VA Dietitian: How I met the Pope

As I opened my eyes, I noticed a team of paramedics standing over me. Then I heard a loud shout, “She is awake.” There was an IV in my right arm and Pope Paul VI was seated next to me.

No, this was not a dream. Rather, it was the result of my first blackout from hypoglycemia, which took place on a vacation trip to Vatican Square years ago.

Now I counsel Veterans at the Cleveland VA Medical Center to help them deal with hypoglycemia and diabetes. I am the program quality manager for Diabetes Self-Management Education and Support at the Northeast Ohio VA Health Care System.

I am pictured above with my son.

When I was diagnosed with diabetes as a high school sophomore, it was a shock. Luckily, there were amazing tools available. For example, I used one-step urine tests, long-acting insulin and a meal plan called, The Exchange List.

I set out to do everything correctly. I took my insulin and tested my urine. My exchange list hung on the refrigerator and my parents ensured I measured everything I ate. I even carried a mini copy in my purse.

I knew the signs and symptoms of hypoglycemia, specifically low blood-glucose. Two years after my diagnosis I experienced my first “LOW.”

Vatican on Italian itinerary

My grandparents, and my aunt and an uncle invited my older brother and me to join them on a three-week vacation to Italy. My aunt was a nurse and my parents felt it was a once in a lifetime opportunity, so they let me travel.

After a long journey with a diabetes fanny pack strapped to my waist, I ventured to Vatican Square with my family. Suddenly, I became confused and disoriented and fell to the ground.

I was experiencing severe hypoglycemia with no symptoms. Hypoglycemic unawareness. I was unable to communicate, but my Aunt told the Vatican’s first responders that I had diabetes and needed IV glucose.

Help came quickly. When I regained consciousness, there was an IV in my arm and Pope Paul VI was sitting next to me. A severe hypoglycemic event resulted in me and my family getting a private audience with the pope. I remember him giving me some hard candy, but cannot remember a word he spoke.

Teaching Veterans what she learned

Eventually, I updated my nutrition strategy, learned to carb count and dosed insulin based on what I ate. Now I teach these practices to Veterans with diabetes and hypoglycemia.

This is important because Veterans are aging, and about one in four has been diagnosed with diabetes.

I go over the drill with them:

• When were they diagnosed?
• What tools do they use to help them deal with it?
• What diet do they follow? Do they use an exchange list, calorie counting or a low-fat diet?
• Can they calculate the amount of carbohydrates in a standard portion of common foods?
• Do they know how to read a label?
• Can they determine a serving size?
• What is their blood glucose before meals?
• Are they taking a fixed dose of mealtime insulin?
• Do they have a sliding scale?
• Can they determine their carbohydrate-to-insulin ratio?

Know your diabetes-related numbers

Severe hypoglycemia is a problem. Numbers matter. I empower my patients to minimize their risk of hypoglycemia. It takes a team and it takes time to teach them their diabetes-related numbers.

November is National Diabetes Month. VA is launching an Understand Your Diabetes Numbers campaign. It is important that Veterans with diabetes learn what those numbers mean for their healthcare.

Watch Tom’s story of partnering with his healthcare team to manage diabetes and avoid low blood sugar.

Mary Julius is the program quality manager for Diabetes Self-Management Education and Support at the Northeast Ohio VA Health Care System.