Past News Articles

Winter 2010-2011

Advice From 176 Years of Healthful Living with Type 1 Diabetes

 

The type 1 diabetes medal is awarded to people who have achieved 50 years of living with type 1 diabetes. To learn the secrets of the medalists’ success, we interviewed three type 1 diabetes medalists who, combined, have lived 176 years with type 1 diabetes: Tom Beatson (68 years), Patricia Glass (50 years), and Gilda Harris (58 years) (see photo).

How has diabetes management changed throughout time?

PG: We used to take a set dose of insulin, with no clue what was going on with our blood sugar. I was a member of a club at school where everyone at meetings got treats and they’d give me an apple. Those diagnosed now have so many more options.

GH: We tested our urine sugar with tablets. You would put a tablet in a test tube and add drops of urine and water. The liquid would change color, and you could match it to a scale to approximate your blood sugar.

How do you think public knowledge/opinion of diabetes has changed throughout time?

TB: People, especially teenagers, didn’t talk about having diabetes. This has changed. General knowledge is improving, but there are still big problems. Everyone assumes when you tell them you have diabetes that you have type 2, especially of older people.

GH: People do know more now, but there are still people out there who believe diabetes is caused by eating too much sugar, or that people with diabetes cannot have foods with sugar. We call them the “diabetes police,” those who say “you can’t eat that.”

To what do you attribute your success at managing diabetes?

TB: The training that my mother gave me, how she went about learning so that I could learn. She acquired a Joslin manual and put it on the bookshelf and made sure I knew it was there.

PG: Seeking out doctors who work with me to find the best regimen.  I also attribute my success to a good diabetes healthcare team.

GH: Trying to keep blood glucose within range at all times, checking 6-10 times per day and making corrections when necessary. I also eat very healthfully.

Did you ever suffer from “diabetes burnout”? If so, what advice do you have for getting through it?

PG: At times I would wonder “why me?,” but I have found that listening to other’s experiences has helped me. In the early years, I had to search really hard to find support groups, but now there are lots of them.

What would you say to the family of a child just diagnosed with type 1 diabetes?

PG: Don’t be afraid to ask assistance from others living with diabetes. It’s not a death diagnosis. It will change your life, but it’s something you can do.

GH: Take advantage of all the current diabetes tools and equipment, stay on top of management, and enjoy life. What was once inconceivable has now become achievable.

What advice can you give to others living with type 1 diabetes?

PG: Learn all you can. Learn more, and never stop learning. Having diabetes is not the end of the world. You can make it work.

Winter Sports Recommendations

When it's snowing up North, many of you will be hitting the slopes on skis and snowboards. As for any skier, you will be sure to wear warm clothing, sox, hats and mittens. Don't forget to use sunscreen. In addition,since you have diabetes, you (or your parents) may have questions about being safe and keeping your blood sugar in a healthy place while you enjoy these cold weather sports.

Q. I know that checking my blood sugar often when I’m active is a good idea. But will my meter work when it’s very cold outside?

A. Checking frequently is a great idea. Because you are exercising and because it is cold you are using more fuel = sugar. And fatigue and low blood sugar can feel the same –shaky legs, tired and hungry. So we recommend that you either a) leave your meter at the base lodge and plan to stop in every 1-2hrs to check; or b) keep the meter with you, under layers of clothes as close to the body as possible. In that case, you may have to warm it up by putting it in your armpit for a few minutes, or by going inside the summit lodge before it will work. The listed operating temperatures for most meters start at 40-50 degree F.

Q. I use an insulin pump. Will the cold affect my insulin?

A. Insulin is stable at temperatures between 40 and 86 degrees F. If it freezes it will not work. So it is recommended that you carry the pump under layers of clothing, close to your body. For those using injected insulin (basal-bolus), it is better to leave your insulin with your supplies at the base lodge, available to you when you stop to eat.

Q. What’s the best way to avoid low blood sugars while I’m on the slope?

A. The approach to preventing low blood glucose levels varies according to how routine your planned activities will be. In other words, if you are usually active on a daily basis, your afternoon on the slopes may require very little change to your usual insulin plan, which already incorporates your activities.

If the day of skiing or snowboarding or sledding will bring more activity than usual, you will need to provide your muscles with additional carbs during the activity and then you will likely need to reduce your insulin doses 7 to 11 hours latter due to the 'lag effect' of exercise. You may have heard before that exercise can drop your blood glucose levels twice, first during the activity when your muscles need extra glucose for energy, and then later when your muscles are replenishing their stored glucose as glycogen.

The amount of extra carbs needed for the exercise, often called EX-CARBS (for exercise carbohydrates) depends on the intensity and duration of the exercise. For exercise that is moderate or intense, a teen may need as much as 1/2 a gram of carbohydrates per minute of activity. So, for an hour of moderate exercise like rigorous snowboarding, you will likely need at least 30 grams of carbohydrates. Speak with your health care team about other approaches involving insulin adjustments that can help to prevent low blood glucose levels during exercise.

After a day or afternoon of substantial activity, you will likely need to reduce your evening insulin. For kids treated with an insulin pump, using a temporary basal rate reduction of 20% for 6 hours has been shown to be effective in preventing overnight low glucose levels in kids with diabetes. For youth treated by injection-based insulin therapy, a 20% decrease in the overnight dose of intermediate (NPH) or long-acting insulin (glargine or determir) will likely reduce risk of overnight lows. Again, speak with your healthcare team and consider meeting with one of our exercise physiologists.

Joslin Pediatrics Receives $1 Million Donation

The Pediatric Unit has received a $1 million gift that will broaden full access to pediatric clinical services for children with diabetes and their families.

The donation, given by the Thomas J. Beatson, Jr. Foundation, will primarily support the care ambassador program, which at its heart consists of specially trained pediatric liaisons between families and their medical team.

Research led by Dr. Laffel and reported in the journals Pediatrics and Quality Management in Health Care clearly proved that youth who received care ambassador support services enjoyed healthier outcomes than those who received standard care, including 40% fewer trips to emergency rooms and half the number of severe low blood glucose episodes.

Joslin is the only diabetes center to successfully incorporate a care ambassador component into the clinical care model. The gift commemorates the mother of Tom Beatson and the care she provided when he was diagnosed with type 1 diabetes 68 years ago. The Care Ambassador program will be renamed the Eleanor Chesterman Beatson Childlife Care Ambassador Program in her honor.

Click here to go to the Joslin news release