Dataphile Type 1 Diabetes Diet: Step 1

DinoPicFitnessSo, I’ve begun the initial earnest stages of “getting fit” (which of course involves all the additional fun stuff that happens when you start getting fit with diabetes).  No, I don’t ever expect to look like the gladiator chick with the T-rex in the picture but I will need to borrow her warrior spirit.

Brief Backstory:  Baby No. 2 (who is now 18 months) was a total surprise!  I’m pretty old to be a new mommy again and also was told I couldn’t have any more kids.   The pregnancy was difficult on my body in many ways, not to mention being Type 1, having Graves Disease, and requiring bucu synthetic hormones to maintain it.  It took me a little over a year postpartum to feel remotely back on track (and finish nursing the babe).  Then the week before this past Christmas I had outpatient surgery (also related to baby No. 2), which I hope was the final step in getting my body more or less regulated again.  Yippee!

MyFitnessPalStep1Now, it’s finally time to lose that baby weight (and hopefully get my A1c back to where it used to be)!  I’ve been tracking my weight and BGs, and keeping a rigid food journal for about three months so that I have a realistic baseline.  Also, while counting carbs is obviously a daily occurrence, I’ve never had occasion to count calories before.  The baseline data really gave me a good idea of where the calories I’m consuming are coming from.  (Note to self:  Yet another variable that I would love to compare long-term via computer algorithm to my BGs to see if there was any correlation between high/low calorie meals or days and BG readings).  I used MyFitnessPal food journaling app and a Fitbit to collect my data.

A week and a half ago I started hitting the gym for regular exercise and cutting out enough calories to supposedly lose 1lb a week.  More on how things are going and how all this is affecting my BGs in future posts : )  Wish me luck!

Check out these related posts:

Photo-a-Day: Exercise

My Fitbit Flex: A Delightful Surprise

Photo-a-Day: Exercise

Photo-a-Day_exerciseAh, this one hits close to home for me these days.  #babyweight.  Before my last pregnancy (which btw was nothing short of a miracle, as I was told I wouldn’t physically be able to have any more children several years earlier) I was in a really good routine with regular exercise and I enjoyed it (Bonus, I was in great shape too!).  The last pregnancy pretty much rocked my world and my exercise routine hasn’t yet recovered.  I feel guilty about it every day.  For my birthday (later this month,) I asked my husband for a Fitbit Aria Wi-Fi scale, which he sweetly let me have a couple of weeks early…yay!  In general, I’m really into data tracking and I know once I do head back to the gym, it will be nice to have a record of it.  I’m not setting a deadline for myself or anything…you might say, I’m just starting to get some little extra pieces of motivation in place.

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

Pixels: Your Personal Diabetes Big Picture

Over the last several weeks my husband and I spent our evenings working on a proposal (below) we submitted to the Target Simplicity Challenge.  The whole point of our idea is to simplify and customize diabetes analysis and management for patients and doctors.  Check it out!  Let us know if you’d use a site like this, or what features you’d like to see to manage your diabetes.


This is an initial mock-up to help convey the idea. Click for a larger pdf version.


PROBLEM:  Diabetes management requires continuous collection, tracking, and analysis of vast amounts of data, however current digital interfaces for diabetes data have four crucial faults.

1)   Web-based programs that pull data directly off of diabetes devices such as glucometers, insulin pumps, and continuous glucose monitors are often designed by the device manufactures and are largely proprietary.  Therefore data is siloed, increasing both access and analysis difficulty.  For healthcare professionals, this means patients come in with data either manually entered on paper, printed from the multitude of proprietary web-based platforms, or still stored on the diabetes device and requiring download assistance.

2)   They usually track only two or three variables, medication (e.g. insulin), blood glucose (BG) levels, and sometimes carbohydrate intake.  This limited number of variables is grossly lacking in context for treating individual patients, thus lending itself only to very generalized treatment recommendations…a one-size-fits-all approach.  In reality many other factors play a major role in optimizing control such as monthly cycle, fat and protein content, glycemic index, physical activity, remembering medication, stress level, etc.

3)   They simply display the data but offer very little or nothing in the way of analysis assistance.  While graphs are helpful, they are insufficient to continuously analyze long-term patterns across multiple variables.

4)   They lack any means of patient engagement and empowerment.  Data entry is time consuming and often complicated.  Analysis is focused on patient error rather than rewards.

PROPOSAL:  In order to optimize diabetes management, we need to simplify and unify diabetes data analysis, while empowering and engaging patients.  Start by creating a single platform for integration of data from multiple diabetes devices. Then leverage the current Quantified Self, and Lifelogging trends to incorporate important variables via smartphone apps and wearable fitness devices that patients already use (many of which utilize an open API), allowing patients to create a custom diabetes management mashup of apps displayed alongside diabetes device data.  The individually tailored scope will have broad patient and doctor appeal, e.g., one patient may focus on testing BG 4 times a day, need a medication reminder, and passively track walking with a pedometer, while another may test BG 10-15 times a day, use a CGM, avidly track running, nutritional information, geolocation, mood, sleep patterns, and monthly cycle.

Enable doctor and patient data mining for potential meaningful and actionable correlations by applying prevailing 3D data visualization and comparative analysis techniques and algorithms (already in practice to mine big genomics data) e.g., compare several data sets to come up with key talking points for limited doctor-patient interface time such as, “75% of your nighttime lows occur during the week following your period in your menstrual cycle” or “On days when you walk after lunch, your BG is an average of 20% lower than on days when you don’t” or use a passive geolocation app to see what places you frequent when your sugars are higher/lower.

Finally, engage users in multiple ways.  The mashup format provides individual context for the data and will enable patients to set small, attainable goals that make sense for their lifestyle.  Incentivize both with rewards and positive feedback, e.g provide coupons and create a gamification aspect where you receive Target rewards as positive reinforcement, or earn badges for meeting your goals, or receive a text saying “Great job checking your BG 5 times today!”.  Integrate the site with social media, so users can share positive feedback and receive/provide support.   Integrate healthy meal suggestions with Target shopping lists.  Provide a Target kiosk to assist patients with uploading device data or setting up an account, etc.

Check out these related (less professional and more personal) posts:

My Fitbit Flex: A Delightful Surprise

Big Diabetes Data Requires Big Analysis

Medical Deja Vu

You know that restaurant you go to once a year because you can’t quite remember why you don’t like it, so you think to yourself “It can’t possibly be as bad as I think it was!”  Then you go…and you remember “Yeah, it’s that bad and then some.”  You say to your spouse “Honey, if I ever suggest we come here again can you please remind me how bad it was?”

Well, I’m having that kind of sudden bad-memory-recall with a medication change.  Why, oh why did I listen to the doctor’s suggestion?  It’s my body and I knew better.

Fitbit sleep Sept-Oct

This image is from my Fitbit sleep tracker. Note over 30 days without HRT how much more restless my nights have gotten even though I’m in bed for the same amount of time.

The super-short version of what is wrong with me (in this situation) is that I’m post-menopausal and have been for the past 5 years.  Yes, apparently my now 15-month-old son is a complete fluke of nature (another story.)  I’ve been on Hormone Replacement Therapy (HRT) to relieve yucky symptoms such as horrible hot flashes (24 hours a day), completely irregular blood sugar readings, vertigo, trouble sleeping, joint pain, bleeding gums, weight gain, etc.  When I’m taking HRT, “Badda-bing!” I’m completely normal again…all symptoms go.  When I’m not, well obviously from the laundry list of symptoms, I’m pretty miserable.

A few months back I started having other female issues and the obgyn discovered a uterine fibroid that will have to be surgically removed (again, another story) but right before she found it she suggested that I go off of HRT just to see what would happen…to see if something had changed.  Gah!  I’d already had all these conversations with my NP but my medical team doesn’t communicate and I honestly think the obgyn just wanted to cover her bases.  Nevertheless after listening to “If it was my body, I’d do it” and “What’s the worst that can happen?  A few hot flashes?” I reluctantly agreed.

It’s been a month and all I have to say is “Never again!”  After all, my obgyn isn’t me.  She doesn’t have a myriad of other conditions to worry about, all of which are affected by drastic hormone changes.  She doesn’t really get type 1 diabetes or understand what I mean when I say “My BGs are really hard to control when I’m having all those menopause symptoms, not to mention that some of them mimic symptoms of low BG and it’s a real challenge.”  So, why on earth did I get talked into doing it again when I knew that wasn’t the issue?  Maybe I felt guilted into it?  Maybe, for once, I just wanted to be that round peg that actually fits into the round hole?  Maybe I simply let myself forget just how bad that restaurant was?  Regardless of the reason, for the next few weeks at least, I’ll be consciously only hugging my husband while I’m facing to the right because leaning my head back and looking left is guaranteed to bring on the vertigo.

You might also be interested in these related posts:

My Fitbit Flex: A Delightful Surprise

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

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

First Things First: Hormones and Insulin Requirements