A Pump for All Ages

I would like to respond to the Reflections article "To Pump or Not to Pump?" [July '09, p. 76]. I was diagnosed with type 1 diabetes in 1934, when I was 2 years old. Around 2002, I started having a problem keeping my blood sugars under control, and I experienced frequent lows. I talked to my doctor about trying the insulin pump, but he said I was probably too old for it. I made an appointment with another diabetes specialist who gave me the OK to try the pump.

Within one month I was on it, and I am living a wonderful new life. I have lows now and then, but I now feel them coming on, and they're easier to deal with. I have nothing but good things to say about the pump, and I would recommend it for people of all ages with type 1 diabetes.
Betty Schultz, Kansas City, Mo.

Sticky Fingers

With regard to Jean Ashmore's letter "A Vote for Reality" [July '09, p. 15], about the finger on the cover of the April issue: I have been a type 1 diabetic for 52 years and have been testing four times a day, or more, for at least half of that time. I decided from the start that I was not going to stick my index fingers for my blood glucose tests, because I did not want to limit my sense of touch in any way.

So, that meant that I was limited to the other three fingers on each hand. I divided my fingertips into eight distinct areas. Eight areas times six fingers equals 48 areas to stick, in order. When I have gone through all 48 and am back to the beginning, that first finger shows no sign of having been stuck. It looks as smooth as my index fingers. I don't think anyone can tell by looking at my fingertips that I am diabetic.
Don Smith, Hendersonville, Tenn.

I have had diabetes for 48 years and have been testing my blood sugar ever since the first meter came out (for about 33 years). If you looked at my fingers, you would not see any scabs, scars, or calluses. The parts of my fingers I use to play my guitar look a lot worse! I rotate finger sticks using all 10 of my fingers.
In my role as a diabetes educator, I see many patients with damaged fingers who react by favoring certain fingers, or by not using the depth adjustment on their lancing device correctly. I usually poke each finger two times on each side and then move on to the next finger. Rotate, rotate, rotate! That's my motto. 
Michele Cordell, RD, CDE, Camarillo, Calif.

The Challenges of Control

I do not agree with Allyson Kish's letter, "Lucky to Have Diabetes" [May '09, page 12]. No one is lucky to have diabetes. Diabetes happens to be under control for Ms. Kish, but this disease is not as easily controlled for many people, even with advanced medical treatment and self-care. Ms. Kish writes, "I control my diabetes. My diabetes does not control me." This is commendable for her, but these comments can be misleading and discouraging for those who must continue to struggle daily with this disease.
Mary Huff, Christiansburg, Va.

Gastric Bypass and Type 1

In Ask the Experts for July [p. 17] a reader asks whether or not gastric bypass surgery is a cure for type 2 diabetes. What about type 1 diabetes? Is it a healthy choice for people with type 1?
Pam Harness, Corning, Ark.

Robert Gabbay, MD, PhD, responds: Gastric bypass, an effective weight-loss treatment for people who are obese, is usually only an option for people with a body mass index greater than 40. However, given the benefits that this surgery has demonstrated for people with type 2 diabetes, it is sometimes recommended for patients with diabetes who have a body mass index of 35 or greater.

Many people with type 2 diabetes are able to manage their diabetes without medications after the surgery.  This "cure" seems to be caused by an increase in insulin secretion (by stimulating the pancreas) and a decrease in insulin resistance. Although gastric bypass significantly improves type 2 diabetes, the same is not true for type 1. Most people with type 1 diabetes are not obese and not significantly insulin resistant, so weight loss does not provide the benefit of decreasing a high insulin resistance. Also, since people with type 1 diabetes cannot make insulin, the surgery does not help with insulin secretion. People with type 1 diabetes who are not significantly obese are unlikely to benefit from gastric bypass surgery.

Stumped by Recipes

What gives with your recipes? So many of them require special foods or foods so far off the wall that I have no desire to try any of them. How about recipes with real food for real people? That is, take the ordinary, as in potatoes or hamburger, or some other foods that are easy to obtain at the corner market, and give a simple recipe, not something that I have no desire to try. I think that out of all the recipes you've printed, I have tried only two of them, simply because they followed the guidelines I mentioned above.
Stephen E. Goll, Bonner Springs, Kan.

Food Editor Robyn Webb, MS, LN, responds: I appreciate your concern about finding ingredients for recipes in Diabetes Forecast, as well as your desire for "real food." However, many people crave variety in their foods, and people with diabetes often feel limited in what they can eat. We try to offer delicious meal options that are also healthful. For instance, the August '09 issue featured tasty alternatives to the typical hamburger, which is "real food" that is easy to find but not the healthiest choice.

One way you can prepare in advance: Stock up on less common spices and other nonperishable ingredients the next time you're at a major foods store. Then, when you have a new recipe to try, you need only pick up the basic ingredients at your local market. And don't ditch a recipe just because you’re lacking one particular vegetable, spice, or garnish. Feel free to substitute for or omit the missing ingredient and see what new versions you can create. This is part of the pleasure of home cooking.

Blood Glucose and Exercise

I want to add a tip for answering the Ask the Experts question "How Do I Control Low Blood Glucose During Exercise?" [June '09, p. 18]. I take a drink with me on my workout, composed of equal parts water and apple juice. For my workouts, I do 1½ to 2 hours of water aerobics and body-building exercises three times a week. I'm 67 and I control my diabetes with diet and exercise. I also walk two or three days a week for a half hour each time.
Shirley Young, Battle Creek, Mich.

Pump Gear Follow-Up

In July's Mail Call ["Looking for Pump Gear," p. 15] you asked readers to send in information about pump accessories. If someone in the family sews, you can try my solution.

I used to have trouble with where to put my son's insulin pump while he was sleeping. None of the "cool" pajamas came with pockets that could be used for pumps, my son complained. He wouldn't wear a pump pouch around his waist, the arm band was not comfortable, and the clip dug into his body at night. After a few trial runs with noisy Velcro, and pumps falling out, we came up with a solution.

We picked up several cartoon T-shirts and I sewed inside pockets. At first, we tried using iPod sleeves for pockets—you can buy them in a package of five colors. Later we discovered that the top of tube socks also works perfectly! Just cut off the tops of old socks (kids' socks work best) and sew them into a shirt to be used as a pocket.

Our other bedtime trick is to buy athletic shorts with pockets that reach the knees. These shorts tend to be slippery, so stitch the pocket closed on the bottom third, or use Velcro. Another solution is to make a portable pocket out of a tube sock and cut a buttonhole into it. Then sew buttons on the inside waistbands of pants, one on each side. Just attach your portable pump pocket to the pants you want to wear. That keeps the tubing under the clothing, where it won't snag on anything or be pulled on by other children.
Jenny Woytassek, Windsor, Colo.

What Does it Take to Stop Diabetes?
You!
This is your chance to tell the world why you want to stop diabetes, once and for all.

In November, the American Diabetes Association will launch a movement to Stop Diabetes: to stop it from stealing moments, hours, and days from millions of people affected by diabetes. To stop the anxiety, fear, and heartache it causes every day. To stop the blindness and amputations. To stop discrimination against people with diabetes. And to stop it from haunting our children's future—and stealing our loved ones all too soon. 

To start this movement, we need your help. Why do you want to stop diabetes? What are you doing to stop diabetes right now? Let us know, and your story could be featured on the Web, used in promotional materials, or published in a future issue of Diabetes Forecast.

E-mail your story and, if possible, a photo of yourself to sharemystory@diabetes.org. Submissions are due by Oct. 15, 2009. Stories should be no longer than 200 words.  
Your story may inspire thousands of others to get involved to help stop diabetes!