Photo by Tanja Heffner on Unsplash

Photo by Tanja Heffner on Unsplash

Having that thing go off, it’s less about it going off every hour and asking me to stand for a minute, but of reminding me of the passage of time, that as a human being, I feed off of motion the same way that I feed off of food.

How often will the watch ask you to stand or move? If standing and moving intrude on my focused work effort which should win out? The stand/move or the focused concentration? What do I do if I am merely a participant in a 2-hour meeting with high-level executives? Do I just stand up in the middle of the meeting and walk out because my watch told me to?

Then linking that into, wow, I actually have more pain today. Tomorrow, I’m going to make more of a conscious effort to really pay attention to when the watch tells me to get up and move, and maybe have a walking meeting.

How do walking meetings work in practice? How easy is it to convince a group of people (or a single person) to go outdoors in very cold or very hot weather and work (think) while walking? What if one member of the group says no (perhaps they have a medical reason)? Does the other members of the team pile on in convincing that person to do a walking meeting?

My wife just walked by while I was reading this article and suggested we go for a walk. I asked her if we could go in about 30 minutes. My Dexcom indicates that my blood glucose is 50 mg/dL. I need a glucose gel. If this had been a request for a walking meeting at a specific time I would have had to decline. For medical reasons that I would not want to explain to anyone.

Were you mindful when you were eating? Did you eat things that, at the end of the day, are going to balance out to cover all of the different nutrients you needed so that your body and your brain can function?

Yes. Sure. I have type 1 diabetes. I already do way more testing and monitoring and daily nutritional analysis than most people.

When we’re talking about health and wellness with colleagues, with patients, or with clients, one of the things that we definitely do talk about is it’s a buffet. It’s rarely going to be a one-size-fits-all. It’s really about paying attention to what it is that you need, and finding that best fit.

Truth!

A few of my friends and family have asked why I don’t have an Apple Watch. They read some hyperventilating article about how Apple is working on a blood glucose monitor for diabetes. My Dexcom G5 CGMS is helping me do 24/7 blood glucose monitoring because of the ever-present risk of hypoglycemia because, like most people who have lived with Type 1 diabetes for a while, I have hypoglycemia unawareness. It’s not a quantified lifestyle device toy.

Even if the Apple Watch could accurately monitor my blood glucose, it would need to be connected to me 24/7. My Dexcom transmitter battery last three months. Snapping in a new pre-charged transmitter takes two hours. The Apple Watch is good for 18 hours and needs to be connected to a charging stand to re-charge. This is nowhere near to being a replacement for my Dexcom G5.

Ten years have passed since my Type 1 diabetes diagnosis, and as I get to know myself more as a person with diabetes, I have learned that to do what I’ve always loved to do and to try new things is possible, but both require more planning than in the past.

Managing diabetes requires me to regularly consider what I need to live every day regardless of what I am doing or where I am. I have to deliberate, prepare, and strategize before heading off into the woods and away from the safety of home and a comfortable routine. What did I forget? What if I my CGMS stops working? What if my insulin gets hot? What if I run out of glucose gels?

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diabetes, checklist, Wunderlist, screenshot
My diabetes check-list in Wunderlist.
For about a year and a half, I’ve worn the ACCU-CHEK insulin pump. It’s about the size of an old Blackberry pager (if you are old enough to remember what those looked like), along with a glucose meter about the same size, which acts as a remote control. The insulin pump is attached via plastic tubing to a small port inserted into my stomach. Every three days I change the plastic tubing and port location on my body, and every five or seven days I fill a new plastic cylinder with insulin and insert into the pump. I check my blood sugar on the glucose meter about six times a day.

Once I count and enter the number of carbohydrates I am going to eat; the glucose meter suggests a dosage (called a bolus) which I can accept or alter as needed. When I decide to be active, I can choose a higher or lower baseline insulin rate depending on my activity level (it’s all guesswork). This system functions as my personal external electronic pancreas, and it’s helped me to live a more flexible life than when I was on 4 to 6 shots a day.

Before I go into the woods to hike or take photos, I run through the list of things I would need. I’ve learned that the added exertion of walking in the woods or long walks around a large city causes me to burn glucose at a faster rate, and it takes me a while to get enough carbohydrates in my system to sustain my activity.

During one recent hike this past spring I downed two 22g glucose gels just to keep my blood sugar high enough to walk back to my car. I brought what I thought was enough glucose tabs to handle possible hypoglycemia and adjusted my insulin based on an estimate of excursion. 30 minutes into the hike and my blood glucose dropped, and the devices started beeping. I used up all the glucose tabs, and things did not improve. Thank goodness my friends had snacks.

The other thing I have to consider is that there is no cell signal out in the woods. If I have a hypoglycemic episode (undetectable without my bio-hardware) or a diabetes device failure, having someone with me provides added comfort in knowing there is someone who can help me if I need it.

T1 (autoimmune) diabetes is not something about which a patient can escape thinking. But over time I’ve developed a go-to checklist, with my medical supplies listed next to my photography essentials, diabetes no longer gets all the attention when I’m planning.[/fusion_builder_column][/fusion_builder_row][/fusion_builder_container]