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You are here: Home / Blog / The 5 Things Over 50 Years That’ve Shaped My Experience with Diabetes

The 5 Things Over 50 Years That’ve Shaped My Experience with Diabetes

November 8, 2018 By Toby Smithson

This year, November is extra special for me in my annual recognition of National Diabetes Month and celebration of World Diabetes Day on November 14th. November 2018 marks my 50-year “Diaversary”—50 years since being diagnosed with type 1 diabetes. At the time of my diagnosis, my family and I were in shock and scared of the unknown. So, after 50 years of managing this chronic condition I feel there is a cause for celebration – a time to “stop and smell the roses.” What roses? I mean all the changes over the past five decades that have made controlling diabetes more effective and, nearly as important, easier. And to celebrate five decades, here are my choices for the top five advances in diabetes management since 1968.

FOOD CHOICES:
The introduction of “carbohydrate counting” for blood sugar management has been an effective tool for people with diabetes. For the majority of my life with diabetes I followed a “Diabetes Exchange” meal planning strategy, where foods were divided into six food groups – starches, fruits, milk, meat and meat substitutes, fats and sweets plus a “free food” list. Diabetes is a family affair since lifestyle is a major component of management, and my family basically followed the same type of meal plan (although I don’t recall anyone else using the food scale to weigh portions). I’m glad I learned exchanges, but carbohydrate counting has added more flexibility in food choices and been a better tool for matching insulin doses to carbohydrate intake.

I can’t leave food choices without mentioning low calorie sweeteners like sucralose as an advancement in diabetes management. This advancement includes over 100 studies conducted over 20 years on safety of this sweetening ingredient. In a previous blog entitled, “Being More Normal – How Healthy Eating With Diabetes Has Evolved,” I discuss this in depth. But, having mentioned the Diabetes Exchange List earlier, I can illustrate my appreciation for sucralose, the no-calorie sweetening ingredient in SPLENDA® Brand Sweetener, by consulting the list and finding the “modest” portion sizes for banana nut bread as ½ ounce, lemonade as ¼ cup, and pumpkin pie as one-twelfth of a pie. Reducing the sugar and calories in these desserts and sweet drinks with low calorie sweeteners makes a significant difference in my enjoyment of sweets.

INSULIN:
Insulin is essential for people with type 1 diabetes. Fortunately for me, insulin treatment for type 1 diabetes commenced in the mid-1920’s. In my fifty-year life with diabetes, it is not so much the discovery of insulin I have experienced, but rather the improvement of insulin. At my diagnosis, insulin was “animal derived” – isolated from the pancreas of pigs and cows. Animal derived insulin caused allergic reactions in some people, and for me tended to irritate injection sites. Now, synthetic human insulin is available, manufactured by bacteria or yeast that have had the genetic “assembly instructions” spliced into their DNA (recombinant DNA).

Insulin has also been modified over the years to create different formulations having different profiles in the strength and timing of their effectiveness in reducing blood sugar levels. “Rapid acting” insulin takes effect very quickly (5-15 minutes), profoundly increases insulin levels in the bloodstream, and its action dissipates within a few hours. The action of “long acting” insulins, on the other hand, are very modest (2-4 hours), but persist for 24 hours or longer. Long-acting insulin improved insulin therapy by acting as a “basal rate” similar to natural human metabolism. Overall, improvements in insulin therapy helped people with both type 1 and type 2 diabetes manage blood glucose levels.

MEDICATIONS:
I’ve always be unsure about calling insulin a “medication” since it is the same hormone I used to produce naturally. But, my long-term health with diabetes has likely benefited from medications effective in preventing heart disease (statins) and kidney disease/ eye complications (lisinopril), all conditions for which diabetes increases the risk substantially. And, people with type 2 diabetes have a range of oral and injectable non-insulin medications that help control blood sugar levels without the risk (in most cases) for hypoglycemia (low blood sugar levels) associated with insulin.

TECHNOLOGY:
Just as technology was booming with electronic games, cell phones, the internet and improved digital TV’s, technology was also booming in the diabetes world. From my diagnosis until sometime in the 1980’s, I checked my blood glucose level by checking for excess sugar in urine, only detectable, by the way, when the level is too high. Now I work with patients whose blood glucose results are automatically uploaded to “the cloud” and will send me a text if the level is too low or too high. I now wear on my arm a “continuous glucose monitor” (CGM) the size of a quarter that can give me my level in 2 seconds. The ten-day active period for my CGM spares me as many as 100 finger sticks. I also wear an insulin pump that saves me 15 insulin injections over its three-day active span, and, more importantly, allows me to regulate my blood glucose levels much more accurately.

SUPPORT:
As the years have progressed, there has also been a huge increase in the availability of professional and peer support, and education. Certified Diabetes Educators (CDE), first credentialed in 1986, can train people to manage diabetes and help them with problem solving their diabetes. There are great resources available online, including peer support “communities.” The growth in diabetes support has allowed me not only to have a path to seek support myself, but also to provide support to others through my website, other media outlets, and as a CDE coach.

I know this may sound odd, but I’m thankful for all the challenges of living with diabetes. Those challenges have also brought opportunities to my life. Living with diabetes has taught me to be independent, a problem solver, a creative thinker and overall healthier by following a healthy eating plan and getting daily exercise starting early in life. And, it’s given me the opportunity to share what I’ve learned with others. Here’s to the next 50 years!

This blog post is sponsored by SPLENDA® Brand Sweetener. All thoughts and opinions are my own.

Filed Under: Blog, Staying Motivated

Toby Smithson Diabetes Everyday

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Toby Smithson dynamically combines her knowledge as a certified diabetes educator and registered dietitian nutritionist with her life experiences successfully managing type 1 diabetes for more than five decades.

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  1. Cheryl Barthelman says

    November 14, 2018 at 5:15 pm

    Toby, this is awesome! Happy Diaversary!

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I can post thousands of photos, but I chose this one. Happy memories of her being here in Hilton head at a beautiful independent living facility.  I’ll be MIA for a while longer to be with family. 💔

Please excuse my absence here on social media. I was busy with the most important thing in life… spending time with family. Two weeks ago, We received a shocking diagnosis for my mom- acute myeloid leukemia. A very aggressive cancer. All energies have been spent with my mom and siblings. My mom passed away with all three of her children at her side.
I can post thousands of photos, but I chose this one. Happy memories of her being here in Hilton head at a beautiful independent living facility. I’ll be MIA for a while longer to be with family. 💔
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I have so many feel goods from attending and presenting at this conference. 
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❤️learning from the amazing speakers at other sessions.
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❤️networking with fellow dietitians throughout the conference.
❤️And reuniting with my dietitian bestie. We were academy of nutrition and dietetics spokespeople together for 9 years. ❤️ 
Thank you Todays Dietitian Symposium for another fabulous conference! 
@todaysdietitian #TDinFL @sarahrdtv #dietitianlife #dietitianapproved

I have so many feel goods from attending and presenting at this conference.
❤️sharing diabetes knowledge at my presentation on Monday morning.
❤️hearing on how the presentation impacted them from so many of the dietitians who attended.
❤️learning from the amazing speakers at other sessions.
❤️learning and schmoozing with vendors at the expo.
❤️networking with fellow dietitians throughout the conference.
❤️And reuniting with my dietitian bestie. We were academy of nutrition and dietetics spokespeople together for 9 years. ❤️
Thank you Todays Dietitian Symposium for another fabulous conference!
@todaysdietitian #TDinFL @sarahrdtv #dietitianlife #dietitianapproved
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Love this message from DJ. Dietitians do promote food first but … there are times that it’s not food only. @djblatner @todaysdietitian #TDinFL @nowfoodsofficial

Love this message from DJ. Dietitians do promote food first but … there are times that it’s not food only. @djblatner @todaysdietitian #TDinFL @nowfoodsofficial ...

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Curious? Are you currently including fermented foods to your diet for gut health?

Fermented foods: may be healthy for microbiome.
Increase gut microbial diversity to improve gut health. I’ve been adding 1/4 cup serving of kimchi to my lunch which is one serving. Listening to @katescarlata #TDinFL #guthealth #kimchi #diabetes #diabetesmanagement @todaysdietitian
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Enjoyed presenting @todaysdietitian symposium this morning. I’ve received many kudos through the day regarding how much the information impacted the audience. ❤️ Thank you for sharing your personal stories about diabetes. Presented alongside Dr Bev. #TDinFL #diabetes #cognitivedistortions #diabeteslife #livingwithdiabetes #diabetes ...

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I’m off to speak at a conference. Hoping that when I get back, my tomatoes will be ripe and ready to eat. I’m already meal planning. Thinking of combining my home grown tomatoes, cucumber and onions with rice vinegar dill weed and a packet of low calorie sweetener to make a low carb side dish. 😋
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Excited to pick and eat a cucumber from our garden. Love this low carb veggie that provides fiber, potassium, magnesium, vitamin c and lots of vitamin k. Simple pleasures… sliced the cucumber in my black bean taco salad tonight. #diabetesfriendly #diabetes #cucumber #gardenveggies #joysofgardening ...

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Best reason in the whole wide world on why I took a break from social media! Spent time with our 4 boys+ 4 daughter in laws + our 2 very very special granddaughters. #family #laughter #relaxation #familyvacation #wearefamily❤️ ...

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Are you bored with what you are eating? Need some inspo plus a huge health benefit? I’m in! This information is good for EVERYONE. Link to latest video in my bio.
Do you have any favorite go to recipes or meals? Please comment below.

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Celebrating earth day all week ( honestly everyday here) with:
🌻 attending a flower arrangement class to prepare for selling our homegrown flowers at our farmers market.
🌻Walking on the bluff in our neighborhood this morning.
🌻Enjoying views of wildlife as I walk my dog.
🌻and tending to my vegetable garden.
Happy Earth Day! Stay beautiful. #earthday #earthday2022 #earthdayeveryday #physicalactivity #joy
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Check out this program for lowering cholesterol conducted by two registered dietitians. More info @nutritionunique @sarahrdtv
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⬆️ definitely a topic to pay attention to… don’t let some of your eating habits get in the way of keeping your bones healthy and strong. TY @graciouslynourished and @eatthisnotthat for using my insight. #bonehealth #eatinghabits #reducesodiumintake #osteoporosis #osteoporosisprevention @kin.di_rd @freshnutritionny

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When is the last time you threw away spices?
#spices #springcleaning #springcleaningtips #whenindoubtthrowitout
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