10 Tips for Cruising with Type 1 Diabetes

cruising with diabetes

by Rebekah Svensson

I am getting ready to head off for my first ever cruise so I was super excited when Rebekah Svensson of Awkwardyethealthy.com agreed to share tips on cruising with type 1 diabetes!

I have Type 1 Diabetes (and I have for the past 18 years) and I have been on exactly ONE cruise. A Disney cruise to be exact. Therefore, I declare myself an expert! Well, not really, but I do have some useful tips for my fellow Type 1’s who are looking to go on a cruise!

Type 1 Diabetes is no joke, and as we all know, things can go from just fine to really bad in the blink of an eye. And being on a ship in the middle of nowhere is probably not the best place for that to happen. Whether it’s you, your spouse, your child, or another member of your traveling party Diabetes can be a huge storm cloud. So how do we keep that nasty rain away?

1. Pack double the supplies. And then pack some more.

luggage to pack

This is one area I do not skimp on in any circumstances. Personally, I am a pump user, so I pack enough ‘hardware’ to get me through twice the length of my trip. And then I usually pack a few more just in case. If you’re a pumper you know that sometimes infusion sites don’t work right, or reservoirs get all wonky. I choose not to stress about it by bringing plenty. This includes batteries too. Oddly, on our family cruise I didn’t have an extra battery and Guest Service’s came to my rescues, but I did NOT enjoy being in that situation. Also, it’s a good reminder that there’s no REAL stores on board.

2. Bring extra insulin

Bring an extra vial if you can. I broke a vial of Lantus once while overseas. Thankfully I had another even though I technically wouldn’t have needed it based on the length of the trip. It can be a huge hassle, but you’ll feel a million times better knowing it’s there if you need it. Because on a ship in the middle of the ocean it’s going to be hard to come by.

3. Carry Glucose Tablets

One thing everyone told me about before our cruise was there is SO. MUCH. FOOD. But the thing is, the food is not ALWAYS available. Or room service might not be quick enough. There’s also the issue of the dining schedule not necessarily being YOUR schedule, which can mean unpredictable sugars. My solution? Always, always, always, carry glucose tablets. Carrying a small purse or backpack is a small price to pay. Throw some glucagon in there too for good measure.

4. Ask to see the menu in advance

food

At least in my experience (I also have Celiac Disease), the waitstaff has access to the next day’s menu at dinner time. Ask to see it! Also, don’t hesitate to ask for substitutions! We all know how hard it can be when you don’t prepare the food yourself, it makes carb counting nearly impossible. The best way to combat that? Knowledge.

Ask for all the information you can possibly have. Tell your waitstaff you have dietary restrictions (Yes, you do. No disagreements here. You need to know what’s in your food. You are NOT bothering anyone!). You can also request that there be something brought to you immediately or waiting at your table, like a glass of juice, just in case. If highs are more your problem, ask them to skip the bread course or give you half portions of certain things. Whatever you do, don’t just eat blindly. I think we all know how bad that can turn out.

5. Plan your day

I know, I know, it’s VACATION! Why should you have to plan!? But hear me out. Think about your meals. If you know that night’s dinner is carb heavy PLAN FOR IT. If you know you want the sugary margarita or you Type 1 kiddo wants ice cream, build it into your day.

Some of us diabetics are a lot stricter than others, so for the stricter folks this won’t seem so bad. For the rest of us who tend to wing it, this can suck. But you know what sucks more? A reading of 400mg/dl (22.2mmol) and getting sick hundreds of miles away from proper medical care. It just isn’t worth it.

If you know you have a physically demanding excursion plan your margarita that day. Lounging on the pool deck all day? Might not be the best time for that 100g carb dessert. It doesn’t have to be down to the minute, but just try and match your carb intake to your activities at the very least.

This is true for ANY vacation, but even more important on a cruise. Simply because you will have access to ALL. THE. TREATS but you might not have a chance to get off the ship for pleasure or medical care.

6. Take a note from your doctor

You will most likely be going in and out of different countries, on and off the ship through security, and traveling on a plane at some point. So have a note from a physician handy. Most security folks nowadays are familiar with Diabetes and the plethora of stuff that comes with it, but just in case it’s good to have a note explaining that you NEED it.

Traveling with needles, vials of medicine, and weird looking medical supplies can make some people uneasy, so this is a just-in-case that will pay off in the rare chance someone tries to take away your supplies. And ALL your supplies should be carry-on by the way. Always. Whether it’s on the plane or getting on the ship, keep them in your personal bag that stays with you.

7. Medical Alert ID: WEAR IT!

I am so guilty of this. I never wear mine, I loathe the thing. But a cruise is a very important place for a Type 1 Diabetic to be properly identified. If anything happens to you and you are not with an adult member of you party this will be what is used to treat you. If you are incoherent this is what will tell the ship’s doctor that you are not just drunk but might be in DKA. Accept the hideous tan line and wear it. While there are doctors on board, this will not be a full-blown hospital. So, if the worst is to happen it’s better to have the information on you and ready to go.

8. Set timers for blood sugar checks

set alarms

It may seem like overkill but set a timer for every 4ish hours during the day to check your sugar. I wear a Continuous Glucose Monitor, but I still checked more often while cruising because the swings could be so dramatic.

With today’s glucometers they are super-fast and super small, so throw it in with your glucose tablets and just take the time to check every so often. I found that we would be away from our room for very long spans of time, so it was easier to carry it with me in my ‘go bag’ rather than return to the room just for a BG check.

9. Talk about it

I know it annoys the crap out of my family and friends when I mention that I have Type 1 in conversations with strangers or servers. But guess what? The more people that know the more people that can help you. Unfortunately, this disease is not as rare as it should be and sometimes you run into a fellow Type 1 (or family member) and they have some good information for you. Or it’s a chance to educate someone. Or it helps remind YOU of what you need to be doing. If you talk about it, you can’t ignore it!

10. Loosen the reigns a bit and have fun!

If it’s you that it Type 1, you are probably fine with this. If it is your spouse or your child, you are likely not ok with this. But, for the sake of your sanity, broaden your range of acceptable sugars a bit. Not to the point of getting sick but expect some lows and just know that there will be more highs than you’d like.

Even with planning your days a bit, taking all the precautions, and counting the carbs to the best of your ability there will still be unexplainable swings. If you are prepared, they will be nothing more than a minor speedbump. But if you go on your cruise expecting perfection, you will be miserable. Type 1 Diabetes is not a disease to be taken lightly, but it should also not rule your life. Make sure you have fun and ENJOY IT!

have fun

Those are some of my thoughts! Of course, there’s always the drink water, eat your fruits and veggies, and get plenty of exercise that all Diabetics are hammered with every day. It still applies on a cruise y’all. Just do it. I know life isn’t fair, but we can handle it, we’re tough.

My personal experience on a cruise was that I had more frequent highs and occasional lows that weren’t very predictable. There was a ton to indulge in, and I did. Maybe too much. But the waitstaff was wonderful at being helpful and informative, the crew was very understanding and always willing to go above and beyond to help in any way, and while I did not have any experience with the medical staff on board, knowing they were there provided peace of mind. Cruising with Type 1 Diabetes is definitely worth it. With a little foresight and flexibility, it can be a truly great vacation!

If you’d like to learn more about me feel free to visit my blog Awkwardyethealthy.com!

Happy Cruising!

To make your next vacation with diabetes a little easier, why not download our complete toolkit for traveling with diabetes. It has packing checklists as well as a list of things to do before you go.

The Signs of Diabetes. Do You Know Them?

I sat in the doctor’s office. It was a room that I had sat in many times before but this time was different. My son was laying lifelessly in my arms.  I was terrified.

We had been to the hospital for bloodwork and x-rays. He hadn’t stirred. I looked across the room and saw a poster that had probably been there for the past 10 years or more but I had never noticed it.  It showed the signs of diabetes.  I have never paid attention before.  It was a disease that happened to other people…until it didn’t.

As I waited I read….

warning signs of diabetes Frequent urination

My son did nothing but soak his diapers for weeks. We were going through Pampers in record time and I had blankets on my couch because accidents were happening.

Constant thirst

We had been to the emergency room in the days before and they said that it was a good sign that he was drinking.  Even when he seemed too weak to get up, he could walk to the fridge and drink a carton of apple juice. They assured me that this was a positive thing.

signs of diabetes blurred visionBlurred vision

My son was 2 years old.  He spent most of his time in my arms. I had no idea if his vision was blurred.  He had no way to tell me either.

Fatigue

My son slept all of the time.  He was sick.  I knew that much.  Sleep was a good thing for a little boy who wasn’t feeling well.

Unexplained Weight-loss

My son had always been tiny.  He hadn’t been eating a lot. He was slight but that was to be expected.

Fruity breath

My son had sweet little boy breath.  I didn’t know that there was anything else that could possibly be going on.

Thrush or other yeast infections

This was a warning sign.  Why did a two-year-old have thrush? The emergency room doctor didn’t offer any explanation.  He simply gave us antibiotics.

I didn’t know the symptoms. I didn’t know that warning signs and neither did the ER doctor. It almost cost my son his life.

Know the signs.  Share them with others.  Together we can save lives. signs and symptoms of diabetes

Download a copy of the signs and symptoms of high and low blood sugar levels here.

Hot Tips for Managing Diabetes in the Deep Winter Cold

winter tips with diabetes The weather outside is frightful! The temperatures are dropping and we are in the midst of deep winter cold.  Managing to stay warm can be a challenge on days like these.  How do you manage your diabetes as well? Here are a few things to remember…

Insulin freezes.

Insulin is liquid. It can freeze. Make sure not to leave insulin in your car.  When you are outside, keep it close to your body. This also means that if you are pumping, make sure to tuck your pump close to your body to keep things running properly.

If you think your insulin has been frozen, throw it out! Don’t take any chances.  It will not work as efficiently once the proteins have been frozen.

Keep warm!

That means keeping your diabetes devices warm as well! I just told you to keep the insulin in your pump warm, but did you also know that your pump (like your phone) also needs to stay warm? Keep your pump and CGM under your winter clothing and as close to your body as you can.

If you are using a tSlim pump, watch for the low-temperature warning on the pump.  This will tell you that your pump is not functioning as it should because of the cold.

Check your blood glucose level.

I know, you normally check but when it is cold out make sure that you still check…a lot.  Some people see their bg levels rise in the cold weather while others see it go up.  Don’t guess or go by how you feel–check then adjust with food or insulin.

Before you check, make sure that your meter is warm as well.  Glucometers function poorly below 40F (4C).  If you feel that your glucometer could be too cold, warm it in your armpit for a few minutes. It will quickly return to a functioning state.

Keep your hands warm.

It can be hard to check your blood glucose levels when fingers are cold and blood isn’t circulating properly.  Keep your hands warm and toasty to help making finger sticks a bit easier.  Wear warm gloves. You may want to consider using  mitts that have removable fingers to make it easier to check .

Carry glucose that won’t freeze.

Juice packs are a handy way to treat lows but when you are playing in the snow, glucose tablets and granola bars are probably a better choice.  Also make sure to keep your glucagon warm and safe.  Frozen glucagon will be as useful as frozen insulin.

Winter activities can be fun but make sure you are prepared.  Follow some of these few hot tips and enjoy your time in Mother Nature’s deep freeze!

This post contains affiliate links 

Preparing for Disasters with Type 1 Diabetes

This year we have seen many mandatory evacuations because of both hurricanes and fires.  When you live with diabetes in your home, how do you prepare for disasters? Do you have a list of evacuation supplies checked off and ready to go?

People in the hurricane states, often have an emergency tote or bag that they can grab on the way out of the door but remembering everything that you could need can be a challenge.  Over the years, we have come up with a detailed list of evacuation supplies for people with diabetes on the Diabetes Advocacy website.  In lieu of recent events, I thought that it might be a good time to go over some of the items with you.

Download your free emergency supplies checklist here.

Keep a container near the door

As I mentioned, it is important to have all of your supplies in a quick, easy-to-grab container.  Evacuations can be planned, but sometimes you are only given minutes to have all of your valuables ready to leave.  Make sure your diabetes bag is always in the same place so that you won’t waste valuable time trying to find it.

Packing Basics

Make sure that you have some of the basics like a Frio pack if you live in a warm climate.  You will also want a flashlight and spare batteries in case your area loses power.  Candles and wooden matches can also provide light and heat if need be.

A first aid kit should also be in your emergency container. While you may have a lot of diabetes supplies, other medical emergencies can happen and basic first aid is a must.  Don’t forget to add anti-diarrhea and anti-nausea medication to your kit.  You should also have copies of all prescriptions in case you are away from your home pharmacy and need to access your medication refills.

Food and drink

We have all seen the images of people stocking up on cases of water and in an emergency it is vital.  If you have drinkable tap water, fill up milk jugs, juice jugs, and other items with water to take with you.  Also pack juice packs, tinned food as well as cheese and cracker snacks. If you pack tinned items, don’t forget a hand can-opener as well.

Diabetes Supplies

It is recommended that you pack two weeks worth of diabetes supplies with you during an evacuation.  Consider bringing a spare meter, spare batteries, alcohol wipes, pump supplies, insulin, syringes, ketone strips, and medical tape.

Other items to remember

Don’t forget to bring spare blankets, cash in case bank machines are down, and pet food for your furry family members.

I am sure that I have forgotten a few things but I would suggest that you view the Diabetes Advocacy Emergency page or download the emergency supplies checklist.  This will help you feel a bit more prepared should a disaster hit your community.

Get your free emergency supplies checklist here. 

Back to school with diabetes

Back to school with diabetes

Heading back to school can be stressful.  There are new books to buy.  Every child seems to need classroom shoes, gym shoes, walking to school shoes and then there are the gym clothes, jeans and more! The list is endless but when you are a parent of a child with diabetes, the list is longer still.  Thankfully there are a few basics to remember when sending your child with diabetes back to school.

Meet with staff

meet with staff

No matter where you live, you should always make sure that you have a meeting with school staff before your child heads back to school.  If you live in an area that has 504 plans or any sort of diabetes care plans in place, this meeting can be where details are finalized.  If you don’t have any sort of official plans in your district, a meeting with staff is still important.

You want to meet with staff to discuss what they can expect when they have a child with diabetes in their school.  While your child may not be their first child with diabetes, each child’s care needs are different. It is important that they understand your child’s individual treatment plan.

At this meeting you will work together to establish roles.  Carefully outline what do you expect from the teacher and the support staff. Make sure that they understand what they can expect from you.  Finally,  ensure that everyone knows what tasks your child can do on their own.

You should also discuss things like, how will exams be handled?  It is important that school staff understand that  diabetes can cause cognitive impairment when the child is out of range.

You also want to establish a method of communication. The school  should understand that they can contact you and that you would like to be able to stay in touch with them.  Working together will make the year go smoother for everyone.

Click here for a few more ideas of what to take to this meeting.

Gather diabetes supplies.

diabetes supplies

Depending on the age of the child, the list of supplies that you require can be different.  A small child will require a change of clothes just in case he/she is high and has an accident in school.  An older child may require access to a phone or cell phone to ask you questions about their care.

Here are a few basic items that can be left in a backpack or put in a safe place at school.

  • juice boxes or glucose tablets
  • granola bars or other carb rich  and carb free snacks
  • spare test strips
  • meter batteries
  • pump batteries
  • a spare glucometer
  • extra needles or pen tips
  • spare insulin vial (to be kept in a fridge)
  • ketone meter and strips
  • spare infusion set
  • spare insulin reservoir
  • alcohol swabs
  • hand wash
  • water bottle
  • sharps disposal container

Other things to remember

go on field trips

If your schedule allows, volunteer to be a part of activities at school.  This will give you a chance to get to know school staff and they will learn a bit more about you.  It will also allow you to discreetly keep an eye on your child’s care without them feeling different.

For younger children, check to see if supports or nurses are available through your district.  The school may be entitled to extra funding that would allow them to have one on one care for your child for all or part of the day.

Make the year fun! Your child is a child first.  Plan ahead with staff regarding things like parties, extra curricular activities, outings and exams so that your child gets the most out of their school year.

For a guide to care policies in many Canadian schools please check out this link.

Tips for Managing Diabetes in the Summer

diabetes family summer partyIts summer!! I mean it really is finally summer! Some areas have been enjoying great weather for a bit but where I live–well, I kind of wondered if summer was ever going to show up.   Now that it is really here, let’s talk about a few tips for managing diabetes in the summer months.

Keep your insulin and test strips cool.

Summer heat can literally ruin blood glucose test strips and insulin.  If you are on injections, make sure to keep your insulin stored in a cool place. If you are pumping, again, make sure that your pump doesn’t get overheated.  You may even want to consider changing out your cartridges more often to ensure that your insulin is fresh and hasn’t been compromised by the heat.

Test strips also react to extreme temperatures.  Again also make sure that they are stored in a cool place.  If you are traveling to the beach or theme parks, you may want to invest in a FRIO Insulin Cooling Pump Wallet.  They are convenient little cooling packs that will help to keep things chilled.

If you don’t have access to Frio packs, another great suggestion is to use frozen juice packs.  You can keep your supplies cool and are prepared for lows!

Mastistol and Antiperspirant are pumpers’ new best friends.

Summer often means swimming and swimming can mean chlorine. Chlorine can bring extra headaches for people with diabetes using an insulin pump in the summer. Personally,  the only way for us  to keep sites on in chlorine was by making sure that a product like Mastisol Liquid Adhesive was used on the skin prior to set insertion.

For people using an insulin pump and/or a CGM, you may also want to look at using an antiperspirant on the site.  Apply a light coat of antiperspirant (not deodorant) to the insertion site area.  This will help to keep sites in place when your body begins to sweat!

Have snacks everywhere.

Summer heat can bring its own challenges for managing diabetes. It tends to mean more exertion and rapidly dropping blood glucose levels.  Make sure to carry extra snack foods with you wherever you go.  One parent suggests that you stock up on Freezies.  They are perfect treats for lows and also help ward off dehydration.  Other families have suggested fruit and frozen grapes as must have snacks for on the go.

Drink lots of water.

Dehydration is a real problem in the heat.  It is especially important for people living with diabetes to stay hydrated because dehydration will cause blood glucose levels to spike.

Test often.

Heat, exhaustion and the fun of the sun can really mess with blood glucose levels so make sure that you test often to avoid any serious diabetes related emergencies.

Bring extras!

As I have said, infusion sets can fall out.  Blood sugar levels can go crazy.  It is vital that you carry extras of everything–extra snacks, extra water, extra test strips, extra insulin and extra infusion sets just in case.

Wear sunscreen.

I know, everyone is supposed to wear sunscreen so really is this a diabetes issue? Well no…and yes! It turns out that sunburns have been known to really mess with blood glucose levels.  The moral of the story? Stay hydrated and wear sunscreen to help keep blood glucose levels in check.

Have fun!

Finally, in Canada especially, we just don’t seem to see summer for long enough so plan ahead and enjoy all that this summer has to offer you and your family!

 

All Children with Diabetes are still not safe in school

school1It has been over 15 years since I was first asked to take part in discussions surrounding the issue of children with diabetes in schools.  I still speak publicly on the issue. I still assist parents but I honestly thought that after 15 years, more insulin pumps and other awareness activities that things would be vastly improved–that all children would be safe in school.

Things have changed.  Years ago, very few schools had policies in place protecting our children with diabetes.  Very few educators knew their roles and parents often struggled as well.

Today there are provinces that  have stepped up to the plate offering guidelines and even legislation surrounding this issue.  Sadly there is still a long way to go.  There are still parents who do not feel safe sending their children to public schools.

Alberta updated their guidelines in February of 2019

I once looked to the US as a standard to achieve.  The rights of their children with diabetes are protected under the American Disabilities Act.  That had to count for something!  A lawyer friend of mine reminded me that while this was a just a law, enforcing it could often be just as frustrating and overwhelming for families in the US as it was for families here in Canada.

The moral? Keep fighting. Keep educating, Continue helping and that is what I am doing.

Many years ago, just after a change in rulings on the Disability Tax Credit, I met a wonderful lady. She worked for what was then called the Canadian Diabetes Association.  She was there first formal advocacy employee.

Our sons were of similar age.  She listened to our struggles and empathized.  Over the years we have worked together on certain projects and simply managed to touch base now and then to see who the other’s family is faring.   Yesterday she sent me an email asking for help.

She too is still working on the national issue of safety for children with diabetes in schools.  There are still many families who are fearful of sending their child with diabetes to school.  There are other families that send their children to school but are constantly at odds with the system to achieve optimal care for their children.

This saddens me greatly.  If you are one of those families that are still having issues with your child with diabetes in school, please comment or message me . I will pass your information along to my friend and she will contact you. Hopefully, together we will be able to highlight the problems and finally work towards a resolution to this issue for everyone.

It Will Happen and It Will Be Okay–Transitioning to Adult Diabetes Care

graduation

It will happen and it will be okay. That’s what I would tell myself if I could talk to the diabetes parent that I was 15 years ago.

You see, once upon a time I could tell you what my son’s bg level was at 3am. I could tell you what his reading was before breakfast. I knew if he had run high or low during school. I would be able to give you his pre and post supper glucose readings. I knew it all.

I knew when his last site change was. I knew what his last A1c was. Years ago, I could tell you when his glucagon kit was going to expire and how many carbs he ate with his last meal.

Today, I can tell you that my son does test his bg levels. His last site change was just the other night. I know this because he asked for my help.  I know that he sees his diabetes doctor again in April. I know that he has some insulin in the fridge.

I have no idea what his last A1c was. His current basal rates are a mystery to me. It’s a real challenge for me to use his insulin pump.

Years ago, I would never believe that I wouldn’t know these things. I swore that I would always test my son at night as long as he was in my house. I would be hands on in my son’s diabetes care  forever. I was certain. I was wrong.

If you are like I was, you are having a stroke reading this. You are probably thinking…Not me! I will know everything regarding their diabetes care always! I thought so too.

For the bulk of his childhood,  I knew every carbohydrate that entered my son’s mouth. I wrote down every exercise that he did and how it impacted his readings. I micromanaged my son’s type one diabetes like nobody’s business. His care would take me over 40 hours per week.  It literally was a full-time job. Keeping my son alive and healthy was one of my top priorities.

The health of my children is still very important to me but this strange thing has happened–they have become adults.  As an adult, my son has asked that I don’t test him at night.  Sadly he wakes up a lot during the night now and tests himself.  He doesn’t see the sense in bothering me as well.

Because my son is an adult, he comes and goes when he pleases.  He treats his lows at work. He programs his pump while he is at school.  My son is completely in charge of his diabetes care.

It was terrifying at first I will admit. I had a need to know.  He had just as strong of a need for me not to know. He would be vague with his answers about bg readings if he answered at all.  It didn’t matter if I was mad or upset.  It was his condition to deal with and he would quietly show me that he could handle it….and when he couldn’t he would ask me for help.

As I have watched him handle his diabetes care,  I have been amazed.  We still occasionally share carb count guesses. I will look up the carb counts in certain food for him.  I will suggest a temporary basal when he is working long hours.  He will tell me what he has already done.

My role in diabetes care is now  on the periphery.  It shocks me that I have managed it but I have.  One day you will step aside too.  It will be hard.  How far you step will be between you and your child but eventually you will no longer know how to work their insulin pump either.  One day you won’t know their A1c but they will still call you when the going is rough–for you or for them.  For me, that remains a  huge comfort.

I have gone from the most hands on parent on the planet to an average mom.  Diabetes no longer is in my every thought. I now only think of it every few hours.  The most amazing thing is that I am somewhat okay with it all.  Don’t get me wrong, the control freak lives on and would love to know more but my son is an adult.  As a young adult, he has taken ownership of his diabetes and Mom is only allowed glimpses when he deems it okay.

Bolus Worthy

Today’s Diabetes Blog Week prompt asks about food.  More specifically it asks us to describe a typical day of eating.  I asked my son at the beginning of the week to do this for one day and send me what he ate.  He told me that yesterday morning he was low so he had some orange juice and around lunch time he ate two cereal bars because he had run out of bread for sandwiches.  This seemed like a pretty light day especially for him.  He said that since I wanted to know what he ate, it was easier to eat less.  So much for that idea!

Like many people with diabetes, my son has heard, “Oh I would offer you one but I know you are a diabetic and can’t have that.”  Of course, like everyone with Type 1 diabetes, the only thing my son can’t eat are poison…and cookies with poison. For every other food, he does his best to balance insulin to what he eats.  And being a teen, he can eat!

I am not sure if it is because of  diabetes and spending a life time educated on nutrition and exercise, if its him or if it is a phase but my son has become very mindful of what he eats.  It is not uncommon for him to sit down to a tin of tuna and a cup of green tea.  He enjoys his fruits and yoghurt.  He can make a mean smoothie (according to him).

He is human however and he is a teen, so he also enjoys certain treats especially when he comes to visit Mom.  He loves his grilled cheese sandwiches. He can eat a pot of boiled eggs for breakfast if given the opportunity. He requests homemade mac and cheese when he arrives.  He enjoys eating snowballs and can demolish a berry pie if allowed.  He can nibble at a tray of cookies or leave an apple with nothing but the stalk.

When he goes to A&W and orders a Grandpa burger meal, does he stay in range? Rarely but he also does not do it every day.  Each time is a challenge to balance the fat, protein and carbs but he does it. He feels it is definitely worth the effort.  Those high effort, high insulin foods are known as “bolus worthy”.  They are the foods whose taste far outweighs any aggravation after the fact.

At 17, my son is very aware of his body.  He lifts weights.  He watches his food intake, not just because he happens to have diabetes but because he wants to stay fit and healthy.  I think he has managed to handle the issue of food very well. Nothing is off-limits–a banana split for lunch? Why not!  Anything in moderation–well his idea of moderation anyway!

Homemade black forest birthday cake...definitely bolus worthy

Homemade black forest birthday cake…definitely bolus worthy

Going to School with Diabetes Has Changed

Today’s prompt for Diabetes Blog Week asks what changes we have seen since diagnosis.

In the past 15+ years, we have seen a lot of changes.  We have seen 5 second glucometer results instead of 30 torturous seconds. We have seen long acting insulin, smart pumps and now sensor augmented pumps.  We have seen Continuous Glucose Monitors go from blinded instruments that you could only get from the hospital to tools that you can wear every day to watch real time trends!

One of the biggest changes that I have seen since my son was diagnosed with diabetes however is how provinces, school boards, and schools are now dealing with children with diabetes here in Canada.

I first began dealing with this issue when my son was 3.  He still had a year to go before he would enter the school system, but the school knew about my knowledge of diabetes care.  They wanted a heads  up on what to expect when a recently diagnosed student returned to school.  Together we were able to explore the roles and needs of both staff and student.

I spent time looking at what was being done in other provinces and other schools.  The results shocked me.  With the exception of New Brunswick, most areas had little to no policies for children with diabetes in schools.  The only thing that they tended to note was whether or not (and usually it was not), they would administer insulin in school and where the insulin was to be kept.

At first I was shocked. Diabetes was not a new disease.  How could it not be dealt with in the school system? Easily…in previous years multiple daily injections, home blood glucose monitoring and insulin pumps were not the norm in diabetes care.  Times were changing and school policies needed to change as well…and they have.

In 2015 provinces such as Newfoundland and Quebec now also have provincial policies in place.  Provinces such as British Columbia are working with their nursing staff to see better protection in place.  In other provinces, people are still working to find something that works for all parties.

The big difference is that today, provinces and parents are talking. Today, school boards are contacting myself, the Canadian Diabetes Association, and parents of children with diabetes to ask what our children’s needs are. There is a willingness to learn and a willingness to create change.

This does not mean that the problem of care for children with diabetes in Canada is solved. It does not mean that parents have no concerns when they send their children with diabetes to schools.  It means that in more places, there are less concerns. It means that in more schools there is already education and policy in place. That is a wonderful thing.  It shows that over time things can change for the better. I am positive that the next 15 years will see many more leaps and bounds for our children with diabetes as they return to school.

diabetes in school
Heading to school with diabetes can be stressful