself picking up a script that big with no where to stash it, I think I’ll ask for a bag.
TI diabetes, Grave’s disease, then early menopause….Geeezzz, what’s next? Apparently, it’s not only pretty common for people with an autoimmune disorder to develop a second autoimmune disorder but also for women with T1 to have early menopause (or premature ovarian failure-POF). Like my autoimmune disorders, I developed POF suddenly and acutely. I was only 35 years old. Without estrogen, my blood sugars skyrocketed and I was advised by multiple Drs to start hormone replacement therapy (HRT), and stay on it until I was 50 or 55.
I’m the kind of person that doesn’t believe a pill will solve all my problems (I wish!) and sometimes that we, as a culture looking for a quick fix, tend to take medications we don’t really need without considering long-term side effects.
I researched painstakingly to find the most bioequivalent (not the most convenient) versions of HRT available, settling on the Vivelle dot skin patch for estrogen coupled with cyclic Progesterone in the form of Prometrium…and (drum role please) they worked! My blood sugars and insulin requirements went back to normal, I lost weight, and generally felt great! Until 3 years later when I got pregnant…WHAT?!
So, despite my acute POF, my non-existent FSH (follicle stimulating hormone), and crazy-high LH (luteinizing hormone), miracles do happen. Now, about a year after my healthy, happy son was born, both my hormones and my blood sugars are a bit choppy. In the past, I used my consistent blood sugars as a barometer to determine what dose of hormones I needed to be on to get back to my pre-menopausal self. But, since the pregnancy my blood sugars aren’t the shining example of regularity they once were, so this time I’m attempting to adjust the hormones first and then concentrate on the insulin requirements. I suppose it’s a bit of a “Which came first, the chicken or the egg?” situation.
I’m currently on the same dosages of Vivelle and Prometrium that I was on pre-pregnancy, however what used to work so well for me….just isn’t working at all now! (Don’t worry I’ll save you the gruesome girly details). The only difference in the HRT is that my insurance Co. started opting for a generic version of Prometrium and I’ve been on that since Feb. My first step in getting the HRT right is to switch back to the Brand version and see if it makes a difference. Here’s to hoping that it works and frees me up to move on to adjusting my insulin dosages!
So, I’ve always been guilty of not rotating my pump sites enough, in fact you could call me downright resistant. I guess when I find something I like, I just want to stick with it and after all, I do ask my Endo about it occasionally and he always replies in his usual fashion “All looks good Julie”.
For years, I used to use my belly for my Omnipod and rotate through about 6-8 sites but last year, during my pregnancy, I had an enormous belly and a lot of discomfort with my pump, so I started relying on only two sites.
Since then (it’s been 13 months!), I guess I just got lazy, or caught up with putting life ahead of routine diabetes management…we’ve all been there right? Frankly, I still have 28lbs of baby weight to lose and the old sites (which were largely around my waistband) just aren’t comfortable anymore.
Well, I started noticing that it looked my insulin needs were increasing?! It didn’t make sense: I was breastfeeding, not overweight (technically), active, hadn’t changed my eating habits, other medications, etc. WTH?!
It finally dawned on me that maybe my poor old sites were just worn out. I Googled it and came across lipohypertrophy and then got scared out of my pants by doing an Image Search for it (fyi, don’t click on this Image Search unless you’re fully ready for the unsettling consequences). Enough said…site rotation here I come!
Now, I don’t have any signs of lipohypertrophy yet but when I was pregnant, my insulin needs tripled and it makes sense that my insulin absorption rates for those belly sites might have taken a toll.
I’m currently a proud wearer of a back Omnipod…day two 😉 It has it’s issues and will take some getting used to (especially when I try to carry a backpack)…but my sugars have been much lower, while everything else has stayed pretty much the same (same insulin rates, same diet and activity, same morning and afternoon coffee, same evening glass of wine…you get the picture). So far this experiment is a success, Phew!
Stay tuned for more pod placement experimentation…