Molly Johannes was diagnosed with type 1 diabetes in 1997 at the age of four. Molly controls her diabetes with a combination of insulin shots, daily exercise, and a healthy diet. She utilizes a Dexcom continuous glucose monitor to remain aware of her blood sugars throughout her busy days at school. Molly is a sophomore English major at the University of Massachusetts, Amherst. Read full bio

Nifty Fifty

Nifty Fifty: Celebrating My 50th Post on ASweetLife

As I sat down to write a blog post for this week, I realized that it was my fiftieth post for ASweetLife (not including any of the feature articles that I have written). I’m pretty excited about this milestone. It’s a good feeling to know that I have accrued fifty pieces of my personal writing during a pivotal period of my life: college.

This past Wednesday, I officially completed my undergraduate career at UMass Amherst. My degree is in English, with a minor in Psychology. On Monday, I started a new full-time job with a company that I interned for over the summer.

When I combine these major milestones with the knowledge that my seventeenth diabetes anniversary is right around the corner, it’s kind of mind blowing.

I guess what I mean by this is that I feel like I should recognize how much I’ve accomplished over the years despite having diabetes. Often, it is assumed that diabetes slows those affected by it down, that it is so dramatically life-altering that it takes a serious toll on a person’s daily activities. On the contrary, I think the exact opposite is true. If anything, diabetes has been a huge motivating force for me. It’s pushed me to prove to myself and to others that I’m capable of anything.

Specifically, I went to college and succeeded. I was terrified to leave the comfort and safety of my home and live independently. But when it came time for move-in day my freshman year, my only option at that point was to make the most out of this new chapter in my life. Three and a half years later, I think I can say that I truly did.

During my time in college, I made many new friends. I took some classes that I absolutely loved and some that I positively hated. I made my fair share of mistakes and I learned from them. I stepped out of my comfort zone on more than one occasion, and despite panicking each time, I was always proud of myself for doing so anyways. I started to pursue my interest in writing by blogging for ASweetLife. I became the chapter president of the UMass Amherst College Diabetes Network. I was crazy enough to take 18 credits during my last two semesters and still somehow managed to secure employment before I was done. And I did it all while managing my diabetes.

It didn’t really occur to me until just now – a week after finishing school – that I ought to congratulate myself for my success both academically and physically. Maybe it’s the fact that I’m aware that the arrival of Christmas Eve means that I’ve had diabetes for just over 80% of my life, or perhaps it’s knowing just how much I’ve done in the short span of seven semesters. Regardless, these numbers are more than mere statistics to me; they represent how I refuse to let diabetes get in my way. Fifty blog posts later and I’m feeling more secure than ever in terms of my diabetes care and consciousness as well as in my membership to the Diabetes Online Community.

As for right now, I’m looking forward to writing even more about my upcoming experiences (both diabetes-related and not!) in the so-called “real world” – definitely stay tuned!

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Thanksgiving Lessons Learned

Thanksgiving Lessons Learned

There’s nothing like a break from school during which time you’re surrounded by tempting foods and lack of exercise facilities to teach you a few diabetes dos-and-don’ts.

I’m approaching my seventeenth year with T1D, so you might consider me a diabetes veteran. But I’m constantly learning ways in which I can strengthen my diabetes care regimen, proving to myself and others that diabetes management is not a static thing.

The proof is in the pudding – or in this case, the turkey dinner. This year, my family gathered at my Aunt Paula’s house for an absolute feast. The selection of dishes included staples like mashed potatoes, rolls, green bean casserole, broccoli casserole, asparagus, stuffing, squash, cranberry sauce, and the turkey centerpiece. Oh, and I can’t forget to mention the several different kinds of wine to wash it all down with.

When I scan that list of food, all the starches jump out at me and make me cringe. The fact that I indulged in a bit of all of them, however, makes me throw up a little. Don’t get me wrong, each and every one of them was positively delectable. What makes me nauseous is the amount of carb counting (or in my case this year, the lack thereof) that is involved in the process of consuming them. Needless to say, my carelessness resulted in some unwelcome hyperglycemia that lingered through dessert time. As a result, I found myself rage-bolusing to correct the high and to account for the slivers of pumpkin pie and blueberry pie that were calling my name. I waited about 45 minutes for the insulin to really take effect, then happily helped myself to some treats.

I’m proud to say that I exhibited impressive self-control when I went to cut my super-skinny slices of pie…but ashamed of my inability to resist adding a couple of fancy chocolates to my dessert plate. Before long, high blood sugars haunted me again. Luckily, upon returning home that evening I was able to get them level again in no time, but the misery of chasing self-induced highs all afternoon long really drove the point home that I need to be more careful.

Lesson 1, learned.

The second lesson is the story of my dependency on my CGM – and its apparent dependency on me. I’m trying to give myself some distance from my CGM. After all, its incessant buzzing and beeping drive me up the wall half the time. But it seems as though my CGM simply cannot bear to be away for me from long before it gives me the cold shoulder and refuses to report my blood sugars.

When I’m at work, visiting family, or hanging out with friends, it can be annoying to have my CGM clipped on my body at all times. So sometimes, I’ll leave it behind in my pocket or in my purse, never straying too far in case it needs to alert me to a blood sugar that I’m not fully aware of yet.

Usually, my CGM is great about picking up a number up to 20 feet away, letting me move into another room or up the stairs without there being an issue. But the other day, when I slipped my CGM into the pocket of the jacket I was wearing, it totally rebelled against me for being shunned into this location. For nearly an entire hour, my stubborn little CGM said it was out of range. I couldn’t understand why it was doing this to me. I felt betrayed. In an attempt to compromise with Mr. CGM’s needs, I clipped it onto my jeans so it could be as close to the chip as possible. This strategy worked, and my CGM gladly recommenced communication with me. I know, we have a complicated relationship, but we’re trying to work things out as we get to understand each other better.

Lesson 2, learned.

As you can see, there are issues faced on a daily basis – some big, some small – by people with diabetes. A little patience, good observational skills, and occasional cursing help us cope as well as prepare for the lessons the next day of diabetes has to teach us.

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Stair Breaks

Unbelievably, we’re more than halfway through the month of November – how did that happen? In any case, this means that I’m in the beginning stages of hibernation. In a college student’s dictionary, this is defined as the following:

Hibernation (verb): to be in forced isolation, as a result of impending final projects and exams. May or may not result in productive behaviors.

This compulsory state of being means that I seldom leave my apartment, let alone my room. It often causes me to feel restless as my eyes glaze over from staring at my computer screen for long stretches of time.

These stairs couldn't look less inviting.

These stairs couldn’t look less inviting.

In turn, this also means that I don’t get to fit in as much exercise as I’d like each day. Tuesdays and Thursdays tend to be the most difficult days because they’re the busiest. Granted, I only have three classes on those days, but they’re spread out so by the time the last one ends I want nothing but to go home and process what I’ve learned over the course of the day (and maybe sit back for a bit and relax while I’m at it).

However, this sometimes has an undesirable affect on my blood sugars. The lack of activity sometimes results in yucky spikes that make my CGM buzz as well as infuriate me.

Normally, I would just take insulin to correct this. But as I’ve discussed in the past, I try to avoid stacking my doses at all costs. So what’s my next go-to?

It might sound kind of weird, but the answer is stairs. I live in a five-story apartment building, and right next to my apartment’s entrance is a stairwell. It’s kind of the perfect solution because most of the time, it works more quickly than insulin and it also forces me to get up and move around. They’re literally located right outside my front door, and I don’t have to brave the cold or find a spare block of time to make it to my school’s gym.

It’s fairly simple. Just as I’m starting to feel antsy and notice an unfavorable blood sugar, I seize it as an opportunity to take a break from my work and climb the stairs. Usually, after about 15-20 minutes, I’ll notice a difference. It’s a good feeling to know that sometimes control can be as simple as taking a brief timeout from homework just to walk around my apartment building.

Now if only the stairwell wasn’t so bleak and gray, then my little exercise breaks would be visually AND mentally appealing…

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Exams and Unexpected Hypos

If someone asked me what my least favorite part of college was, I would say it’s the exams.

I understand they’re a necessary evil to evaluate my knowledge, but there are few things in this world that are more anxiety-provoking to me. As a result, I get sweaty palms and restless feet the moment the dreaded Scantron and exam packet are placed before me.

The other day, I had a communications exam that evoked all of these symptoms about an hour prior to the exam. At first, I brushed it off as nerves. But when it evolved into feeling shaky and a little dizzy, I realized I might have a bigger problem on my hands.

It couldn’t have been a more inconvenient low. I had just finished eating an early dinner a half hour before, so it didn’t seem possible to me that the insulin had already started working that quickly. I tried to ignore how I was feeling and study my notes, but an inability to concentrate forced me to test my blood sugar.

Yep, I was going down – I was 71 and perplexed. Just 45 minutes before, I was something like 191. Usually, I have to wait about 60-90 minutes to really see my insulin kicking in, regardless of whether or not I’m high before taking the shot.

In addition to freaking about my exam, I was now freaking about my blood sugar. The fact that I had to leave in about 20 minutes to get to the exam room in a timely manner wasn’t helping me keep my cool.

As my CGM started to alert me to my falling blood sugar, I shoved four glucose tablets in my mouth and decided to call my mom. I explained the situation to her and she talked me through it, mitigating some of my concerns. She gave me advice that I already knew to follow, but I still found it comforting to hear it from someone else as affirmation that I had a good plan to follow from that point up until my exam.

Fifteen minutes after the 71 reading, I tested to see if I was coming up at all. I went up to 87 – a minor increase, but it was just what I needed to see and I got ready to head out. I packed my bag, putting an extra juice box as well as a granola bar and Humalog pen in with my regular set of supplies (it couldn’t hurt to be prepared for anything). I set off for my exam, wondering all the while whether I was more worried about doing well on it or what my blood sugar would be doing during it.

A short while later, exams were being distributed by my professor: it was officially go time. Gradually, my mind shifted focus from my diabetes to each of the 100 multiple choice questions. It was all over within an hour, during which time my CGM did not go off once. I walked home and tested again, with a blood sugar reading in the 170s. Not my best, but I was proud of myself for catching the low before it got worse. And I’m pleased to report that I did just fine on the exam, proving to myself again that I can overcome just about any obstacle associated with my diabetes, which is an A+ in my book!

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To Stack or not to Stack

To stack or not to stack...that is the question.

That is, indeed, the question. What exactly do I mean by stacking? This is when a person with diabetes takes multiple shots of insulin in a relatively short span of time.

Personally, since I’m still on insulin shots, I typically will wait at least three hours in between insulin dosages. Once that minimal amount of time has elapsed, I can be fairly certain that the insulin I took earlier has run its course through my system.

I try to avoid stacking at all costs, because it seems to do more harm than good. The most common problem it causes for me is lows. If I’m too impatient for insulin to kick in and give myself a corrective dose, the stacking can work against me and make me go from a horrible high to a horrible low.

So I didn’t really want to resort to stacking, but my disrupted schedule on Saturday prompted me to do so. I ate breakfast at 9:30 and left my apartment at school around 12:00 on a ninety minute drive home. Before I left, I tested my blood sugar to see where it was at: right around 180. I took a small dose in the hopes that I would come down to a better number over the course of my drive.

Around 2 o’clock, I found myself at my parents’ house with a blood sugar of 179. Frustrated, I decided to correct for this as well as bolus for lunch, which consisted of some delicious homemade tortellini soup and a biscuit. I was well aware of the carb-y nature of this meal, so I tried to be a little more aggressive in treating it.

No dice. By 3:30, I was on the road to Boston with my boyfriend and our friends for an exciting evening during which we’d view a screening of The Evil Dead, preceded by a meet-and-greet with the cult film’s star, Bruce Campbell. Over the course of the ride, I kept an eye on my CGM and tested to confirm a spiked sugar of 250. At 4 o’clock, I took yet another shot to correct for this high. Note the time intervals in between each shot – 2.5 hours, 2 hours, and 2 hours…which translates to an inordinate number of stacks for this girl.

It seemed as though I made the right call, though. At 4:45, my boyfriend and I were shaking hands with Mr. Campbell and proudly posing next to him in a photograph. We rejoined our friends and decided to go across the street to a bar to kill some time before the movie at 7.

When I tested at the bar, I was much better with a reading of 140 mg/dL with a single arrow going down. But I had to make a choice: do I skip this one chance to order some drinks and a small appetizer in order to maintain a predictable blood sugar pattern, or do I take another shot and compensate for food and drink alone, assuming that my earlier correction dose would bring me down to my desired target of 100 mg/dL? Clearly, it was a complicated decision with multiple variables.

I went with the former and took a shot to cover a couple bites of a shareable appetizer as well as two beers. I found myself relaxing as my CGM did not vibrate once over the next few hours. It felt refreshing to enjoy my time with my boyfriend and our friends, and I felt comfortable with my stacking. I’m glad to say I survived the guts and gore of the movie, as well as Bruce Campbell’s twisted sense of humor as the night came to a close. My last blood sugar reading of the night was 127, much to my relief and satisfaction.

After this experience, what do I think about stacking? I still don’t love it. I think it’s more anxiety-provoking than anything else if you’re consciously doing it. For much of my Saturday, I wondered if I would come crashing down at some point and curse my impatience. On this occasion, though, it seemed to be the right thing to do as it decreased my hyperglycemic readings. Plus, this particular incident did give me a newfound appreciation for my normal insulin regimen. But when it’s all said and done, for me, stacking falls short.

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Un-fogging the Future

Crystal BallI don’t own a crystal ball. I can’t read palms. I don’t have the fortune-telling prowess of Professor Trelawney (or, more accurately, the centaurs) from the Harry Potter series.

But I find that I am constantly asked, “What are your plans after graduation?”, “Where do you see yourself ten years from now?”, “What do you hope to accomplish in life?”, and other questions of this nature.

Let me state the obvious here: these are HUGE and LOADED questions! As a college student in her final semester, I am asked about my future plans with increasing frequency. It seems as though anyone who asks me about my future is expecting a detailed answer, as if I can simply foresee what my life is going to be like. Whenever I do take a stab at explaining my future, I generally try to say something along the lines of, “Well, I hope to be working full-time for either a publishing or editing company, I think. I want to be able to use my reading and writing skills in a job that makes me happy.” I used to think that this answer was satisfactory, but I still often get the same reaction – a simple head nod or an “Ahhh, I see!”

These kinds of reactions evoke a few different responses from me, all of which I internalize. First, I feel a wave of confusion as my answer doesn’t seem good enough to most people. Then, my mind goes into overdrive as I think about how I should maybe rethink my entire short-term plan and make it more concrete. If I come up with something more specific, maybe, I’ll get a better reaction from people – and then I stop.

Why am I so concerned with what other people think? After all, it’s MY future, my potential job prospects and life plans that I am solely in charge of pursuing. This dawned on me the other night as I was working on an assignment for one of my classes.

The prompt was to write out an answer to a series of mind-boggling questions: What happens to you in the ten years after you graduate UMass? What obstacles might you face? Tell a story or discuss what you might be doing.

I had no idea how to answer these questions, so I just started writing. I wrote about my hopes and goals, keeping everything sort of vague and focusing in on the facts that I want happiness and good health for myself and my family. I talked about the success I will work to achieve. While I might not know exactly where I’ll be ten years, I do know that my motivation, passion, and hard work will help bring me to that place.

Now, what does this have to do with diabetes? I think the most prominent commonality between the two is the drive that pushes me to take care of myself as well as accomplish certain goals that I have set for myself. The incentive to flourish as an individual will always be present for me, particularly regarding my diabetes.

So, while I don’t have the ability to un-fog the future, I do have the ability to control it using my motivation to thrive – not just in terms of my diabetes, but in every other aspect of my life.

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A Nearly Perfect Day of Diabetes

Personally, I find it easier said than done to have good, consistent blood sugar levels on a weekend – forget it if said weekend involves alcohol consumption or an imbalanced diet.

That being said, I think it’s an absolute miracle that I had a nearly perfect 24 hours on this past Friday according to my CGM readings and blood sugar tests. On a normal day, I strive very hard to stay within those lines on my CGM. It’s my goal to stay above 80 mg/dL, but below 180 mg/dL. It sounds simple, doesn’t it? In reality, it involves a lot of hard work.

A nearly perfect day of diabetes

It was made more complicated by the activities I did this past weekend. My friends and I made plans to celebrate the beautiful autumnal weather by participating in the stereotypical fall activities. You know, by carving pumpkins, watching scary movies, and consuming apple cider and candy, among other goodies. We also decided to venture downtown to check out some of the bars in Amherst.

Phase one of the day went by almost seamlessly. I was able to get a good workout in which helped my blood sugars level out in time for the pumpkin carving and candy eating. I don’t believe in depriving myself completely of treats because of my diabetes, but I’m also careful to not overindulge. As a result, I was able to have a bunch of mini candies as well as some surprisingly good sugar free cider without any intrusive buzzing from my CGM.

The fall fun was followed by an evening trip to the High Horse bar. I’m still trying to figure out drinking and diabetes – they don’t exactly complement each other – so I made sure I was armed with everything I might possibly need over the course of the evening. I brought a large bottle of glucose tablets, my humalog pen, my test kit, plenty of needles, my CGM…I wasn’t fooling around, I know well enough by now that it pays off to be prepared.

I was more paranoid due to the fact that I had somewhat of a low prior to leaving my apartment. I think it’s safe to blame it on the fact that I overcompensated for the beer that I drank with my dinner because of its presumed carbohydrate content. I corrected the low in no time, but worried some more when I saw that I was creeping past the 180 mg/dL mark. I didn’t stress too much, though, because I knew I would be walking downtown to get to the bar.

It was great to spend more time with my friends and indulge in a few drinks with them. It was even better to (sort of) forget about my diabetes for a couple hours. Instead of declining drinks because of a high or low blood sugar, I was able to enjoy them because of my persistence in maintaining healthy readings. I stayed constant the entire evening without dramatic drops or highs and it felt fantastic. And when I saw the 24-hour results on my CGM, I was very happy to see scarcely any of the dreaded yellow or red dots littering the screen.

It’s a moment like this that makes me feel better about my diabetes management. It proves to me that I can successfully get past the trickier diabetes obstacles, all it takes is some monitoring and motivation.

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It Takes More Than One Touch To Get A New Verio IQ Meter

Sending off the last faulty One Touch Verio IQ replacement. Buh-bye!

A few weeks ago, I blogged about my frustrations with One Touch and their lack of customer service when it came to some problems I was having with my Verio IQ meter.

Here’s the short version of the story: more than a year ago, I heard about a recall on the Verio IQ meter. I reported my meter to One Touch, and they assured me I’d receive a replacement one in the mail. At the time, Verio IQ meters were on backorder, so I was sent an Ultra Mini meter to use in the meantime. However, I never received a new Verio. When I told my endocrinologist about this, she said it was fine for me to continue using my old one. I did, but when it began to malfunction sporadically, I realized I needed to give One Touch another call, which rapidly turned into three phone calls over a short period of time. They sent me replacement meters a total of three times that were not up to par. Each replacement meter was covered with scratches and looked like they had been previously used.

Naturally, this alarmed me. I still don’t have an explanation for why the replacement meters came in less than perfect condition, but I did receive a phone call from a manager at One Touch that alleviated many of my concerns.

What made this phone call different from the others is that I felt like someone was actually listening to me. I was able to explain the full story to a sympathetic ear, and we were able to clarify a major point of confusion that arose in my case: the meters I was receiving in the mail had not been previously used or refurbished. They were new meters, and it still remains unclear as to why they were flawed. I was very glad to hear this. While I was fairly certain before that the meters had not been touched and that it was a simple aesthetic issue, I still felt comfort knowing that I wasn’t being sent someone’s old meter.

At the phone call’s conclusion, the manager assured me that my feedback wouldn’t fall on deaf ears. They’d look into my complaints, and they would also send me a brand new meter in a box (like the ones sold in pharmacies) that week for my trouble. Finally, the request I had put in from the beginning was fulfilled. Within a couple days, my mom called me and told me that my new Verio IQ would be waiting for me the next time I came home.

Although it was an irritating experience, I’m content with its outcome. I feel better about customer service from this particular company, and I really appreciate the manager for taking the time to call me and listen to me tell my story in extensive detail. In this case, all’s well that ends well!

 

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Purple with a Purpose

Alzheimer's Walk Family Photo

Blue is an important color to me because it represents the fight against diabetes. But others close to me probably know that purple is another color that is just as significant.

Purple is the color of the Alzheimer’s Association. A week ago, my family and I proudly donned purple and participated in our fourth consecutive Walk to End Alzheimer’s in my grandmother’s memory.

On the day of the Walk, I was reminded of how powerful it is when I saw just how many people were there – well over 1,000! Each person was there as either a caregiver, loved one, or a supporter of an individual affected by Alzheimer’s. Despite it being fairly early on a Sunday morning, spirits were high as everyone reflected on the reasons why they were there. There was an amazing sense of community, much like the diabetes one, as we listened to other people’s stories.

The most beautiful part happened during the pre-Walk ceremony. Each participant got to design a flower pinwheel however they saw fit. When prompted, we would lift them in the air and have a moment of silence to remember our loved ones. My family’s team name is Mary’s Little Lambs, named after my grandmother. It was quite a sight to gaze at our little group’s flowers, adorned with messages of love for Grammy, spin in the wind and catch the light of the sun.

It almost felt like she (and my Grandpa) was with us as we set on our walk. The day was bright and warm, without a trace of humidity. As we walked the three miles, my family joked around and sang silly songs to keep our energy up. It’s been indescribably difficult to deal with losing a family member to Alzheimer’s, and it was also our first Walk without my Grandpa around. Instead of dwelling on our sadness, we were able to make it a positive experience and honor Grammy (as well as Grandpa!) by participating in an event that truly makes a difference.

This Walk is a reminder to me that you don’t have to be a bystander when it comes to something like Alzheimer’s or diabetes. You can make the easy and often fun choice to play an active role and support a cause you believe in. Whether it’s through writing a blog like this, having a bake sale fundraiser, or simply talking to others about your cause, you can join a fight to find a cure for these diseases.

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Date Night: Diabetes and Drinking …Oh My!

Sounds disastrous, doesn’t it? Diabetes is tough to manage. Throw in factors like drinking alcohol and spending a night out with your partner and you could have a bit of a meltdown in the process of maintaining a good blood sugar.

When my boyfriend said he was coming to visit me this past Sunday, I was pretty excited. He doesn’t live too far away from my school, but the distance is just enough to be annoying. We visit each other when we can, but we both have busy schedules between school, work, and other miscellaneous obligations. So I was happy to spend a day with him and planned for us to do a few fun things.

I've got my game face on - Donky Kong„JPGWe spent the afternoon eating lunch at the dining hall, strolling around campus, and relaxing with a couple of books and some music. Later in the evening, we decided to go to a sports bar and indulge in some beer and wings. Oh, and a platter of onion rings. Honestly, who can say no to a delicious Southern Tier Pumking with a cinnamon sugar rim? And I mean, it totally makes sense to get a greasy glut of appetizers to accompany it…

However, I started to panic a bit when our food arrived and I saw just how enormous those onion rings were and the thick layer of honey barbeque sauce covering those wings. How on earth would I know how much insulin to take to cover the meal? Just as I was about to freak, I realized I had to take a chill pill. I knew it wouldn’t be worth it to agonize over the carb count while my boyfriend dug into the meal because I knew it would just make me anxious for the rest of the night. So I did my best to add everything up, took my shot, and enjoyed the moment.

It was the best thing I could have done. An hour later, we were at another bar, this one catering to lovers of old arcade games. We enthusiastically played classics like Tetris, Galaga, Ms. Pac-Man, Donkey Kong, and Paperboy. In between games, I snuck a glance at my CGM to see how I was doing and was elated to learn I was not only sitting pretty at 120, but that I was also steady. No shaky lows or thirsty highs for this girl!

And this beautiful pattern continued as we started phase 3 of date night: wine and a movie. Again, I was a bit concerned about the affect the alcohol might have on my blood sugar. But thanks to a little research on low carb wines and careful monitoring, I was doing just as well as I had been earlier. I almost chalked it up to some wonderful sorcery, but I would have been selling myself short. I was responsible for doing the right thing in my diabetes care, despite a few potentially scary obstacles thrown in my path. It felt great and I know my boyfriend was just as glad as I was to see my success.

My Sunday of diabetes, drinking, and date night is a reminder to me to celebrate the victories, big and small, where my diabetes management is concerned.

 

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