Last night, I was the ‘here’s one we prepared earlier’ on a panel discussing CGM technology. The audience was all healthcare professionals – mostly DEs, but some dietitians, RNs and also a GP-in-training (so much yay to him for coming along!).

I love being in the room for these events! I wrote about my last experience giving the same talk here. I cannot speak highly enough of the two experts on the panel last night. Dr Peter Goss – who spoke at the last one of these events – is what I would call a disrupter in the diabetes healthcare space and, honestly, all the power to him. He may ruffle some feathers with his sometimes unorthodox approach, but it is undeniable that he is a champion for kids and teens (and young adults) with type 1 diabetes. Also on the panel was A/Professor David O’Neal who is best described as a truly awesome endo (I have heard that from every single person I know who sees him as their endo) and an absolutely brilliant mind. His expertise in diabetes tech is second to none and he is genuinely interested in how the technology can safely, efficiently and effectively be incorporated into the lives of people living with diabetes.

I know that all sounds rather effusive. But I need to point out that they are remarkable. And that they are the sorts of HCPs you want on your side if you are a person with diabetes.

Because now I am going to talk about language and why I pulled them up a little bit after we all did our presentations and sat on the stage ready to answer questions from the audience.

As happens frequently when I am in the room with a group of healthcare professionals, the conversation turned to language. Okay, I made that happen. In fact, the words I used were ‘I’m going to hijack this conversation because we really need to talk about language here.

One of my biggest pet peeves is the jokey, and somewhat snide, comments made about people with diabetes making up numbers in their diabetes log books. Because, it’s not a joke. It’s not something for HCPs to roll their eyes over and dismiss as ‘non-compliant’ behaviour.

The word that was used for PWD who make up numbers in their books was ‘fakers’. I cringed the moment I heard the word. And cringed even more at the audience’s response – laughter, heads shaking from side to side and knowing looks. I looked around the room and knew that we would be talking about this later on in the evening!

As I pointed out when the panel was seated on the stage, I absolutely did this. And I was incredibly good at it – different coloured pens, splotches of blood on the pages, dog-eared corners of the book. Once, I even splattered a few drops of juice, because on that particular page, I was having a lot of lows and I thought the juice would make it look more authentic.

Now, let’s all just remember for a moment that I was diagnosed as an adult. This wasn’t insolent teenager behaviour. This was a woman in her mid-twenties who was terrified of disappointing and being judged by the HCP to whom she would be handing the grotty book and its made up numbers.

I told the room my story of this last night and there was laughter – because the way I spoke about it was amusing. It was a cheeky anecdote. But at the time, it wasn’t funny. I was scared, I hated checking my BGL, I was paralysed by numbers that didn’t make sense and I didn’t know what to do about it. So I lied. Of course my HCPs knew that. And I knew my HCP knew.

But the question is about WHY people do this. The discussion needs to stop being about diabetes at that point, because really, managing BGLs and most other diabetes tasks is not the issue here. The issue is distress, anxiety, fear. And, in my case, I felt desperate.

One of the panellists made the point that the reason that he brought it up was because HCPs need to know what to do when someone is ‘faking’ their numbers. He’s right. I completely agree. And then there needs to be understanding of how to approach it, which is likely to be different with each PWD.

For me, it took until I found a HCP who I felt I could trust – one who wouldn’t judge the numbers that were out of range (which one HCP always circled in red pen, making me feel even more like a delinquent adolescent) – and was interested in knowing what was stopping me from feeling able to check my BGL.

When we worked through that, I was better equipped to not only regularly check my BGL, but also to deal with the numbers and act upon them. I came to understand that a number was nothing more than a piece of information that I could use to make a treatment decision – not an indication of me being a good or bad person.

Language does matter. And words count for a lot. Using the word ‘faker’ in this context is loaded with judgement and accusation, and even if that is not the intention, it made me – a person with diabetes – feel very uncomfortable. But mostly, it fails to consider the real problem at hand which is not that a PWD is making up numbers in a book. It is why they feel the need to do that.

On Sunday, I pottered around the front garden, doing a bit of weeding and tidying up and decided to cut a couple of small branches from the beautiful Little Gem magnolia trees we have along the fence-line, doing their best to hide us from the bluestone lane that runs along the side of our house.

I took them inside and arranged them in the largest vase in the house, setting it in the middle of the table in the kitchen. They looked magnificent – the leaves are the most beautiful glossy dark green on one side and a matte brown on the other.

Standing in the kitchen later that day, I said to Aaron ‘Aren’t the magnolia leaves gorgeous?’ ‘Yep,’ he answered. And then added ‘Are they steel magnolias?’

The term steel magnolia is a term used in the US South and refers to a woman who is traditional and feminine (that’s the magnolia part) and strong (that’s the steel part). I didn’t know this until quite recently – it isn’t a term we use here in Australia and for me, it was just the name of a film.

I can remember first watching the film years and years ago when I was babysitting. I can’t remember who I was babysitting, but I know that the kid was in bed and I was looking through the families VHS collection (I said it was a long time ago!) and there on the shelf was Steel Magnolias. I popped the tape in and watched it, and was a completely dishevelled mess of tears by the end of it.

There was no comprehension of what it meant in terms of someone living with diabetes – I had no idea. And yet, a little seed was planted: women with diabetes shouldn’t have babies or they will die. From somewhere, the seed became a huge tree the day I was diagnosed with diabetes, because one of the first questions I asked the endo treating me on 15 April 1998 was ‘Does this mean I can’t have children?’

On Sunday night, as I was flicking through the TV channels, there in front of me was the scene in the hair salon from Steel Magnolias. It was early on in the movie, and the women were discussing Shelby’s wedding (‘My colours are blush and bashful’).

I snapped a photo and snapped off the TV quickly, because I knew watching Julia Roberts have a hypo in a hair salon, and then two hours later die after having just had her beautiful baby was not going to be a good way to end the weekend.

I joke about this movie, I quote this movie, (frequently a juice is accompanied with the comment ‘Drink your juice Shelby’), and I shake my head at how ridiculous it is and how untrue – or at least old-fashioned – it is in its portrayal of diabetes and pregnancy. Most women with diabetes I know have a Steel Magnolias story.

I may mock it. But there is no way that I can watch it. Which is what I said on Facebook when I posted the photo I had just snapped of the TV.


The comments after my photo (and in some private messages) were from friends around the world with diabetes. The impact and consequences of this movie for women with diabetes – many of them having seen it for the first time as children or teens – is far reaching and actually did shape their decisions about having babies.

Yesterday, as I was standing in the kitchen making dinner, I walked over to the leaves on the table and gently rubbed one between my fingers. I thought of how in a few months’ time the trees out the front would be covered in beautiful white flowers that last for days before their beautiful petals drop to the ground. ‘White flowers‘, I thought, and shook my head because I always connect them with babies – my babies – lost.

And then my kid ran into the kitchen to tell me about something that had happened that day. I listened to her and watched her unstack the dishwasher, barely pausing for breath as she told me her funny story. We giggled together and I reached out and gave her a quick hug. And as I do more and more often, I marvelled at her just being there. That movie terrifies me. But not as much as the thought of not having had my baby girl.

I woke up today to feeds full of tech – diabetes tech. Plus I seem to be reading heaps and talking about not-so-new, but still awesome tech-y stuff.

Diabetes technology has been on my mind a lot lately (as well as on my body). Mostly, I have been thinking of the evolution of how dtech moves from being a niche market embraced by only a few, to becoming mainstream.

Back in 2001, those of us using pumps were seen as leaders in the dtech area. Many diabetes HCPs had never even seen a pump and certainly were not comfortable encouraging people to use them. The only reason I started using this technology was because I met someone using one at a diabetes event and asked her. I then spoke with my endocrinologist who was incredibly dismissive, labelling the technology as dangerous. I interviewed for a new HCP team to find people who were more willing to embrace technology.

The same thing happened when CGM was launched here.

And the same with new and different other devices. iBGStar, Libre, diabetes apps – most often, the interest is led my people with diabetes who force the establishment to catch up and get on board.

And I think it is still happening. Here are some things that are being spoken about by patient advocates A LOT. How many of your diabetes HCPs would know about the current state of play in the space? Next time you see them, why don’t you ask?

TANDEM

Makers of very cool (and, frustratingly, unavailable here in Australia) t:slim insulin pump, Tandem Diabetes Care, has joined forces with digital health company, TypeZero Technologies. Yesterday’s announcement explained that the two have entered into an agreement whereby the next generation t:slim pump will integrate TypeZeros’ artificial pancreas technology.

More here.

BIGFOOT

#IBelieveInBigfoot even more after news today from the start-up that they have commenced clinical trials of their smartloop automated insulin delivery system. BigFoot Biomedical is hoping to commercialise their product by 2018. That’s way less than 5 years, folks!

More here from the team at Diabetes Mine and here from the team at ASweetLife.

FDA votes on CGM

Looks like our Dex 5-wearing friends in the US will soon have the same classification on their devices as us here in Australia (and in Europe) with the FDA voting to revise labels to support treatment decisions based on CGM data without confirmatory BGL checks.

The live tweeting from the FDA Panel hearing was interesting with some really valuable and insightful comments from patient advocates. (And can I just say how refreshing it is to see that advocates were given such a huge opportunity to speak here?!)

Some interesting discussions on the interwebs as the vote was announced (and in the lead up too). Not everyone is as excited by this development, or on the same side of the advocacy fence, with some claiming that they don’t have the same faith in the tech and fear that access to BGL strips will be removed.

For what it’s worth, my experience with this technology – and using it as classified – has been nothing but positive. The accuracy of the system is, for me, undeniable and I trust it implicitly to treat both high and low BGLs without doing a confirmatory blood check.

And I have also written before that I have used my CGM ‘off label’ for some time – even before the G5 – and am confident in saying I know I am not the only one. This seems like an example of the regulators finally catching up to the reality. Welcome to the party, guys!

More about the FDA vote here.

GONG FOR ED DAMIANO

Congratulations to Ed Damiano who was awarded Boson University’s Innovator of the Year for 2016.

Ed was recognised for his work in developing the iLet Bionic Pancreas.

More here.

WHAT THE HELL IS #OPENAPS?

Someone asked me this the other day – actually using those exact words. I bumbled my way through an explanation and after about 60 seconds remembered THIS piece by Dana Lewis.

Have you had a discussion about this with your (or any) HCPs? And if so, what have they said? Most HCPs here I have spoken to either do not know about it at all, or are very dismissive of it.

It seems that there are a lot of people in the DOC who have kept across the ‘movement’, but not a whole lot of break-through in more traditional corners.  As is often the case, I suspect that the way, it will be PWD who drive that.

IN MELBOURNE?

Check out this tech event: Translating type 1 diabetes technology into the everyday. It’s free and there is lots on the agenda.

 

 

Last night’s OzDoc tweetchat was a beautiful tribute to someone who has been part of the OzDOC community pretty much since it started four years ago. Tony, better known as @EatYourMeter, passed away last week, and Kim from OzDOC knew that we would all like to remember him together in our weekly chat.

I didn’t know Tony all that well. Our interactions took place mostly on Tuesday evenings between 8.30 and 9.30. He always provided a compassionate and thoughtful voice to the discussion. Tony lived with type 2 diabetes, and I learnt so much from him because he frequently reminded us that our type 1 perspective (which is, for the most part, the voice of the online community) did not necessarily mirror his experience.

A couple of times he gently pulled me up on some dismissive comment I made about ‘just eating something and giving insulin to deal with it’, with a reminder that not everyone has the ability to do that – not everyone uses insulin! He was never aggressive about it – there was no SoMe outrage in his approach – just a friendly nod to remembering that we all are navigating this diabetes road in different ways.

Tony was very good at noticing what people were interested in and sharing information that he thought they might like. Early on, he picked up on my word nerd tendencies, particularly my love of collective nouns and every now and then, he would tweet me an obscure collective noun reference that would inevitably delight.

Last night, as a group, we remembered Tony. Kim led us through a gorgeous chat where we shared memories of our on- and offline encounters with Tony.

OzDOC started four years ago after three of us – Kim, me and Simon (@STroyCrow) – decided that it would be a good idea to have an Australian-focused chat because we felt that there were particular issues that were of interest and importance to Aussies with diabetes. That was the idea, anyway.

And we were right. But what has happened is much more than that. The group grew to more than just a group of strangers on Twitter coming together for an hour a week. Friendships were formed and many of these friendships moved outside the world of Twitter.

Simon and I have stepped away from coordination roles, but Kim has taken the group from strength-to-strength and her work has meant that a tight-knit, supportive and respectful network has formed. The term used to describe this is #dlove and #dlove is thrown around generously.

Last night, we said good bye to one of our own. I, for one, am so glad to have known Tony, and am terribly sad that he will no longer be a voice in the OzDOC community. But I know that while we all feel this loss, we will not forget Tony or his compassion. He will always be part of the OzDOC world.

#RIPEatYourMeter

Some people may have seen news reports yesterday about changes to access of blood glucose strips for people with diabetes in Australia. Some reports were a little light on detail (and by ‘light on detail’ I mean ‘incorrect’) and there has been a lot of discussion on SoMe with people trying to get the facts and work out what it means for them.

This information on the Department of Health’s website gives all the details to date.

Following the news piece, quite a few people have been in touch asking me if I can provide some clarification. I have no details other than what has already been announced publicly. When the announcement was made last year, I wrote this piece about it, so for some background of the issue – and my take on it – have a read.

But what does it mean TODAY for people with diabetes in Australia?

  • These changes DO NOT affect people with type 1 diabetes or insulin-treated type 2 diabetes.
  • No one should be denied access to BGL strips today, tomorrow, next week or next month. While the change in policy took effect from 1 July 2016, an initial six-month supply has been automatically granted to all NDSS registrants with non-insulin treated type 2 diabetes. This means the earliest anyone may be affected by the changes is 1 January 2017.
  • Further information will be coming, so keep an eye on the NDSS and Department of Health websites.
  • Speak with your HCP about the changes if you are concerned about how this will affect you and your diabetes management.

I know that many of us are feeling a little confused about diabetes supplies at the moment with the recent changes in how we access our consumables, and this seems to just be another change we need to deal with.

And as with all change, there is often a lot of speculation and misinformation being shared around. The sensationalist nature of yesterday’s reports did nothing to allay any of these concerns and only fuelled the fire of uncertainty. And is yet another example of poor reporting of diabetes in the media.

I’m almost ready to take a deep sigh of relief, because National Diabetes Week is almost over. It’s been a busy week – it always is. I’ve been working for diabetes organisations for a very long time, and have seen quite a few national campaigns, including some of which I was very, very critical. (Just ask the Comms Manager I worked with for over 10 years who had to deal with me complaining a lot!)

But today, I am writing only of this year’s campaign, which has highlighted the need for a National Diabetes Amputation Prevention Strategy. The campaign has not pissed me off which is a pleasant surprise for everyone who has to work with me. I don’t think it is a scare campaign. I don’t think it is graphic and gory. And I don’t think it is laying the blame for developing diabetes-related complications on people with diabetes.

On Sunday, within hours of the launch, the criticism started. I posted this on my FB page, and my frustration is pretty apparent.

Throughout the week, in between doing interviews trying to raise awareness of diabetes and why it is really crap that each year 3,740 have diabetes-related amputations that could have been prevented, I have read many comments about the campaign. A lot of them – in fact the vast majority – are really positive. Many people understand the complexity of communicating a really difficult message to a very diverse audience. But not all of them.

I have never subscribed to the idea that everyone needs to have the same opinion. And I have never ever shied away from people criticising me or the work I do. I like robust discussions, especially if they are respectful and that everyone is open to considering – not necessarily agree though – with all sides to the debate. (Unless we’re talking vaccination. Then there is only one side.)

But I what I absolutely despise is that any time diabetes is in the media and someone doesn’t like the angle, because what is being discussed is not relevant to them, or they don’t like the message, they respond with immediate outrage and negativity and refuse to consider other positions. This is not just a diabetes thing – social media outrage is the default position for many – hell, I’m guilty of it too. But often with the outrage comes assumptions and the perpetuation of misconceptions about diabetes.

In my capacity as an employee of a diabetes organisation, I have read the comments and not replied. That includes to the direct messages I have received on Twitter and Facebook and email that have been personally attacking and have called me some pretty choice names. (There is no denying the power of deleting and blocking!)

But today, I thought that here, I would put down my responses to some of the comments I’ve seen online. (Please remember that this is my blog and all opinions are mine. Nothing I have written here necessarily reflects the thoughts of the organisation I work for.)

  1. The campaign is not relevant to people with type 1 diabetes.

Of course it is! You have diabetes – any type – and you are at risk of complications. That’s the reality. It’s unpleasant; I hate thinking about it; it terrifies me.

Here is what denying this reality does: it adds shame and stigma to those who do live with complications. Had a limb amputated? Well, obviously it’s because you didn’t look after yourself and are not a diabetes superhero like me.

  1. Type 1 and type 2 diabetes are not the same thing.

Yeah, I know. I get it – they are two different conditions. Sometimes though it’s not relevant to differentiate. 4,400 people have diabetes-related amputations each year. Some are type 1 and some are type 2; some are men and some are women; some are older and some are younger. They are all people and they all have diabetes.

  1. People already diagnosed with diabetes know what happens if their condition is not well managed.

Absolutely not true and a dangerous idea to perpetuate. And this sort of comment is a brilliant example of not being able to look outside your privilege bubble.

If you are in a position to know a lot about your health condition, have access to specialist care, have wonderful support around you, (or know where and how to access support), can afford the latest treatment and technology and are managing really well – that is fantastic. I am one of those people and I know how lucky I am. But many people do not. If you are sitting on the end of a computer, complaining on Facebook and/or blogging about your experiences, you are privileged.

If you are one of those people and think everyone else is just like you, you are wrong and I would really urge you to maybe look beyond the Facebook page where you do your bitching and moaning.

Also – what is it saying to the people who have done everything ‘right’ and still have developed complications?

  1. People with type 1 are well aware – it’s people with type 2 that have no idea what they are for if they keep mismanaging their health.

Really? Just wow! Let’s break this into two sections:

  • It’s a mighty big assumption to make that all people with type 1 are aware, capable and well-informed of their condition. It’s also incorrect. And it says that we don’t need to be focusing on people with type 1 because we are all clever clogs and know everything!
  • The idea that it is only people with type 2 diabetes who have no idea is wrong and also really stigmatising. And it shows a complete and utter lack of understanding about type 2 diabetes and those living with it. Maybe that campaign about the different sorts of diabetes needs to start from within the diabetes community first. How can we expect people completely unaffected by diabetes to know the facts of those of us in it are so ill-informed at times?
  1. What would you know? You don’t live with diabetes.

Hi. I’m Renza (or Brenda, Peta, Wenzer). Here is my blog about living with diabetes.

One of the things I have come to learn is that there is no way that a single diabetes campaign will appeal to everyone or be relevant to everyone living with the condition. And that there is no making all people happy all of the time. In the spirit of this piece of advice, I am calling the week over and putting it in the vault. Have a great weekend everyone!

 

The new Prime Minister of Britain has type 1 diabetes. I am sure that you have heard this about her, possibly mixed up in the commentary about her hair and shoes. (Which is, of course, THE most important thing about a woman who has become one of the most powerful leaders in the world and absolutely what we should all be talking about. Ugh!)

Pretty much everyone I have ever met has informed me that the new PM has type 1 diabetes. I have had calls, emails, Facebook posts and texts from people excitedly telling me that Theresa May is just as pancreatically-challenged as me! Many have asked if I am excited that we have a new pin-up gal for ‘our cause’.

I’m not commenting on May’s politics – that is actually totally irrelevant to how I feel about having a world leader with type 1 diabetes.

Here is what I would love to see about Theresa May’s own diabetes. Very little. Because I don’t want her type 1 diabetes to become a focus. I don’t want type 1 diabetes to be ‘blamed’ for questionable decisions, political gaffs, or the fact that she fell asleep in parliament last week.

Because people without type 1 diabetes make bad decisions all the time. And people without type 1 diabetes make political gaffs. (Barnaby? David? I’m looking at you two…) And people without type 1 diabetes fall asleep in parliament because often there is a man in a suit speaking in a monotone about something possibly rather uninspiring. For a very, very, very long time.

In the same way that every move AFL player Paddy McCartin makes is scrutinised from the position of his defective beta cells, I fear that may be the case for Theresa May.

A world leader with type 1 diabetes is brilliant because it can show people that diabetes need not be a barrier to being at the top of your game. We all love a story like that!

But being the excuse for any negativity – or becoming the focus of her time as PM? That can do ‘our cause’ more harm than good.

Related – but not really

Discussions about Theresa May have included me saying: ‘Well if Jed Bartlet can be President of the United States of America with MS, Theresa May can be PM with type 1.’ I had to be reminded that Jed Bartlet is not real – and no matter how hard I hope and wish for it to be true, it never will be. Damn. 

The contradictions in diabetes are complex and confuse my little mind sometimes. Today is one of those days.

Getting the message that diabetes is serious – and needs to be taken seriously – is sometimes messed up in our determination to show that diabetes won’t stop us from being superheroes. In our proverbial capes*, we do amazing things; we are brilliant; we advocate; we inform. All while pretending to be a pancreas.

We use language that empowers us and makes others see us as forces with which to be reckoned. I say I live with diabetes (often saying I live well with diabetes, never struggle with it. I refuse to even suggest for a minute that I am suffering with or from diabetes and will correct anyone who suggests otherwise.

But is that undermining the seriousness of it? And is it ignoring the days where it does seem like a battle – and an uphill one at that.

I refer to diabetes as a condition, never a disease. Is that the right terminology? And why do I do that?

According to this piece at Health Writer Hub a disease is an …’ abnormality in systemic function…that causes both physical and emotional signs and symptoms’. A condition is …’an abnormal state of health that interferes with the usual activities or feeling of wellbeing’. Both are actually correct when talking about diabetes, and yet I (and many others) object to using the term disease.

Perhaps we don’t want to be thought of as ‘diseased’ or as if there is something wrong with us and ‘disease’ does suggest that.

We want people to think we are superheroes who manage to not only thrive and excel with the condition (disease?) we have been dealt, but also demand that they don’t think of us as any different to everyone else and are given the same opportunities and choices.

Are we doing ourselves a disservice by appearing so ‘in control’ and, dare I say it, ‘normal’, when there is truly nothing normal about having to pretend to be an internal organ, day in day out?

I don’t for a minute want to stop being the empowered, confident, secure and capable person I am. But sometimes I do feel that in all my cheerleading efforts, I sometimes forget – or rather refuse to admit – that it can be tough.

And mostly, I wonder, and fear, that if we all are making diabetes look so easy to manage and impact us in such insignificant ways, do others not see and understand the urgency that we feel every single day in our desire to make things better? Who needs a cure if we look so bloody happy and competent with our little condition?

*I totally do wear a cape! 

Today I attended the Victorian Kellion Victory Medal Award Ceremony. There before me, sixty-six people were awarded medals for having lived with diabetes for 50, 60, 70 and 75 years.

I write about this event every year, and each year, I write about how much hope and inspiration I feel while sitting in the room.

Because it’s true. I walk away from the Kellion awards full to the brim and amazed at what these people have achieved. I’m never sure if it is despite or because of their lives with diabetes that I feel this way. But, undeniably, it is a special day.

Frequently the stories are the same – a shock diagnosis, sometimes a misdiagnosis. Many are unable to pursue their chosen career, especially in days where teaching or nursing were not possible vocations for people with type 1 diabetes. Many spent a lot of time in hospital as they adapted to their post-diabetes-diagnosis life. And many reminisce about injecting into an orange, which apparently was the done thing for a newly diagnosed person 75 years just as it was 18 years ago when I was diagnosed – and still today!

And they share tales of brutal management instruments and tools that in equal measure terrify me and make me glad of the time I was diagnosed.

The hope exists for me because when I look around the room, and I listen to the stories and I speak directly to the recipients and their families as they proudly hold on to their well- earned medals I don’t see diabetes. I see people.

They don’t all claim that diabetes has been fun or that it has been a breeze. In fact, some of them are really open about just how tough it has made their life. But even those who say they have really struggled, still do not believe diabetes has been the single most defining aspect of their life.

I’ve always said that I wish all newly diagnosed people could meet a Kellion medal so they can see that everything will be okay. But I think that was a little naïve of me and actually undermines just what it has taken for these people to be standing there in front of us, accepting their medal. And it also suggests that diabetes hasn’t actually had some sort of impact on their lives.

These are ordinary lives made extraordinary by diabetes. And while their achievements are not there for my benefit, I am so glad that I get to hear their stories.

Source - @DiabetesVic

Source – @DiabetesVic

On our last full day in New York, we walked down some stairs to the subway. My phone started vibrating and beeping and I knew that I was heading low.

I hadn’t really managed to get the whole hot-weather-walking-a-lot thing sorted out on this trip. I dealt with insane Conference Hypo Syndrome from literally the second I stepped foot into the conference centre in New Orleans, and just managed by setting a lowered temp basal rate and drinking a lot of juice.

And then, we were on holidays and while I know diabetes is for life, not just for X-mas, I couldn’t be bothered ‘doing diabetes’ and being smart about making some changes and addressing the lows properly.

For the most part, I was right. I responded to the rapid fall warnings on my Dex and avoided any super-nasty lows.

But this day in the New York subway, I was already firmly in ‘deal with me now’ hypo territory. I had a bottle of juice in my bag, but walked into a little kiosk on the platform to see what I could use instead. And there before me I saw these:
And I squealed.

‘Oh my god. Babe. BABE. LOOK!’ I said to Aaron as I grabbed a couple of packs and started to open them before paying. I think he fished out a couple of dollars from his pocket to pay the guy who was watching me carefully. ‘I love these,’ I announced loudly. ‘Green apple Mentos! I LOVE these!’

Aaron corralled me back to the platform and we sat down waiting for our train and I started to munch my way through the pack.

Want one?’ I asked him, pushing the tube into his face. ‘No thanks. I don’t like green apple flavour.

This was a fact I knew well because every time I mention how much I love green apple flavour, he reminds me he doesn’t.

‘What? WHAT? Of course you do!’ I said. ‘It is the best flavour ever. EV-ER! Remember? It is everywhere in France. Remember, babe? Remember? And there was that time that I found green apple Mentos in Melbourne at a servo and got so excited that I bought, like, 40 tubes. Remember? Have one… Have one babe.’

‘No, I’m okay,’ Aaron said. He went back to reading something on his phone.

‘Babe. Do you remember that time at the servo? I told you, right? I was really low and I went in and saw them and got excited and was ranting and raving to the poor attendant about how excited I was and how I’d never seen them in Australia. Do you remember? The guy thought I was really weird because I couldn’t stop talking about how excited I was and how much I love green apple flavoured lollies. Do you remember?’

Aaron shut off his phone and turned to me. ‘I guess I’ll read this later,’ he said smiling.

I ignored him and continued. ‘So I told him how green apple flavour was EVERYWHERE in France, but not here in Australia and how you could get green apple gum and soft drinks and heaps of other stuff and how I love it. LOVE. IT! Remember how it is everywhere in France? Yeah? And then I asked him how many packs of Mentos they had and I dumped them all on the counter and bought them. I spent, like, sixty dollars on lollies. Green apple lollies. I was so excited and speaking really quickly. Like, super quickly. Almost ranting. Like the fast talked in Seinfeld. Remember Jackie the lawyer in Seinfeld? I was talking really, really fast. Like that.’

‘Kind of like now?’ Aaron asked.

‘Am I? Am I? I am… Aren’t I?’ I said. ‘Yeah – I guess. Maybe it’s the green apple. Do you think that’s what it is? Do you, babe? Could it be the green apple? I LOVE green apple flavour! I should have bought more. Will I go back?’

‘I think it could be because you are low. And I think maybe you should eat a few more of those Mentos instead of just speaking about them.’ Aaron said gently.

‘Do you want one? They are great! I love this flavour!’ I asked.

The train pulled into the station and we found a seat. I checked my iPhone and saw that I was no longer dropping. I took a deep breath and looked around the carriage.

‘I really like green apple flavouring,’ I murmured to Aaron. He reached over and took my hand.

‘I know. And you’re really funny sometimes when you are low.’

I rested my head on his shoulder and concentrated on my heart rate, which was slowing down. By the time we got off the train I was feeling fine. And happy. Because tucked away in my bag was a yet to be opened packet of green apple Mentos.

Read about Renza

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