pain medicine

Archive for September, 2019

boyBy Eloise D. Keene, MS, MPH, RD, LDN, CDE, Certified Diabetes Educator, Diabetes Management & Supplies

Whether they travel 1,500 miles or drive fifteen minutes away, going off to college for an individual living with Type 1 diabetes (T1D) is a challenge. Therefore, it is important that students with T1D learn to self-manage the disease on their own.

As a college bound student, they may have limited opportunities to ask, “Hey Mom or Dad have you ordered my diabetes supplies and insulin?” However, the need to replenish these critical items are detrimental to managing the disease. In light of this, colleges around the country have made accessing resources easier for students living with chronic illnesses like diabetes through the school’s Office of Disability Services (ODS).

ODS’s policies call for reasonable accommodations to be made for students with documented disabilities on an individualized and flexible basis. It is the responsibility of the student to seek available assistance and to make their needs known.

To access these resources, the ODS may require a few things: a letter from the student’s physician with the Type 1 diagnosis, a letter stating that the parents or family are still allowed to participate in and have knowledge of the student’s current healthcare status, and a list of things the student will need to make self-care possible. Students living with diabetes should always be prepared to request support and assistance with managing campus activities. Here’s a quick list of items T1D students may need to make their college experience safer and better:


  • Students should request a room that has a refrigerator for snacks and insulin. Also, ask for housing close to the cafeteria and work with cafeteria staff to obtain nutritional information on the meals they serve.
  • Be sure to inform roommates, friends, and residential assistants that the student has Type 1 diabetes.  Educate them about the disease and garner their support as the student’s “survival team” to help them during highs and lows.


  • Inform instructors and professors about the condition.They will need to know if the student must leave the classroom or if they are showing signs of blood glucose swings.
  • Consider asking for early registration for classes or breaks for self-care.
  • Inquire about attendance policy waivers to accommodate for high and low blood glucose episodes or diabetes-related illnesses. This includes being prepared to ask to reschedule exams because of hypo or hyper glycemic episodes.


  • Know and understand the symptoms for low blood glucose. These can include slurred speech, confusion, tiredness, shakiness, cold pale skin, cold sweats, blurred vision, headaches, nausea, nightmares, and many more symptoms.
  • Know how to treat these symptoms: be sure to carry at least 15 grams of a rapid acting glucose source.  Students will need to carry with them supplies to treat “lows” and keep a “low box” filled with goodies in a frequented place. Items in the box can include skittles, glucose tabs, glucose gel or icing, jellybeans, raw sugar, regular soda, juice, or even gummi bears. The box should also contain emergency glucagon.


  • Students should always know their numbers and carry all supplies with them to late-night study groups or parties.
  • If relying on external insulin delivery systems, always have a back-up insulin pen or vial.  When using a continuous glucose monitor (CGM) always be prepared to check numbers with test strips and monitor if the value does not seem appropriate.
  • When partying, remember, drinking alcohol has effects on blood glucose values and alcohol is processed differently in everyone’s body.  In one evening, a T1D student could go high, go low, or stay low and pass out, not from drunkenness but due to hypoglycemia.
  • Always eat something before drinking and be sure to let friends and roommates know about the disease and ensure they understand that hypoglycemia may have the symptoms of drunkenness. Be aware that hypoglycemia could happen several hours after ingestion of alcohol.

Although self-managing on their own may sound daunting, everyday across the country students with T1D are on college campuses living and loving their post-high school years. To learn more about your college’s Office of Disability Services, please inquire about ways to contact them via the school’s website or admission’s office.

Comments Comments Off

Obesity in Children

Posted by: | Comments Comments Off

By Eloise D. Keene, MS, MPH, RD, LDN, CDE, Certified Diabetes Educator, Diabetes Management & Supplies

obesity graphic

Childhood obesity affects all groups of children in today’s America and in 2019 the United States is experiencing an epidemic of this condition.

The Centers for Disease Control and Prevention (CDC) reports in data from 2015 -2016 that the rate of childhood obesity has more than tripled since the 1970’s with as many as one in five (1 in 5) children aged six through nineteen (6-19) who suffer from this condition. CDC statistics have children from two through five years old experiencing a 10.4 % (percent) rate of obesity. Children between the ages of six to eleven (6 -11) fare worse with an obesity rate of 15.3% (percent). These rates are based on growth charts that measure height and weight by age and gender.

Obesity in children is defined as a case in which BMI (Body Mass Index) exceeds the recommended level for age and height. Obesity has previously been defined as a state of malnutrition. Over nutrition with excess caloric intake but lack of necessary nutrients is still a form of poor nutrition.

Developing obesity in childhood can be influenced by factors of lack of economic resources, lack of physical activity, social conditions (lack of access to food, unsafe neighborhoods) mental health status and genetics.

Research suggests that childhood obesity can be a precursor to chronic adult health conditions, such as hypertension, dyslipidemia (i.e. high cholesterol, high LDL and high triglycerides) cardiovascular disease and Type 2 diabetes.

Families may create an aggregate of risk factors that predispose the children to obesity by the choice of high fat, high caloric foods and the lack of physical activity or exercise. For children in most stages of growth it may be more important to encourage more physical activity than caloric restriction.

The keys to less childhood obesity may be found in an increase in physical activity, the limitation of less healthy high fat, high sugar, high sodium foods and the choice of higher nutrient density and lower in calorie and fat foods.

Comments Comments Off

Ordering Supplies and Equipment

A diabetes treatment plan is very important. Make sure you know how things should work. Carefully following any medication orders and instructions is vital to your plan's success. Make sure you don't run out of supplies just as you refill prescriptions so you don't run out of medication.

Here are some ways you can let us help you reorder supplies:

At Diabetes Management & Supplies, we value the part we play on your treatment plan team and realize that winning is promoting good health.