Welcome?

If you have found this blog, saying Welcome does not really seem appropriate. I know you wish you weren't surfing the internet for diabetes. I felt the same.

A big part of me wishes I were not writing about diabetes, nor did I anticipate to become so opinionated or informed on the subject, but it happened. In 2010, my son was diagnosed with Type 1 Diabetes.

It wasn't really part of the plan… Correction - it was not part of the plan, but it happened. It is not always easy, but I think we are all doing okay, and I hope we continue to do so.

Why the Middle East? I happen to live in Dubai. I don't think that living in the Middle East makes mine or my son's diabetic experience any more unique or challenging than it does elsewhere in the developed world.

I hope you stick around, or read something you like. Feel free to comment and join the conversation, subscribe or follow this blog by liking the Facebook page Diapoint.

Please note: This blog does not give medical advice. I am opinionated, and I share my experiences, but the first rule of diabetes is to follow up with your doctor and/or nurse educator about your care, diagnosis or medication. If you do not have a medical practitioner that is helping you find your way through this crazy world, then do not give up until you find the right one.

Sunday, August 31, 2014

Should Diabetics Be Banned From Driving?

The title of this post is the same that the Dubai newspaper, Gulf News used in an article that was published last weekend.

My immediate gut reaction was NO.

Trying to keep an open mind, I read the article, and did some further research before writing this.

While I do applaud that the article for starting with the statement Diabetics should not be banned from driving but be educated about their condition so that they are ready for the challenge when they take the wheel, specialists said, it digressed from there.

It continued to say that diabetics are banned from driving in the US.  This is simply not true.  Diabetics do drive in the US.

Yes, there can be risks involved, and some symptoms may impair a diabetic if they are not careful.  Every state in the US has different laws on driving, but a blanket statement that diabetics are forbidden to drive in the US is false.

Everyone must pass an eye exam - diabetic or not.  In some cases, a letter from a physician that the person is fit to drive may be required.

The newspaper interviewed an endocrinologist at a local clinic who cited that diabetic truck drivers that have to wait a long time at check-points may suffer from hypoglycemia, or low blood sugar.  The doctor then goes on to say that "there are smart drugs today that can treat diabetes and no ban on diabetics driving light vehicles is necessary".

It is so important to not have a drop in blood sugar because it can effect judgement, someone may faint, have a seizure or worse.  Obviously this would endanger others on the road too.  There are other complications the article discusses, so yes, it is important to manage your diabetes while driving.

The article emphasizes the importance of eating when this happens.  This is key for any diabetic at any place, any time.  A diabetic driver should always have at minimum a basic diabetic medical kit (glucometer, glucagon and a few other items) a spare juice box and a small non-perishable snack with them; and if driving, in their vehicle to treat a hypoglycemia.  This is a very cost effective treatment.  No "smart drugs" required.

I am not sure what was meant by this reference.  Perhaps insulin is the "smart drug", but whatever it is sounds really expensive and out of reach for someone working on a truck driver's salary. Continuing the discussion about the importance of eating and proper snacking would be much more beneficial for truck drivers at check points.

The article says that 20% of residents suffer from diabetes.  Maybe.

The last time I did a diabetes study, long before my son was born and diabetes was part of my life, the UAE local population had one of the highest prevalence rates of diabetes in the world.  Today,  according to Diabetesuae.ae, the "UAE is ranked 15th worldwide, with 18.98% of the UAE population living with diabetes".

World studies of diseases are typically done on location populations, not the residents or expatriate populations. This 18.98% is the estimated population of Emirates with diabetes.

The website goes on to state that "A sedentary lifestyle and bad eating habits have been cited as the main causes of the increasing prevalence of Type 2 diabetes in the UAE."  It is important to note that Qatar, Kuwait and Saudi Arabia had a slightly higher prevalence of Type 2 than the UAE, making it a regional issue for the Gulf.

Based on my previous research and this information, I felt the article needed a little more probing into who that 20% is.  Typically, the drivers referred to in the article are from Pakistan, India, or other Near Eastern countries.  India does have its share of diabetes, but in the context of Indians living in the UAE, I cannot confirm those statistics.

The article mentions that "given the socio-economic background of most patients, many would not have the money to take time to take care of themselves".  This is the statement that really bothered me.  It bothered me a lot.  Why?

In the context of Type 2, which is the bigger issue in this region, it is not money and time that is the factor.  To some extent yes, these resources will play a role in any disease. But they are not the main culprit, or excuse for poor diabetic management.

The number one resource needed to fight Type 2 is education.  The need for diabetes education is universal. Education about healthy eating, exercise and a healthy lifestyle.  Education about diabetes management.

So if I may ask, Gulf News, RTA and the medical community of the UAE.  If there are increasing numbers of road accidents caused by the diabetic population in the UAE, could we please work together to develop an education campaign to target this issue?

A focus on checking blood sugar before getting behind the wheel, carrying proper snacks and a healthy lifestyle will go a very long way.


If you want to read the article that was in the Gulf News, you can find it here

Thursday, August 28, 2014

Celebrating Diabetes

Since my son was diagnosed, I read about people who celebrate their "Dia-versary", the day they were diagnosed with Type 1.

The day my son was diagnosed is very vivid as well as the hospital stay and events that followed.  While everything changed drastically that day, I no longer think of it often as diabetes is just part of our life now.  For my son, he was diagnosed at 20 months old so he does not remember life before diabetes. It just is.

I forget the date now, and then I will read about someone celebrating their dia-versary and I am reminded.  That happened today and I realized the day came and went last week and I didn't even realize it.

When cleaning some shelves last month, I came across the calendar I kept that year.  There were all the typical notes of a working mom, a doctors appointment and a few diabetic notes that I remember writing when we were calling different places to figure out what to do.  The rest of the year was empty.  There was only one thing to focus on the remainder of that year, and that was accepting diabetes.  There were many things to write and follow, but I had no idea what those were at the time.  I threw that calendar away in my office clean up as I had no need for it, and I do not want to live in the past.

While we don't focus on our diagnosis day, we do focus on other milestones.  A better A1C, an insertion site taken to the stomach, being brave for the annual blood draw for testing, overcoming a bad stomach virus... The list goes on.  Sometimes it is diabetic related, other times not.

There are many opportunities to celebrate diabetes.  I think you have to find what works for you and your child.  Just as every diabetes case is different, the way you celebrate the milestones will differ as well.

Saturday, August 23, 2014

ALS Ice Bucket Challenge & Diabetes

There is a lot of discussion about the ALS Ice Bucket Challenge right now. Within the Diabetic community many are asking the question how we can raise that kind of attention and money for the JDRF foundation.

I agree with the diabetic blog, A Sweet Life, on this one.  It is too soon.  The ALS challenge is still high profile, and maybe ALS needs it more than us right now. Sure, I would love to see a cure for diabetes, but I am very happy to see ALS get this attention and growth that it probably needs.

The ice bucket challenge grew organically.  If the diabetic community did something similar, the message would be diluted with all the focus on ALS and other communities trying to draw awareness to their cause.  I also think the natural viral activity of the ALS challenge is one of the things that is so appealing about it.

So what should we do to draw more awareness to diabetes?  I do not have the answer or any suggestions right now.  I personally will keep doing what I have been doing to share information and educate anyone who asks.

On the subject of media attention and diabetes, last week I retweeted coverage of Matthew McConaughey wearing a fanny pack to a baseball game.  When a reporter asked him about it, Matthew says,
"I'm not afraid of the Fanny Pack.  You gotta kind of put it to the side to make it look a little not as nerdy, but still, practicality wins out.  I got so much gear in here that I don't want it in my pockets".

Obviously, he mentions nothing of diabetes, but he sums up the pump pack for me.  Do not be afraid of it. Most importantly - it is practical.

Many celebrity sites and news agencies called it unfashionable.  I tagged him and thanked him for making diabetes a little cooler.  No response as of yet. None needed. I just hope he ignores the media and continues to strive for practicality.


Sunday, August 17, 2014

Advocacy & Education

It seems that lately I've been reading more about hospitals, schools, businesses and organizers that just do not seem to understand the needs or reality of Type 1 Diabetes.

School will start soon, so we all need to take the time to sit down and write out directives and plans for our children's schools, teachers and others, and meet with them all to go over those plans in detail.

This is just one of the many things we have to do, and it does not mean that our guard is down the other 50 or so weeks of the year.  As the caretaker of a child with Type 1, you always have to be on top of it.  You know the in's and out's as a pancreas, but you should also not be afraid to be your child's advocate and educate those that need it, regardless of the situation.

I have found myself doing this, but I didn't actually realize I was doing it at the time.  I thought I was just insisting my son get proper medical care and normal social treatment.

One of our first experiences with this was during our first DKA that put us in the hospital.  My son was overdosed twice during that visit - once in the ER when a hydration drip was not set properly, and again on the floor when the nurse proceeded to give him glucose with no insulin running.  We are very fortunate that these were not serious overdoses.

My husband and I have a background in healthcare management.  We know that human mistakes can still occur anywhere at anytime, but that really got our attention.

You do not have to be a doctor to be involved in your child's care.  Although there are doctors and nurses, once you live with Type 1, no one will know your child better than you will. Make sure they are getting the correct care and medication they need.  If you are not getting that, then keep escalating and talking to people until you find someone that can understand your needs.

Sometimes you may find yourself educating medical staff about diabetes or some of the latest devices available.  I was shocked when no one at the hospital knew there was a glucose meter that could measure keytones, or knew how to insert the site of an insulin pump.  It was quite a site to see the pediatric nurses quickly run down the hall to our room to watch me do this.

After that first DKA experience, and other medical errors in the years that followed, I now follow up on medical orders given.  Nurses are great advocates, but they are also human.  Always understand what it is the doctor has ordered them to do.  You have the right to ask questions and understand the treatment plan.

Advocacy and education does not always take place in a hospital room.  It happens in other places too - when scheduling doctor's appointments, dealing with insurance, extra circular activities, in public, at school and more.

I am lucky that my son's school has been very supportive to ensure he is not excluded from anything because of his diabetes.  However, the first time he had a field trip, the KG1 lead was insisting that no one could go with him to be his caretaker for diabetes.  Neither I nor a designated caretaker would be allowed to attend. Period.  The obvious result, would be my son would not be able to attend the event.

My heart broke for him and I wanted to cry on his behalf when the teacher informed me. Instead I took a deep breath, went home and wrote an incredibly long letter to his teacher, the principal and school health office.  The nurse was great in helping me advocate for him.

With a few bits and pieces of paper work, it was resolved.  It didn't make me feel any happier that someone who was uneducated about the situation would be so quick to dismiss a child from an activity to make him feel different. At least he never knew it happened and I was able to manage this first road block behind the scenes to ensure he experiences all school activities as normal as possible.

Not every day is full of education and advocacy, but be ready for it.  It is something the diabetic child will face at different times throughout their life for different reasons.  Like anything, as a parent we need to be prepared to handle it, and once our children are old enough they need to also know how to manage it.

Where to start?  If faced with a tough situation, don't hesitate to reach out to a support group - whether in person or online.  Its most likely something someone has dealt with before and other parents of Type 1 would be more than happy to offer their advice and support.