17 Tips From a Diabetes Patient-Expert

04/07/2011 04:44 pm ET | Updated Jun 07, 2011

I've been doing a lot of flying lately and it's given me time for reflection. While aloft a few days ago in JetBlue's comfy seat, as I took out my syringe and Apidra (rapid acting insulin) to dose for my snack, I realized how many things I no longer do that I was once taught to do to manage my diabetes. I've had diabetes now 39 years.

1. I no longer sneak away to a dimly lit bathroom to take my insulin injection. I shoot up at the table, or in an airplane seat (yes, probably not kosher...) discretely. No one ever seems to notice.

2. I stopped using alcohol swabs before injecting in 1986, when I moved to Tokyo. At my Japanese clinic, the nurse, who appeared to have never seen anyone with diabetes before, gave me a jug of alcohol and a suitcase-sized bag of fluffy cotton balls -- the type that shred and stick to everything. As she handed me the bulky paper bag, we shared a mutual look of dismay. That was the day I stopped using alcohol before an injection. (I later learned from an official diabetes source that it is not advisable to use alcohol swabs because they dry out your skin.)

3. I no longer treat a low by eating everything in my refrigerator. A banana, a slice of pie, toast with raspberry jam and some ice cream was a really poor method for recovery. By time my blood sugar came back up (about an hour) it was over 300 mg/dl (16.6 mmol/l) and I'd gained 3 pounds. Now it's glucose tablets or SweeTarts always at the ready in every pocket and my poorly organized, but well-equipped, designated diabetes drawer.

4. I don't use cooling packs for my insulin. Maybe I'd need them if I were going into the Ecuadorian jungle, but my usual jaunts always seem to have moderate temperatures along the way and a refrigerator at the end. As for insulin overheating in the car: I don't have a car.

5. I don't have special compartmentalized bags for my supplies. My syringes get disbursed throughout everything I wear and carry. There are always a few in my pocket, my purse, and various zipper linings. My insulin goes into my fanny pack or purse and my meter hooks onto my fanny pack or fits into my purse. I just don't see the need to take a big carry-all. But then I've always been a minimalist and not much of a fashionista.

6. I don't use a new lancet each time I test my blood sugar or a new syringe each time I inject. Really, does anyone? I know that the points on these instruments become dull over time and can be tough on your skin. But I must have magic fingers -- they heal immediately after being punctured. So I change lancets and syringes when I pay my monthly maintenance or when I notice my pain threshold lowering. Even the American Diabetes Association now says you can reuse lancets and syringes if the needle isn't bent. But never ever share them, so I don't.

7. I don't check my feet or in between my toes every time I see them. When I step on crumbs in my house, fallen acorns around someone's pool or that darn pen I couldn't find, it reminds me that my feet are more than capable of delicate feeling. (If yours aren't, it's imperative you ignore this advice!)

I don't necessarily advocate that you do what I do. We must all be responsible to our own bodies and needs. I am only making the point that much of what we were taught years ago is outdated or may not serve your needs.

If you're new at the diabetes game, you're probably overwhelmed with all you think you have to do. I heard once that a group of diabetes educators stopped counting diabetes tasks when they reached 150!

So I'm going to lend you my "To-Do" list. It is very small, and it has served me well.

8. Learn everything you can.
Search websites, question your health care providers, read books and magazines and attend local classes or a support group. There are always tips to be had.

9. Test your blood sugar frequently.
Include post-prandial checks (two hours after you begin a meal). Correct blood sugars as necessary with exercise or insulin. This, above all else, has kept my A1cs between 5 percent and 6 percent.

10. Test before bed.
I always do. If I'm low I bring up my blood sugar. If I'm low and had two glasses of wine with dinner, I bring up my blood sugar and take a few bites of an Extend Bar. It keeps me level till morning. Before I began doing this I was a sweaty, babbling mess at 3:00 A.M.

11. Move every day.
It makes you more insulin sensitive. I walk an hour a day. When I was sick and didn't walk for two weeks, my blood sugars rose with abandon.

12. Habit-ize.
Turn tasks into habits so that you can stop thinking about them. For instance, I always keep my meter on my kitchen counter so I can find it easily. No searching, no excuses.

13. Before you run out of stuff you need, get more.

14. Ask for help when you need it.
Ask people to back off when you don't.

15. Bring food to the airport.
They serve next to nothing on airplanes and chances are high you won't find anything worth eating in the airport.

16. Feel proud about handling your diabetes in addition to your life.
You won't get a medal for managing diabetes, but you certainly deserve one.

17. Use caution when following this advice.
Side effects may occur. For instance you may just find life a little easier.

I'm just saying, as a patient, learn enough so you can safely and intelligently know what to do and do what works for you.