Category Archives: medical disease

Sodium Intake


Dear Diabetes

Nov. 2017 

Dear Diabetes,

In 2012, you entered my life unexpectedly. You were the new chapter of my life.  You changed my view on food and beverages. Before you came into my life, I used to eat whatever I wanted.  Because of you, certain beverages and food items are off-limits such as sugary stuff, pizza rolls, French fries, dinner rolls, etc. It was hard to give them up, but it was for the best. I thought you would be the reason I couldn’t travel, but it turned out I was wrong.

Our relationship is full of ups and downs.  The ups are days with perfect glucose levels and the willpower to avoid certain things that I can’t eat at parties or restaurants. I’m mostly a stickler for rules, routines, and schedules because of autism. The downs are accidentally overmedicating and overeating or eating the wrong stuff. Sometimes, I have high glucose levels all day, some days the levels are low, and some days are in-between.  Sometimes, I have rebounds after being low. Sometimes, my autism causes stress which results in hyperglycemia. I used to panic when you gave me high numbers. I learned that it was better to be high than low. In fact, I learned lessons from my diabetic-related mistakes.

Because of you, I switched to better versions of chicken, fries, desserts, etc. I exercise a little more by dancing, running, and walking.  A strict diet makes me healthier and skinnier than I used to be. After you came along, I was even more confident about myself. The number of my meltdowns decreased. Before you, I had autism-related meltdowns.      

You and I will be together for life.



Dating and Diabetes

You landed the date. Nabbed a reservation at a nice restaurant. Even wore that fancy shirt that looks great but sort of itches. You’ve thought of everything—except how to divulge your diabetes.

If you’re stressing about when to tell your date about your diabetes (or whether you should keep it a secret after all), take heart. There’s no rule book you don’t know about.

Your comfort level, your date, and a dozen other factors will influence how and when you tell. Still, there are some guidelines you can follow to determine what’s right for you. Read on for tips that’ll help you transition from “Nice to meet you” to “I have diabetes.”

Making It Work

Here is what Kelly has done to best support her health and her relationship over the past 10 months.
Be honest. Kelly has been very honest about her food, exercise, and lifestyle needs to remain healthy. When her sugar levels were a bit elevated after big meals at relatives’ homes, she and her boyfriend, Joe, adjusted accordingly, and Joe was able to speak about portion sizes with relatives. He believes that being open and honest initially about topics that affect you is key to any relationship, and diabetes is no exception.

Teach with patience and love.  Joe liked Kelly’s method of teaching him her processes for maintaining her diabetes. She kindly asked him, “Hey, do you want to learn xyz?” and engaged him in different tasks if he felt comfortable. She taught him how to set up the glucagon pen with an old one (not to worry—it was properly disposed of and not used on her). Essentially, you don’t have to teach that person everything at once. But ultimately, if this person is someone you spend a lot of time with and want to spend the rest of your life with, it is important to determine if you can handle what it takes for
a healthy future.

Patience, patience, patience. Joe cannot tell you how many times Kelly will share a reading with him, and she will ask, “Is that good?” She is the calmest person he has ever met, including when he sees her calmly explain to him how this affects her. Patience is key as your significant other gets a handle on your diabetes.

Take care of yourself. Kelly continues to run around the block, notes her infusion set changes in her phone, and monitors her blood glucose levels. Her self-care habits are inspiring, and her example has helped Joe to lose weight. As a result, he feels healthier and more confident, and the chain reaction continues to ripple through all elements of their relationship.

Ask for help. It was very helpful when Kelly told Joe about eating habits she wanted his help to improve, such as consuming more fruits and vegetables. Her confidence in him for support has improved the relationship significantly.

Here is what has helped Joe help Kelly manage her diabetes and strengthen their relationship:

Ask questions. You get educated, your worries are eased, and it shows that you care.

Get involved. Joe exercises and encourages Kelly to exercise. They’ll go to the gym together. He eats well and encourages Kelly to eat well. They go shopping and he’ll fill their grocery cart with foods that her nutritionist recommends. To get involved, you have to be aware of the unique needs of your significant other, so once again, ask questions to see how that person would best like you to get involved.

 Diabetes and dating means doable.

To Tell or Not to Tell

The biggest concern most people with diabetes have is that a date will stop liking them once diabetes is in the picture. Generally, most people are more concerned about that than is reasonable. Which is to say, your date probably won’t be freaking out as much as you are when you mention your diabetes.

True, there’s always a chance you’ll be dumped because of your diabetes, but that’s not likely. And if it does happen, ask yourself: Do I really want to date someone like that? You might meet a person in your life who may be turned off or freaked out about your diabetes, and that might break your heart. It’s going to be a tiny, tiny portion of all the people you’re going to see in your life.

We often project our own feelings about diabetes onto the person we’re dating. If you see diabetes as something to be ashamed of, or if you see yourself as somehow deficient simply because of your diabetes, you may expect others to treat you accordingly. The goal, then, is to work through those feelings until you accept your disease and understand that diabetes doesn’t make you less worthy of love.

In the end, whether you tell a date about your diabetes is up to you. If you’re more comfortable keeping it to yourself, that’s your choice and it’s a valid one. But keeping secret something that affects every aspect of your life may cause problems as your relationship develops. This is especially true if you have type 1 diabetes because it’s harder to hide insulin injections or a pump, and you’re more likely to need to treat lows.

If you’re in a serious relationship, your significant other should be told. To leave your significant other out of that doesn’t lead to an honest relationship. Not only will you be hiding who you really are from someone you’ll increasingly spend more time with, but the lengths you’ll have to go to in order to hide your diabetes can be tiring and cause stress.

The Timing’s Right

There’s no right or wrong time to tell someone about your diabetes, but earlier is generally better. That doesn’t mean you need to reveal it during introductions or even on your first date, but the longer you wait, the harder it will be.

If you wait very long to tell someone, you run the risk of your significant other believing you didn’t have enough trust in them to tell about your diabetes.

Plus, you might devote a great deal of time to a relationship that you wouldn’t want to pursue if your significant other isn’t supportive. Kelly from the story above said that, “My diabetes is such a big part of my life.” It used to take him about five dates to make sure she liked a man enough to talk about her type 1 diabetes. She said, “I want somebody that’s supportive. If somebody gets concerned or scared, that’s a red flag.”

How soon is too soon to tell all? That’s a matter of individual preference. It’s like talking about exes or your previous relationships. You don’t want to give too much information too soon.


No Big Deal

Diabetes is a part of who you are, but it’s not who you are, so there’s no need to make a huge deal about it when you decide to broach the subject with your date. Sometimes what you do on your date, such as going out to dinner, will open a window for you to discuss diabetes.

“I didn’t really plan it out, how I did it,” says Kelly. “I said, ‘Oh, by the way, I’m diabetic. I don’t know if you’ve seen me doing this. That’s me checking my blood sugar and giving insulin.’ ” Turns out, Joe, hadn’t noticed her meter or insulin pump but asked her all about his diabetes when she mentioned it.

Remember, your date doesn’t need to know the inner workings of your glucose meter or exactly how to count carbohydrates right off the bat. Simply mentioning it—that diabetes is time consuming but treatable, for instance—will get the ball rolling. Once you mention that you have diabetes, the pressure’s going to be off. Things will come up naturally.

Couple’s Diabetes

Does dating (or marrying) someone with diabetes make for smoother sailing?

One of the advantages of a diabetic couple is that, in day-to-day life, that’s a topic that comes up often.

Your diabetes management may not work for your significant other—and that can cause problems. You may exercise for an hour a day while your partner barely fits in a workout. You have to respect that and just move on. Everyone has a different philosophy.

Crucial Details

Even if you plan to share the bare minimum about your disease, there’s some basic information your significant other should know. Anyone with whom you plan to spend a great deal of time should know about hypoglycemia and its warning signs—and not just because you might get a bit cranky when low. Understanding how to treat a low and what to do in an emergency is important for partners of people with diabetes. Plangetis learned how to give glucagon by practicing with a pillow and one of Dallas’s expired kits.

Teaching a boyfriend or girlfriend how to handle a diabetes crisis isn’t just for those on insulin. That can also apply to diabetes with pills.


Information Overload

Think about how long you’ve had to get used to the day-to-day tasks of diabetes. Springing everything you know about diabetes on someone who may have no prior knowledge of the disease can overwhelm him or her.

The best thing to do is take the lead of the other person. If they ask questions and seem to want information, then you can give them all the information they want. If they don’t fire away with questions, it may be a sign you need to move more slowly in sharing aspects of your diabetes.


On the Same Page

Consider how involved you’d like your boyfriend or girlfriend to be in your diabetes management. Do you want him or her to avoid the topic completely? Are you looking for someone to push you toward your goals? There’s no right or wrong answer—it’s your diabetes so it’s your choice.

But keep in mind: Your date isn’t a mind reader. If you want the person to avoid foods you can’t eat, or if you need to be held to your exercise goals, you’ll need to spell it out. That’s what Kelly did for his boyfriend  She told him ‘Help me out. My weakness is I have a big sweet tooth.’ She said, “If he’s too intrusive, I’ll tell him.”

As two people become serious, it’s natural for diabetes to play a bigger role in the relationship. The size of that role is up to you, but many people consider their significant other a partner in their own diabetes. “I wanted him to be as supportive and as involved as possible,” Kelly says. “I treat him as if he has diabetes.” The burden is lighter now that they share it.




Marriage or Companionship and Diabetes 

They said that the first year of marriage is often the hardest. Learning to live as a pair and work as a team when diabetes is in the picture often requires some adjustments, even for the longest-term couples. Here are some tips:

1. Unite as a Team

After planning a wedding and celebrating the big day, then coming back down to Earth, you may find that you have neglected parts of your relationship. Starting off as a married couple means investing in togetherness—even when it comes to tackling diabetes. When one partner is removed from the other’s disease management, it can get in the way of a team approach and healthy relationship.

2. Be Aware of Care

Your partner should not be left in the dark about your diabetes management. For example, Peanut Dalton has been married to her husband, Tony Martinez for 2 years. She was diagnosed with  type 1 diabetes in her late teens. She manages it properly by following a healthy diet. It’s up to the person with diabetes to educate their partner in the care of their health. If a partner is willing to attend an educational program or a session with a diabetes counselor, that would be a huge step forward for the couple.


3. Have Patience.

Dylan Harwood, mid-20s, has been living with type 1 diabetes since she was a child. Her boyfriend, Diego Vasquez, doesn’t have diabetes, so his learning curve has been a bit steeper. They’ve been together since 2016. “Life with diabetes, or a new life with a loved one with diabetes, is like learning a new language,” Vasquez says. “There are lots of new terms, new tools, different meanings, and jargon to learn.” Diego read all kinds of things about diabetes, but that was only part of the story.” He had a grandparent who was a Type 2 diabetic. Talking about expectations for both partners, as well as any assumptions either might have, has helped the couple navigate life together.


4. Set Some Rules

Nina Zhou-LaCotti, a literary attorney, said that she and her husband, Jack set ground rules for how they would manage her type 1 diabetes as a shared responsibility. When Jack thinks she’s low, he has permission to tell her to check her blood glucose, no questions asked, and Nina will comply. But they also have boundaries. There is a risk for the partner without diabetes to become the “diabetes police,” over-managing the spouse’s health—and likely frustrating both. Allow people with diabetes to make their own decisions about their diabetes management. It’s important that the person without diabetes … be flexible and understanding.

5. Safeguard Reproductive Health and Pleasure

Problems with blood glucose control can affect intimacy in the bedroom, too. Men with diabetes, especially those with poor glucose control, can develop erectile dysfunction. Women with diabetes who are trying to get pregnant should aim for excellent glucose control—an A1C as close to normal as possible—and should have their thyroid function tested before trying to conceive. Women may face urinary tract infections, experience pain during intercourse, or require additional time to become aroused. If your spouse begins to have sexual issues, don’t take them personally. There are effective treatments. Talk to your health care provider about what may work for you and your spouse. And if one doesn’t work, try another. Intimacy is a very important area of your life together. You don’t have to say farewell to it just because one or both of you have diabetes.


AUTHOR’S NOTE: I made those people up.

How to Prevent Long-Term Problems

Improper management of diabetes can lead to long-term health problems.

Heart and blood vessel problems 

Over time, fat can build up on the walls of your blood vessels. It’s hard for blood to flow through the clogged vessels. When blood can’t get to the heart, it can cause a heart attack. When blood can’t get to the brain, it can cause a stroke. There are other things that increase your risk of heart disease and strokes such as:

  • Too much weight around your waist (waist size 40 inches or more in men and 35 inches or more in women)
  • Abnormal blood fat and cholesterol levels
  • High blood pressure
  • Smoking

To prevent those problems:

  • Manage your blood sugar levels
  • Follow your meal and physical activity plans
  • If you smoke, try very hard to stop, or seek help from your diabetes care team. You can also visit for help in quitting
  • Limit salt and alcohol intake
  • Know your cholesterol and blood fat (triglyceride) levels and manage them
  • Check your blood pressure and manage it

Cholesterol and Blood Fats 

A blood test will tell you how much of various kinds of fats and cholesterol you have in your blood. Try to reach the goals that you and your diabetes care team have set. Meeting your goals will help protect your heart and blood vessels from damage.

Blood Pressure

Blood pressure is the force of your blood pushing against the insides of your blood vessels as it moves through your body. You should have your blood pressure checked at every visit and ask what it is. Your diabetes care team will give you two numbers. For example, if your blood pressure is 130/88 mm Hg, your team will say that your pressure is “one thirty over eighty.”

The first number is your systolic blood pressure. That’s the pressure as your heart beats to pump blood. The second number is your diastolic blood pressure. That’s the pressure when the heart rests between beats.

High blood pressure (also called hypertension) means that your heart has to work harder to pump blood. High blood pressure can:

  • Strain the heart
  • Damage blood vessels
  • Increase your risk of heart attack, stroke, eye problems, and kidney problems

Ask your diabetes care team about your blood pressure goal. The goal for most people with diabetes is less than 130/80 mm Hg. If you are not at your blood pressure and blood fat and cholesterol goals, you and your diabetes care team can talk about what steps you can take to reach them.


High blood sugar can damage the tiny vessels that supply blood to your eyes. This can cause a number of eye problems. Over time, these problems can lead to blindness. There are some ways to protect your eyes:

  • Manage your blood sugar and blood pressure
  • Get a dilated eye exam by an eye care specialist every year
  • Call your diabetes care team right away if you notice any sudden change in your sight, such as blurry vision or little specks floating before your eyes


Your kidneys filter waste products out of your blood. Over time, hyperglycemia damages the small blood vessels of the kidneys. It also forces the kidneys to filter too much blood. The extra work is hard on the kidneys. After many years, they can fail. Taking good care of yourself can help to prevent this damage. Taking good care of yourself can help to prevent this damage. Here’s what you can do:

  • Have a urine test for protein every year. This test is called a microalbumin test. It can help find kidney damage in its early stages before it gets worse.
  • Have a blood test for serum creatinine at least once a year. This test can also show kidney damage in its early stages.
  • Keep your blood sugar levels as close to normal as possible.
  • Manage your blood pressure. HIgh blood pressure makes the kidneys work extra hard.
  • Don’t smoke. Smoking adds more damage to the small blood vessels.


High blood sugar can damage nerves in the body. Some of the symptoms are:

  • Numbness, tingling, or pain in the toes, feet, legs, hands, arms, and fingers
  • Nausea, vomiting, or indigestion
  • Dizziness or faintness
  • Problems with urination
  • Weakness

Here’s what you can do to help reduce your risk of nerve damage:

  • Manage your blood sugar levels
  • Limit how much alcohol you drink

Teeth and Gums: 

Diabetes can increase the amount of sugar in your saliva. Over time, this can cause tooth decay and gum infections. Here’s how to keep your teeth and gums healthy:

  • Manage your blood sugar. See your dentist at least every 6 months for a checkup and cleaning. Be sure to tell your dentist that you have diabetes.
  • Call your dentist if you have red, bleeding, or tender gums for more than a few days. These problems may be an early sign of gum disease.
  • Floss your teeth after every meal. Then brush your teeth for 3 minutes.


Diabetes can harm your skin in many ways. High blood sugar causes your body to lose fluid. That can make your skin dry. Dry skin can crack easily. Germs can get in and cause infections. High blood sugar feeds the germs, which can make infections worse. Hyperglycemia causes you to sweat less. Decreased sweating can cause dry skin. Here’s what you can do to take care of your skin:

  • Bathe or shower each day using a mild soap. Rinse very well and pat yourself dry.
  • After washing, use a lotion or cream to keep your skin moist.
  • Check your skin after washing. Look for dry, red, or sore spots that might lead to an infection.
  • Tell your diabetes care team about any skin problems.


Diabetes can hurt your feet in two ways:

  • High blood sugar damages your nerves, including those in your feet. With damaged nerves, you might not feel pain, heat, or cold. A sore or cut may get worse and become infected without your feeling it.
  • Diabetes reduces blood flow to your feet. When your feet don’t get enough blood, infections may not heal.

Protect your feet by taking extra care of them:

  • Have a comprehensive foot exam every year
  • Wash your feet in warm water every day and dry them well
  • Never go barefoot
  • Wear shoes and socks that fit well
  • Inspect your feet every day for cuts, bruises, blisters, or swelling
  • Ask your diabetes care team how you should care for your toenails
  • Call your diabetes care team if you injure your feet in any way
  • Make sure your diabetes care team checks your feet at every visit


Some people with diabete experience sexual problems. It is difficult to talk about sex, but your diabetes care team can help you. You may want to ask for a few minutes to talk about it at the beginning or end of your next appointment. Setting the time aside will ensure that it gets the attention it deserves. And there is no need to feel embarrassed. You can be sure that your diabetes care team has dealt with the issue before. Keeping your nerves and blood vessels healthy can help to reduce sexual problems. You can help keep your nerves and blood vessels healthy by managing your ABCs—that is, your:

  • A1C
  • Blood pressure
  • Cholesterol levels


Diabetes problems don’t have to happen. You can work to avoid them. There are many things you can do to reduce your risk. But the most important is to manage your blood sugar. That’s the best way to live an active, full life with diabetes. You can do it! There’s no can’t, CAN!