Children mature physically and emotionally at different rates. With children with diabetes this creates a challenge for any adult involved with their care. This brings me to my point: when are kids emotionally ready to assume the full challenge of diabetes self care? And how does emotional maturity impact their physical capabilities for self-management? A solid, well laid foundation is essential for building a quality home. Likewise, a strong diabetes "home" is built upon a foundation of self care skills and equipment. Yet insulin injections, pump infusion site changes, reading a food label or properly measuring a blood sugar level are just skills. Important, yes. But just skills. The true
I have previously explained the most common hormone deficiency in persons with type 1 diabetes: hypothyroidism (low thyroid) due to a common autoimmune disorder known as Hashimoto's thyroiditis (model gland shown on the right). I will next explain the opposite state created by an overactive thyroid and also driven by a misdirected immune system. This condition is called Graves' disease (a specific type of hyperthyroidism, the gland shown on the left; the middle is an example of a normal size thyroid wrapped around the windpipe). The first president Bush (George H. W. Bush) was found to have this condition after he was initially discovered to have the heart condition atrial fibrillation in Ma
Have you made a good diabetes excuse today? One common excuse overheard in a diabetes clinic is that someone "forgot" to bring their blood sugar data in with them to the visit. This excuse is effective at least once. But then as BG data is "forgotten" visit after visit, and metabolic control deteriorates, the excuse evolves into something else. The increasing use of continuous glucose sensors is redefining the term of "patient involvement" with diabetes self care. New excuses are needed. Another good excuse is when a patient/parent says "I was afraid of that" when the A1C is found to be elevated. "Two weeks ago Billy was sick with the flu and his blood sugars were high all week". This excu
One of my favorite movies growing up (and even as an adult) was The Wizard of Oz. I learned many lessons about life from its symbolism. Without question, the most profound message I learned was that inner peace and happiness are never found “over the rainbow”, but in our own back yards (faith, family, and personal relationships). It was only at the end of her journey through Oz that Dorothy realized she always had the power within her to return home (to family and happiness). The magic of the ruby slippers in truth resided within her. But first she had to believe; not in the slippers, but in herself. That message has resonated with me over the years regarding many other aspects of life. I se
Our diabetes technology is amazing. But it's no better than its weakest link. With diabetes therapy there are many potential stumbling blocks on the path to good control. Case in point. The device above is an insulin pump catheter. The cost to make one one these is pennies. The sales price is a bit more. But this one created a $15,000 bill for one family. Insulin pumpers know exactly what I'm talking about. The owner of this catheter changed an infusion site one evening and went on his business. The next morning, feeling nauseous, he chose not to say anything to his family and went to high school. His blood sugar was 279 mg/dl [15.5 mmol/L]. He took a correction dose of rapid-acting insulin
