By Hope Warshaw, MMSc, RD, CDE
The expression, “When life gives you lemons, make lemonade,” encourages optimism and positivity in the face of life’s challenges. For sure, the diagnosis of diabetes can be a life challenge. For our Tandem Blog series, Making Lemonade from Lemons, we’ll profile people with diabetes (PWD) who’ve squeezed lemon from the diagnosis of diabetes and made lemonade - they exemplify this expression. These PWD make living with diabetes just a bit easier for everyone and show the world just how well PWD can live. This profile features Manny Hernandez, a person who has lived with diabetes since 2002. In 2008 Manny co-founded one of the first diabetes advocacy organization Diabetes Hands Foundation (DHF). He served as President of DHF until 2015. In May 2015, he joined Livongo, where he has held various roles, most recently, Head of Community. At the 2019 International Diabetes Federation (IDF) Congress, Manny was given the prestigious Living with Diabetes award.
Manny: I went for an annual physical in 2002. I was told I had type 2 diabetes. Good assumption because I was 30, overweight and diabetes ran on my father’s side of the family. I was shocked but determined to take action. I lost nearly 50 pounds. I started training for a half marathon – a fundraiser for the American Diabetes Association (ADA). After the marathon and trials on several type 2 diabetes meds, my glucose was still not at target. My physician and I were stumped. Eventually, my physician admitted he was out of options so he referred me to an endocrinologist. Turns out I had elevated antibodies and a very low level of C-Peptide. My correct diagnosis was a form of type 1 diabetes - LADA (Latent Autoimmune Diabetes in Adults). From that day on, I started injecting insulin.
Today, I deliver insulin with my t:slim X2 insulin pump with Basal-IQ technology, connected to a Dexcom G6 CGM. I find this combination does a very good job at preventing me from going low by suspending insulin when I’m trending low. I try to stay active. I walk a few times per week. Earlier this year, I participated in my first biking fundraiser. It was for JDRF. I rode 40 miles - the longest I’ve ever been on a bike!
I’m fortunate to work for a company that empowers people with chronic conditions, such as diabetes, to take the time they need to care for their condition. When I’m low, for example, people get it and are ready to help.
My first foray into peer support was in 2006 when I participated in an insulin pump users group. In one hour of being surrounded by my peers - my tribe - I learned more than I had in my first four years with diabetes. It was a very powerful experience, one that changed my life. This inspired my wife and I to explore ways to replicate this experience. One year later, TuDiabetes.org (in English) and EsTuDiabetes.org (in Spanish) were born, two social networks for people touched by diabetes and the first programs of Diabetes Hands Foundation. Today, although the foundation is no longer operational, the two communities continue to thrive. Since 2017, the nonprofit Beyond Type 1 took over both programs, something I will forever be thankful for.
In my current role at Livongo, I’m responsible for infusing the member experience for all PWD with the benefits of community and peer support. Outside of work, I’m involved on a number of different fronts. I participate regularly in online diabetes conversations. I’m subscribed to the advocacy mailing lists from ADA, JDRF, AADE, and others. I take action when prompted.
Connect and engage with others on your own terms. Today, there are many ways for PWD to derive the benefit of peer support:
Online: I recommend moderated communities, such as TuDiabetes.org and DiabetesDaily.com and ChildrenWithDiabetes.com for parents/caregivers of children with diabetes. I’m on the fence about recommending Twitter or Facebook as a first place for PWD to connect with peers because it can be more difficult to control the quality of content.
Offline: I wholeheartedly believe everyone with diabetes should attend a TCOYD conference. These take place throughout the year in various US cities. They combine the best of in-person community with an immersive day of diabetes know-how. On a smaller scale, but not to be discarded as a powerful source of support, are local diabetes support groups.
Diabetes doesn’t always behave. I am also far from perfect (though I was a perfectionist earlier in life as a trained engineer). My mantra for life with diabetes is: “One day at a time. If it was hard, or things with your diabetes didn’t work out today, you can go back tomorrow and try again.”
If you’re a person who believes you’ve made lemonade from your diabetes diagnosis, or if you know someone who has, let us know at community@tandemdiabetes.com for a chance to be featured.
Author Bio: Hope Warshaw, is a Registered Dietitian and Certified Diabetes Educator. She has spent her career involved in diabetes care and education and has authored several books published by American Diabetes Association (ADA), including Diabetes Meal Planning Made Easy. She was President of the American Association of Diabetes Educators (AADE) in 2016. She actively and passionately promotes the value of peer support to people with diabetes, caregivers and healthcare providers.
Hope Warshaw was compensated by Tandem Diabetes Care for her contribution on this topic. However, she created the content and it is based on her personal knowledge, experiences, and observations.
From time to time, we may pass along: suggestions, tips, or information about other Tandem Insulin Pump user experiences or approaches to the management of diabetes. However, please note individual symptoms, situations, circumstances and results may vary. Please consult your physician or qualified health care provider regarding your condition and appropriate medical treatment. Please read the Important Safety Information linked below before using a Tandem Diabetes Care product.
Caution: Federal (USA) law restricts the t:slim X2 insulin pump, the t:slim X2 pump with Basal-IQ technology, and Control-IQ technology to sale by or on the order of a physician. The t:slim X2 pump, the t:slim X2 pump with Basal-IQ technology, and Control-IQ technology are intended for single patient use. The t:slim X2 pump, the t:slim X2 pump with Basal-IQ technology, and Control-IQ technology are indicated for use with NovoLog or Humalog U-100 insulin.
t:slim X2 insulin pump: The t:slim X2 insulin pump with interoperable technology is an alternate controller enabled (ACE) pump that is intended for the subcutaneous delivery of insulin, at set and variable rates, for the management of diabetes mellitus in people requiring insulin. The pump is able to reliably and securely communicate with compatible, digitally connected devices, including automated insulin dosing software, to receive, execute, and confirm commands from these devices. The pump is indicated for use in individuals 6 years of age and greater. t:slim X2 insulin pump with Basal-IQ technology: When used with a compatible integrated continuous glucose monitor (iCGM), the t:slim X2 insulin pump with Basal-IQ technology can be used to suspend insulin delivery based on CGM sensor readings. The t:slim X2 pump with Basal-IQ technology is indicated for use in individuals 6 years of age and greater. Control-IQ technology: Control-IQ technology is intended for use with a compatible integrated continuous glucose monitor (iCGM, sold separately) and ACE pump to automatically increase, decrease, and suspend delivery of basal insulin based on iCGM readings and predicted glucose values. It can also deliver correction boluses when the glucose value is predicted to exceed a predefined threshold. Control-IQ technology is intended for the management of Type 1 diabetes mellitus in persons 14 years of age and greater.
WARNING: Control-IQ technology should not be used by anyone under the age of six years old. It should also not be used in patients who require less than 10 units of insulin per day or who weigh less than 55 pounds.
Control-IQ technology and the t:slim X2 pump with Basal-IQ technology are not indicated for use in pregnant women, people on dialysis, or critically ill patients. Users of the t:slim X2 pump, the t:slim X2 pump with Basal-IQ technology, and Control-IQ technology must: be able and willing to use the insulin pump, CGM, and all other system components in accordance with their respective instructions for use; test blood glucose levels as recommended by their healthcare provider; demonstrate adequate carb-counting skills; maintain sufficient diabetes self-care skills; see healthcare provider(s) regularly; and have adequate vision and/or hearing to recognize all functions of the pump, including alerts, alarms, and reminders. The t:slim X2 pump, transmitter, and sensor must be removed before MRI, CT, or diathermy treatment. For additional important safety information, visit tandemdiabetes.com/safetyinfo.
