# The "right" way to talk about diabetes?

**URL:** <https://forum.fudiabetes.org/t/the-right-way-to-talk-about-diabetes/4268>\
**Category:** Treatment\
**Created:** [June 22, 2018, 8:40pm UTC](https://forum.fudiabetes.org/t/the-right-way-to-talk-about-diabetes/4268 "2018-06-22T20:40:11Z")\
**Posts on this page:** 16\
**Page:** 6

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**Author:** ![Nickyghaleb](https://avatars.discourse-cdn.com/v4/letter/n/5f8ce5/32.png) [@Nickyghaleb](https://forum.fudiabetes.org/u/Nickyghaleb)\
**Post date:** [June 29, 2018, 5:13am UTC](https://forum.fudiabetes.org/t/the-right-way-to-talk-about-diabetes/4268/102 "2018-06-29T05:13:25Z")

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> [@Katers87](#):
>
> IMO this is part of the basal problem with your pump

Could be. I’m here getting help with some of these things, so I won’t waste any time pretending like I know for sure whether or not my basal rates are set up right… However, I really do think it’s more a matter of diet and how fast my blood sugar can move. For instance, my line since last night has been flat as a straight edge. And my sensor “accuracy” has been spot on. But if I were to have a banana, my blood sugar would skyrocket, and my sensor would take forever to get caught up. It’s why auto was not great for me… for one, I think the technology maybe is not all it’s cracked up to be, but two, it CAN’T stand a chance when it’s basing itself off my delayed sensor readings like that…

> [@Katers87](#):
>
> the only time I’m trending up so fast that my cgm is that far off (70 mg/dl) is when I forgot to bolus or I’ve severely underbolused.

I get it then, too, but I also get it from a banana. Or a 13 g of carb turkey and cheese wrap… Oh, that one really ticks me off.

> [@Katers87](#):
>
> My understanding with the 670g (please correct me if I’m wrong) is that the basal shuts off after you bolus. That’s effectively eliminating your basal for a period of time. A strong, accurate basal is crucial to being able to predict the effects of everything else.

You’re not wrong but also also are only partially right. The 670G when in Auto Mode does this. It’s got two modes, auto and manual, and manual is just regular pumping with the additional suspend features. I can’t deal with auto mode for this reason (and 62 others). It doesn’t always shut you down, but it’s very common. It’ll shut you down if your sensor is trending down, if you have recently received a lot of insulin through micros, or if your food bolus is big. For me, this is not a great time to shut down when I’ve had a big food bolus. Maybe reduce the micros… I can’t say that wouldn’t work, but canning my insulin for anywhere from 20 to 45 minutes following a bolus is just silliness.

> [@Katers87](#):
>
> If I haven’t eaten for 2+ hours, then I should only need to check my cgm every 30 minutes or so (maybe even less).

If I’m sitting nicely and not doing anything to disrupt the calm, yes, I could maintain about the same schedule. In reality though, I’m not sitting nicely not doing anything. And 15 minutes could be enough to cause major problems. 5 minutes could be enough. Not every day. Not all the time. But it’s just got to be constant looking, constant testing, constant analyzing, planning, predicting, hoping, treating, reevaluating… And the real kicker is all of that is not enough. Because no matter how much effort I’ve put into keeping track of it, it’s nothing without action. I’m not crying about it, but it gets a bit tiring… and the BIGGEST concern is that when I burn out, I BURN OUT, and because I don’t feel like acting on it, I start to not want to look, and when I’m not looking, well, I’m on vacation mode, and thinking such as, “I’m messing up anyway, I might as well…” starts kicking in. I’ve learned to clean it up faster, but I worry about my ongoing ability to snap back and get moving again…

WOW. I can’t even remember what we were talking about. It’s okay. This is a gift to be able to do this another diabetic. It really is. So thank you for listening, by the way. 😃

> [@Katers87](#):
>
> I’m sorry I’m raining a bit on the 670g

Oh, you don’t need to apologize. Your rain drops are lost in my monsoon. 😃

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**Author:** ![Nickyghaleb](https://avatars.discourse-cdn.com/v4/letter/n/5f8ce5/32.png) [@Nickyghaleb](https://forum.fudiabetes.org/u/Nickyghaleb)\
**Post date:** [June 29, 2018, 5:21am UTC](https://forum.fudiabetes.org/t/the-right-way-to-talk-about-diabetes/4268/103 "2018-06-29T05:21:43Z")

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> [@Jen](#):
>
> I have an upcoming trip to the US

You’re not in the US? Don’t know why, but now I like you even more. 😃

My oldest son has celiac disease, my middle one probably does, and my littlest son has a very severe milk allergy. We pretty much keep cardboard in the house. And a salt shaker. With all of these allergies and food issues, I sometimes forget that what I’m eating is terrible for ME. It’s gluten-free and dairy-free, but oh yes, it’s 56 grams of carbs… it’s a lot to try to keep an eye on all of it. So we don’t go out, and we don’t order in. But I still manage to raid the pantry and clean out all of the over-priced high carb gluten-free crackers and chips before I get a hold of myself. But that was me up until yesterday. This is the new me. And my line is flat as an arrow. Today.

Traveling for us, with all of these allergies, is a nightmare. It can also be very expensive. What allergies do you have?

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**Author:** ![Jen](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/jen/32/4777_2.png) [@Jen](https://forum.fudiabetes.org/u/Jen)\
**Post date:** [June 29, 2018, 5:42am UTC](https://forum.fudiabetes.org/t/the-right-way-to-talk-about-diabetes/4268/104 "2018-06-29T05:42:25Z")

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> [@Nickyghaleb](#):
>
> You’re not in the US? Don’t know why, but now I like you even more. 😃

Heh. I’m Canadian. 🙂

> [@Nickyghaleb](#):
>
> Traveling for us, with all of these allergies, is a nightmare.

Yep. Many people think I’m crazy for packing ALL of the food I’ll eat for a trip. But that’s better than having allergic reactions and blood sugar rollercoasters. Been there, done that. It seems there are a few of us in this boat (I think @Pianoplayer7008 might be another). Maybe we should start a “Travelling with diabetes and other dietary restrictions” thread. 🙂

> [@Nickyghaleb](#):
>
> What allergies do you have?

Anaphylaxis to potato (from a young age); eosinophilic esophagitis to wheat, dairy, eggs, soy; oral allergy syndrome to tomato, banana, avocado, walnuts. And maybe more foods that I’m still trying to sort out. Like you, I basically don’t eat out, and finding processed products I can eat is fairly difficult.

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**Author:** ![T1Allison](https://avatars.discourse-cdn.com/v4/letter/t/c77e96/32.png) [@T1Allison](https://forum.fudiabetes.org/u/T1Allison)\
**Post date:** [June 29, 2018, 11:47am UTC](https://forum.fudiabetes.org/t/the-right-way-to-talk-about-diabetes/4268/105 "2018-06-29T11:47:00Z")

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> [@Nickyghaleb](#):
>
> is it a given that ALL women will experience a change in insulin needs as a result of hormone fluctuations?

I agree with @Jen’s response on this.

I would also say that there isn’t anywhere near enough research on this to know anything concretely from a scientific standpoint. So it’s up to us.

There is a “if you’re too high, take more bolus next time” contingent that seems to be mostly male. There is a “nothing I do is working consistently” contingent that seems to be mostly female. I don’t think that’s coincidental.

Of the VERY little information I’ve found on this topic (the generic "most women need more insulin 3-5 days before…), it doesn’t match hormone variation of textbook cycles. I’m lucky enough to have a textbook cycle. So if what they were saying was in any way scientifically based, it should match my experience w hormones. It does not.

Hopefully hormones don’t impact your insulin resistance. They always have impacted me to some degree, even on birth control. Now without birth control they impact me in a very consistent fashion that matches what we do know about changing progesterone levels each cycle. That doesn’t make each basal change easy or thoughtless, but I’m saying the science (that the medical community is not paying attention to) lines up with my experience.

I live very repetitive days that give me a lot of constants with which to compare things. If I did not have so many constants, it would be MUCH harder to isolate this information.

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**Author:** ![T1Allison](https://avatars.discourse-cdn.com/v4/letter/t/c77e96/32.png) [@T1Allison](https://forum.fudiabetes.org/u/T1Allison)\
**Post date:** [June 29, 2018, 11:59am UTC](https://forum.fudiabetes.org/t/the-right-way-to-talk-about-diabetes/4268/106 "2018-06-29T11:59:37Z")

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![IMG_8587](https://canada1.discourse-cdn.com/flex030/uploads/fudiabetes/original/2X/d/db99e222a15b84e4cd40f1b3e581334770c39958.jpg)

This is my fortunate bg overnight last night while I’m approaching my peak progesterone-induced resistance. +30% is doing a nice job keeping my bg level. Without it, I’d probably be stuck level at 220 and correction doses couldn’t budge it. And stuck at 220 means nothing else I do all day will work.

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**Author:** ![docslotnick](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/docslotnick/32/75_2.png) [@docslotnick](https://forum.fudiabetes.org/u/docslotnick)\
**Post date:** [June 29, 2018, 1:05pm UTC](https://forum.fudiabetes.org/t/the-right-way-to-talk-about-diabetes/4268/107 "2018-06-29T13:05:27Z")

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I think that the noobs need to know the truth. That diabetes WILL suck if you don’t or can’t take care of it. We tell our kids that they’ll be poor if they don’t get a job, why not tell them they’ll be miserable and maybe dead if they don’t take care of it.

Bottom line, it’s just a part of life that could trip you up, so it must be controlled.

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**Author:** ![Katers87](https://avatars.discourse-cdn.com/v4/letter/k/a9adbd/32.png) [@Katers87](https://forum.fudiabetes.org/u/Katers87)\
**Post date:** [June 29, 2018, 1:22pm UTC](https://forum.fudiabetes.org/t/the-right-way-to-talk-about-diabetes/4268/108 "2018-06-29T13:22:23Z")

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I didn’t realize you don’t use auto mode now! In that case I retract many of my comments. This specifically appeared to be a major problem to me. I’m sure we all have some basal rate problems at times, and I really don’t know enough to be able to judge yours (nevermind that I haven’t been asked!).

> [@Nickyghaleb](#):
>
> It doesn’t always shut you down, but it’s very common. It’ll shut you down if your sensor is trending down, if you have recently received a lot of insulin through micros, or if your food bolus is big. For me, this is not a great time to shut down when I’ve had a big food bolus.

Yes, exactly.

> [@Nickyghaleb](#):
>
> my line since last night has been flat as a straight edge.

Congrats!!! Don’t you just love those nights? Sounds like you’ve got your night basal rates down pat.

> [@Nickyghaleb](#):
>
> the BIGGEST concern is that when I burn out, I BURN OUT, and because I don’t feel like acting on it, I start to not want to look, and when I’m not looking, well, I’m on vacation mode, and thinking such as, “I’m messing up anyway, I might as well…” starts kicking in.

Come binge on FUD and maybe that’ll keep you going 😁 No burning out!

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**Author:** ![Beacher](https://avatars.discourse-cdn.com/v4/letter/b/a6a055/32.png) [@Beacher](https://forum.fudiabetes.org/u/Beacher)\
**Post date:** [June 29, 2018, 1:26pm UTC](https://forum.fudiabetes.org/t/the-right-way-to-talk-about-diabetes/4268/109 "2018-06-29T13:26:42Z")

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> [@T1Allison](#):
>
> There is a “if you’re too high, take more bolus next time” contingent that seems to be mostly male. There is a “nothing I do is working consistently” contingent that seems to be mostly female.

My impression is that these are responses to two very different situations.

If you’re either sex and eat something and afterwards “you’re too high, take more **bolus** next time.”

If you’re a female and you’re trying to mitigate hormonal changes with **basal** changes, you may well say, “nothing I do is working consistently.”

I don’t think anyone is saying if women just take more bolus with their cycle, they’ll be fine.

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**Author:** ![T1Allison](https://avatars.discourse-cdn.com/v4/letter/t/c77e96/32.png) [@T1Allison](https://forum.fudiabetes.org/u/T1Allison)\
**Post date:** [June 29, 2018, 1:36pm UTC](https://forum.fudiabetes.org/t/the-right-way-to-talk-about-diabetes/4268/110 "2018-06-29T13:36:05Z")

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> [@Beacher](#):
>
> I don’t think anyone is saying if women just take more bolus with their cycle, they’ll be fine.

I’m not saying this based solely on FUD interactions. I’m saying this based on my interactions with diabetic community “experts” over my T1D life who were also Type 1 themselves…but did not factor female hormones into their coaching because they have no personal experience with them, and they are largely unreported on…

I’m not beating the drum for personal gratification. I don’t think you think that, but I want to say it anyhow. I’m beating the drum because I’ve always believed that T1D success comes down to the last 5% of what you do…and if you don’t carry the football the last part of the run, you’re going to miss the mark almost altogether. Female hormones are not well understood, not well discussed, and make or break my diabetes results. It’s the last 5% that everything hinges on in my case. If it’s taken me years of personal observation and testing and isolating to determine that which I have a front row seat to, I can’t reasonably expect people who don’t experience this to give the most accurate advice for a given situation. I hope this comes across as optimistically and open-minded as I intend for it to.

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**Author:** ![T1Allison](https://avatars.discourse-cdn.com/v4/letter/t/c77e96/32.png) [@T1Allison](https://forum.fudiabetes.org/u/T1Allison)\
**Post date:** [June 29, 2018, 1:45pm UTC](https://forum.fudiabetes.org/t/the-right-way-to-talk-about-diabetes/4268/111 "2018-06-29T13:45:37Z")

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> [@Beacher](#):
>
> I don’t think anyone is saying if women just take more bolus with their cycle, they’ll be fine.

As a follow-on thought, when I started on the pump five years ago, the expert I was working with to get up and running quizzed me with the following question to assess my acumen as a client:

“If you are level but high, do you need more basal or a correction bolus?”

And I answered:

“I think you are looking for ‘correction bolus’ but I do not agree with that statement if I am in a timeframe of hormone resistance. If I am hormonally resistant, I will naturally level at a higher point and I will need more basal.”

I was told politely that I was wrong. I wasn’t…not for my body.

Anyway, my point is that this is not a well understood topic and I think it warrants more discussion for the women it affects, however large that population is, for best outcomes and quality of life.

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**Author:** ![Beacher](https://avatars.discourse-cdn.com/v4/letter/b/a6a055/32.png) [@Beacher](https://forum.fudiabetes.org/u/Beacher)\
**Post date:** [June 29, 2018, 1:59pm UTC](https://forum.fudiabetes.org/t/the-right-way-to-talk-about-diabetes/4268/112 "2018-06-29T13:59:13Z")

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> [@T1Allison](#):
>
> I hope this comes across as optimistically and open-minded as I intend for it to.

It does. I thought you were describing divisions on this forum, and what I meant was “I don’t think anyone HERE is saying …”

BTW, I mentioned Dr. Jerilynn Prior in another thread. In the words of [her online bio](http://www.cemcor.ubc.ca/media/prior_bio), “She has spent her career studying menstrual cycles and the effects of the cycle’s estrogen and progesterone hormones on women’s health.” Her (and her foundation’s) research is not diabetes-specific, but if you haven’t been there already, you may find some useful information at [http://www.cemcor.ca/](http://www.cemcor.ca/). They have found, for instance, “that variability in ovulation and huge variation in the amount of progesterone that each menstrual cycle makes are very common” – countering the textbook cycles you rightfully find fault with.

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**Author:** ![Eric](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/eric/32/9209_2.png) [@Eric](https://forum.fudiabetes.org/u/Eric)\
**Post date:** [June 29, 2018, 2:08pm UTC](https://forum.fudiabetes.org/t/the-right-way-to-talk-about-diabetes/4268/113 "2018-06-29T14:08:49Z")

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> [@Beacher](#):
>
> If you’re either sex and eat something and afterwards “you’re too high, take more **bolus** next time.”

I totally misread this sentence the first time!  
🤣

[![](https://img.youtube.com/vi/RRbg7K75w0I/hqdefault.jpg "Seinfeld- Classical Conditioning") ](https://www.youtube.com/watch?v=RRbg7K75w0I)

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<div class="post-metadata">

**Author:** ![T1Allison](https://avatars.discourse-cdn.com/v4/letter/t/c77e96/32.png) [@T1Allison](https://forum.fudiabetes.org/u/T1Allison)\
**Post date:** [June 29, 2018, 2:18pm UTC](https://forum.fudiabetes.org/t/the-right-way-to-talk-about-diabetes/4268/114 "2018-06-29T14:18:38Z")

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@Beacher, I have been looking into her research since you mentioned her. Thank you for that!

My family still gets each other birthday gifts as adults which I think is sweet, so all of my birthday gift requests are for the most current books I can find on women-specific diabetes treatment books.

Maybe I’ll find out that there is this great source of information out there that would have made my trial-and-error look silly and ill-informed. That would be funny. And then I would have to eat a lot of crow on here because it would take forever to revise my 5 million posts about it on here. 🙂

You guys have permission to laugh at me if that happens.

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**Author:** ![T1Allison](https://avatars.discourse-cdn.com/v4/letter/t/c77e96/32.png) [@T1Allison](https://forum.fudiabetes.org/u/T1Allison)\
**Post date:** [June 29, 2018, 2:19pm UTC](https://forum.fudiabetes.org/t/the-right-way-to-talk-about-diabetes/4268/115 "2018-06-29T14:19:46Z")

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@Eric, that’s hilarious. That’s a different thread. 🙂

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**Author:** ![lh378](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/lh378/32/601_2.png) [@lh378](https://forum.fudiabetes.org/u/lh378)\
**Post date:** [September 12, 2018, 12:43am UTC](https://forum.fudiabetes.org/t/the-right-way-to-talk-about-diabetes/4268/116 "2018-09-12T00:43:57Z")

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I have learned so much from you @Eric in regards to treating lows/highs. I used to be so wimpy when it came to treating highs. It was frustrating because I could not understand the stubborn highs. It makes complete sense, because one can bring up a low very quickly, whereas the insulin is S-O-O S-L-O-W to become effective.

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**Author:** ![lh378](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/lh378/32/601_2.png) [@lh378](https://forum.fudiabetes.org/u/lh378)\
**Post date:** [September 12, 2018, 12:47am UTC](https://forum.fudiabetes.org/t/the-right-way-to-talk-about-diabetes/4268/117 "2018-09-12T00:47:39Z")

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This may be off topic, I just looked ahead in my month at a glance calendar and saw the following:

October is Pasta Month  
November is National Diabetes Awareness Month

Is this considered to be bad sense of humor or irony? (Literary analysis was not my strong suit in school, lol.)

[Previous page](https://forum.fudiabetes.org/t/the-right-way-to-talk-about-diabetes/4268.md?page=5)
