Category Archives: Diabetes and your body

Body image and issues, exercise and diabetes

100 Year Old Marathon Runner Renews My Perspective

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I just read about Fauja Singh, 100 years old, who just completed a full marathon.  By the time I lifted my jaw off the floor I had read all I could on the man.  He’s a vegetarian, eats a low fat diet, won’t consume rice or caffeine, and runs 10 miles a day in training.  He strives to be positive, doesn’t get offended or angry, focuses on charity work, and advises that to be happy and live long we must do what we love, give back, live stress free, and eat to live, rather than live to eat.

It occurred to me this man is an example of someone who eats what fuels him properly and doesn’t eat what doesn’t fuel him properly.  I think we all need a different diet and discovering what that diet consists of is no easy feat but it sounds like he’s done it.  It’s clear he also knows how to live a stress free life, something I have always seen as impossible.  Yet, here is someone who has endured stress.  He lost his wife a long time ago.  His son died prematurely.  He used running as a way to get busy and focus on something, as a way to cope.  He doesn’t have much education, was a farmer in India before he came to live in England, but he seems to know all the secrets to happiness and health and actually practices them.

For some reason his story provides me with a lightening bolt of a paradigm shift.  I feel renewed energy to eat only when I’m hungry, not paying attention to people who say one should eat often in order to avoid feeling hungry and then binging.  Hunger doesn’t make me want to binge, it makes my food taste better.  I’ve heard people say that we shouldn’t compare ourselves to the Kenyans who run amazing races or people who stay active into their 90’s like this man.  Yet, why not?  We’re human just like them and what these people do with their bodies is inspiring.  I know that I am at my current level of fitness in part because I grew up thinking that a mile was a long distance on foot.  Whereas people who grow up walking several miles to and from work or school each day don’t see a mile as a long way at all.  Their knowledge of a mile is so different and as a result, what they see as possible is very different from what I see as possible.

This man’s story provides me with a renewed perspective in how I think about our bodies and what is possible.  Surely I can run more if a 100 year old man can complete a full marathon.  Perception is key.  If I believe a 10 mile run is doable, does that make it more doable?  I once thought that keeping my blood sugar below 250 most of the time was impossible.  Then I looked at it different.  I believed keeping it around 100 was doable.  It’s not easy, and like running each day, it takes discipline and preparation, but I did it.  When I stopped the discipline surrounding what I ate and when I did or didn’t do something, that level of glucose management fell away.  However, I know it’s within my reach again.  All I have to do is firmly know it’s possible and act on that belief, ignoring all others.

An Intro to Running with Diabetes

Chris

This is a guest post from my dear friend and adventure seeker, Chris Scully who blogs at CanadianD-Gal.  I read an old post of hers recently where I realized that she didn’t always run half and full marathons and it hit me that everyone has to start somewhere.  Many of her posts detail her diabetes management prior, during, and post run (or bike) and she is a world of knowledge when it comes to handling intense and long duration exercise and diabetes.  For all of you wondering if you too, could become a runner, check this out for some seriously valuable advice.  Take it away Scully!

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I am not a professional.  Not even close.  I have learned everything through experience and trial and error.  Please consult your physician/CDE/Endo on how to start running while managing diabetes.

30 seconds into it and I feel like I’m going to cough up a lung.  I’ve never breathed so hard in my life.  I feel dizzy and nauseated.  I have no idea how some people do it for 26.2 miles at a time.

I’ve taken my first steps into running.

I think it happens to everybody who decides to pick up running.  That is the best thing one can try to remember.  Pretty much EVERYBODY goes through that.  The trick is not letting that feeling make you want to throw out your running shoes.  The trick is getting PAST that feeling.  It’s going to hurt no matter what you do.  The other trick is learning to harness that discomfort and find a way to level it out.

The best piece of advice I can give from someone who tried many times to become a runner is “SLOW DOWN”.  I think most of the time new runners bound out the door sprinting rather than running.  It’s hard to tell that you’re probably going too fast when you’ve never run before.  Take it slow and steady.  Walking does not make you a failed runner.  Some people learn very well with the walk/run approach.  At the beginning, walk more than you run while eventually increasing the run time and decreasing the walk time.  Slow down and ease into it.  It’s going to hurt at first and it’s going to hurt a lot.  Let your body recover between runs.  With time and patience the pain will subside.

Learning to run takes a long time.  Especially if you have very little athletic foundation to begin with.

One of the things that helped me more than anything else is an article I read on breathing while running.  This was over 10 years ago so I can’t quote it and have no clue where I read it but it goes like this:  2:3 ratio.  2 in, 3 out.  Breathing, it’s that simple.  2 steps of inhaling, 3 steps of exhaling.  The day I put that to practice is the day I learned to love running.  I remember reading that your exhale should be longer because you want to really empty your lungs. Focus on long deep breaths from the belly, not the diaphragm because then you end up shallow breathing.

To this day I let my breath guide my body and it has become second nature that I am always counting the breaths in my head.

Running with breath allows control I find.  There’s two ways to look at it, let the body guide the breathing or the breathing guide the body.  If you force one, the other will follow.  This breathing technique is similar to the “conversation” marker.  Can you feel like you can carry on a conversation with a running partner? If the answer is no, then you’re running too fast.

That’s how I learned to run.  That’s what worked for me.  Paying close attention to my breath made it so it stopped feeling like my lungs were going to explode out of my chest.  It taught me a comfortable pace that I could eventually maintain for longer periods of time.

As for the diabetes aspect? I haven’t always had an insulin pump and I wasn’t always the most responsible diabetic.

When I began running (post diagnosis) I didn’t have an insulin pump.  I was on shots of Novorapid and Lantus.  The timing of the runs were what was most important.  I was an evening runner so hopefully there wouldn’t be any weirdness from leftover insulin and food by the time I got home from work.  I probably took a bad approach to it because I wouldn’t leave the house if my BG was under 10.0mmol/l (180mg/dl).  I would normally eat a granola bar or something that my stomach wouldn’t try and regurgitate half-way into the run.  There was a lot of waiting.  I would still carry my glucose meter and some sort of fast acting sugar just in case and would really only use it if I was low.

I don’t remember very much from the running and pre-pumping days.

Blood sugar management while running really depends on a lot of factors.  Doesn’t it always though? But seriously, I’m going to stick strictly to running for now.    The key to my success (when I have it) is the temp basal option on my pump.

What effects the BG while running?

-Types of runs, ie: Speed work, LSD (long slow distance), Hill repeats, short runs, etc… etc… etc.
-Time of day
-personal insulin requirements
-duration, intensity

LSD runs are usually anything over an hour.  They are meant to be run at a slower than usual pace and therefore won’t rid me of glucose as fast. However, because they are long (for me 2 or 3+hours) eventually I will run out of stores.  When preparing for my LSD runs I find it optimal to manage my blood sugars so that taking in a gel or the equivalent of 25-30g carbs per hour won’t ruin my BGs.  If I set my temp too low, I might have to take insulin with my gels.  I need the fuel during the long runs just like a non PWD and having to take any amount of insulin is sketchy.  I try not to have any IOB since I find even just a little bit of insulin can have a huge effect.  Though if I do need some insulin just to take the edge off or if I’m high when I really need a gel, I will take a bit.  maybe just a unit.

Early mornings for me are different.  I usually run about an hour but I am super insulin resistant at that time and don’t need to do anything for my BG.  I don’t need a temp basal even though at that time my basal rate is at the highest for the whole day.  I run on an empty stomach and my blood sugar still rises by the end of the run.  Unless I am low before the run, I don’t need any carbs.

My evenings are when my basal rates are the lowest and subsequently when I am the most insulin sensitive.  I need a very low temp basal and usually still need to eat something before I run.

I find when I run under 1/2hour it’s easier to do nothing than to suffer the consequences of post run high BGs.  It’s too short to effect my BGs.

Post run is touch and go.  I often need to set a high temp basal before the exercise finishes.  That would be to counter the effects of the extra glycogen that is released from the liver and is now running rampant through my body when I stop.  I will set a +50% temp basal about 20 minutes before I’m done running and leave it on for 2-3 hours depending on the time of day and how it relates to my insulin sensitivity factor.

About 4 hours after the run is when my BGs will start to go down and I might set a -15% basal.  More often than not this is when I’m ready to eat and I will just make adjustments with my bolus.

So the main factors to remember are:

-Your personal insulin sensitivity at that time of the day
-The intensity of the run – high intensity often means higher glycogen being released (depending on the duration of course)
-The duration of the run – the longer the run, the more glucose stores you use up

ON THE RUN!

I carry at LEAST 1 gel at all times.  The longer runs I will have 2 on my person as well as the bananas and dates that I stash ahead of time with water.  I never run without my glucose meter.  EVER.  I used to carry it in my hand the entire time.  That was before I discovered Tallygear.  I used to test nearly every 15 minutes for learning purposes.  Now I test about once an hour unless I feel weird.  I always carry my phone on longer runs in case of emergencies, diabetes related or otherwise.  I don’t have a medical ID because I rely on my medic alert tattoo but that’s important too.

TIPS FOR STRIPS!

They don’t work in the cold or when they are wet.  My meter acts up at about 5C (41F).  The strips will sustain a bit colder but not the meter.  I put hand warmers in my meter case all winter long.  If they are wet, they won’t work.  Even just a little bit of sweat.  Mini Zip lock bags work but I find they still get wet inside after awhile.  I have been using the strip container but the rattling of the strips drives me bonkers.

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The best thing I can say is, start slow and always carry a glucose meter and sugar no matter what.

If there is something about running and diabetes that I might have some experience on, feel free to contact me.  I’m always willing to share, even the embarrassing problems.   I know what I know because I put myself through the “learn through experience” program.  Available everywhere.

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Thank you, Chris!  I am so eager to put this advice to work and I’m sure many others have appreciated an insider scoop.  I urge everyone to check out this post on Chris’ blog where she talks about her love of running and how far she has come (and potentially, where you and I could one day be because frankly I’m still in the huff and puff stages).  Just knowing it takes time and practice and knowing what to look out for blood sugar wise makes me very hopeful.

A Sigh of Relief

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I held my breathe for the last week or so because of my annual eye exam.  I’m happy to report that after almost 17 years with type 1 diabetes I’m still hanging on to eye health.  I breathed out a long sigh of relief that literally lifted my headache away.

My pressure decreased in both eyes just as it did last year which tells me to more or less keep doing what I’m doing. There are no signs of the 2 faint blood vessels spotted two and a half years ago during my twin pregnancy which makes me happy but also proves to me how delicate a balance this all is.

A little extra pressure or strain, a little bodily stress and that’s all it takes to get the ball rolling on some damage?  It’s a tough pill to swallow but it makes me that much more aware of how important small daily decisions are.  Of course, the doctor always reminds me that with time I’m likely to meet some obstacles but she has a great point when she says not to worry because worrying is pointless, what matters is what we do with the present.  And currently I’m working hard to maintain good blood sugar management.  That’s the best any of us can do.

On different but related note, I realized I’m probably considered close to being legally blind-vision wise.  I have also realized that no matter how cute my glasses frames are, they can never hide the extreme chunkiness of the lens and as a result I’m extremely grateful for contact lenses.  A sigh of relief there, too.  See?  It’s not always about diabetes. :)

Getting to the Bottom of This

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Worrying is like a rocking chair, it gives you something to do, but it gets you nowhere.

Glenn Turner

 

“This” is whatever issue(s) I have going on which have been causing me to feel a lot less than great the last few months.  In the last few weeks I’ve been dealing with some stronger symptoms like frequent headaches and nausea and water retention.  I visited an allergist and we have ruled out Celiac disease but I’m still going to omit gluten to see if it helps in any way.  (Omitting gluten is a small price to pay if I just so happen to feel better!)  I had lots of other allergy testing done and we found I’m not allergic to any new things so that’s a plus.   Although I am allergic to about 30 different things.  No, my immune system is not confused at all. (Dry humor helps, try it!)

I was reminded that I have an asthma diagnosis from about 15 years ago.  It seems I have mild exercise induced asthma and have forgotten over all these years OR was initially misdiagnosed.  Perhaps when I’ve had my “panic attacks” I’m really just panicking over my breathing?  Could be.  I will get a breathing test soon.  In the meantime I’m just glad those symptoms are mild and I don’t require an inhaler.  Although I do get laryngeal spasms from time to time but although those can cause a person to pass out, the good thing there is that if I do, my throat will relax and air will pass once again.  Phew, what a relief.

Next I go get my hormones and ovaries checked.  Before having my kids, when my PCOS was causing more pain and ovarian cysts were growing all over the place, I remember having nausea and water retention-like I am now.  So hormonal imbalance issues may be the root of this.  It wouldn’t surprise me you know?  Lately, my blood sugars have been higher than they have been in a long time and that definitely affects hormones in the body.  My worry about that is how do I fix the problem?  I don’t feel well on birth control.  What else can I do?  Keep perfect blood sugars?  What else can I do?  Sometimes I dislike being a girl.

I also go to the eye doctor soon.  I’m sure my prescription has changed (everything is a tiny bit blurry) and although that is a bad sign of something diabetes eye related…I’m used to my prescription increasing every single year since age 14, so maybe that’s what the headaches are about.

Some of my symptoms could be tied to anxiety so I’m seeing a psychiatrist soon.  I know I said I would do this over a month ago but I have procrastinated.  But no more, I’ve just made an appointment.

I don’t necessarily want to share all of this with the world (Hello! Look at me! I’m broken!) but here is why I do:  Many of you out there are going through similar scenarios where you have multiple health issues going on and you can’t figure out what’s the cause of what and you feel really overwhelmed and as a result don’t do anything about it.

My advice is to just stop.  Breathe.  Write down your symptoms.  Make doctor appointments.  Visit one doctor at a time.  Get tests done.  Get to the bottom of this.  Ruling out different things will be strangely comforting as you move closer to what is making you feel ill.  Symptoms are our body’s way of saying “help!”   We need to listen and play detective and then tweak our lifestyle until we feel better.   We deserve it.

I should not have waited so long.  I’m already feeling better knowing I’m being proactive.

Any of you out there go through something similar?  Did it help?

Happy Diabetes Art Day 2011!

By Ana Morales

Over the past two years, I’m pretty sure I’ve thought about my diabetes more than I ever did when I was younger. As I’ve been learning more, I’ve also been getting more scared. However, I’ve heard and read about people with diabetes that inspire me and give me hope. In my piece for diabetes art day this year, I wanted to illustrate part of the silver lining in my own and many others’ situation. Sure it’s no fun sliding needles and tubes into our skin every day and having to count carbs and wait for the insulin to kick in, but for now it’s what keeps us alive and we should be thankful that we have fairly easy access to it. At the same time, we should continue to promote diabetes awareness in hopes that one day every person with diabetes will be able to receive the supplies he or she needs.

So smile because you woke up to another day of possibility. Don’t ever forget how strong you are, even when you mess up. For more inspiration, check out the Diabetes Art Day website and The Butter Compartment, the website of Lee Ann Thill, creator of diabetes art day. I can’t wait to see what everyone else has created! Happy Diabetes Art Day! :]

Here’s what Sysy made: (she asks that you remember she is not an artist :)

It says “You deserve a halo, for jumping through hoops of fire”

And Sysy’s husband, Alex made this drawing from his perspective of things.  To him, what we diabetics do day in and day out looks like…

Wednesday Revisit: The Dreaded Monthly Visitor

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Here is something I posted originally on:

October 24th 2009

Diabetic Women and the Dreaded Monthly Visitor

It’s basically a list of things that I implemented to help greatly alleviate my period related symptoms.  I really did go from super painful periods to mild ones that tend to get worse the farther I stray from the things on this list.  So for me, they work pretty well and maybe they’d help you or someone you know.

Happy Wednesday to ya!

New Year’s Resolutions for July and August

Thanks to Federico Stevanin for the cute photo!

 

July has just about gotten away from me and I am now realizing I was supposed to work on something specific this month and the next.

Using Leo Babauta’s 6 Changes Method, I have been using two months at a time to tackle one goal I have.  It worked great last year and it’s helping me out this year.

People knock New Year’s Resolutions because they don’t do them correctly.  It does no good to tell yourself “I will lose weight this year” because first, that’s not specific to any ACTION you are going to take and also, is this string of proclamations coming with some commitment and energy behind it?  Are you  literally going to try to tackle ten goals at once?  There is no method to that madness.

That’s why I love the 6 Changes Method.  It’s simple and focusing on one thing that I want to make into a habit for 2 months means I’m giving my new goal a real shot.

For May and June I wanted to wake up early and focus on creating.  My twins do not let me get much done during the day.  They are both very physically active and you can bet that one will be on the dinner table about to leap into the air in an attempt to grab the chandelier if I don’t constantly keep my eye on him (yes, I’m talking about you, Henri).  My blog is my creative outlet, my passion, and what probably keeps me sane so I didn’t want to neglect it.  Therefore, getting up early and getting the writing out of the way as well as my exercise has proved the best change I’ve done all year.  We’re talking about a life changing change!  It’s not easy because I am not a morning person but I’m starting to enjoy the peace and quiet I get when it’s just me and the “taka taka taka” of the keyboard.

For July and August my goal was to get into the habit of exercising every day.

I’ve skipped a few days this month but only a few and I’ve been running, getting on the elliptical, and doing yoga.  I just need to keep it up.  It’s challenging lately because Alex leaves for work at 6am and gets home at 6pm.  Yesterday in fact, he got home past 8pm.  By the time we put the kids down and do some house maintenance, it’s really late.  But this is no excuse, I need to work to get things done so that come 4 or 5am every day, I’m rested enough to get up and get on with my routine.

I have to keep my blood pressure stable so this exercising each day goal I have is a MUST.  Wouldn’t it be nice if exercise was like brushing teeth?  That’s what I’m going for, lol.  Wish me luck!

Wednesday Revisit: The Super Long Killer Bike Trip

Originally posted on:

May 18th 2010

Three years ago I went on a wonderful bike trail in the woods with my then fiance and made some diabetes related mistakes that could have proved costly!

In retrospect this feels a little whiny because I now know people who do this sort of mileage on a bike all the time, but the truth is I wasn’t conditioned nor prepared for it.  You’ll see what I mean if you read on Smile 

The Super Long Killer Bike Trip

The Weird Place I Usually Inject

Photo courtesy of Zirconicusso

 

Does anyone out there inject insulin into the area just above their breasts?  This feels awkward to admit but I do.  Just above the breast tissue but below the collar bone is where I mostly inject insulin. 

I’ve been injecting there for about 6 years now.  I got desperate to inject somewhere other than my stomach.  My stomach and hips were just all knotted up with scar tissue from years of pumping (and perhaps not rotating sites adequately).  I’ve been getting allergy shots in both arms every week for 10 years so my arms are out.  My legs have always been the most muscular part of me and so I just don’t feel comfortable injecting there.  It hurts more, too.  Sometimes I’ve gone into the muscle and that changes insulin function (makes it faster). 

A doctor once told me I could inject anywhere on my body as long as it was adipose tissue.  I looked down one day and thought, gee, there is some easy to access adipose tissue right there.  This is not to be confused with breast tissue or the pectoral muscle by the way.  Many of us who are not super skinny have a tiny bit of fat just above the breast, especially since most of us wear bras, which do some lifting action.  (Trust that this post is actually making me squirm right now)

Anyway, I find insulin absorption is really fast in this area so I find it particularly helpful to use when high.  I also don’t like pulling up my shirt to inject in my belly out in public and I don’t like injecting through clothes (makes me nervous that the insulin won’t reach me).  Thus, for so many reasons, I really like injecting here.  Want to see what it looks like?  I have to show you because it sounds crazier than it looks.  Just remember, this can’t be done if you’re really thin or just don’t happen to accumulate any extra fat in the chest area.  I’m an hourglass so unfortunately, I just gain all over, evenly.   

Demonstration video which you WON’T be making fun of:

DSMA June: Troubleshooting Diabetes

 

Photo courtesy of Renjith Krishnan

 

 

The June DSMA Blog Carnival Topic: When it comes to diabetes, sometimes it seems things change more than they stay the same. Every so often, we may start to notice things going a bit out of whack and some new blood sugar patterns emerging. Part of being an informed and educated patient is learning to identify these problems. So this month we’d love to hear:

What are the best resources you have used to help trouble shoot?

I don’t believe in just counting carbs and then reacting to the subsequent highs and lows.

My philosophy

Well…after 16 years of diabetes and lots of note-taking and troubleshooting and learning about how insulin works and what factors can influence insulin resistance, insulin absorption, and blood sugars….I don’t usually get confused about my blood sugars.  I know that sounds like an arrogant lie but I’m being honest.  I mostly get confused about why I couldn’t muster up the motivation or energy to do what I know I needed to do.  The overwhelming majority of my out of range blood sugars are due to my own self-discipline issues-which are impossible to always avoid because, duh, I’m human.  I try not to kick myself when I choose incorrectly, I just move on.  I believe in accepting full responsibility for my actions but showing guilt the door.  Anyway, here is how I have arrived to this point.  I certainly didn’t get to this place quickly or easily.

Low blood sugars

When my blood sugar is low, the first thing I do is to recall the last time I gave an insulin shot and how much I gave.  (I take mental note of the time every time I inject)  If it was within the past two hours then I know this low is going down fast.  Especially if I’m low and my last insulin shot was within the past hour.  So by remembering this insulin info I know whether or not I need more than 15 grams of carbs or not.  I really stay on top of these lows since they tend to feel more dramatic and are more dramatic.  

If my blood sugar is low and I haven’t given insulin in the past two hours I take my 15 grams of carbs and relax, the low shouldn’t be too harsh. 

Usually, when I’m low, I realize it’s because I didn’t eat as much as I thought I might or I forgot to finish something I was drinking which contained carbs.  This morning for example, I woke up low and right away knew that it was because I gave too much lantus (basal insulin) last night and yesterday morning I worked out 30 minutes longer than I normally do.  I had a light dinner and woke up really hungry and of course, low.  I should have known (and usually know) to have a light snack before bed or to give a little less lantus.  Either one usually does the trick for me.

High blood sugars

When my blood sugar is high, the first thing I do is to go through a mental check-list that looks like this:

-Am I PMS-ing?

-Did I give enough insulin last time I ate?

-Have I been abnormally stressed during the past few hours?

-Did I exercise within the past 48 hours?

-Did I snack on anything without giving insulin for it? (Even a bite of something turns into a high hours later)

-This is a TMI but, when was the last time I had a BM? (Believe it or not, going regularly reallyyy helps keep blood sugars regular, too)

-How much lantus did I give last night?

-Do I have any active/on board insulin?  If so, how much?

-Do I possibly have any infections?

-Am I in any pain?/ Does anything hurt? (Because that can do it, too!)

-Did I overeat during my last meal?

-Have I had any processed foods in the past 24 hours? (this makes it impossible for me personally, to avoid highs at some point in the 24 hours following processed food- and I do mean impossible)

-There are probably more but that’s what I tend to go through when I am high.

99% of the time for me, one or more of these reasons is the culprit.  So I don’t usually change my routine or my insulin doses, I just make a mental note for next time and often, I have to work on my discipline.  Lately, when I’m high it’s usually because I make a conscious decision to do something I know I shouldn’t do-or I don’t do something I know I should do.  Either way, the blood sugar is on me, not on some mysterious phenomenon.  But like I said before, and I really want to reiterate, guilt or shame have no place here.  We’re human.

Along with plenty of blood sugar checks, this is how I have avoided many lows under 50 and many highs over 250. 

After having many of the above scenarios play out, I’ve learned to see them coming and therefore prevent them instead of reacting to them when they happen. Reacting to highs and lows is exhausting and doing it for years really wore me out-much more so than using extra discipline or simply sticking to certain habits that guarantee me better chances. 

Taking notes or the journaling trouble shooting method

I really advocate for note-taking.  Not just blood sugars but activity and physical and emotional stuff, too. 

It’s so important to narrow down the cause for out of range blood sugars.  For example, when I’m nervous, I will quickly go from 100 to 300 and then have a hard time going down (and this is without food being involved!).  Lately, I’ve been dealing with more anxiety and will soon get evaluated for that because I know I can’t ignore something that is messing with my blood sugars.  I wouldn’t be so sure this was a problem without my note taking though. 

Sidenote:  This really is a challenging area for parents of children with diabetes for all sorts of obvious reasons.  The troubleshooting on my blood sugars truly got easier for me as an adult (not to mention I often relayed inaccurate info to my parents and hid emotions from them).  So parents, hang in there and never beat yourselves up.  You’re in a super hard, outside position for troubleshooting because you can’t feel what your kid is feeling and they aren’t always going to be able to articulate certain feelings and symptoms.  Please do not be discouraged.  Keep up the amazing work!

Also, I hope no one feels that I’m pushing advice on them.  I am compelled to share this info because it helped me SO much and I wish someone had shared it with me long ago.  So take it or leave it, it’s brought to you with the most sincere of intentions  :)