Evolution of Diabetes Management: From Old School to Insulin Pumps #17

The evolution of diabetes management is at the forefront of this engaging episode of DiabeticReal. Deborah opens the discussion by emphasizing the importance of self-acceptance and the journey towards better health, especially as listeners transition into a new year. The conversation reflects on the traditional methods of managing diabetes, such as calorie counting and strict meal timing, and how these approaches often felt overwhelming during childhood. Deborah shares personal anecdotes, illustrating the challenges of adhering to these rigid dietary rules while navigating the complexities of growing up with diabetes. This heartfelt discussion serves to connect with listeners who have experienced similar struggles, reinforcing the idea that they are not alone in their journeys.

“This method did save my life... at the time I was diagnosed... [re: old school method of counting calories]...” 

Deborah, 03:52

Transitioning from the past to the present, Deborah explores the significant advancements in diabetes management brought about by insulin pumps. She discusses how these devices have transformed the landscape of diabetes care, allowing for more flexibility and spontaneity in daily life. The ability to calculate carbohydrate intake and administer short-acting insulin in real-time is a game-changer, enabling individuals to enjoy meals without the stress of meticulous planning that characterized older methods. Through her experiences, she conveys a sense of relief and empowerment that comes with adopting new technologies, showcasing how these innovations can enhance the quality of life for those managing diabetes.

• Accepting ourselves while striving to improve is a key theme in diabetes management.
• The old method of managing diabetes was focused heavily on calorie counting and food groups.
• Insulin pumps have revolutionized diabetes management by allowing more flexibility with food intake.
• Living with diabetes can be easier now with technology like insulin pumps and apps.

As the episode draws to a close, Deborah delivers a powerful message of hope and encouragement. She reminds listeners that while managing diabetes can be challenging, the advancements in technology and the support of a community can lead to significant improvements in health outcomes. She urges the audience to embrace these changes and to celebrate their progress as they step into the new year. With a focus on community support and shared experiences, the episode ends on a positive note, leaving listeners inspired and optimistic about their journeys ahead.

Chapters

• 02:08 Introduction and Returning Back to Basics
• 02:50 Understanding Diabetes Management Techniques
• 11:08 The Balance of Insulin and Food (aka Old School)
• 13:06 The Transition to Insulin Pumps
• 17:46 Living with Diabetes: Embracing Change and Technology

Episode Resources

• Calorie Tracker & BMR Calculator to Reach Your Goals | MyFitnessPal
• Medtronic Diabetes (Minimed)

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Episode Credits

Perfectly Wonderful World [Episode Music]

• 🎵 Perfectly Wonderful World 🎵 sung by Deborah...

Episode Transcript

(03:03):
Welcome, everyone, to anotherepisode of DiabeticReal, and I'm
your host, Deborah. I hope youall had a nice holiday break. I know
I did. I didn't want to take abreak. You know, consistency is everything
with podcasts, but also I knowmy personality, and if I just push

(03:24):
and push and push and tellmyself I can never miss a week. Then
I'll burn out and then I'llfeel guilty and then, yeah, I'm a
work in progress. But aren'twe all? And that's part of why DiabeticReal
is here. So we can supporteach other and we can learn through
the joy of growing and notexpecting perfection, but just. Learning

(03:49):
how to accept ourselves andhow to make each day better than
the last. So with that, we'reentering the new year. And I promised
you guys a couple of weeks agothat I would talk about the old-style,
method of managing diabetes.And some of you already know the

(04:09):
answer to this. And it's like,how do I make this topic exciting?
I don't know that you can makethis topic exciting, but it's a core
topic, so going to go back intime. Although, you know, in all
fairness, some people maystill use this method. So I don't
want to downgrade it, be downon the method or anything like that,

(04:31):
because it may work for somepeople. So if it works for you, great,
use it. Personally, I found itbeing. Well, it felt like being shackled
and it did not give me theresults that made me feel healthy.
So for me, I'm very happy to.Leave this particular method in the

(04:52):
past. But that said, I like tolook at the cup as half full instead
of half empty. So this methoddid save my life. I needed this method
at the time that I wasdiagnosed, and so for that I'm very
thankful. But I'm also glad tohave moved. On to the insulin pump

(05:13):
method now. So what we'retalking about is calorie counting
in the broadest sense of theterms. But it's funny because even
just this. Morning, my husbandwas looking at something. He goes,
well, this has. I don't knowwhat it was. X number of calories.
And honey, the number ofcalories doesn't matter to me right
now. That doesn't help me.Calories takes into consideration

(05:36):
the amount of calories. Forinstance, there's three main groups.
You've got your proteins,you've got your. Carbs, and you've
got your fats. And every foodcan basically be broken. Into one
of those groups or acombination of those groups. Well,
I should say a lot of foods.You look at them and say, okay, how

(05:57):
many grams of carb, grams ofprotein, how many grams of fat are
in each food? And then there'scertain values that are. Associated
with each of those. And youadd those up and that's how you get
your calories. It's likelooking at an algebraic equation
and you're looking at thefinal result. That's your calories.
Well, if you look at calories,what does that tell you? That really

(06:20):
doesn't tell you how many.Fats or carbs or proteins are in
what you're eating. That justtells you a final algebraic equation,
amount. And that doesn'treally help you in. What you're doing,
especially when managingdiabetes. So when I was a little
kid. And I remember that, youknow this. Okay, I'm six years old
and this just sounded fun,this part, there's this. Little booklet

(06:43):
thing, it opened up, it waswhite. I wish I had in front of me,
I would describe it, I'mdescribing it from memory. So there
was like these little pages.Like there's a little tiny page and
then under that, what do youcall that? Accordion style or something?
No, not accordion style.Somebody can send me an email or
a text or. I wanted to saytweet. I so desperately want to say

(07:04):
tweet. Send me post on X andlet me know what it's called. But
you know where each page is. Adifferent length and you lift them.
Up and then you can read eachpage. It's not that I'm using to
an adult, but to a six yearold, believe me, that's amusing.
Especially when each page is adifferent color. So you've got on
each page, it's like this onedescribes all the different. Foods

(07:25):
that are in the fats group.All the different foods that are
in. The carbs group, all thedifferent foods. That are in the
meats or the proteins group.So here you have a six year old that's
trying to learn how to be anutritionist. And yes, I had to meet
with nutritionists, I had togo through all this as a 6 year old
and all of a sudden 0 to 60,learn how to be on a diet. Because

(07:51):
part of managing diabetes,especially in this old school method,
was learning how to manage thefood. Because the core of this method
was that you took insulin byshot, by injection and there were
two types of insulin. You hadthe long acting insulin and that

(08:14):
was the kind you took both ofthem in the morning or I should stop
saying you, I'm saying You. Asin the ya. I took two types. The
long acting was the kind thatwould, what they say is peak. It
would peak later in the day.So that was the type that would work
more towards the suppertimeand kind of COVID me in that long

(08:34):
acting. And then there was theshort term that would work for the
morning, that. Would kind ofpeak at noon. The idea was that it
would cover me throughout theday and hopefully cover me to the
next day. Now it got to thepoint where I had to take insulin
in the evening and that wasbetter coverage because then you
had insulin. And it makessense. You're trying to cover the

(08:56):
body for 24 hour period. Soyou take insulin, that would cover
the long acting, would coverto the suppertime, that short acting
would cover to noon. Butyou're taking both of those, those
are two different types ofinsulin, the short acting and the
long acting. And you take themboth together in the same needle,
you'd mix them together,obviously make sure you're taking
the right amount of each, mixthem together in the needle, take

(09:20):
that shot in the morning, andthen you do something similar at
night. But at night Igenerally just take the short acting
to cover me for the eveningfor like the supper that. I would
eat and maybe any snack. Butthat meant that you had to. Eat at
the same time every day,ideally. And you had to take the

(09:40):
shot at the same time everyday, ideally, because it wouldn't
work if you're taking randomshots at different times, because
then you could have the shotsoverlap. Now you have too much insulin
on board, and then at othertimes you don't have enough insulin,
or if you eat at differenttimes because then you. Have too
much food on board, the. Foodis overlapping, so you've got too

(10:03):
much food, not enough insulin,or you don't have food when you should
have food. And now you'regoing to have what's called an insulin
reaction, which is low bloodsugar. And that's not good either,
especially if you have like meand you have seizures when you have
low blood sugar, or as I foundout later, if. You don't have seizures,
you just end up dead. Not agood thing. Everything was about

(10:26):
balance. It had to be timedperfectly, the. Shots, the eating
and what you ate. Becauseagain, it was all about the insulin,
the amount of insulin that youtook. So you couldn't eat less because
you'd have that insulinreaction. And you couldn't eat more
because you. Hadn'T takenenough insulin to be ready for more
food. And that meant you hadto have A diet. It wasn't that I

(10:50):
was on a diet. That's kind ofa misconception. You see someone
and say, oh, you're diagnosedwith type 2 diabetes. You must be
on a diet because of thediabetes. You know, someone might
be on a. Diet to lose weight,but that's a separate issue from
being on a diet to control thediabetes. It's about managing the

(11:10):
blood sugars. When you're onthis particular regimen with the
insulin and the food, it'sabout the timing. You don't want
that insulin in there withoutfood, and you don't want the food
in there without insulin. Theyhave to work together. It has to
be balanced, and it has to betimed, especially when you're. On
the insulin injections. As akid, I had to learn what the values

(11:32):
were for the food. I had tolearn that potato was. Not a vegetable,
it was a starch, also known asa carbohydrate. Now, that got me
in trouble in school. I'd goto school, first grade, second grade,
and they would tell us, okay,kids, ready? Here's your foods. What
is this? Is this the peas?They are a vegetable. And snotty

(11:54):
little kid. No, I wasn't asnotty kid. I was just a determined.
It was like, peas are not avegetable. They are a carbohydrate.
They are a starch. And myfriends would be looking at me like,
what is wrong with you? And myteacher, wise teacher that she. Was,
would realize, oh, okay,that's right, this is the diabetic
kid, okay? So she would giveme a pass. On my quizzes and tests

(12:19):
and things, because I keptcategorizing the foods according
to the diabetic standard,according to the. Nutritional standard,
according to the dieticianstandard. Rather than the way the
schools were teaching as faras that corn and. Peas and potatoes
were vegetables. I wasclassifying them as starches, as

(12:39):
carbohydrates, as in the samefood group as bread. So it was an
interesting, you know. Lateron, I learned how to interpret things
according to the culturalenvironment that you're in. And if
everybody wants that to bevegetable, okay, whatever. But I
know it works different as faras diabetes management, but when

(12:59):
you're a kid, you don't quiteunderstand those people. Management
skills, sociology, things likethat. We bounce forward a couple
decades, and. In comes insulinpumps. Now, with the insulin pump,
the beauty. Is you remove thelong acting insulin. And now you

(13:20):
have short. In fact, you haveeven shorter acting insulin. They
have synthesized insulin.Well, that came in with injections
as well. But let's notovercomplicate things. Okay? So now
you have short acting insulin.That actually rather than working
within a. Half hour, it workswithin 15 minutes, which is really
good for a pump. Now what youcan do is you can look at the food

(13:45):
and just calculate the carbsbecause the carbs are what is going
to translate into sugar in thesystem. Now you look at food, like
even pie, thinking about therecent holidays and. Look at the
insulin pump, calculate howmany carbs are in that pie and dial

(14:07):
in the carbs. When I say dial,you take your pump, you go to this
thing called my pump. Now,pumps vary. I'm on the Medtronic
MiniMed pump and I would dialin the number of carbs that that
pie is worth for that servingsize. And since I have all the calculations.
Already worked into the pump,that's something that I use. I do

(14:29):
it myself. But you workthrough it with your endocrinologist,
if you're diabetic or with theclinical trainer, whatever, whoever
it is that's helping you withyour insulin pump, you dial it in.
So the bolus wizard in thepump. Will automatically calculate
that the math for. You so youdon't have to do it. I also do it
in my head. But anyway, thepump will do it for you, so you don't

(14:52):
have to know math. It willcalculate how much insulin this short
acting, really short acting.Now short acting insulin you have
to. Take to counteract thecarb that's in that pie. So I take
the insulin, I serve up thepieces or the pie is served up to
me, whatever the situation. Soyou can picture yourself at a fast

(15:13):
food restaurant, whatever, andthen you go back. Now the only thing
is when you get that food, yougot to eat it right away because
you've just dialed in someinsulin, otherwise you're in trouble,
just like we mentionedearlier. Got to have the insulin
with the. Food, the food withthe insulin. You can't be dialing
in insulin and then not eat oryou're in trouble. That's when I

(15:34):
have like low blood sugar,seizure, death, you know, that kind
of stuff. So make sure thosethings go hand in hand. But the nice
thing is now they can go handin hand at the same time. Now you're
not giving an injection at thebeginning of the day and then. Trying
to make sure that you eat atcertain times and make sure you in
a place where you can eat atcertain times, that you're not taking.

(15:55):
A bike ride and complicatingthings with. Exercise and that you're
not at a place where you caneat or you. Forgot to bring a sandwich
or all. These other things inlife that can complicate things and,
and have trouble. And you'renot having to stick to a diet. Now
you can live life normalbecause you have this insulin pump
and you. Can actually justeyeball it, as I call it. Now. I

(16:15):
also use a tool and no, I'mnot being paid by them. I'm not an
affiliate or anything likethat. I use my fitness pal, myfitnesspal.com
I. Actually pay for thepremium subscription and. It'S got
a barcode reader and I. Alwayscarry my iPad around with me. So
you know, you go pick upsomething even, even cookies. I love

(16:36):
grandma's cookies, the peanutbutter cookies. And they're already
in my, in my iPad andMyFitnessPal. Once you eat something,
it's already in your system.But I mean using that as an. Example,
I can read the barcode with.My iPad with a barcode reader. And
I say I pay for the. Premiumon MyFitnessPal because that's what
allows. You to use the barcodereader. I can read it right there.

(16:59):
Sticks the carbs into mydiary, into my fitness pal. Pops
up the carbs. I've got thecarbs right there. Dial them into
my pump. Giving the insulin,Eating my cookies. Easy as that.
So much easier. Even though Ilove those multicolored, multi sized
papers from when I was six.Life is so much easier. With the

(17:24):
Medtronic MiniMed pump and myfitness pal. I can live life as if
I. Was not a diabetic and Idon't have to stick to some 1700
calorie diet where I'mmeasuring everything with measuring.
Cups and teaspoons andtablespoons at certain times of the
day. So life is so muchbetter. And with that I hope I've

(17:48):
given you hope that life doesget better over time. There are things
to look forward to andespecially with the New year. And
hugs to all of you as. Weenter into our New Year of 2025.
This is Deborah signing off on DiabeticReal.