Diabetic Shaming

Laughter makes everything better.  Let me explain:  My husband came up to me randomly, asked me to hold up this piece of paper without reading it and snapped my pic.

Diabetic ShamingWhen he showed it to me, I started cracking up, even though minutes before I’d been upset about my recent bout of high nights.  Even when we do our damnedest to maintain good BG control, we can’t always get it right and sometimes laughter really is the best medicine.  If you’re confused by the post title, or the sign I’m holding, and yet still reading, see DogShaming.  This is also my “Photo-a-Day: Frustration” for National Diabetes Awareness Month.


This post is one in a series for the National Diabetes Month of November.  Kerri from sixuntilme.com initiated the Photo-a-Day idea and prompts and lots of other diabetes bloggers have chosen to follow suite.

Is Type 1 Diabetes Different for Women than it is for Men?

I read this article that’s been circulating the Internet over the past few days entitled “Men With Type 1 Diabetes Are Better at Blood Sugar Control Than Women” and I found myself thinking that maybe this isn’t such a surprise.  Although the media’s inflammatory word choice for the article title seems to imply “men do it better”, the actual study title, “Sex differences in glycaemic control among people with type 1 diabetes” and study content lean towards biological differences.

Why am I so interested in this study?  As a woman I truly believe that hormone balance is a key issue in my BG control.  In fact I’m sure of it because I’ve tested my theories in my own private lab (i.e. my body).  When my hormones are balanced, I’m proactive with my BG control, fine-tuning my basal rates and having reasonably good predictability of bolus outcomes.  Whereas, when my hormones are not balanced, suddenly my fine-tuned basal rates and boluses don’t work as well as they used to, my insulin resistance goes up, and I’m constantly chasing highs and treating lows.  Even PWDs who don’t have extra complications beyond a normal monthly cycle often mention having higher BGs the week prior to their periods.  Are there type 1 diabetes issues related specifically to women that we should be aware of?

I decided to look further into it.  First, I wanted to actually see the real study this media story was based on.  It took some digging but I found the Abstract and Poster submitted by Dr. Wild to the European Association for the Study of Diabetes (EASD).  The study divided individuals into 3 age groups, under 15, 15-24, and over 24.  womens life stages 3The final conclusion states: “In this cross-sectional analysis of international data, there was a small difference in glycaemic control in males and females in the youngest age group, however control of type 1 diabetes was poorer in women than men in the two older strata.  This association did not appear to be confounded by age or duration of diabetes.”   Seems reasonable to me that the youngest strata is the least different from males, in that most of that age group hasn’t started a monthly cycle yet.  (Yes, I’m sure there are also many other biological reasons to consider.)

Secondly, I looked up information about Dr. Wild and found an interesting recent article she authored related to female cycles, diabetes, and diabetes-disease correlations, entitled “Diabetes in women − A life-course approach”.  I’m hoping this means more future studies will be conducted related to PWDs and hormones.  The lack of information on this has been frustrating for me, to say the least.  A few specific women’s health correlations to diabetes from the article are below.  While most of the correlations are negative, I’m certainly not trying to be Ms. Diabetes Doomsday.  But I do feel that as PWDs, these are women’s health correlations that we should be aware of.  If for no other reason, than that our local OBGYN, Endo, or Primary Physician may not be (mine weren’t aware of quite a few).

And after all, let’s call a spade a spade; women do tend to be more complicated ^_^

  • T1 diabetes appears to be associated with a delay in menarche and with menstrual irregularities.
  • Diabetes is associated with less frequent ovulation and the ability to conceive was about 75% of that of a non-diabetic.
  • There is evidence to suggest that women with diabetes undergo earlier menopause than women without diabetes.
  • Women lifecycles 2Effect of pregnancy on pre-existing diabetes:  Pregnancy leads to increased insulin resistance and is associated with a higher frequency of hypoglycaemic episodes (and reduced hypoglycaemia awareness) in women with type 1 diabetes.
  • If you have gestational diabetes, you are at increased risk for developing subsequent T2 diabetes.
  • Odds of developing T2 diabetes were 4-fold higher for women with PCOS than those without.
  • Post Menopausal Hormone Replacement Therapy (HRT) in PWDs:  Given the risks of both diabetes and the menopause, each case needs to be evaluated on its individual merits. Do the vasomotor and osteoporosis benefits outweigh the risks of endometrial or breast cancer? A large meta-analysis found that women with diabetes taking HRT had significantly reduced insulin resistance (12.9%, 95%CI 19.8–51.7%), reduced fasting glucose (11.5%, 95%CI 5.1–18.0%) and reduced fasting insulin (20.2%, 95%CI 4.2–36.3%), compared to those taking placebo or no treatment.
  • HRT in PWOD’s:  A meta-analysis of 107 randomized controlled trials found a 30% reduction in the incidence of diabetes in women taking HRT vs no treatment or placebo.  They also found non-diabetic users had significantly lower abdominal adiposity and waist circumference and more positive lipid profiles than non-users. Again individual women need to weigh the risks and benefits of HRT.
  • A number of studies have repeatedly confirmed osteoporosis as a complication of T1 diabetes.
  • Women with T1 diabetes were 12.25 times more likely to report an incident hip fracture than women without diabetes.
  • A number of researchers have looked at the relationship between diabetes and endometrial cancer and consistently found an increased risk of endometrial cancer amongst women with T2 diabetes.   No association has been shown for T1 diabetes.

You might also be interested in these related posts:

Synthetic Hormones and Type 1 Diabetes: A Call For Sharing Personal Stories

First Things First: Hormones and Insulin Requirements

I Ate an Entire Tube of Glucose Tabs During the Night: So Much for My SoloHealth Station Assessment

Wednesday night was date night for my husband and I, just a relaxing dinner for two.  We planned to make it an early night (since I had a cold) but didn’t want to get home before the kids were in bed (sorry sweeties…we love you but mommies and daddies sometimes need a little break).  So, we stopped at the drug store to pick up a couple of things, where we spotted the SoloHealth Station and, being in no rush to get home, decided to give it a whirl.

Love Tester MachineOk, I confess we were a bit like kids playing around with the old-school “love testers” at the fairgrounds.  “My turn, my turn! Yeah, take that test too! Giggle, giggle.”

Turns out my husband could stand to work on improving his sleep patterns, but me? I passed all the tests with flying colors, including BMI, Blood pressure, Sleep Assessment, and a Health Risk Screening.

SoloHealth Station

I’m not the most photogenic person. My husband is forever laughing and calling me out for “talking” during the picture.

However, last night I definitely wasn’t’ the shining example of health portrayed by my friend, the trusty SoloHealth Station. Last night I was low, low, low.  Don’t you wish there was an easy or obvious answer for every bout of irregular blood sugar readings?  I may feel guilty when I miscalculate my carb intake and end up high or low…but at least I know why!  I find it infinitely more frustrating to be left guessing…or to have irregular blood sugars for some other reason that I have no control over, like an illness.  While I do have a pretty wicked head cold right now, I’ve already had it for about 5 days and usually being sick raises my sugars instead of lowering them.  Last night my CGM woke me at least 4 or 5 times!  A couple of those times I was only a little low, so I just popped a single tab or two and fell back asleep (thinking the issue would be over).  Only to be woken again, and again, and again.  Finally I was woken in the 40s and upon dragging myself out of bed I realized that my menstrual flow had gone haywire in the night and was extremely heavy.  Huh? Now I’m sick, having hard-to-ditch low blood sugar in the middle of the night, and a heinous menstrual cycle?!  Is this the Universe’s cocked-up way of letting me know it’s Friday the 13th?  Not funny Universe…not funny.

Dexcom CGM low nightAs bad as it is, I’m thankful for my CGM and the peace of mind it provides in situations like this.  What could have happened if I didn’t have it?  After all, I was pretty zonked out on cold medicine.  This isn’t the first time since having my second child and going back on HRT 6 months ago that I’ve had a crazy girl cycle.  Guess it’s time to bite the bullet and go to see the Dr again just to be on the safe side and make sure I’m not missing anything (short of the Universe’s evil Friday the 13th plan, of course).  But, it’s also definitely one of those mornings where I wish I could just catch a break.  I wish I could just be an average Joe, someone who could actually use the SoloHealth Station (with it’s simple metrics and variables) to get a realistic snapshot of my health.  Sigh…

mySugr Diabetes Logging App: Awesomesauce!

How on earth could a diabetes logging app earn the term “awesomesauce”?  I mean, come on, we all know logging is lame.  Well, read on!  mySugr is easy to use, modern looking (seriously, no medical clunkiness here!), and extremely rewarding.  It’s fun to play, keeps my information stored and accessible in a bunch of useful ways…and it’s pretty too!

When you first create your account with the app, you get to name your “Diabetes Monster.”  This little guy sits on your home screen and chides you with silly faces and “na nanny booboos” until you earn 50 points in a day and then he gets a zipper placed over his mouth (literally) and you’ve “tamed the monster” for the day.  Here, mine is named “Yo Cyborg Yo” and I currently have 38 points, (which is tracked with a blue progress bar in the top portion of the screen).

mySugr home screen

mySugr logbook blank entry

Logging entries is quick and easy.  The time  and location are auto-set.  Most of the fields use your phone number keypad (as opposed to scroll wheels with limited options).  There are three screens of fun little icons for quickly adding information that you’d have to type into a notes field in other apps, like “alcohol” or “menstruation” (don’t worry, there is still a manual-type notes field for when you want it).

mySugr icons

One of my favorite features of this app is the ability to take pictures of what food I’m logging (right from the log entry), because it’s not about the number of carbs but the type of carbs, right?  They really hit the nail on the head here.  No more laborious, typed descriptions of what kind of food I’m eating…just snap-and-go!

There is a colored BG graph at the top of the logbook and as you scroll back through your entries, the graph moves too and shows the BG data occurring in the 24- hour period surrounding the logbook entries currently showing on your screen.  I love how dynamic this is!

mySugr-logbook      mySugr photo entry

You can also look up past entries by searching for any term you typed in (such as descriptions or notes), location name, or chose a picture from the photo library and then see the same 24-hour graph displayed for any search results entry you chose.  Great for checking to see what happened to your BG the last time you tried you a pint of stout from that new place down the street :)

mySugr challengesTo get the Pro version (which includes the keyword search, unlimited photos, and various personalization options), all you have to do is “play” the challenges.  Yes, there are enough challenges to let you win and keep Pro without paying for it…if you keep playing and completing them.  Two of the challenges involve logging a certain number of BG entries and two of them involve logging a certain amount of activity  (bonus: one of these earns community points towards JDRF donations!).  All challenges are available once a week.

Even though there isn’t a corresponding website where you can access your data and reports, your data is stored on a server and you can access it on multiple devices (iPhone and iPad) at the same time after entering your account info into the app.  This is key for me so if my iPhone gets lost/stolen I won’t lose all my past data forever.

In a perfect world, what would I add if I could?

  • I’d love if it had a way to enter information for an extended bolus.  When I eat something that I use a bolus extension for, I like to try to look back at similar entries and see if past extensions worked or need modification.  i.e. Did I extend 50% for 2 hours or 30% for 3?
  • I’d also like to be able to save “activity descriptions” I’ve entered in some kind of dropdown, so I didn’t have to type the same ones over and over.
  • And I’d like to be able to reorganize the order of the tag icons, so I could put the ones I use the most on the first screen and not have to flip through several screens to get to them.

A word on customer service:

I had a syncing error when the app was updated and lost enough data to make me loose a couple of challenges.  Sad face.  I contacted customer support (turned out to be Scott Johnson) and he promptly sent me a coupon code to redeem several days of Pro (plus some for my trouble).  When there was a glitch in the system to cache in those days on my account, I contacted him again.   It took quite a few trial solutions for them to figure out what was going wrong and fix it but they really stuck with it until a solution was reached….for one little piddly customer.  I was impressed.

mySugr Made with loveAs a final note, I really appreciate when I scroll down on the home screen and see a little “Made with love ♥” tag.  My husband, who is a designer, uses this saying a lot.  When we go out to eat he uses it to describe a plate of food that he thinks someone gave a lot of cooking time and attention to, as opposed to slapping it on the plate.  So, if mySugr were a plate of food I ordered in a restaurant, it would certainly earn the term Made with love!

A Few Blogger Reviews: