Sock Snobs

Socks are important for everyone – not just those with diabetes. The other day my son was preparing for a hike and I reminded him that “wool wicks; cotton kills.”

Choose socks that don’t have seams that could rub or cause breakdown of the skin.

Choose wool socks when hiking or there’s a chance of getting wet. When cotton socks get wet they stay wet and can also cause your skin to break down. Wool socks wick moisture away from your skin.

Choose socks that fit. Socks that are too small may slide down your feet until your skin is exposed and rubs against your shoe(s) causing blisters (not good!). Or if they are too big, they can bunch and cause unnecessary rubbing. Taking care of our feet means avoiding undue stress – pressure or rubbing – of any kind.

So consider becoming a sock snob and choose socks that protect your feet.

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Back to Diabetes

Sometimes there’s just too much diabetes in our lives. Between living it, discussing it, reading about it, writing about it, hearing about it… you get the point.

Last June, when school got out, I took a break from my blog. I didn’t do it on purpose; it just happened. And it felt good! I also payed less attention to diabetes in social media, and while I did have a fantastic vacation, I did not take a break from my own diabetes.

Oh I may have checked my blood glucose less frequently while I was away this summer, and I definitely ate more and different foods than my usual. But now I’m back. Today is the first day of school for my kids. So they are “back to school” and I’m considering myself “back to diabetes.”

It’s good to be back.

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AADE Twitter Campaign Continues

Here is the latest update from the American Association of Diabetes Educators (AADE) on the diabetes education for all campaign:

AADE’s federal legislation has gained FIVE new cosponsors within the past month (read more here: we need {continued} help building momentum and gaining additional cosponsors. If you could share the following links through your twitter account, it would be greatly appreciated by AADE and the diabetes education community. We are looking for individuals to reach out to their Members of Congress in the following ways:

1.       Twitter -

2.       Email -

3.       Phone -

Thanks for your help!!

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Tips for the Fingertips

Pokey the diabetes mascotChecking blood glucose levels by poking fingers is a common practice in diabetes management. But how can we keep our fingertips happy and healthy despite all that poking?

I poke my fingers between 8 and 10 times each day. That’s not an exaggeration, and it’s not because I’m neurotic (as I’ve heard frequent checkers called, believe it or not). I check when I wake up, before I take insulin, if I feel low, before I exercise (sometimes during and after), before I drive (if there’s any question), and before I go to bed. I also might check if I’ve taken insulin to bring down a high blood glucose level.

I think my fingertips look pretty darn good for all that poking, if I do say so myself. And here’s a little secret: I even use the big, huge, old, blue lancets from the dark ages (because I got so many boxes of them for free at diabetes camp in the 80s and they’re still not gone!!).

Here are some tips I’ve learned along the way:

  • rotate fingers (I literally poke a different finger – inside then outside – each time I check – this allows time for healing)
  • use cream daily (I use Amlactin – be sure it’s cream and not lotion)
  • use a dial-a-depth lancing device and choose the right setting so you only have to poke once
  • change your lancet every once in a while (used lancets get rough and can do more damage)
  • use a fine lancet (unlike me, but I’ve found that even with thicker lancets, rotating and cream do the trick)

Good luck and enjoy your happy fingers!

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Diabetes-related Ketoacidosis

Our bodies must have energy to survive. Typically we burn glucose to make energy, but when glucose is not available, or when the body cannot burn glucose for any reason, fat is the back-up fuel. And ketones are a by-product of fat metabolism. So when we burn fat to get energy, our bodies make ketones, which are acid bodies that enter the blood stream.

Because our blood is neutral (not too acidic or too alkaline) when we are healthy and everything is working properly, ketones can really throw things out of whack. When our blood becomes too acidic, we can become very sick. Typical signs of ketoacidosis are fruity odor and deep, labored breathing.

When there is not enough insulin available for the body to break down glucose, fat metabolism and ketone production can occur. People who experience diabetes-related ketoacidosis may have nausea, vomiting, abdominal pain, and even loss of consciousness.

This can happen for many reasons; here are some examples:

  • exercising with a high blood glucose level and not enough insulin working (blood glucose will actually go higher and not lower)
  • not taking enough insulin either by accident or on purpose
  • running out of insulin (for instance, not ordering in time or being away from home and not bringing enough insulin)
  • running out of insulin in an insulin pump
  • having a bad infusion set/connection and not having insulin delivered by insulin pump
  • using insulin that has gone bad (exposed to extreme temperatures or expired)

Usually only people with type 1 diabetes are at risk for ketoacidosis; however, some people with type 2 diabetes can have it happen as well. Be sure to check with your health care provider to find out if you are at risk for ketoacidosis and how you can lower that risk.

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Diabetes Issues

???????????????????????????????????????This week is dblog week, where literally hundreds of diabetes bloggers write about certain topics each day (I counted 203 participants in this year’s list!). I participated in dblog week in 2011, 2012, and 2013, but this year time got away from me and I didn’t even realize it was the week until last night. I was looking at the topics and decided I’ll write about some of them anyway – in my own time (because they are good and/or fun and/or interesting).

Monday’s topic was to discuss diabetes issues that get me fired up. I admit I can get fired up about a lot of things (I like to say I’m passionate about things…). One of the biggest things for me is the apparent gap between diabetes health care professionals and people living with diabetes. I see and hear comments about it on social media pretty consistently and it makes me sad, frustrated, and concerned. As someone living with diabetes, and as a diabetes health professional, I take this very seriously. I want good care for myself and I want it for everyone else who has diabetes.

It’s bad enough that many, many people with diabetes don’t get care at all (for a variety of reasons), and we need to work on that also. But in the meantime those who do, should definitely get good, effective care from providers who listen and work as a team. The “compliance” model is outdated and useless. We’ve been talking and writing about the “empowerment” model for about three decades, and yet we are not truly there yet. And I think that’s pathetic.

In order to deal with my fired-upness, I work to help others live well with diabetes and help diabetes professionals take a closer look at how they deliver care, more specifically how they work with people living with diabetes.

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How to store insulin

DSCN2322Here’s my motto for storing insulin: if I’m comfortable, my insulin is comfortable. Insulin is a protein, so it can’t get too hot or too cold or it will denature (change shape and not work the way it’s supposed to – think of an egg when you boil or fry it). Insulin should never be left in a car (cars can get very hot or very cold), placed in checked baggage (cargo gets extremely cold), or stored in any location with extreme temperatures (radiator, freezer, directly on ice, by a bonfire, you get the idea).

Insulin should be stored in the refrigerator until you are ready to use it. While in the refrigerator, unopened, insulin is good until the expiration date stamped on the box. Once you open a vial of insulin, it is good for approximately 30 days. Opened vials of insulin can be kept at room temperature for the 30 days. While it’s OK to do so, it is not necessary to keep the insulin you are currently using in the refrigerator, and cold insulin hurts more going in.

If you are using the insulin to fill a pump cartridge/reservoir, bringing it to room temperature first actually helps to reduce the risk of bubbles. The only time I keep the insulin I’m currently using in a refrigerator is if I am traveling to a place that it very hot. In some cases, it may be a good idea to keep insulin in a cool pack, for instance, if you are hiking in an extremely hot climate, or at the beach.

Once you open an insulin pen, it is good for the number of days indicated on the package, and it is kept out of the refrigerator (leave the remaining unopened pens in the refrigerator).

Most insulin is clear. NPH is the only cloudy insulin available in the US, and because it is a suspension, it needs to be mixed evenly (by rolling the bottle upside down between your palms) before using. All the other types of insulin available are clear – if your clear insulin suddenly appears cloudy or if any insulin has crystals or clumps in the bottle, discard it immediately and open a new vial/pen.

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Advertising and the Self-Control Muscle

Psychologists say that self-control is like a muscle that can be exercised and strengthened.

I read an article online about exercise and sleep, both of which are critical to managing and living well with diabetes. On the side of the page was an advertisement for Little Debbie Swiss Rolls, complete with a photo of the delicacies and a “find a store” tab.

Self-Control-Is-Knowing-T-A63043_LI found myself staring at the Swiss Rolls and wondering how many people would have the self-control to continue reading about exercise and sleep (on the left) vs. clicking on the tab and finding a store with Little Debbie snacks (on the right). Great opportunity to work on strengthening that self-control muscle!

But seriously, just when we thought we were saved from advertisements on TV (thanks to the “pause” and “fast forward” buttons), now we have to see them on the Internet. It was bound to happen, but still a bummer. Hopefully we’ll take advantage of this opportunity and get stronger at self-control.

PS I love this quote, which I found here, because it is such an important message. It’s not about can or can’t – it’s about choices.

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I Am A Nurse

JanenursephotoToday is National Nurses Day (May 12th is International Nurses Day and the anniversary of Florence Nightingale’s birthday), and I just want to say that I am honored to be a nurse and to have worked with and learned from some amazing nurses.

Today I am thinking about nurses who made an impact on my profession and me:

  • Florence Nightingale
  • Virginia Henderson
  • Sue Adamczyk
  • Judy Krauss
  • Mary Young
  • Jennifer Hawke-Petit
  • Wendy Mackey
  • Melanie David
  • Hannah Chatillon
  • Robin Froman
  • Cheryl Beck
  • Peggy Chinn
  • Carol Polifroni
  • Maureen O’Reilly
  • Cheryl Kindred

I’m sure there are many more!

Although I work in diabetes education, which is a multidisciplinary specialty, my foundation is nursing. I will never forget the nurses who paved the way and those who taught me how to be a nurse. Most of all, the people I’ve worked with have shaped who I am as a nurse. Thank you and Happy Nurses Day!

PS The photo is me in a Jr. High play long before I knew I’d become a nurse in real life.

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My Diabetes Street Sign

street signThe other day I was having a conversation with a friend and she randomly asked, “What if we had to come up with a street sign name for our life?” I said, what a great idea for a blog topic!

So I’ve been giving it some thought, and I’m working on coming up with a good street sign name that represents my diabetes life. Here are some ideas:

Don’t Stand In My Way

I Can Do This Drive

I Often Check Before I Drive

Well On My Way

Positive Path

What would your diabetes street sign say??


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