Diabetes doesn’t take Vacation

Diabetes doesn’t take Vacation

Yeah, Vacation!!

In a recent TIME magazine I read that 96% of Americans recognize the importance of taking vacation, yet we are taking fewer days off than in the past and leaving unused vacation days at year’s end.

Vacation is a time to de-stress, to break away from our everyday life and daily grind whether it be through a ‘stay-cation’ or by exploring new surroundings or making an annual trek to our favorite location. Having time away can help with peace of mind, and help us reconnect with family or to interests not fully explored with the demands of work and everyday life. I know I focus better, perform more effectively and work harder when allowed time to break away and rejuvenate both physically and mentally.

This may come from a week-long vacation or simply a long weekend without work vying for my attention.

For those that need reminders I encourage you to do the same. Carve out some vacation time in any manner you will find pleasurable and doable.

Use the tips given by Gabrielle Kemble, Fit4D Health Coach, who recently wrote about how to plan for summer travel, and frankly, travel at any time of the year.

What I would like you to think about is this…while I extoll the virtues of vacation remember that diabetes doesn’t take a vacation. It goes where you go. Taking a break is vital, taking a break from the daily grind of diabetes self-management is also refreshing. However, to take a complete break from lifestyle habits or your medication regimen may impact your diabetes not only for the time away but into the days and weeks following your time off. It may be difficult to reign in the excess of vacation, just as it can be difficult after the holidays. Remember your A1C is a 2-3 month average of your blood sugar which includes what might be a weeklong break from healthy eating along with any change in activity level. So, to have it both ways, vacation with diabetes control I encourage you to plan ahead and get the best for your diabetes management and get the most out of your vacation.

Consider This

Consider how you may include occasional special treats while not over doing it. An increase in activity may help balance extra calories but we  don’t burn as much as our mind assumes. And excess calories and carbohydrates can cause the hyperglycemia you’re trying to avoid. Pack snacks, and easy foods to prepare when you have kitchen facilities to reduce frequency of dining out – and you’ll save money, too! Indulge with conscious thought to do so but in a controlled manner. Share a dessert and if you plan to do this, skip the appetizer. Or, if you plan to stop at the creamery for a frozen dessert, pick something light for dinner and not the pasta special. Enjoy the sights and take an additional walk after your meal. Manage alcoholic beverages and limit snacking. Why stock the camper, fridge or car with a multitude of snacks we wouldn’t ordinarily have at home? Don’t use vacation as an excuse to eat junk food, fast food or too much of any food. Keep snacks out of reach while driving so as not to eat out of boredom.

These are tips to manage food intake and reduce hyperglycemia. On the other hand, for those who are more active on vacation, you’ll want to plan ahead to prevent the hypoglycemia that can come with an increase in physical activity.

Medications

Everyone’s needs and desires are different just as medications are. So, think about how your medications work, and discuss with your Certified Diabetes Educator (CDE) or Health Care Provider (HCP) your vacation plans before leaving. They can help you learn how to make necessary adjustments with considerations for your medication regimen while on vacation to accommodate any change in sleep pattern, activity level, or food habits.

If you travel with a plan you are more apt to stick with it and be healthier for it, mind, body and spirit. Upon returning home you will feel better and ease into your routine more easily as well. I wish you all a fun, restful and healthy vacation!

 

Lori Muller RD, LD,

CDE Fit4D Diabetes Health Coach

Summer Travel & Diabetes

Summer is upon us, and for many people that means travel plans!  Diabetes shouldn’t hold anyone back from getting out and enjoying the fun!  The important thing to focus on, is taking your care routine with you.

 

The Essentials

Packing double the amount of medication and supplies you usually use is a great idea, incase of delays in traveling or other unexpected events.  Think about packing medication, test strips, lancets, batteries for your meter, and ketone strips.  Always take copies of prescriptions with you, should you need to get refills on the road.   Keep your health insurance card and emergency contacts in an easy to find place for emergencies; wear your medical ID bracelet or necklace.  If on insulin, be sure to bring a glucagon kit, as well as plenty of syringes or other insulin delivery devices.  It is also a good idea to check out where to get medical care near your travel destination as well.  Better to be prepared and not need it then want it and not have it.

Bring a note with you from your doctor explaining that you have diabetes and what medications you need.  If traveling to a location where a different language is spoken, consider having the note translated into the appropriate language(s).  Medications and other diabetic supplies should be packed in your carry on bag, rather than in checked luggage so that there is no risk of losing it.  Keep time zone changes in mind as you go, and be sure to take your medication at your usual times.

If you utilize an insulin pump, there are a few extra things to consider.  Request a private screening at the airport, rather than going through the body scanner.  Make sure you have extras of all your supplies – reservoirs, infusion sets, inserters if you need one, extra batteries for your pump, glucose tablets, non-perishable snacks and insulin.

 

Move!

With driving, or flying, there is always a risk of blood clots when you sit still for awhile.  Try to move around every hour or two if you are at risk for these.  Insulin that is open and in use, needs to be kept at room temperature.  If you will be in a hot car or other area, remember to pack your insulin with a cooling ice pack, putting a towel between the ice and medication to prevent it from accidentally freezing.  If you are in an area that will be excessively cold, keep your open insulin close to your body to keep it the appropriate temperature.   Unopened insulin should always be kept at refrigerator temperature, so this should be wrapped in a towel and placed with an ice pack as well.

 

Prepare for Lows

Pack plenty of pure sugar items that you can use in case of a low blood sugar.  Healthy snacks like fruit, raw veggies and bottled water are a good idea too as these are not always readily available on the road or in the air.  Make sure you have access to nutrition information.  If the places you will be eating at don’t have carbohydrate information readily available, download a nutrition database app such as Calorie King or Nutrition Data, or get a hard copy of their pocket guide versions.

Once you arrive at your travel destination, try to maintain your usual activity level to keep blood sugars in check.  And above all else, test your blood sugar!  Even more than usual, since changes in routine, eating and exercise habits can drastically affect blood sugar levels.  The more you check, the more chances you have to improve the results.  It can be difficult to balance your diabetes with changes in routine, but it if you plan ahead you can fully enjoy your summer vacation!

 

Gabrielle Kemble, RD, CDE

Fit4D CDE & Clinical Manager

 

Are Two Hats Better Than One?

We all have many hats that we wear in our lives  – parent, partner, colleague, community member etc. For me, two of my most important roles are that of being a mother and a Diabetes Educator.  The fact that my son has type 1 diabetes means that these roles intersect and overlap on a regular basis.

I often wonder how my job affects the way I parent and vice versa, and I often ask myself; is all this overlap a good thing?

As a diabetes educator, learning about and working with the latest diabetes management technologies and insulin therapy options are part of my daily routine. This gives me the opportunity to get detailed information about different diabetes self-management tools and regimens and make assessments about which ones fit well with my son’s diabetes management.


The “Holy Grail”

When I first started my career as a diabetes educator, I found myself thinking that I could outsmart this disease. If I learned enough, incorporated the latest tools, managed things closely – I could achieve “target” blood sugars for my son and protect him from any potential complications.  As I got further in my diabetes education, I came to truly understand why achieving the holy grail of blood sugar management, the “perfect blood sugar”,  with today’s treatment options just was not realistic.

The pancreas is an amazing organ and able to seamlessly manage the 28+ factors that influence our blood sugar levels. To say that being the pancreas for your child from the outside-in is hard would be the understatement of the century.  Not only is it hard, but it is near impossible to do it perfectly.

So while I know that keeping blood sugars in the target range for the majority of the time will protect my son from diabetes complications, I now use my knowledge as a diabetes educator to inform my decisions and expectations about realistic diabetes management goals for a nine-year-old boy. For instance, changing the lancet every time he checks his blood sugar isn’t one of them. Never having blood sugars spike above 200 isn’t one of them. 

Turning Emotions into Manageable Data

I’ve learned to emotionally distance myself from individual blood sugar readings and look at them as data points with patterns and trends that I can use as a basis to make adjustments to pump settings, timing of insulin or food choices. 

Experiencing the day-to-day challenges and frustrations of diabetes management allows me to connect with my patients from a place of “knowing what it’s like”. I believe the fact that I really do know how hard DM can be helps me form a partnership with my patients to reach their DM health goals. This feels way different than just looking at the numbers or policing their food intake.

Perspective

But there’s another side to wearing the two hats of mother and diabetes educator.  As an educator working on the endocrinology unit at a children’s hospital in a major city, I’ve seen and worked with kids in intensive care due to Diabetes Ketoacidosis (DKA).  Sadly, many of them I see time and time again. I’ve had to see firsthand the devastating impact of severe hypoglycemic events.

Even when we’re in a “smooth” diabetes period at home (proving that everything in life is relative), working in the hospital reminds me how quickly things can go wrong with diabetes management. I know that most kids living with type 1 diabetes are happy, thriving and living life exactly as they were meant to live it. But logic doesn’t always win – the reality is, every time I work with a child struggling with life with diabetes I can’t help but worry about my son and experience a moment of grief that he has to rise to face this challenge every single day – no exceptions, no vacations.

 
It’s All About Community

Whether I was a CDE or not, I believe I would be actively involved with the diabetes community. Being part of the community is a great source of emotional strength. There is so much to be gained from the resilience and energy of others and the knowledge that you’re not in this alone.

I feel that staying connected with other type 1 parents (who aren’t CDEs) helps me stay grounded first and foremost in being the best parent I can be for my kids – with and without diabetes. No one knows your child like you do and learning to trust your instincts – even when it comes to diabetes management decisions – is critical. 

There is no single perfect way to do diabetes management. The best gift you can give your child with diabetes is to become their advocate in finding the diabetes management plan that best fits their life and not to make them slaves to the latest study of best practices of diabetes management.

Studies may show that overall, people wearing insulin pumps have better blood sugar control than those who use multiple daily injections but if it’s bathing suit season and you have a teenage daughter – you may find that wearing an insulin pump that sits in the pool bag all day isn’t the way to go. Kids first – diabetes second. 

Life with diabetes is a marathon – not a single three-month A1c test. Let your kids make choices where you can and push your diabetes health care team to provide you with options so you can make decisions that will allow your kid to continue to pursue what’s important to them while managing their blood sugars.

As a mom, I can imagine a conversation some years in the future where my son tells me that he and his wife have discussed it and they feel it’s inappropriate for me to continue to come over to change his infusion sets. As a diabetes educator, I know that my ultimate goal is to equip him, and my patients, with the best self-management skills and the confidence to become their own health advocates.  

At the end of the day, it’s a tremendous honor and responsibility to wear these hats and I’m grateful to have the benefit of dedicated experts, patients and parents to help me on my journey to improve the lives of people living with diabetes.

 Jackson-8

Written by:

Diane Herbert MSS, LSW

Fit4D Clinical Manager