Confessions Of A 35-Year Diabetes Veteran

This article has been reproduced in an edited version by kind permission of its author, Riva Greenberg, on whose website,, it first appeared.

Times change, and we learn a thing or two. (Driver, my dad)

| Sep 16, 2007

I've been doing a lot of flying lately, and it's given me time for reflection. While aloft a few days ago in JetBlue's comfy seat, as I took out my syringe and Humalog to dose for my snack, I realized how many things I no longer do that I was once taught to do.

I stopped using alcohol swabs before injecting in 1986, when I moved to Tokyo for six years. At my new Japanese clinic, the nurse, who apparently had never seen anyone with diabetes before, gave me a jug of alcohol and a suitcase-sized bag of fluffy cotton balls, the type that shred and stick to everything. As she handed me the bulky paper bag, we shared a look of dismay. That was the day I stopped using alcohol before an injection. (I later learned from an official diabetes source that it is not advisable to use alcohol swabs because they dry out your skin.)

I don't use cooling packs for my insulin. Maybe I'd need them if I were going into the Ecuadorian jungle, but my usual jaunts always seem to have a refrigerator at the end and moderate temperatures on the way. As for insulin overheating in the car: I don't have a car.

I don't have special compartmentalized bags for my supplies. My syringes get disbursed throughout everything I wear and carry. There are always a few in my pocket, my purse, and various zipper linings. When I'm travelling, my insulin goes into my fanny pack or purse. Right now, I'm trying out the new UltraMini meter from OneTouch. It straps right onto my fanny pack, and I can fit it in my purse. I just don't see the need to take a big carry-all.

I don't use new lancets each time I finger test or a new syringe each time I inject. Really, does anyone? I know that the points on these instruments become dull over time and can be tough on your skin. But I must have magic fingers - they heal immediately after being punctured. So I change lancets and syringes when I pay my monthly maintenance or when I notice my pain threshold lowering.

I don't check my feet or in between my toes every time I see them. When I step on crumbs in my house, fallen acorns around someone's pool, or that darn pen I couldn't find, it reminds me that my feet are more than capable of delicate feeling. (If you have neuropathy in your feet, ignore this advice!)

I don't necessarily advocate that you do what I do. We must all be responsible to our own bodies and needs. I am only making the point that much of what we were taught is outdated.

If you're new at the diabetes game, you're probably overwhelmed with all you think you have to do. I heard once that a group of diabetes educators stopped counting diabetes tasks when they reached 150! So I'm going to lend you my "To-Do" list. It is very small, and it has served me well.

  1. Learn everything you can. Search websites, question your healthcare providers, read magazines, and attend local classes or a support group. There are always tips to be had.
  2. Test your blood sugars frequently, including post-prandial checks (two hours after you begin a meal), and correct when necessary. This, above all else, has kept my A1cs at between 5% and 6%.
  3. Test before bed. I always do. If I'm low, I take a few bites of an Extend Bar, and it keeps me level till morning. Before I began doing this, I was a sweaty, babbling mess at 3:00 am.
  4. Move every day. It makes you more insulin sensitive. I walk an hour a day. When I was sick and didn't walk for two weeks, my sugars rose.
  5. Habit-ize. Turn tasks into habits so that you can stop thinking about them. For instance, I test first thing upon waking, and I always keep my meter on my kitchen counter. No searching, no excuses.
  6. Before you run out of stuff you need, get more.
  7. Ask for help when you need it, and ask people to back off when you don't.
  8. Bring food to the airport. They serve next to nothing on airplanes and you won't find anything worth eating in the airport.
  9. Feel proud about how much you're handling in addition to your daily life. You won't get a medal for managing diabetes, but you certainly deserve one.
  10. (Because no list can end at 9) Use caution when following this advice. Side effects may occur. For instance, you may just find life a little easier.

At fifty years old, after 32 years of living with type 1 diabetes, Riva Greenberg consulted a diabetes educator for the first time. That experience led her to combine her growing knowledge of diabetes care with her writing and illustrating talents. Today she is educating and inspiring others to live well with diabetes through her articles, research, and motivational lectures across the country. Riva is a contributor to Close Concerns, a diabetes consulting services firm in San Francisco. She also serves on the editorial committee of the Juvenile Diabetes Research Foundation International in New York City and on the Advisory Board of Methodist Hospital's Diabetes Education and Research Center in Brooklyn, N.Y. To learn more about her work and read her blog, visit her web site at:

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Sep 16, 2007

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