Tuesday, May 17, 2016

Type 1 Meets Type A

Today's #DBlogWeek prompt: We think a lot about the physical component of diabetes, but the mental component is just as significant. How does diabetes affect you or your loved one mentally or emotionally? How have you learned to deal with the mental aspect of the condition? Any tips, positive phrases, mantras, or ideas to share on getting out of a diabetes funk? (If you are a caregiver to a person with diabetes, write about yourself or your loved one or both!)

Recently I submitted a "solution" to a NASA collaboration site. NASA often puts out calls for ideas on a variety of topics just to get a mix of potential solutions, and this one had to do with "telehealth tools". I would like to share my solution in response to today's #DBlogWeek prompt about mental health. The mental side of Diabetes is something I really struggle with, and I have a feeling Type A personalities (i.e. astronauts) may have a hard time dealing with it too.


First, a bit of background. I have lived every day since Dec 30, 1998 with Type 1 Diabetes. For 18 years I have balanced the physics of this disease – ingest carbohydrates, calculate insulin based on food and blood sugar, test blood sugar 5+ times per day. Gradually devices made some of these logistics easier – an insulin pump meant less injections and pre-programed equations, and a continuous glucose monitor meant blood sugar updates every 5 minutes. On the surface it sounds like the disease is straightforward, a simple dance of eating and replacing the body’s missing insulin. However, Type 1 Diabetes is much more complicated than these simple equations. For example, it is hard to be spontaneous with Type 1 Diabetes. The combination of carbohydrates, fat and protein means blood sugars spike at different times following meals, exercise must be planned hours ahead of time to ensure the blood sugar won’t go too low, and extra supplies are a must, just in case of equipment malfunction or failure. Even seemingly unrelated influences like fluctuations in hormones or sleep patterns can make blood sugars unpredictable.

All of these “outside influences” are difficult to explain to doctors, and even more difficult for them to understand and consider when making recommendations to their patients. Not to mention, much of the difficulty of having such a disease comes more from the mental side than the physical side. Sure, shots hurt, but facing a life where every carbohydrate must be counted, every exercise planned, multiple shots a day and finger stick after finger stick with no days off, no cure in sight, and the ultimate consequence of death is a bit mentally challenging. Sometimes it’s hard to stay motivated and vigilant. This is where patient networks and the “patient perspective” come into play. Diabetics all over the world have joined together through social media (blogs, Twitter, Facebook, YouTube, etc) to create what we have named the “Diabetes Online Community”, lovingly referred to as the DOC. We voluntarily share our experiences with this disease and support community members who want to talk to someone other than their doctor – someone who actually understands what it means to be a Diabetic. From these humble internet beginnings, the DOC has grown exponentially and even has spawned in-person conferences to discuss some of the realities of the disease patient to patient.

This model can be applied to NASA and long term space travel in two ways. First, NASA should place high importance on flying future astronaut physicians, even on short-duration spaceflights. An endocrinologist can’t force Type 1 Diabetes on himself in order to connect better with his patients, but an Aerospace Physician CAN fly in space to gain this perspective. Just by pure statistics, it will be more likely for a long-duration mission participant to experience a health problem and having a similar perspective from your physician is priceless. Second, NASA could implement a sort of health-related wiki. Voluntarily participating astronauts can record messages about health issues, how they coped with them, mental aspects, and words of advice. This wiki, once established, would act similarly to the DOC, a collection of searchable entries from previous astronauts who experienced similar issues – a source of comfort and mental support. Type A to type A could connect and find common ground through narratives written by like-minded people. The caveat is that NASA would need to allow these entries to be raw and unfiltered to have the most benefit, and likely only searchable by persons with the right credentials. Astronauts could even make entries pre or post flight to record feelings or experiences which may be beneficial to others. It may seem trivial at this junction in space travel, with so few astronauts actually in space at one time, but by building this database now it will likely come in handy when manned space travel is more prevalent. 


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