Creating a 504 plan for children with type 1 diabetes.

504 plan for back to school

Sending a child with diabetes back to school can be a stressful event. You worry about the care your child will receive. Will the staff know anything about diabetes care? Will they understand high or low blood sugars and how they impact your child? The best way to alleviate your fears is to make sure that you have a 504 plan in place to outline everyone’s roles and responsibilities.

What is a 504 Plan?

If you live in the United States of America and are sending your child with diabetes to a publicly funded school, you should have a 504 plan in place.  According to Crystal Jackson of the American Diabetes Association, “schools typically respond to news of a student’s diagnosis by requesting a copy of the doctor’s orders for the child or the child’s diabetes medical management plan (DMMP), a document that outlines not only doctor’s orders concerning diabetes management but also other school-relevant issues, including how skilled the child is with blood sugar checks and other care tasks.”  She further reminds parents to check to see if their school has its own health forms that need to be completed by your child’s diabetes team.

Whether your child is newly diagnosed or returning to school for another year, you have a right to request a 504 plan which will spell out the school’s responsibilities for helping your child manage his/her diabetes care during the school day.  To do this, send a formal request to the school principal or designated 504 coordinator.

Once the meeting is set, you will want to draw up your own 504 plan.  There are many templates available online including ones from www.childrenwithdiabetes.com

What should you include in your 504 Plan?

creating a 504 plan for a child with diabetes. Diabetes Advocacy

In your plan, you will want to include things like:

  • Providing for extra snack times
  • Allowing extra time to finish a test when class time was missed because of taking care of a diabetes-related task
  • Checking blood glucose levels before and during exams
  • Not being penalized for diabetes-related absences
  • Specific locations for blood glucose checking and insulin injection(allowing the child to check/inject in the classroom if he/she prefers)
  • Having a buddy system in place to ensure that the child never goes to the nurse’s office alone
  • Specific guidelines on who will train staff on diabetes care, insulin and glucagon use
  • Information on how supervisions for field trips will be addressed
  • Guidelines for handling school parties and snacks
  •  Information on dealing with diabetes and supply teachers
  • Other age-appropriate accommodations like carb counting and assistance interpreting blood glucose readings for younger children
  • Juice or glucose tablets should always be wherever your child is
  • Check blood glucose levels before intense physical activity
  • The range in which your child can participate in physical activities. Note when your child is too high to participate and what you consider to low to be active.
  • Unrestricted access to water and washrooms
  • A time to speak to fellow classmates about living with diabetes and what they need to know to best help their fellow student

To learn more about how to prepare for a 504 meeting, read our ebooklet.

Who can administer insulin and glucagon in school?

administering insulin and glucagon in school Diabetes Advocacy

Depending on the age of your child, when sending them back to school with diabetes, you may be wondering one of two things—Who can administer insulin to them during school hours? And who will administer Glucagon in an emergency situation? The answers to those questions depend on where you live.

Administering Insulin and Glucagon in the United States

If you live in the US and have a school nurse, it will be the nurse’s responsibility to assist with diabetes care.  He/she will also be responsible for the administering of Glucagon via injection or nasal spray.

If your school does not have a nurse, the American Diabetes Association states that you still cannot be made to go to school to care for your child’s diabetes.  The school must arrange for the training of staff members in necessary diabetes procedures like insulin injection and glucagon administration.

Administering Insulin and Glucagon in the United Kingdom

If you live in the United Kingdom, the situation is quite similar to the United States.  There is usually a pediatric diabetes specialist nurse assigned to the child with diabetes who will be responsible for care. Other staff members may be asked to support a child with diabetes but must first be trained.  Training usually will be done by a pediatric diabetes specialist nurse.  Once trained, staff members will be able to assist with both insulin injections and glucagon administration.

Insulin and Glucagon administration in Canada

In Canada, schools for the most part, no longer have full-time nurses.  In most districts, the injection of insulin falls to the parents.  They must either arrange someone to come to the school or do it themselves if the child is not old enough.

There are some provinces that do offer assistance, however.  Outside nursing services can sometimes be utilized to assist with the diabetes care of small children.  To find out the policy of your province, see our school policy section.

The administering of glucagon also depends upon where you live.  There are some boards that allow for a staff member to be trained in the administering of glucagon for emergency situations.  There are other boards however who are not as accommodating. Often when speaking with school staff, you will find someone who will gladly take on this responsibility.

What can you do?

No matter where you live, you should make sure to meet with the school staff before sending your child with diabetes back to the classroom. At that time, you can address the issue of insulin injections and the use of glucagon. Some staff may already be familiar with diabetes care or simply want to go that extra step to care for your child when they are at school.

Learn how to prepare for your first school meeting with our back to school ebook.

Yes, he has diabetes but some treats are bolus-worthy

bolus-worthy food Diabetes Advocacy

We try to live a healthy lifestyle. I watch what I eat. I am conscious of what I feed my family.  It is the way I have always been—before and after diabetes

My children are now adults with their own minds and their own tastes.  They enjoy treats that cause my arteries to convulse in sympathy. My son, with type 1 diabetes, will also enjoy treats that have more sugar than some might think possible for a person with diabetes. He just deems them bolus-worthy and moves on.

Having type 1 diabetes means that he produces no insulin of his own. (Unlike someone with type 2 diabetes who often has some insulin production but the body is not using it properly) If he eats any food that has any caloric value, he must match that food with insulin.  Sounds simple right? It isn’t. 

Sometimes you will make a mistake and give too much or too little insulin for a meal.

He makes mistakes. When he does, his blood sugar levels will either spike really high or drop really low.  If he is high, he will need more insulin. Should he drop low, he will have to find more fast-acting sugar to eat right away. Despite that fact, as we said, some foods are just bolus-worthy! They are worth the math and the work that goes into figuring out how much insulin he will need to enjoy them.

If you don’t have type 1 diabetes, you probably don’t think about this. The reality is that many people living with diabetes don’t either because it is part of their lives. As a mother of a child with diabetes, I do think about it.

He boluses without a second thought

bolus-worthy donut holes Diabetes Advocacy

One morning, many years ago, I was sitting at the table enjoying my morning coffee.  My son had eaten his breakfast. I gave him the carb count for his meal and he bolused his insulin through his pump. As he got up from the table to put his dishes in the dishwasher, he spied the box of Timbits on the counter from the night before. His hand darted into the box and he popped a little morsel into his mouth.  I yelled out to his back “Don’t forget to bolus for that!”

It hit me then…he could not just walk by and grab a snack.  He had to give himself insulin for each piece of food that touched his lips. This wasn’t the first time that this fact had hit me but it broke my heart a little bit more. 

As I said, for my child with diabetes it was such a natural act. He simply grabbed his insulin pump while grabbing his doughnut hole and bolused what he needed. 

Living with diabetes isn’t just about figuring how many carbohydrates are in a doughnut hole and delivering some insulin.  You must also consider things like fat, protein, physical health, stress level, and activity level. 

Some meals are just bolus-worthy no matter how much thinking is involved

bolus-worthy burger Diabetes Advocacy

Now that my son is a young adult living on his own, his bolus-worthy treats now tend to involve fast food meals. He once sent me a picture of his meal and asked me to help him to figure out how much insulin he would need.

I asked him what his blood sugar level before his meal. He had been high and made a correction. We totaled up the carbohydrates in the meal. We then considered the high-fat content. Fat would mean that it would take longer for the carbohydrates to be used. We would need to prolong the delivery of the insulin rather than cover the entire meal right away.

After a bit of back and forth, we decided on the correct amount to cover the fat, the high, the protein, the activity level, and the carbohydrates in the food.  Time and blood sugar checks would tell us if we made the right guesses or not.

When you live with diabetes, counting carbohydrates and all that goes with it is just part of your day. You don’t think a lot about it. For those of us who don’t have to watch every morsel that passes our lips, the process is awe-inspiring. Imagine if you had to decide if what you wanted to eat was worth the hassle and the thinking involved just to enjoy a treat?

What the Disability Advisory Committee Annual Report means to Canadians with diabetes

Disability Advisory Committee report Diabetes Advocacy

The Disability Advisory Committee (DAC)  was brought together to “provide advice to the Minister of National Revenue and the Commissioner of the Agency on the administration and interpretation of the laws and programs related to disability tax measures; ways in which the needs and expectations of the disability community can be better taken into consideration; current administrative practices and how to enhance the quality of services for persons with disabilities.”  In May of 2019, they released their first report.

The 107-page document was a very interesting read.  It had 42 recommendations in all.  For people living with insulin-dependent diabetes however, the most important issues to note were the following: 

Forms should be easier to access and to fill.

Many individuals, groups and physicians found the form T2201 confusing and difficult to fill out. Current wording left some doctors feeling that they were not qualified to fill out the forms. This left a rift between them and their patients that they felt should not exist.

The DAC recommended that the forms be much more streamlined and easy to use.  They also suggested that individuals should be able to apply for the disability tax credit online.  This change has been implemented by the Canada Revenue Agency this year.  You can now upload your application and supporting documents using your “My Account” access code.

More people should be aware of the credit.

awareness of the DTC Diabetes Advocacy

The Disability Advisory Committee felt that more individuals and their caregivers should be made aware of the disability tax credit.

They felt that a public awareness campaign on the credit and its eligibility criteria should be a high priority for Revenue Canada. They felt that physicians and individuals would benefit from videos and in-person sessions.

CRA staff should be uniformly trained.

Individuals, groups and doctors noted that it was very difficult to get assistance from Revenue Canada agents when they had questions.  If they did manage to get through to a person for help, the person was either no help or provided contrary advice to what was told to another taxpayer. It was felt that all agents should receive identical policy training and that a dedicated call center be created for questions related to the disability tax credit.

It was also felt that there should be a uniformity in the way applications were handled.  A more streamlined process would help both individual taxpayers and the staff involved in accessing applications.

Approval should be based on a diagnosis.

The DAC recommended that certain conditions should automatically be approved for the disability tax credit if they are using specific forms of life-sustaining therapy. 

It was felt that if a taxpayer was alive, they had to be successfully using life-sustaining therapy.  “These are therapies that are lifelong and continuous, requiring close medical supervision. Without them, the individual could not survive or would face serious life-threatening challenges… These therapies include but are not necessarily limited to: intensive insulin therapy for type 1 diabetes…”

The DTC should be a refundable tax credit.

access to financial assistance

Currently, the disability tax credit is a non-refundable tax credit. In a nutshell, this means that it reduces your taxable income.  If you are a low-income earner, this credit has very little financial value to you.  The DAC would like to see this credit turned into something that would offer greater benefit to those who have a lower income.

Registered Disability Savings Plan Access

The Disability Advisory Committee suggested that there should be another avenue of access for the Registered Disability Savings Plan. They felt that clawing back the RDSP when someone no longer qualified for the tax credit was inappropriate and punitive. Such a practice makes it impossible for many individuals and families to do solid financial planning.

While the Federal government has not yet created another way to access the RDSP, in their February 2019 budget they have announced they will no longer claw back money contributed if the DTC is lost.

Follow up letters should have more transparency.

Follow up letters are the bane of our existence. Some people get them. Some people don’t. If you get them, you tend to feel stress and pressure.

According to the report, in most cases, these letters are not even necessary.  The only thing it does is stall the process and make doctors feel that their credibility is being undermined.

To make things worse, the Canadian Revenue Agency does not always let individuals know that a follow-up letter has been sent to their doctor.  The DAC finds this unacceptable.

The committee feels that complete transparency on the part of CRA would “reduce the stress, time and cost involved in applying for the DTC. A more open and respectful process would also reduce the need to appeal CRA decisions regarding DTC eligibility.”

Easier access to appeal services and tax court.

disability tax credit

If a person is denied the disability tax credit, they often do not know that they can ask to have their application reviewed by another agent.  They don’t know that they can send in more supporting documents from their doctor before even starting a formal appeal

Many people who apply for the DTC are intimidated by the idea of taking on the federal government in court. They may lack the knowledge or the resources to take their case forward even if they would most likely win. The committee, therefore recommends that a straightforward, transparent and informed process should be created.

Applicants should have access to all relevant information (including the precise reason their application was denied) and documents (including copies of all information submitted by health providers that pertain to their application).

The Disability Advisory Committee feels that the CRA should create a document entitled “Your Rights When a Notice of Determination Denies a Claim for the DTC”.  It would explain the requirements, timelines and details for filing a review; a notice of objection with the Appeals Branch; and a notice of appeal with the Tax Court of Canada. It would further explain many more details required to launch a successful appeal.

What can we do with the Committee’s recommendations?

These recommendations echo much of what has been suggested by the Senate Review Committee.  The repetition of the same themes can only serve to strengthen our position…that the Disability Tax Credit should be fairly and equitably applied to all individuals with intensely monitored insulin-dependent diabetes.

Now that both groups have presented their reports, it is our job as advocates and people living with diabetes to share their message. We must ensure that our sitting Members of Parliament are aware of these recommendations and support them. 

It also falls on us to keep this issue relevant in the upcoming Federal Election. Make sure that those individuals seeking to be your next MP are also aware of the issues.  Help to educate them and share with them why these changes must be made by the Canada Revenue Agency.  Ask that the next Minister of Finance work to see these changes happen and allow people with insulin-dependent diabetes fair and equitable access to this credit.

What does this mean for Canadians with diabetes?

Currently, the findings in both reports remain suggestions.  Some suggestions like easier access to the DTC online, have been implemented by the Federal government but most have not. 

Until all of these recommendations are accepted by the Federal government and the Canadian Revenue Agency, access to the Disability Tax Credit remains the same. Unless you are under 18 years of age, you still must prove that you spend 14 hours per week on approved therapies.

Diabetes Advocacy has a short quiz that can help you to decide if you should apply for the tax credit based on your current insulin therapy regimen.  We also have a spreadsheet that can help you to track the time you spend on your diabetes care.

You can learn more about what is involved in applying for the Disability Tax Credit here or message us any time with your questions.

DAC May 2019 report infographic Diabetes Advocacy

YpsoPump® receives Health Canada Approval

ypsoPump Diabetes Advocacy

Ypsomed Diabetes Care recently announced that their insulin pump YpsoPump® has been approved for sale in Canada and is now available for purchase. Here are a few things that we know about the YpsoPump®.

Who is Ypsomed?

Ypsomed is a Swiss company with a long history of involvement in area of diabetes devices. twicediabetes.com states that they were behind the Disentronic insulin pumps that were available between the 1980s and early 2000s.

According to Ypsomed Diabetes Care “Ypsomed has set itself the goal of making medical self-treatment a matter of routine for people with diabetes. This is why the development team of the YpsoPump had your needs in mind. The result is an insulin pump which focuses on the essential functions and is easy to handle. It features the best of 30 years Swiss medical device engineering.”

How big is the YpsoPump®?

According to the Ypsomed Diabetes Care website, the YpsoPump® measures 7.8 cm × 4.6 cm × 1.6 cm and weighs 83 g (including battery and filled cartridge).

In comparison, the Medtronic ® 670G measures 5.3cm x 9.6cm x 2.4cm and weighs 85g.  The Tandem t:slimX2® is 7.95 cm x 5.08 cm x 1.52 cm and weighs 112g.  The OmniPod system includes the OmniPod is  4cm x 6cm x 1.8cm and weighs 34 g with a filled pod.  The PDM is 6.35cm x 11.4cm x 2.2cm and weighs 125g.

What are some of the key features of the YpsoPump®?

The YpsoPump® is marketed as an “easy to learn” insulin pump offering the “essential features”. 

Ypsopump insulin to carb screen

The features that we have seen include:

  • 4.1 × 1.6 cm, OLED touch screen that uses icons to help you navigate the insulin pump options
  • Pre-filled, 1.6mL (160 unit) glass cartridges that will last for 7 days in the insulin pump or up to 30 days if filled and kept in the refrigerator
  • Waterproof rating of IPX8 (immersion to a depth of 1 m for up to 60 minutes)
  • Bolus delivery in increments of 0.1, 0.5, 1 or 2 units
  • 2 custom basal patterns set in increments of .01 units by the hour
  • Temporary basal patterns that can be set at 0%-200% for 15 min to up 24 hours.  They must be set in 10% increments.
  • Uses one AAA alkaline battery that lasts for 30 days
  • Mylife mobile app for smartphones that sync with the YpsoPump® via Bluetooth® technology.

Mylife Mobile app

YpsoPump

The Mylife app can be downloaded for both iOS and Android. From this app you will be able to customize screens and setting for your YpsoPump®. This is also where the carb calculator and insulin on board will live. You will not find these options on the insulin pump itself.

Ypsomed log book

This app does not currently speak to the insulin pump. This means that once calculations are done on the Mylife app, they must be manually input into your insulin pump.

The Mylife app also has a great looking built-in log book. You will be able to enter data from activities as well as bg levels and carb counts in one spot to analyze.

Does it have a Continuous Glucose Monitor?

At the moment, the YpsoPump® does not work with any CGM or flash technology.  It has been suggested that Ypsomed Diabetes Care is in talks with the key players and plan to add this technology in the future.

What will the YpsoPump® cost?

The regular retail cost of this pump will be $6400. YpsoMed is currently working with all provinces to have their insulin pump added to provincial programs but at the moment, it is not covered.

YposMed’s introductory offer

The YpsoPump® pump will be offered for free to existing pumpers who apply to switch to the YpsoPump ® between July 8 and September 30th, 2019. You will be required to purchase three months supply of both insulin cartridges and infusion sets at the time of purchase. This will be in addition to the free supplies that will come with your pump start.

If your pump warranty has expired, you’ll receive a 1-year warranty on your YpsoPump ®. If your insulin pump hasn’t expired, your warranty will last until 5 years from the purchase date of your new pump. 

You can contact YposMed Canada for more details.

What does it mean for people with diabetes?

four insulin pump choices Diabetes Advocacy

Choosing an insulin pump is personal.  The pump must fit your lifestyle and your needs.  The fact that there is now a fourth option for people with insulin-dependent diabetes is wonderful. 

If you are considering insulin pump therapy or are wondering if you should change from your current insulin pump, remember to shop around. Meet with all of the insulin pump reps and find the best fit for you.  Our ebook on choosing an insulin pump can help you to figure out which features are important to you and give you ideas of questions to ask the representatives that you speak to.

Mothers Day Ideas for Diabetes moms

It is May once again and that means Mothers Day will soon be here!

Finding the perfect Mothers Day gift can be a huge challenge. I often struggle to come up with the perfect idea for my mom and have an even harder time when my kids ask me to come up with ideas for their diabetes mom. 

This year I thought I would give you a few gift ideas that I think mothers with diabetes and mothers of children with diabetes might truly enjoy.  Whether you have a lot to spend or nothing at all, here are things that Mom is sure to love!

Myabetic

Myabetic bag

Myabetic has incredible bags and accessories for people living with diabetes.  You can scroll through many amazing styles and designs.  One is bound to be just perfect for your special diabetes mom!

Tah Handcrafted Jewelry

Tah ring

I love this place.  Years ago I purchased an awareness ring and the customer service was fantastic.  A quick scroll through their Facebook page shows that they are still producing gorgeous items that will definitely appeal to your mom.

Sugardrop Sweetwear

sweat shirt

Sugardrop is a great clothing line started by an inspirational young woman with diabetes. Get Mom a fun hoodie or tshirt that she will love! This one is on my wishlist!

Spa Day for your diabetes mom

spa day

Whether you send Mom for a day of pampering or create one yourself, Mothers Day is the perfect time to remind Mom to take time for herself. 

Tea or Wine Time

give wine

Find Mom that perfect mug or glass and allow her to fill it with the beverage of her choice.  Whether she is a tea drinker, a coffee lover, or enjoys a lovely glass of wine at the end of the day, pick up a special treat for her and allow her the time to truly unwind with it.

Book Lovers Heaven

diabetes books

If Mom is like me, you can never go wrong with a book. Find her a great new read (we have some awesome ones here) or give her a gift card and allow her to choose one of her own. Once again, make sure that you also help your diabetes mom to have some private time so she can enjoy her new book and recharge herself.

Coupons are a great gift for the diabetes mom in your life.

coupons are a great gift for diabetes moms

Give Mom coupons for things like a night of uninterrupted sleep when someone else will handle the diabetes care.  Give her a coupon for a lunch made just for her by you. Think of other tasks that Mom could use a little help with and add them in as well.  Allow her to redeem the coupons on days when she just needs a little break.

Time with you is the best gift for any mom.

time together with your diabetes mom is the best gift

This honestly is the absolute best gift of all.  Plan a day with Mom or even just a few hours.  Make it all about both of you! Schedule a walk in the park, take in a movie or meet for a coffee.  Time for just the two of you to make memories will be the best gift you can give.

What is your favourite Mothers Day memory? Which gift stands out in your mind? We’d love to know!

Talking to Political Candidates about Diabetes

talking to candidates about diabetes

Alberta and Prince Edward Island have both just elected new provincial governments. Residents of Newfoundland and Labrador will soon be going to the polls as well.  In the fall of 2019, all Canadians will be asked to elect members to the House of Commons to represent them at the federal level of government.

But how do you decide who to vote for? How do you decide who will best represent your interests while they are in government? That is for you to decide but thankfully we have a few tools that will help you to make an informed decision.

In Canada, as in many other countries of the Northern Hemisphere, we are free to evaluate candidates and elect those we judge to be most in line with our own values.  For people living with diabetes, this often means searching out candidates who are willing to invest in research; who will help to reduce the cost of diabetes supplies; and who will help everyone living with diabetes to have equal access to devices, supplies, and programs

How can you find out what their opinions are on issues that surround people with diabetes? How can you figure out if they know anything about diabetes? Here are a few things that you can do.

Ask them when they come to your door

Often candidates will tour neighbourhoods asking for your support.  When a candidate comes to your door, ask them directly how they feel about lowering the cost of diabetes care? Will they consider expanding the current insulin pump program to include CGMs or include people of all ages who require insulin? Ask them if they support increased funding for research and development.  Find out where they stand on the issues that matter to you.

Question them when they call you

Candidates and their supporters also will reach out to potential voters over the phone. Again, this is your chance to ask them one-on-one what they think and how they will support people living with diabetes if they are elected (or re-elected).

Reach out through social media

Many candidates nowadays have a strong social media presence as part of their campaign.  Reach out to the candidates in your riding or contact the parties who are running candidates in your area and ask them for their position.  Have they included diabetes-related issues in their platform? Are they planning on it? These are just some of the questions that you can ask on Facebook or Twitter pages for example.

You can also look for your local political hashtag like #nlpoli or #peipoli to call out all candidates in your province.  Posing a question and using a political hashtag or tagging candidates can generate some great interactions both from those in office and those looking to be elected.

Attend town hall meetings

townhall meeting

Contact party offices to see if their candidates will be hosting any town hall meetings.  These are forums that allow constituents to stand up and ask for opinions on issues that are important to them.  You may only have a short amount of time, but it can allow you to get those questions out there. You can also enlist friends and family to attend. Your larger presence can show the candidates how important this issue is.

Submit questions to news program debates

debating

Often leaders of political parties will take part in live debates.  News programs will usually reach out to the general public to ensure that they have a broad variety of questions to present to candidates.  Send in your questions and again, allow your voice to be heard.

To make it easier to keep track of what each candidate has to say and to ensure that you are clear on what you want to know, we have created a great single-page, fillable download. With this page, you can clarify your ask as well as take notes on the information provided to you by the various candidates.

35 Candy-free Easter Basket Ideas

Candy free Easter

It is almost that time of year again. Time for Easter treats, Easter hunts, the Easter bunny and memorable time with family.  Our house was never really big on a lot of chocolate at Easter.  There was the occasional trail of jelly beans for them to follow but for the most part, my children loved to search for hidden treats like small cars, new colouring books and a new movie to watch. 

Parents of children with diabetes know that it is possible to cover treats with insulin.  If you are multiple daily injections or an insulin pump, you can simply inject or bolus insulin to cover the treat based on your carb to insulin ratio.  Despite that fact, many parents of children with diabetes or not, don’t want to give their children a lot of sugar and are looking for alternatives. For those who are trying to control the amount of “junk food” that their children eat, it can be a challenge to come up with candy-free alternatives. 

Here is a quick list of 35 items we came up with to fill Easter baskets that don’t include candy.

  • Stickers
  • Finger puppets
  • Lip gloss
  • Magic grow toys
  • Bounce balls
  • Magic grow capsules
  • Glitter glue
  • Hair ties
  • Earrings
  • Wind-up toys
  • Slime
  • Play dough
  • Silly putty
  • Temporary tattoos
  • Toy cars
  • Bubbles
  • Nail polish
  • Colouring books
  • Crayons
  • Toy cars
  • Books
  • Movie passes
  • Lego
  • Sidewalk chalk
  • Bath toys
  • Ear phones
  • Body wash
  • Bath bombs
  • Silly string
  • Sunglasses
  • Gift cards
  • Plush toys
  • Tooth brush
  • Socks
  • Body spray

If you are still struggling to fill your child’s basket? Check out these great ideas…

For One-year-olds

easter for one year olds

Baby O and I has fun suggestions including PlayDough packs and rubber boots! Read all of their suggestions here.

For Toddlers

candy free for toddlers

Mommy Takes 5 shows you everything that you need for a toddlers basket from the basket itself to great things to put in it right here!

For all ages

candy free easter

The Teal Bandit has another 35 ides perfect for kids of all ages here.

Heather, over at Finding Our Green Life shares healthy treats as well as more great basket ideas here!

What is your favourite Easter basket idea? Let us know in the comments!

5 tips for eating out abroad when you have diabetes

Having just returned from a trip away, I know how important it can be to plan ahead when eating. Here are some great tips from our guest blogger Patrice Lewis.

Planning a holiday when you have medical conditions can be tricky. There’s packing the right medications, concerns like eating out and finding an insurance package which will actually cover your condition. For those with diabetes, there’s no need for it to be a barrier to enjoying your overseas holiday. Here are five tips for helping you enjoy the cuisines of other countries:

1. Research the restaurants at your destination location

do your research

Just like eating out at home there’s no real way to know the exact ingredients of every dish placed before you when you’re on holiday. However, it’s possible to use the internet to have a browse of the local eateries before you travel. This allows you to get a sense of what food will be on offer, before you commit to your holiday plans. If the destination only has high carb, and high sugar offerings, it might not be the best place to eat out every night. There will nearly always be somewhere, though, where you can find food to complement your diet.

2. Use forums, blogs, and ask questions

Websites and blogs like the one you’re currently reading and others have a wealth of information for those with diabetes. Search for diabetes forums and you’ll probably find that plenty of people have already asked the questions you need the answers to. If not, there’s normally a friendly community you can join to ask about eating out at your preferred destination. Use the experience of others, and when you return from holiday, you’ll be able to share your own experiences and advice.

3. Consider how much exercise you’ve had that day

exercise

You might have a pretty strict diet at home, and be completely on top of managing your blood sugar levels. It’s worth remembering, though, that when you’re on holiday you might exercise a lot more than on a standard day at home. Swimming, hiking, walking on the beach and even souvenir shopping can all cause your blood sugar to drop to lower levels than you might be used to. Glucose tablets can be a real help with this, as detailed in this blog entry about eating out when on cruise ships. Consider your level of activity when thinking about how often you need to be sitting down to eat, and what sort of food you should be eating.

4. Plan your day out to include plenty of food stops

If you are out and about all day, have a think about how often you’ll need to stop and refuel to keep your blood sugar levels where they need to be. If you’re planning a whole day out in the back of beyond, you might struggle unless you carry loads of provisions. Check what restaurants and cafes there are along your route, and take advantage of them accordingly.

5. Mention your condition to restaurant staff

Don’t be afraid to tell the staff that you have diabetes. What looks like something very savoury might actually be full of hidden sugars that you will want to properly cover with insulin. Discussing this with staff could stop you from getting a very nasty surprise indeed!

To learn more about making your vacation memorable, see more tips on our travel page.

Pros and Cons of using an Insulin Pump

I love insulin pump therapy.  I think that it is the best way of delivering insulin BUT it is not the only way AND it is not for everyone.  There, I said it. Insulin pump therapy is not for everyone. Some people really don’t like using an insulin pump and still have fabulous success in managing their diabetes care. Check out Ginger Vieira and Christel Oerum for great examples.

Whether you get your insulin through a pump or a pen or a syringe, it is important that you weigh out the pros and cons.  You must find the insulin delivery method that best suits your lifestyle.  

Here are a few of the pros and cons that we have come across when it comes to using an insulin pump.

The Pros of using an insulin pump

1.  Less Jabs

infusion sets

Infusion sets for insulin pumps only need to be changed every 2-4 days depending on the type of set used. While you may still require emergency site changes or an injection to bring down a stubborn high, you will still only use one or two injections vs multiple daily injections.

2. Flexibility with food

food

When using an insulin pump, you only use rapid-acting insulin.  This means that you don’t have to have snacks or meals at specific times.  Ideally, you don’t have to feed your insulin when using an insulin pump. You eat what you want, when you want to.

3.  Flexibility to exercise

exercise while pumping

You can adjust your background insulin to increase or decrease based on your anticipated activity level.  Some sensor augmented insulin pumps will even suspend your insulin delivery if your blood glucose levels are dropping too low or too rapidly.

4. Can be integrated with your CGM

cgm and pump

There is currently a category of insulin pumps that are “sensor augmented”.  This means that they can receive information from specific continuous glucose monitors.  This information is then used by the pump to help you make dosing and basal decisions.

5.  Micro-manage your blood sugars

An insulin pump allows you to make small corrections to your blood sugars.  The ability to dose fractions of a unit of insulin without injections gives you the flexibility of great control with greater ease. It allows you to tailor your insulin needs to your lifestyle rather than the other way around.

6.  Reduced episodes of severe hypoglycemia

Insulin pumps deliver small amounts of rapid insulin on a constant basis.  There is less variance in absorption rates and ultimately a reduced incidence of extreme hypoglycemia.

7. No peaks to chase

Again, because insulin pumps only use rapid acting insulin, there are no peaks of insulin that need to chased with food. 

8.  Built in dose calculator

You don’t have to do the math.  Your insulin pump will help you to figure out how much insulin you have left in your system and how much more insulin you will need to cover a meal or bring down a high bg level.

The Cons of using an insulin pump

1.  You are attached to something 24/7

insulin pump

Whether you are tethered to an insulin pump directly or just having to have a PDM nearby, you and your pump are attached…always.  There is no taking it off or leaving it behind unless you have gone back to at least some form of injection therapy.

2.  You can’t tell if the insulin has been delivered properly or not

Infusion sets can kink inside the body.  You can’t tell until your blood sugar levels start to spike for no apparent reason. 

3.  They cost a lot of money

RDSP

Not everyone has great insurance coverage.  Not every region offers public programs that pay for insulin pumps.  If you must pay for an insulin pump and then the supplies out of your own pocket, it can be a costly venture.

4.  Changing an infusion set takes more effort than an injection

To change an infusion set, you must prep the site, fill the tubing with insulin, inject the infusion set into the body, connect it to the tubing and fill the cannula, that is now under the skin, with insulin.

5.  Increased risk of DKA

An insulin pump uses only rapid acting insulin. This means that there is no background insulin in the body if there is a pump failure.  Without the background insulin, there is a greater risk of DKA.  A person using an insulin pump should be monitoring their blood glucose levels more closely and checking for blood ketones when readings begin to climb.

6.  Increased risk of infection

Because an infusion set stays in the skin for a period of 2-4 days, there can be an increased risk of infection to the sites.  Therefore, site rotation and proper skin prep is vital when using an insulin pump.

Make an educated choice

talk to an expert

 Choosing to inject or use an insulin pump should be a choice that you make based on your needs and comfort level.  Before you decide, spend time speaking with your diabetes team and take time to educate yourself.

If you decide to use an insulin pump, again, choose the insulin pump that is right for your lifestyle. To help you decide what is right for you, download our eBook. It has a checklist of features that will help you decide what is important to you.  It also has a list of questions that you can ask your pump reps before making your choice. 

Remember that all pumps come with some sort of guarantee. Ask your pump rep what their return policy is before you purchase.  Your insulin pump is a 4-5-year investment.  You don’t want to have buyers’ remorse.