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Blue November: Week 3

We are now into week 3 of Diabetes Awareness month

and kicking ass! Coral's BG has been in range 74 percent of the time for the past three days! That's a new success for us since pumping back in April. One of the most critical reasons we keep her BG in range as much as possible is to prevent diabetes complications and we don't ever want to see her in diabetes ketoacidosis again. Read below for more daily awareness posts also seen on Instagram.

diabetes-ketoacidosis-t1dlife

Day 13: Diabetes ketoacidosis (DKA)

can lead to a diabetic coma and even death. This is NO joke and many T1ds, like Coral, are in DKA at time of diagnosis. When your cells don't get the glucose they need for energy, your body begins to burn fat instead, which produces ketones causing your blood to become so acidic due to the inability to produce working insulin. Dehydration occurs, hence the insatiable thirst, because the excess glucose carries water with it into the urine. The more you drink, the more glucose is flushed out and more fat is used for energy, sending a patient into further deadlier #DKA. The person must be hospitalized, receive IV re-hydration, insulin, and electrolyte replacement as soon as possible. ๐Ÿ†˜
. . .
Early symptoms include fruity-scented breath, increased thirst and dry mouth, excessive urination, increased hunger, lethargy, confusion, nausea, and abdominal pain. Later urgent symptoms include vomiting, severe abdominal pain, rapid breathing, shortness of breath, unconsciousness. ๐Ÿจ
. . .
To prevent DKA, many experts advise T1ds test: ๐Ÿ“‹
• Their urine for ketones when their BG is over 240 mg/dl ๐Ÿšฝ
• When you are ill (when you have a cold or the flu, for example), check for ketones every 4 to 6 hours ๐Ÿค’
• Also, check for ketones when you have any symptoms of DKA ๐Ÿคข
• Check your pump site and tubing ๐Ÿ“Š
. . .
Source: Walsh, John, PA, CDTC and Ruth Roberts, MA. “Pumping Insulin,” 6th ed. P 181-187. ๐Ÿ“˜
. . .
Share and tag @type1diabetic_life on Instagram or @typeonediabeticlife on Facebook.

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Day 14: Happy Birthday Sir Frederick Banting

and thank you for saving our lives. November 14th is World Diabetes Day. Please wear blue to show your support for Coral and all the millions of diabetics fighting this disease everyday. Share and tag @type1diabetic_life when reposting. Mahalo and live well. ๐Ÿ™๐Ÿผ๐Ÿ’™

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Day 15: The glycemic index (GI) of a food ranks how quickly it raises the blood glucose

High GI carbs raise the glucose faster and often higher than low GI carbs which have a slower rise in BG. Foods are compared to glucose, which ranks 100. Ripeness, cooking time, fiber, fat content, and how foods are combined impact how long they affect the glucose. The GI of a food varies somewhat from person to person. I would much rather give Coral something with a lower GI as much as possible and especially when her BG is over 150mg/dL prior to eating. Having a CGM helps to track and prevent any spikes in BG. For the recently diagnosed T1d, it’s best to start off with low-carb and/or lower GI foods until you get into the rhythm of things, carb counting, and a CGM and/or pump. Do some experimenting and record-keeping to see how certain foods affect you, but don’t be disappointed if it’s different one day - 3’s a charm. ๐Ÿ‘๐Ÿผ๐Ÿคž๐Ÿผ
. . .
Some carbs with low GI are Mission whole wheat low-carb tortillas, beans (lima, pinto, etc.), green apples, cherries, grapefruit, barley, cracked wheat, whole-grain rye bread, and plain Greek yogurt. Some of our favs are Skinny Popcorn (all products), Halo Top Creamery, Arctic Zero ice cream, Enlightened Ice Cream, Chocorite, Simple Mills (all products), and Aidells Pineapple Bacon Sausage. ๐Ÿซ๐Ÿฟ
. . .
Source: Walsh, John, PA, CDTC and Ruth Roberts, MA. “Pumping Insulin,” 6th ed. P 41-44.

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Day 16: A continuous glucose monitor (CGM) is a computerized device that continuously transmits glucose readings

with trend arrows and sends those to a smart phone or Apple Watch. This helps T1ds and their caregivers keep a close watch on their BG, correct highs and prevent lows, and gives slight piece of mind overnight while fasting due to user-set alerts. Both real time and downloaded data can be used to modify basal (slow-acting Insulin) and bolus (fast-acting) doses. It is also especially vital for young children and/or those who are hypounaware and not able to “feel” when their BG is low (typically below 70mg/dL). Great for traveling, driving, or high-risk profession or activity. Other benefits include sharing data with others, tighter glucose management and overall improve health and prevention of further diabetic complications. The only con is that a CGM such as Dexcom is painful to insert. Well worth the added security and investment though. NOTE: Once a low glucose is treated, fingerstick readings will be more accurate than that from a CGM for the next 20-30min (DONT CALIBRATE AT THIS TIME until you get a ➡️) because the CGM algorithm requires time to verify that the glucose has actually changed direction. Don’t ever judge someone’s management based off of a Dexcom graph or at all. Period. ⌚️๐Ÿ’ช๐Ÿผ
. . .
Source: Walsh, John, PA, CDTC and Ruth Roberts, MA. “Pumping Insulin,” 6th ed. P 13-21.

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Day 17: Tips for helping a Type 1 diabetic when they’re feeling “low” (blood sugar below 60-70mg/dL):

  • Stay calm๐Ÿ’ช๐Ÿผ
  • Recognize hypoglycemia is underway๐Ÿง
  • Minimize embarrassment maximize cooperation๐Ÿ˜‰
  • Take charge of the situation using gentle, but a firm tone of voice๐Ÿ˜Œ
  • Try not to react to any irrational comments or accusations๐Ÿคญ
  • Treat the person quickly with fast-acting carbs (Juice, Smarties, wafers)๐Ÿฌ
  • Suggest rather than demand eating or drinking something like saying, “You’ll feel better after you eat (or drink) this.”๐Ÿ˜ฌ
  • Avoid direct questions such as “Are you low?” or “Do you need to test?” They may not be able to think clearly and just say “No” or become defensive๐Ÿ˜ค
  • Severe hypoglycemia - use glucagon injection if non-responsive, unable to eat or drink anything, having seizures or unconscious (finger poke ASAP to confirm low BG) CALL 911๐Ÿš‘
  • Don’t ever put anything in the mouth of a unresponsive person! ๐Ÿ˜‘
. . .
Source: Walsh, John, PA, CDTC and Ruth Roberts, MA. “Pumping Insulin,” 6th ed. P 175-176.

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Day 18: Celiac disease is 8 times more common in people with Type 1 diabetes

affecting 1 in every 12 and one in every hundred people in the U.S. of all ages. It’s another autoimmune disease where there’s an abnormal response of the immune system to gluten, an ingredient found in all wheat foods, several other grains, and in many food additives. Other foods can also be contaminated with gluten when processed in the same equipment used to process gluten-containing grains. ๐Ÿฅ–๐Ÿš
. . .
Celiac symptoms vary from vague to severe and overlap those of other diseases like gastroparesis, irritable bowel syndrome, ulcerative colitis, chronic fatigue syndrome, intestinal infections, and depression. Those symptoms may include intestinal problems such as bloating, cramping, stomach pain, diarrhea, absorption problems leading to vitamin deficiencies, bone loss, osteoarthritis, anemia, “failure to thrive” children, inflammatory reactions, irritability, headaches, joint pain, and itchy skin. Early diagnosis can be made with blood tests for Tissue Transglutaminase Antibodies (tTG-IgA) first, then IgA Endomysial Antibodies (MA), Deaminared Gliadin Peptide (DGP, IgA and IgG), and total serum IgA. An Endocrinologist will give a Type 1 diabetic these blood tests once a year usually by the time of their Diaversary. If negative but strong reasons to proceed exist, oral endoscopy with intestinal biopsy is required to detect telltale intestinal changes. This will be very unpleasant for a young child. Full presence of antibodies plus a positive biopsy is considered the gold standard for diagnosing celiac disease. Contact Your PCP or Endocrinologist with questions or suspicions. DO NOT eat gluten-free based solely on a “hunch” prior to testing. ๐Ÿ‘ฉ๐Ÿป‍⚕️
. . .
Source: Walsh, John, PA, CDTC and Ruth Roberts, MA. “Pumping Insulin,” 6th ed. P 193-194.

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Day 19: If you’re a non-d and have been following @type1diabetic_life and all my recent educational posts, then give yourself a round of applause because you’re a gem 

The least anyone - either family or friend, can do to support a Type 1 diabetic is to EDUCATE themselves. Seriously, how hard is it to just #Googleit??? I’ll say it again: Type 1 diabetes is an #autoimmunedisease - not a lifestyle disease, where the body’s immune system attacks the insulin-producing beta cells in the pancreas. T1d’s need insulin to live either by injection or pump (more in the hashtags below). It’s already crazy difficult to adjust to this new life on the drop of a dime. Make it easier for us by showing a willingness to learn and stock our fridge with lowcarb goodies. Thank you! Share and tag @type1diabetic_life ๐Ÿ’™๐Ÿ’ช๐Ÿผ๐Ÿ™๐Ÿผ
. . .
When you or your child are newly diagnosed, it’s important to seek the support you’ll need to get you through that first year. Cut ties with those who fail to put in a mutual effort. They were selfish to begin with and relationships like those are toxic.✂️
. . .
Mahalo for reading this far and sticking with me! Are you ready for all the holiday sales and craziness? I'm shopping for Thanksgiving groceries on Tuesday. 

Peace out,
Shelsea

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