It’s Valentine season – a time when love, romantic getaways, and even engagements abound. For engaged couples hoping to make their special day even more special, wedding planning can feel like an all-consuming process. And when you throw type 1 diabetes into the mix, there’s even more to consider.

For a glimpse into wedding planning when type 1 diabetes is involved, we caught up with JDRF’s own Lianna Wingfield, a bride-to-be with type 1 who is busy planning her wedding with her fiancé, Billy.

Q: So, typically the first thing on the wedding planning to-do list is finding the right venue. Are you concerned about your venue not being educated about brides with type 1 diabetes?

A: We’re planning for our wedding to be a little nontraditional, with an outdoor setting at an estate or farm, so we’re kind of making up our own venue. So I haven’t encountered that, but I’d imagine many people with type 1 would have this issue with venues and their staff, since the general public often lacks knowledge about type 1.

It really helps that the people who will be at my wedding are the biggest support system I have. I think everyone will be supportive and fully informed about what I need. Even all my friends that I’ve met here in New York are learning about me and my type 1, especially since I work at JDRF.

Some of my JDRF colleagues tease me that I should get married at the JDRF Ride to Cure Diabetes in Vermont, since we’re planning to have our wedding in the New England area. Hey, at least then my venue’s staff would fully understand type 1!

Q: Hilarious! And let’s not forget one of the most important wedding details: the gown! Will you have to include any special designs in the gown’s structure (like a hidden pocket) to allow for a pump or glucose monitor?

A: I haven’t started wedding dress shopping, but I’ve definitely thought about that. I do use a pump and a continuous glucose monitor (CGM) and I’m always looking for waistbands or pockets to hide them in, so that will certainly be a consideration. Obviously I’ll need my pump and my CGM on my wedding day – they just make it so much easier for me to understand what’s going on with my type 1…you know, things like whether it’s my emotions that are making me feel a certain way or whether it’s my blood sugar, or just the stress of the day. They also allow me to see where my blood sugar is trending instead of just what it is at the moment I test. That’s why I love my CGM so much. I will really have to explore getting hidden compartments sewn in for my pump and CGM.

Q: Some brides with type 1 have their bridesmaids carry candy or some other form of sugar or glucose in bouquets or other hidden places – do you think you’ll have your bridesmaids do anything special to help?

A: Actually, I am not going to have bridesmaids since we are only going to have about 50 or 60 guests. But Billy’s daughter, Emma, will be in the wedding, and I may plan for her to have glucose tablets with her if they’re not going to be in one of my hidden pockets.

Q: No matter how many guests you’re having, one thing’s for sure: they’ll come hungry! Do you think your type 1 will influence your menu plan?

A: I mean, it always does. Because I’ve had type 1 for so long, it’s always been a factor in my meal planning and it’s made me a lot more health conscious. But that’s what is great about planning your own wedding and being able to plan ahead – you have an idea of what’ll be served, so you can make adjustments. Billy loves barbeque food, which can be very high in sugar and carbs, so I’ll definitely have to plan for some lower-carb options…ones that I already know how my blood sugar will react to. I’ll have to do some taste testing, too…after all, taste testing is the best part!

Q: Now, a question you probably get a lot: How did you and Billy meet? And how far into your dating did your type 1 come up? Was dating more difficult because of your type 1?

A: Billy and I met through mutual friends – he was living in New York and I was living in Seattle. We had talked a few times over the phone before I met him in person more than three years ago here in New York. I think my type 1 came up in one of those early conversations, because I’m not one to hide it. I’m sure he would’ve noticed, anyway, on our first date when I’d have to pull out my insulin pump! I’m not shy about explaining my type 1 because I really believe in educating and spreading public awareness about it, since not many people know what type 1 is.

When dating Billy, it also really helped that he totally “got it” right away – he’s my biggest support.

Q: Wonderful. And are you two planning to have a honeymoon?

A: We haven’t made any plans yet for a honeymoon, but knowing us, I’m sure we’ll end up going somewhere involving a lot of travel.

Q: Traveling with type 1 diabetes can mean more than just the annoyance of jet lag. How do you approach traveling? What will traveling mean in terms of your type 1?

A: Luckily traveling is something I’ve done a lot of, especially with Billy and I dating bi-coastally for two years. The most important thing is to plan ahead. I have never been a light packer anyway, but as a person with type 1, I also have to pack extra needles, pumps, glucose tablets, testing strips, and so on – in double the amount that I think I’ll need.

I always believe that if you have type 1 in a foreign place, you should try to eat foods that you’re familiar with, so you can maintain control. And if you’re experimenting with new foods, just be aware of how your body is responding. Again, this is where I think the CGM is so helpful.

Q: Thanks so much for sharing about your wedding planning with type 1 diabetes. There are many type 1 brides-to-be out there, and it can be cathartic to both share and hear about some of the challenges that exist. Do you have any parting words of wisdom or advice to others who are planning their weddings while having to factor in type 1?

A: I really feel for other brides-to-be with type 1, because just the wedding planning or just the type 1 alone can be such stressful parts of our lives. So we have to be in control of it all and stay positive – it’s only one day of your life! And remember: In the end, if you’re marrying the right person, your big day will be amazing, no matter what!

When I was diagnosed with type 1 diabetes in August, 2004 at 23 years old, I was set to go fight our current war on the Iraqi-Syrian border. I was a Second Lieutenant serving in the United States Marine Corps and working as an infantry officer.

I was stationed in Twentynine Palms, CA with the 1st Battalion, 7th Marines, Baker Company. I had a platoon of forty-eight Marines and one Corpsman from the Navy. We were leaving for Iraq in about sixty days. Our mission once we were on Iraqi soil was to guard and patrol the Syrian border. I was on base for a thirty-day field exercise where we worked on our infantry skills, patrolling operations and standard operating procedures. During the field exercise I experienced some weight loss, and I suffered from extreme fatigue and had the constant urge to urinate upon my return. I had lost twenty pounds in two weeks and I couldn’t get through the night without having to use the bathroom at least once every hour. The medical staff on base attributed the weight loss and fatigue to the stress about my imminent deployment and my lack of sleep and proper nutrition. The constant urge to urinate was explained away by all the water I had been drinking to keep myself hydrated during the 135 degree weather in the desert.

After the field exercise, I flew home to Muncie, IN to visit my parents on my two week pre-deployment leave. They were shocked at what they saw at the airport. My parents’ only son was unrecognizable, weighing thirty pounds lighter than when they last saw him. Upon seeing my sunken eyes and gauntness, and noticing that I couldn’t read the time on my own watch, they drove me straight to the doctor. My mom knew something was gravely wrong, something that the medical staff on base didn’t. When I told the doctor my symptoms, he immediately set up the tests needed to check for diabetes. My blood sugar was 737, a level that would send most people into a coma.

I spent the next week in the hospital while the nurses and doctors tried to lower my sugars safely. Once my levels returned to normal I lost even more of my eyesight because sugar crystals had formed in my eyes and were distorting the light coming though them. I wore glasses for the following three months before waking up one morning with suddenly restored 20/20 vision. Because I could no longer be deployed to Iraq with my condition, I was put in charge of the Remain Behind Element for the battalion. I was in charge of 250 Marines and Sailors who were not going over to Iraq due to injuries or because they were being processed out of the military. I also had the duty of Next of Kin notifications, which meant I had to make house calls and tell mothers and wives that their son or husband was alive but had lost three limbs fighting in the war. I couldn’t wait to get out of the military after this experience and was honorably discharged in January of 2005. I moved back to Indiana to live with my parents.

Just after the new year, I had my first hypoglycemia-induced seizure, which tore all the ligaments in my right shoulder. I had been drinking that night and did not know that alcohol brings down your blood sugar and inhibits and prolongs the action of insulin. I had no hospital education on the effects of alcohol and being diabetic, so I didn’t know to eat something before I went to bed so that the slow-acting insulin I give myself at night wouldn’t cause my sugar to crash to dangerous lows. I had surgery to repair the ligaments, and I have remained seizure free since that night.

I currently live a very active lifestyle and compete in triathlons in my spare time. I eat a healthy, low-carb diet, but I don’t deny myself some sweet indulgences. I have never had an AIC level above 6.0. Although having diabetes is a huge part of my life and I take it into consideration with any decision I make, I refuse to let it hold me back from the goals I want to pursue, and that is why I try to be as diligent as possible in controlling it. Much of my success with this tight control of blood sugar levels is due to the support of my wife. She has done research on her own about type 1 diabetes, especially low blood sugar symptoms and the longterm effects of the disease, and always makes sure we have glucose tablets nearby in case my levels dip. We were both members of the JDRF Young Leadership Committee (YLC) in Chicago, and helped launch the new YLC in San Francisco, so we can further our knowledge about the disease, new developments in its treatment, spread diabetes awareness, and raise money for its research.

I’ve heard it said that there are as many versions of diabetes as there are diabetics. This condition we call Type 1 Diabetes is diagnosed when we are 6, 16, 36 and 60; we end up in the hospital in DKA and we manage on oral meds for a year or two; we are plagued by continuous highs, regular lows or are blessed with consistently stable blood sugar (I want to switch bodies with that Type 1!).

We eat low carb, moderate carb, anything that crosses our kitchen table; we are overweight, underweight and just right. We have a Ph.D in calculus and we are put into panic by the word ratio. We have neighbors, aunts, co-workers who tell us we can cure our diabetes with diet and exercise. We feel like we are alone on Planet Earth. Until now.

We may have lots of differences in how we experience our diabetes, not to mention how we live the so-called “rest of our lives”. But we have more common ground than differences. We all got thrust on this crazy path called Managing Type 1 Diabetes and none of us expected or wanted it. Some of us were too young to know how much it would change our lives. But it did. It does. And we handle it amazingly well most of the time, though once in awhile we all feel like running away screaming, “No more! Take away the whole carb-counting-finger-sticking-number-crunching mess…now!” But no matter how well we do with it, we would do a lot better if we could share… our successes as well as our struggles. Come and spend some time with other women who KNOW, really know how it feels.

- Zoe Heyman

Type 1 Women Support Group in Berkeley, supported by the JDRF.   Facilitated by Zoe Heyman, LADA Type 1, a counselor with 30 years experience running groups.

Hi, my name is Katie and like you, I’m an adult living with type 1 diabetes.  I was diagnosed in 1977 at the age of two. My oldest daughter, Ellie, was diagnosed with type 1 in 2004 at the age of four. My family has been involved with the Juvenile Diabetes Research Foundation (JDRF) and has been participating in various events for many years.

Through JDRF I found an event that I’m extremely passionate about: The JDRF Ride to Cure Diabetes. It’s an adventure of a lifetime. Riders from around the world take on two challenges: raising the critical money that funds research that will cure diabetes, and reaching a personal training goal that will prepare them for their cycling experience. The Ride to Cure Diabetes is both physically and emotionally challenging, but it has made a changing impact on my self-confidence and in my diabetes management.

My husband, Steve, and I first joined the Ride to Cure Diabetes in March of 2006. Back then, the list of reasons not to seemed pretty daunting: no bikes, no time, two fulltime jobs, two kids, other priorities…. and really, the last time I had been on a bike I was in college. I wondered how having diabetes would affect my training and performance for an endurance event. But even though I kept thinking about all the reasons not to, I have always lived believing that diabetes cannot hold me back. I wanted to prove that to Ellie, and really, I wanted to prove it to myself.  Walk the walk, as they say. Steve and I signed up together to ride 100 miles, in one day, in Death Valley, California. That was four years and five Rides ago.

Back then, I had become complacent about my diabetes care. Before my first Ride I worked with my  endocrinology team and the JDRF coaches to prepare.  I learned to manage my diabetes when I ride, a skill I can now put to use not only while I am on the bike, but also when I garden, when I’m coaching Little League, or when participating in any of the other activities I enjoy. Because of the Ride, both Steve and I are far healthier now than we were five years ago. After doing all the work of training, raising the money, and riding the 100 miles, the fact that I controlled diabetes during the hardest thing I’ve done in my life was a small personal victory.

I pushed myself further than I ever imagined I could. When I thought I wasn’t going to be able to achieve my goal, I had my teammates right there beside me to keep me going. The hard work and dedication paid off when I crossed that finish line. It is still hard for me to put that feeling into words. It was all worth it to see our daughters take our Ride medals to school as their ‘show and tell,’ to see how proud they are of us for riding our bikes 100 miles to cure type 1. Participating in the Ride was one of the greatest experiences of my life. There is a tremendous feeling of empowerment that comes from being surrounded by 300+ people who are all there to cure type 1 diabetes. Other fundraising events just don’t compare, and there is something about the experience that keeps me going back for more.

The people involved in the Ride are adults living with type 1, parents of children with type 1, and family members and friends of people with type 1— and then there is this other group. This is the part of what makes the Ride so inspiring to me—the people out there giving their time and their fundraising ability to cure Ellie and me when they don’t have a direct connection to diabetes. Together, we’ve laughed. We’ve cried. We’ve supported and encouraged each other. And we’ve celebrated together. All while on our bikes. We have become “cyclists”, and we will be back in Death Valley to ride again this year.

The JDRF Ride to Cure Diabetes has shown me a way to take charge of my diabetes—and go beyond. When I train, when I fundraise, and when I ride, I play a part in finding a cure for type 1 diabetes.  I don’t do it alone, either. Friends, family, teammates, and supporters are all with me, focused on ridding the world of diabetes.

What are you doing to bring about a cure? Will you join us?

I invite you to visit the Ride to Cure Diabetes website at ride.jdrf.org. There you can find more information about the Ride and also read testimonials from participants.

There are still spots open at Rides all over the country this year; it’s not too late!  If you have any questions at all, from riding to fundraising, there are coaches and riders, like me, all over the country who can help including a JDRF Bay Area Team Coach. Visit the website to learn more or contact Alison Urmson at 415-597-6309 or aurmson@jdrf.org who can answer your questions about this life-changing experience.

I hope to see you on the road soon.  Note that Death Valley Ride is already at capacity.

The UCSF Diabetes Teaching Center Patient Symposium presents Diabetes: Back to Basics on Saturday, June 5, 2010, 7:45 a.m. – 12:30 p.m.

Adults with diabetes and their family members are invited to hear the latest news involving diabetes research and clinical care from respected UCSF- affiliated researchers and clinicians.

The event is $25 per person; $35 for a family of two.  Ticket price includes continental breakfast and syllabus.

The Patient Symposium will be presented at Genentech Hall, UCSF Mission Bay Campus, 600 16th Street, San Francisco, CA 94158.  Surface lot parking is available for $2.00.

For a map and directions, click here directions-to-ucsf-mission-bay

To learn more and to see an agenda, click here adult patient symposium.   For more information, contact Marina Demetsky via e-mail at Marina.Demetsky@ucsfmedctr.org or by telephone at 415-353-2266

Being a Type 1 diabetic is a funny thing because it never becomes routine, no matter how long you’ve had it. I’ve been diabetic for over two decades, and every new chapter in life brings new challenges.

High school: a school cafeteria where I can buy any food I want?!  College: I can stay out as late as I want and sleep in until noon without my parents telling me to get up and test my blood sugar!? Law school: wow, studying for hours on end really does lower your blood sugar. Finally I graduated. I am an attorney, striking out on the beginning of an amazing career! Wait, hold on, new schedule, new life, new control issues.

The learning curve has been steep for me in trying to quickly take care of a low blood sugar right before an important meeting (I have never devoured a Snickers bar so quickly) or trying to draft a memo on a tight deadline while also experiencing symptoms of a high blood sugar (hopefully the memo didn’t reflect a tired and grouchy author).

Learning to respond to work demands and take care of diabetes is not at all the more cushy environment I experienced in college and law school, where I could – for the most part – eat what I wanted, on my schedule. My schools generally went out of their way to provide testing accommodations and extra time for assignments as needed. Nowadays, if a client needs me to work through dinner time, there isn’t a lot of wiggle room to say no without looking like a slacker.

All these issues can be worked around, as I’m learning, but having people who can relate to them, and maybe even have tips on how to handle them, is invaluable. Dishing over drinks about work, life and being diabetic with other diabetics who have similar work demands and interests seemed like the perfect solution to my steep learning curve. Thus, the idea of a T1 Young Professionals Happy Hour was born!

And of course, getting together with new friends and having drinks is a great way to end the work day, diabetic or not.

The next meeting of the T1 Young Professionals Group is Wednesday, May 19 at 5:30 p.m. at The Cosmopolitan (121 Spear St., between Mission and Howard) in San Francisco. I hope to see you there!

For more information, please visit, curetype1.org/outreach-events.html.

My husband and I arrive at a trendy restaurant to join a lovely birthday celebration for a mutual friend.  There are about 10 people listed on the reservation and we are asked to wait for the others in the bar.  My husband orders two glasses of wine and a snack mix is offered to us.  I’ve had a long day and so this should be a welcome and relaxing scene. But before I dip my hands into the snack mix and take a sip of wine I start counting the carbs. Then I start wondering if I should have a glass of wine before eating a real meal. My mind wanders deep into that part of my brain reserved for calculating and analyzing my every move and how it might affect my blood sugar level. I decide that I should excuse myself and quickly run into the women’s room to check my blood sugar. The number is inexplicably high so I administer a corrective dose of insulin. Then I worry that I may have possibly overdone it with the correction.  What if I have a hypoglycemic reaction in the restaurant?

The dinner party has not even started and I already feel apprehensive. This is an Asian restaurant and while I love the cuisine, the sauces make it very tricky to compute the carbohydrates.  Most of our group does not know about my condition. Will I be able to administer my insulin without calling too much attention to myself?  How will I respectfully decline a piece of birthday cake without everyone saying “Oh come on!” as if I am simply dieting? Or, how will I deal with the guilt if I decide to go ahead and have that piece of cake?  My husband, sensitive and noticing that I am not quite all there, asks me what’s on my mind.  “Oh nothing”, I say, not wanting to worry him. After all, this constant analysis never ends and I can’t bother him with it every time it rears its ugly head.

How I wish I had a pal to commiserate with at this party. If I really were just dieting, chances are there would be at least one other person at the table would understand my plight. The truth is, I feel alone all the time, not just at dinner parties but also at business meetings, luncheons, neighborhood block parties, etc.  In fact, I feel alone at times that do not involve food at all. Going for a walk (will the exercise bring my blood sugar level too low?), any kind of stressful situation such as a struggle with my toddler (is my blood sugar level rising?), or it is just plain sitting there (sometimes there is no identifiable explanation for a high or low reading.) When we were young, our parents worried for us. As adults, no one can understand this relentless maintenance and worry but another adult living with Type 1 Diabetes.

Imagine being told you had to “manual shift” your heart or kidneys or liver, functions that are supposed to be automatic. This is how I attempt to describe Type 1 Diabetes to my friends and family. However, even if we Type 1s were expert “drivers”, with the highest levels of skill – we know exactly what to eat and when, exactly how much exercise works for us, and we have perfected the insulin ratios for our individual bodies, we would still fail at times.  In fact, we would still fail many times.  As Dan Hurley mentions in his excellent book, Diabetes Rising: How a Rare Disease Became a Modern Pandemic, and What to Do About It, we were not put on this earth to stare at our blood sugar readings all day.  Although he does something I hate – meld Type 1 and Type 2 Diabetes into the same topic – he happens to have Type 1 Diabetes and describes the loneliness and struggle of the disease very effectively.  I can’t even begin to list all of the points he nails right on the head. Here is the transcript from a recent interview on NPR:

http://www.npr.org/templates/story/story.php?storyId=122250567&ft=1&f=5#

The fact is, being an adult, everyone assumes I have Type 2 Diabetes and all I need is some discipline to correct the situation. This is not only untrue, and insulting, with regards to Type 2 Diabetes but it could not be further from the truth when battling Type 1 Diabetes . This confusion can make us feel even more alone and misunderstood. Therefore, I applaud the Juvenile Diabetes Research Foundation Bay Area Chapter for reaching out to adults with Type 1 Diabetes. JDRF, an amazingly tireless organization, has identified this dilemma and has created venues for adults with Type 1 Diabetes to interact and share stories, thoughts and fears. I encourage those of us in the Bay Area to join the Adult Type 1 Group. I would like to meet you.

Everyone is welcome to attend the Adult type 1 diabetes Group which meets next on Thursday, January 28, 2010, at 6:00pm in the JDRF office at 49 Stevenson Street, Suite 1200, San Francisco, CA 94105.  For more information on attending contact, Carolyn Eisen, Outreach Manager at JDRF by email: ceisen@jdrf.org or by phone: 415 597 6317.