That’s the light-hearted advice of Gary Scheiner (pictured right), an experienced diabetes educator from the US who has himself been living with type 1 diabetes for more than 20 years.
Gary visited Melbourne late last month, where he spoke about intensive blood glucose management using the latest technology as part of the Type 1 Expert Speaker Series.
Diabetes Australia – Vic caught up with Gary to learn more about his own diabetes, eating pizza, his latest book Think Like a Pancreas and how to stay positive in tough times.
DA–Vic: When were you diagnosed with diabetes?
Gary Scheiner: I was 18 … between my first and second years at university. The interesting part is where I was diagnosed. It was in a small town in Texas called (are you ready for this?) SUGARLAND.
DA–Vic: How do you manage your diabetes?
GS: I have used an insulin pump since 1994. Love the pump – it gives me better glucose control and much more lifestyle flexibility than I could ever achieve with injections. I do carb counting to match my insulin to my food intake.
I also use a continuous glucose monitor (CGM). I’m not very good at sensing my lows, so the CGM is helpful for detecting them while I’m still reasonably rational.
Besides insulin, I take an injectable diabetes medication called Victoza (liraglutide). Victoza belongs to a class of drugs called GLP-1s*, similar to Byetta (exenatide). It helps me to control my incessant appetite. By not eating huge amounts of food and snacking constantly, I’m able to manage my blood sugar and my weight much more easily.
Finally, I use daily exercise to keep myself sensitive to insulin and reasonably sane. I consider my workouts as important to my diabetes management as all of the above.
DA–Vic: You’ve created a Type 1 University. How did the idea come about and what is its main purpose?
GS: T1U came about for two reasons.
First, the vast majority of people with diabetes receive inadequate teaching and management from their healthcare providers. That goes for both rural and urban areas, in both industrialised and less-established parts of the world. Healthcare providers just don’t have the time, resources, and in many cases, the expertise to offer advanced, ongoing care for those who want and need it.
Second, I got tired of seeing webinar-type programs being offered only to providers and not the patients themselves. Why should doctors and nurses have all the fun? Webinars are convenient, easily accessible, cost-effective, and serve as effective modes of teaching. It’s time everyone benefitted.
For those who want more one-on-one education or management help, my practice, Integrated Diabetes Services (www.integrateddiabetes.com) provides coaching services worldwide for people with diabetes through phone, fax, Skype, text, live chat and data downloads. Our primary focus is in working with insulin users of all ages on intensive diabetes management.
DA–Vic: Your tutorial video on how to manage your diabetes and enjoy all types of pizza is very interesting and has been well received on the internet. Why is it important for people living with diabetes to be able to enjoy pizza like everyone else?
GS: For the same reason it is important for people with diabetes to be able to enjoy Halloween candy, Valentine’s hearts, birthday cake, and all the other wonderful treats the world has to offer. We’re people. We just happen to have a medical condition that requires some preparation to enjoy them safely.
DA–Vic: Why is it important for people with diabetes to Think Like a Pancreas, as the title of your book suggests?
GS: That’s really just a way of saying, match your insulin to your body’s needs, the way a healthy pancreas would do. Our ultimate goal is match normal physiology as closely as possible. In practical terms, that means spending as much time within an acceptable glucose range as possible, without having excessive hypos and without it dominating your life.
Thinking Like A Pancreas is all about being on an insulin program that simulates the basal/bolus insulin secretion of the pancreas. The basal insulin should hold glucose levels reasonably steady between meals and overnight. The bolus (mealtime) insulin should be matched properly to one’s food intake, physical activities, stress, and other factors that affect glucose levels. And there are many!
DA–Vic: You see people with diabetes every day. What is the most common question people ask you?
GS: Almost everyone wants to know how close we are to a cure. My answer is always the same. I was told when I was diagnosed 27 years ago that it would be five, ten years until a cure is found. They are still telling people that it will be five or ten years until a cure is found. Instead of waiting around for a cure, take good care of yourself today. When the cure does arrive, and someday it will, you’ll be in the best shape possible and will have enjoyed the best possible quality of life in the meantime.
DA–Vic: It can be really hard to stay positive and keep your spirits high, particularly when you’re newly diagnosed. What advice would you give to people who have just been diagnosed or are feeling a little low?
GS: Everyone has challenges to deal with, so get over it. To deal with diabetes effectively, you have to start each day fresh. Don’t dwell on what happened yesterday, and don’t sit around waiting for a cure or worrying yourself sick. Focus on the here and now.
It never hurts to keep a sense of humour about things. There are some good things that can come out of having diabetes. You’ll never get lost because you can follow the trail of used test strips home. You can get seated in restaurants faster, and receive priority booking for medical procedures. Most amusement parks will let you jump to the front of lines. And there’s almost always some form of food within arm’s reach! Not to mention all the amazing, inspirational people you can meet online or in person through the diabetes communities (like Diabetes Australia!).
*Please note: GLP-1 medications are only approved for use in type 2 diabetes in Australia.