While volunteering in Nepal, I was diagnosed with type 1 diabetes at age 31. It was Valentine's Day 2014, and my wife and I were in the middle of a backpacking trip around the globe. We had just finished a hiking trip in the Himalayas that almost killed me.

I had been losing weight and had to run to the bathroom constantly. And I had never in my life been so thirsty. I dismissed the symptoms as consequences of the dry weather, until I stepped on a scale and saw how much weight I'd lost: about 40 pounds.

A trip to a local doctor gave me the diagnosis that would change my life and land me in two hospitals in Nepal before I was cleared to fly home. I spent a month learning about diabetes and understanding the ins and outs of a chronic autoimmune disease. Then it was time to make my decision.

My wife, Cassandra Kramer, and I resolved to get back on the road and finish what we had started. I knew that if I accepted limitations so early in my life with diabetes, I would always accept limitations, and that was a dangerous state of mind.

We caught a flight to Bangkok and made our way through Southeast Asia, South America and Iceland before coming home.

Diabetes is a disease with which the body no longer produces enough insulin to regulate blood sugar. In type 1 diabetes, the pancreas stops producing insulin altogether, requiring daily injections of artificial insulin and constant blood sugar monitoring. In type 2 diabetes, the body's insulin isn't used effectively, which is sometimes the consequence of being overweight. Type 2 diabetes can require some combination of lifestyle change, medication and insulin injections.

Yet the cause of diabetes is unknown. Although some cases of type 2 may be a result of obesity, that answer does not apply to everyone, and there are no such clues for type 1.

Diabetes still has a stigma attached to it, largely because of a lack of education and awareness. But people are constantly defying it by showing that there is no reason to accept limitations or boundaries when living with diabetes.

It may require more planning, but it's not a reason to say "no" to any experience.

Will Cross was diagnosed at the age of 9 in 1976, when diabetes care was nowhere near what it is today. He became the first person with type 1 diabetes to summit Everest when he scaled the highest peak in the world in 2006. He has also climbed the Seven Summits -- the highest peak on each continent -- and traveled to the North and South Poles.

"I never aspired to be a baseball or football player," Cross told Beyond Type 1, an organization dedicated to living with type 1 diabetes. "I just wanted to climb; diabetes didn't hinder that desire."

One person who did want to play football was Jay Cutler. The former quarterback for the Chicago Bears was 24 when he was diagnosed, making him one of a small but growing number of people with type 1 diabetes diagnosed after puberty. (Type 1 diabetes was traditionally called juvenile diabetes, but that term is becoming outmoded as the number of adults diagnosed with type 1 diabetes increases, though researchers don't fully understand why.) Cutler went on to play nine more seasons in the NFL, and he has become one of the best-known athletes with diabetes but certainly not the only one.

Perhaps the most famous celebrity with diabetes was Mary Tyler Moore, who used her fame to advocate for people with diabetes. Moore served as the international chairman of the Juvenile Diabetes Research Foundation. Her death in January sent shockwaves through diabetes community, which had lost one of its biggest influencers.

And if you're looking for a celebrity to pick up where Moore left off, singer Nick Jonas has carried the mantle so far, founding Beyond Type 1 and being candid about dealing with diabetes.

"It is very easy to want to hide what diabetes means for us in the workplace, but that just does a disservice to us, to other people with diabetes and to our coworkers," adventure athlete Erin Spineto said.

Diagnosed with type 1 diabetes in college, Spineto has completed a 100-mile standup paddling trip and sailed the Florida Keys solo, all the while proving that anything is possible, despite the disease. "The more real information and firsthand experience people get with this disease, the less stigma will be attached to it."

I was able to use my diabetes diagnosis, in a way, to improve my health. Though I have a chronic disease that requires constant blood sugar checks and insulin injections each day, I also have the most powerful of reasons to eat healthy, exercise and take better care of myself: a functional life.

Failure to stay healthy and keep my blood sugars in check can lead to the severe complications of diabetes: nerve damage, eye damage, cardiovascular disease and much more. Regular exercise and healthy eating help regulate blood sugar levels in people with diabetes.

Diabetes was the catalyst for that change, even if it means I am now walking around with a medical time bomb waiting for me to make a mistake.

Perhaps the most frustrating part about diabetes is the lack of definitive answers. Questions such as "how did I get it?" or "will there ever be a cure?" must remain open-ended for now. Although there are procedures that show promise for reducing or eliminating the need for insulin and an artificial pancreas (a device that manages blood sugar automatically) is on the horizon, a true cure for diabetes remains elusive. The same is true for understanding the cause.

Yet it is a manageable disease. With experience, discipline and a support network, diabetes should never be a reason to say "no." It's just a matter of figuring out what preparations you need to make to be able to say "yes."

Since finishing our backpacking trip, my wife and I have continued to travel when we can. Hiking Kilimanjaro is high on our priority list, and I want to return to the Himalayas to hike once again, this time knowing how to treat my diabetes.

For me, it is an extension of the most important decision I have ever made: the decision to live life without limits.

Maybe I'll even climb Everest.

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Diabetes can't stop you from climbing Everest - CNN

HARI SREENIVASAN: More than eight million Americans suffer from diabetes, and more than $320 billion are spent every year treating the disease.

But an innovative program in San Diego is trying to improve health and reduce those costs by encouraging better self-management of the disease.

Special correspondent Cat Wise has our report.

CAT WISE: Fifty-one year old Alma Ayala is not a doctor or a nurse, but she is on the front lines of the diabetes epidemic in her community. Shes a peer educator for a program called Project Dulce, which works with people who have diabetes or are at risk of developing the chronic illness.

Her classes are part informational, part support group. Ayala says the goal of the program, which has been held up as a national model, is for people to feel empowered about changing their health. Thats something she didnt feel 30 years ago when she was first diagnosed with the disease.

ALMA AYALA, Peer Educator: I was devastated. I didnt want to hear the word diabetes. I felt that my life was done, that I was signing a certificate of death.

CAT WISE: Here in San Diego County, nearly half the adult population has pre-diabetes and about 8 percent have diabetes. Its a disease that affects all socioeconomic groups and races, but the Latino community has been disproportionately impacted. And thats the population Project Dulce has been targeting for the past 20 years.

ALMA AYALA: There are lots of barriers for the Latino community, language, insurance. Sometimes, doctors dont have the time to spend with them. So the classes that we provide is that extra support, working together with a clinical team to help our participants stay healthy.

CAT WISE: The program is scattered throughout 12 clinics in Latino neighborhoods throughout San Diego County and was designed by several local health care organizations, including the Scripps Whittier Diabetes Institute.

Dr. Athena Philis-Tsimikas is an endocrinologist who oversees the program.

DR. ATHENA PHILIS-TSIMIKAS, Scripps Whittier Diabetes Institute: This is a disease in which you have to do a number of management components, not only every day, but many times a day. And its not that easy to expect someone to remember to test their blood sugar, take their pill, to go out and take that walk, to have exactly the right meal on the table all the time to take care of this.

I dont see any lows there, so I dont think we have to worry that you might dip down too low.

CAT WISE: To help patients, a team is set up at each clinic with a physician, nurse practitioner, a dietitian and multiple peer counselors like Ayala who come from the communities they serve and also have the disease.

DR. ATHENA PHILIS-TSIMIKAS: If you can train these other people and professionals to help you do the other components that take longer, but are still absolutely necessary, then youre using your team to work very synergistically to deliver everything that patient needs in order to improve their care.

CAT WISE: The program is now adding another layer, technology. Last year, Tsimikas conducted a study to see if patients receiving daily text messages could manage their disease even better.

Artist Gloria Favela-Rocha was one of the participants. Shes a muralist who does large scale works for hospitals, schools and private clients. She says, before the study, she often forgot to regularly check her glucose levels. Project Dulce changed that.

GLORIA FAVELA-ROCHA, Diabetes Patient: The text message would come every day at the same time, so if I would lose track of where I was during my day, I would hear it ring, and so I would start checking my blood sugars, send in my result right away. It would send me back a message according to whatever my result was, like good job, or maybe you need to eat something that has a little more protein today.

So, it was just very it was very convenient.

CAT WISE: Dr. Tsimikas team has also been studying the effects of continuous glucose monitoring, which uses Bluetooth technology to send results to the patient and physician in real time.

MAGDALENA HERNANDEZ, Diabetes Patient: This device is reading my sugar levels.

CAT WISE: Magdalena Hernandez wears a small monitor on her stomach.

MAGDALENA HERNANDEZ: I love it. I love it because I dont have to prick my finger many times during the day, and it alerts me when my blood sugar goes high or goes low.

CAT WISE: And what happens if your levels go above 200? What do you do?

MAGDALENA HERNANDEZ: I grab a bottle of water, and I get up and walk for five minutes.

CAT WISE: Thirty miles away, Dr. Tsimikas is also able to keep tabs on Hernandezs levels.

DR. ATHENA PHILIS-TSIMIKAS: This is just over the last three hours, that she probably ate breakfast here, it went up, and is now declining.

CAT WISE: This technology has been on the market for several years, but has not been widely used because of cost and a somewhat complicated user interface. But Tsimikas says those barriers are being reduced and she predicts it will have a big impact on health.

DR. ATHENA PHILIS-TSIMIKAS: It is reinforcement to both the patient and to the provider thats helping to make recommendations on whether this is working or not. I think its really going to revolutionize the way we can take care of patients.

CAT WISE: Dr. Tsimikas says the objective is to prevent the serious complications that can accompany diabetes, including blindness, kidney failure, amputations or heart failure.

MAGDALENA HERNANDEZ: I really love the black beans and all the vegetables in here.

CAT WISE: According to studies conducted by the University of California, San Diego, and elsewhere, Project Dulce has helped lower patients blood sugar and cholesterol levels, while at the same time reduced the number of costly hospitalizations and emergency room visits.

While some elements of the program are being used in other communities, Project Dulce stands out for its comprehensive approach. So, why arent similar initiatives being rolled out in every neighborhood in America?

DR. ATHENA PHILIS-TSIMIKAS: Its probably the way we reimburse for each of these components. Thats probably the biggest hurdle. We traditionally have reimbursed only for physician visits. If we could find a way to actually reimburse for each of these components, it may be more sustainable for the future.

Or maybe we simply reimburse based on our success. If you are successful in achieving better outcomes, maybe then you pay for what led to those better outcomes.

CAT WISE: In the coming weeks, Project Dulce will begin a new study of patients that combines text messaging with continuous glucose monitoring and a wireless pill box that will alert a nurse if a patient isnt taking his or her medication.

From San Diego, Im Cat Wise for the PBS NewsHour.

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Self-empowerment is sweet for diabetes patients in this innovative program - PBS NewsHour

A St Austell man had to have his leg amputated after a small blister on his toe that developed while he was on holiday in Tenerife turned into a serious infection which wouldn't heal.

Diabetes UK is sharing the story of 63-year-old Chris Witt in an attempt to warn men with diabetes of the importance of foot care.

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Mr Witt has type 2 diabetes and had his leg amputated in late 2016. The guest house owner developed a small blister on his toe after going for a walk in new sandals while on holiday in Tenerife.

This turned into an infection which wouldn't heal, leading first to the amputation of part of his foot and eventually to the loss of his leg below the knee.

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He said: "I didn't realise how dangerous it could be to have an infection and that it can come on so quickly. I wasn't vigilant enough. If you're a man with diabetes you need to check your feet every day and if you see anything wrong get in touch with your surgery. Push for quicker treatment if it's not going fast enough.

"If I'd realised the dangers, I might have saved my leg."

Diabetes UK south west regional head Phaedra Perry said: "Men with diabetes can protect their feet this May by ensuring they attend their annual foot check and that they come away knowing what their risk of developing foot problems is and whether further action is needed.

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"If your feet have not been checked by a healthcare professional in the past 12 months if you've not been invited in for your foot check or you missed your appointment do not put off booking or taking up the offer of a free check. Also, if you spot a problem or have any concerns do not wait for your 12-month check-up make sure you book an appointment as soon as possible as problems can escalate extremely quickly.

"Putting your feet first can prevent the devastating loss of your toes, feet or legs, which will have a huge impact on your life. Everyone with diabetes is entitled to an annual foot check or more frequent checks if you are deemed to be at medium or high risk.

"Checking regularly yourself and having an annual foot check with a health professional can keep you on your feet."

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A spokesman for Diabetes UK said: "Men with diabetes are at a higher risk of chronic foot and leg wounds which can lead to devastating toe, foot or leg amputations, Diabetes UK warns today. Nearly three out of four people who have diabetes-related foot ulcers are men.

"During Foot Health Awareness Month in May, the charity is urging people with diabetes and particularly men with diabetes, to take care of their feet and if they've not had them checked in the past 12 months to not delay in booking in for their free annual foot check with their doctor or nurse.

"Latest figures show there are 20 diabetes-related amputations a day, despite four out of five of these being preventable with good foot care."

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The charity warns that not all people with diabetes are getting the annual foot check they're entitled to on the NHS.

According to the National Diabetes Audit 2015/16, nearly one in six people with type 2 diabetes in Cornwall (16.3%) are missing out on this essential check-up, compared to one in ten across England.

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This rises to more in one in four people with type 1 diabetes in Cornwall (27.6%), in line with the England average.

They said having an amputation has a devastating impact on a person's life through loss of work, immobility and the inability to drive. But if a foot problem is treated quickly it can prevent serious problems in the future.

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Check your feet daily for any signs of redness, breaks in the skin, pain, build-up of hard skin or changes in the shape of your feet. These could be warning signs of early foot problems, so tell your doctor straight away.

Wash and dry your feet every day especially between the toes. Don't soak them in water as this can increase the risk of damage.

Moisturise every day, but not in between the toes (this can make infections more likely).

Check your shoes daily for anything that may rub.

Cut your nails carefully and don't cut down the side of your nails.

Don't use corn removing plasters or blades as these can damage healthy skin.

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The 'touch the toes test' can help you find out if you are losing sensation in your feet. Go to http://www.diabetes.org.uk/feet-care.

Alternatively, you can call the Diabetes UK helpline on 0345 123 2399.

Read more: See all the latest news from around Cornwall

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St Austell man with diabetes Chris Witt had leg amputated after blister on toe on Tenerife holiday - Cornwall Live

This Saturdays Notorious Nick Memorial Shotgun Match sponsored by the Single Action Shooting Society and the Founders Ranch Shotgun Sports Club will raise funds for the Juvenile Diabetes Research Foundation.

Sign up starts at 8:30 a.m. and shooting begins at 10 a.m. for the event at Founders Ranch at 74 Barton Road. Cost is $50 for 100 target sporting clays, $25 for 50 target 5 stand sporting and $12.50 for 25 target cowboy clays.

The event in its fifth year also brings attention to the causes of juvenile diabetes and diabetes in general, which is a health concern for the area and statewide. According to advocates, more than 12 percent of the states adult population is living with diabetes, which is more than 248,000. Another 615,000 are estimated to have prediabetes, which means their blood sugar levels are higher than normal but not yet high enough to be type 2 diabetes.

Prediabetic is now the new term for people who will likely get diabetes in the future without making changes now to their diet and sedentary lifestyles, said Dr. Linda Stogner, medical director of the Esperanza Family Health Center. Doctors used to call the condition borderline diabetic, but people didnt take the diagnosis serious enough to make significant lifestyle changes.

Brenda Richter, who has been attending a weekly diabetes self-management workshop in Moriarty, said she had been diagnosed as borderline diabetic, which quickly blew up into full diabetes, changing her life. Participants in the workshops held Monday afternoons at Bethel Community Storehouse say the classes have helped them get focused on what they can do to successfully change their lifestyles and diet to better manage the disease.

Danielle Berrien of the Cooperative Extension Service, which sponsored the workshops with the state Department of Health and state Aging and Long Term Services Department, said there is a lot of misunderstanding about the disease, which can lead to kidney failure, blindness, loss of limbs and heart disease. The workshop aims to teach participants about what they can do to better manage the disease by coming up with an action plan with measurable goals to successfully make better food choices and work in more exercising into their daily lives.

You pretty much have to say good bye to processed food, Richter said.

Jennifer White said the workshops have helped her feel less isolated and Effie Zirnheld said the workshops were able to go into more detail than advice given at a doctors office. Participants said it helped that the workshop has Margie Snare as facilitator as she is a person living with diabetes. Berrien said she wants to hold the diabetes workshop twice a year.

Stogner, who has been treating patients in the East Mountains for 30 years, said the disease is one that cuts across all walks of life from mountains residents to flatland farmers. But Stogner said she has patients she has been working with since coming to the area who have been successful in making the necessary lifestyle changes to manage the disease.

I have patients in their 80s who I first saw in their 50s, Stogner said. Im happy to say that none of them have lost their vision, no amputations and no one on dialysis.

Stogner acknowledges that it can be hard for people in rural areas to get good access to unprocessed food. On the exercise side, even taking short walks daily can do a lot to prevent the disease, she said.

Berrien said there are good online resources, such as the websites for the American Diabetes Association, the International Diabetes Center, the Joslin Diabetic Foundation and the National Diabetes Education Program.

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Fundraiser, program shine light on diabetes - Mountain View Journal

According to Selig, 30 million Americans have diabetes right now and about every 23 seconds someone else is diagnosed with the disease.

Rick Selig, director of the Arkansas Chapter of the American Diabetes Association (ADA), spoke to Stuttgart Lions Club members and guests Wednesday about diabetes and the ways the ADA works to educate the public about it.

According to Selig, 30 million Americans have diabetes right now and about every 23 seconds someone else is diagnosed with the disease.

Thats epidemic proportions, people, and we realize that it affects a lot more than that, that theres people out there that dont even realize that they have it or have what we call pre-diabetes, Selig explained.

The goal of the ADA regarding diabetes is ultimately to find a cure, Selig said, but until then the organization focuses on education, advocacy, research and services to help those living with diabetes.

Selig said the ADA will educate through lunch and learns with different companies and attend health fairs. People can also get information about diabetes through their website at http://www.diabetes.org or by calling (800) 342-2383. According to Selig, the ADA is one of the leading organizations that funds diabetes research, however, several other organizations get involved in funding.

One of the ADAs major services is the diabetes camp for children 8 to 13 years old with diabetes, which is held in Little Rock. He said they have approximately 55 children from around the state who attend the camp each year.

Donations from people like the Lions Club and other organizations is what puts this on, Selig said. It costs us $650 per child to send a kid to camp for one week.

The camp allows children to participate in many fun activities, such as zip lining and canoeing, however, the children are also able to learn about diabetes, including learning how to use pumps and give themselves insulin shots, as well as counting carbs and exercise. Selig said this is sometimes the only time some of the children with diabetes get away from home.

For one week, they get to be just like everybody else, Selig explained. Some of these kids are in rural schools and smaller schools where they may be the only one with diabetes.

When advocating for people with diabetes, Selig said its hard to make everyone happy, but the ADAs goal is to help those with the disease no matter what.

He said recently the Arkansas Legislature passed a law called the Safe At School Law that the ADA advocated for, which allows someone trained in the school, other than the school nurse, to administer insulin to a child in need in an emergency situation. He said this is important, because some school districts have only one school nurse who covers several buildings and may not always be available.

Selig explained that the ADA recently petitioned Congress to look into price gouging for the pharmaceutical companies and medical supply companies in regards to diabetes medications and supplies. He said the investigation is not taking place yet, but they have been assured the issue will be looked into in the future. He explained people across the U.S. often have to make the decision between eating, paying bills and buying insulin or supplies.

Thats a decision nobody should have to make, Selig said.

Another way the ADA is advocating for people with diabetes is showing opposition against the reform of the Affordable Care Act, because if its reformed right now, insurance companies could charge people with pre-existing conditions more for their insurance, according to Selig.

Were standing up for the people with diabetes whether its local or on the national scale, Selig explained.

Selig added, Were actually trying to work ourselves out of a job, because we want to see an end to diabetes.

Lions club member Dave Strauss explained that the club promotes sight and that diabetes is regularly linked to eyesight, stating that eyesight is often one of the things that gets compromised if the disease gets too bad. The club presented Selig with a $1,000 donation to the ADA after his presentation. The Stuttgart Lions Club meets at noon each Wednesday at the Stuttgart Country Club.

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Selig talks diabetes advocacy - Stuttgart Daily Leader