Episode summary
Mike Natter is a type 1 diabetic diagnosed at age nine, now a resident physician in internal medicine in New York City and a visual artist known for illustrating medical concepts on Instagram as Mike.Natter. He talks about using measured patience and self-love to manage a condition with constant variables, and how switching to the Medtronic 670G closed-loop system with CGM eased the daily burden. He describes managing blood sugar through 30-hour hospital shifts, and his anger when a nursing student with type 1 was told by a professor she couldn't succeed in the field. He shares his vision for an integrated diabetes clinic and explains why diabetes pushed him toward medicine.
Key takeaways
- Natter says switching to the Medtronic 670G hybrid closed-loop system with CGM was the biggest improvement to his diabetes management in the last five years.
- He manages blood sugar through 30-hour hospital shifts as a medical resident, dealing with stress, adrenaline, and insulin resistance.
- Natter says extreme exclusion diets like keto or paleo can be dangerous or hurt quality of life if taken too far, though he says they work for some people in moderation.
- He was angered when a nursing student with type 1 diabetes told him a professor said she couldn't succeed in nursing because of her condition.
- Natter's long-term goal is an integrated diabetes clinic where an endocrinologist, educator, nutritionist, therapist, and other specialists treat each patient together at one table.
Show notes
Name: Mike Natter
Hometown: New York, New York
Date of Diagnosis: 09/17/1994
Tool: Self Love
Diabetes Devices/Treatment Methods: Medtronic 670g Insulin Pump & CGM Hybrid Closed Loop System
Animal Personality: Slow Loris
Questions this episode answers
What diabetes device does Mike Natter use?
Natter uses the Medtronic 670G hybrid closed-loop insulin pump and CGM system, which he says was the biggest improvement to his diabetes management in the last five years.
How does Mike Natter manage type 1 diabetes during long hospital shifts?
As a medical resident, he works 30-hour shifts that bring stress, adrenaline, and cortisol spikes, leaving him insulin resistant for stretches of time, which makes blood sugar control especially hard.
What does Mike Natter think about keto and paleo diets for diabetes?
He says restrictive diets work for some people but aren't one size fits all, and that overly restrictive eating can be dangerous or lower quality of life. He favors moderation instead.
What is Mike Natter's tool of type 1?
His tool is measured patience and self-love, recognizing that blood sugar swings are often outside his control and not his fault.
Full transcript Searchable, with timestamps
Rob Howe: You are listening to the Tools of Type 1's podcast on Diabetics Doing Things, Episode 5. Your guest, you know him as the medical doctor who doodles things to learn the medical stuff, Mike Natter, Mike.Natter on Instagram, type 1 diabetic, incredible artist, funny dude, also undercover basketball star. More to come on that in the future. Mike's going to dive in. This is also a video episode. You can check it out on Diabetics Doing Things YouTube. That's youtube.com slash diabetics doing things. So you can see Mike's face. He's a looker, ladies and gentlemen, not just a voice for radio, got the face for TV. And he really dives into what makes him tick. Really, really excited. He took the time and really gave some super thoughtful answers. Very grateful for that. His tool, self-love. His name is Mike Natter. Check out this episode. I'm Rob Howe signing off. Tools of type ones.
Mike Natter: Who am I? All right. So I'm Mike Natter. I'm a type 1 diabetic for, oh geez, since I was nine. so many many years so that would be 24 years I've been diabetic. I am a doctor I'm currently a resident physician in internal medicine in New York City. I'm also an artist and I really have been utilizing my my skills as a visual artist to help me learn and teach and cope with the medical training. And my connection to type 1 really is that I not only want to go into endocrinology to help other type ones, but I also feel as though I'm very vocal about my type 1, especially in a career that is extremely demanding. And I hope to inspire others who may be wanting to go into medicine and have type 1 diabetes.
Rob Howe: What is your tool of type 1s? And what's the one thing that a person living with T1D could learn from you or your experience?
Mike Natter: My type 1 tool, I think, is measured patience and self-love. I think understanding and recognizing that diabetes is literally a day-to-day, hour-to-hour condition. And it has so many variables to it. and a lot of those variables are out of our control and it's important to recognize that my blood sugar might spike and it might dip, but I have to be patient with myself and recognize that it's a process and that it's never really truly my fault. And I think that's extremely important and sometimes I need to remind myself of those things.
Rob Howe: What is the simplest thing you've done that has helped you with the management of your type 1 diabetes? Where did you learn it or who showed it to you?
Mike Natter: I think recognizing, like I said, that there's this ongoing process about type 1 and not being so hard on myself because no good can come from that if you're too hard on yourself and understanding that also stress and those types of responses can only worsen your blood sugars and your control. And so recognizing that being patient with yourself and understanding this is a process and that it takes time and people make mistakes and that it's okay.
Rob Howe: what failures or apparent failures with t1d have made you better at living the rest of your life or made you more well-rounded as a person
Mike Natter: so as a physician especially one plan to go into endocrinology i think my standards are a little bit higher for myself than they really should or need to be in terms of my diabetes i never really feel like I'm ever at goal. I never really want to consider myself a hypocrite. So while I sometimes see myself as failing with my diabetes, I also note that in a way it makes me a better, more understanding doctor. I think my struggle with my chronic illness gives me the empathy and understanding for my other patients who may suffer either with diabetes or other chronic long-term conditions. And so I think in that way, it's quite a bit of a positive. And I also think that if I wasn't diabetic, I don't know if I would have sparked this interest and passion for medicine. And it may have truly opened the door to help me find my calling.
Rob Howe: What unusual or absurd opinion or approach regarding your diabetes do you have?
Mike Natter: Oh, that's a good one. So even though I know all the pathophysiology and mechanisms and biochemistry of diabetes and the lag that hypoglycemia symptoms take to resolve, I still inevitably find myself polishing off entire sleeves of Oreos and washing it down with a gallon of lemonade and naturally causing rebound hyperglycemia and kind of finding myself in that seesaw of sugars, even though I know better. I think that's an absurd thing that I find myself doing and continually to work on.
Rob Howe: What's your favorite thing? What gets you to smile or laugh almost every time?
Mike Natter: I would probably say French bulldog puppies. Every time, inevitably.
Rob Howe: In the last five years, what new adjustment to your lifestyle has improved your life with diabetes the most?
Mike Natter: Without a doubt, it would be switching to the Medtronic 670G closed-loop system with the CGM. It's fantastic. It's taken a lot of the diabetes process, which is very conscious and ongoing and ever-present, and made it kind of subtly push to the background and let some things become more automated. So that's been, I think, really huge and a little bit of a mental break for me, especially when I'm constantly running around the hospital.
Rob Howe: What challenges related to T1D did you encounter or have to overcome while you were doing your thing?
Mike Natter: being a medical resident is extremely hard no matter what you're dealing with but I think managing diabetes can be especially challenging when you have to stay away for 30 hours straight on your shift when you have to take care of very sick patients when your sugars may be up and down you know there's adrenaline rushes there's stress there's cortisol spikes I'm constantly insulin resistant for chunks of the time and so I'd say that it's very very difficult being a resident and trying to help others and manage my own diabetes but in the same way that it's a challenge and difficult I still think it actually helps me be a better doctor like I said before on Instagram a nursing student with type 1 reached out to me and it It really upset me because she was having a difficult time with one of her professors who straight up said to her that she shouldn't and won't be able to make it as a nurse given her type 1 diabetes. And it angered me like I can't tell you. It's one of these things where I feel as though type 1 diabetes is never ever a limiting factor for anything and should never ever be the reason you don't or can't do something. That's just not true. and especially I think in healthcare or really any challenging field, having the experience of dealing with your own condition makes you stronger, more resilient, and more empathetic and better than otherwise. And so I think in situations like that where I have stories of people that are told they can't or shouldn't do something because of their diabetes, it particularly pisses me off.
Rob Howe: What bad advice regarding diabetes do you see or hear that you'd like to address?
Mike Natter: I'm always a little bit hesitant about the exclusion diets or the kind of very extreme dieting. I think like paleo dieting and keto diets are very popular and I think they work for plenty of people and I'm not denying that but I do think that it's not one size fits all and I think sometimes people take the dieting to an extreme that can be potentially dangerous. I think overly restrictive diets can be dangerous at worst and at best can actually affect your quality of life because you're restricting things that you may want or crave. And I think with moderation, everything should be accepted. And as long as you've lived your life by that motto, that everything in moderation is okay, then I think that's the way to do it.
Rob Howe: What priority are you focusing on in your own life currently? This can be diabetes related or not.
Mike Natter: Right now, it's probably surviving residency, but also low-key trying to illustrate my own personal medical textbook. That's the goal.
Rob Howe: Who is someone that you look up to, and what have they taught you? How do you apply that to your life?
Mike Natter: there is um a handful of people i look up to i always feel as though my parents are people that have been extremely supportive and i've always looked up to them um there was a couple of mentors i had in medical school and an art professor i had an undergrad and an art teacher i had in elementary school that all have kind of taught me different things along the way I think most recently it would have to be an attending physician who I was working with on the medical floors a couple months ago. And he said something to me that really struck me and stuck with me. And he said, there are two ways you can lead. You can lead atop your throne from above or you can lead from the front line and lead from, you know, in front. And he showed me how important to lead from the front really is and showing how as a physician, as a diabetic, as a friend, as anything, kind of showing that you are no different from the person next to you is really, really important.
Rob Howe: What are you most hopeful for? This can be diabetes related or not.
Mike Natter: I am happy to be within medicine. I'm very happy I'm in medicine, but I'm also very cognizant of how difficult and how much struggle is entailed in this process. But what would make me kind of most hopeful is the idea of getting through this training process and then creating something like a medical home for diabetics. I envision having a beautiful clinic where people walk in and it's beautifully decorated, it's comfortable, people want to be there. They set aside a chunk of their day to come in and it'll be me as an endocrinologist, certified diabetes educator, nutritionist, therapist, ophthalmologist, podiatrist, but also exercise physiologist and trainer and life coach and all these people in one place. And the diabetic patient will come in, they'll meet with all of us, and then we'll all sit around a, you know, a large round table with the patient there as part of the team and not being spoken down to. And we would all come up with a comprehensive plan to make that person's life better and healthier. And I think that for me would be really kind of the dream and what I'm hopeful for.
Rob Howe: What advice would you give someone who has T1D and is trying to pursue a career in your line of work?
Mike Natter: It just kind of harkens back to that nursing student who instant messaged me. I think that diabetes should never, ever, ever limit you. And it can also be very much harnessed for good. And it's what I'm trying to do and what I'm trying to exemplify is how diabetes helped me find my passion in medicine. It helped me become an empathetic person with my patients. It helped me understand their side of the bed. And I really want to serve as someone that can instill that passion in others and break down that barrier that anyone can do anything and that diabetes should never limit you.
Rob Howe: What's the one facet or trait that you think makes you uniquely you? Explain why.
Mike Natter: So I think while I'm a doctor, I'm a patient before a doctor. And above all that, I'm an artist first. That makes sense. I definitely identify as an artist. I am becoming a more proficient and competent doctor. and being a patient is something that will always ring true to me because I know what that's like my entire life and that's something that's very much germane to who I am and I find that empowering and not a weak aspect.
Rob Howe: Where do you get plugged into the T1D community the most?
Mike Natter: I would love it if you guys wanted to follow me on Instagram I'm Mike.Natter N-A-T-T-E-R and you'll kind of see my journey through my medical training there and mostly my illustrations and my drawings and some comics about the humor of what I'm going through and I hope that that inspires some of you guys and I hope some of you who are interested in medicine will pursue it I'm also on Twitter at Mike underscore Natter N-A-T-T-E-R and Facebook as well
Rob Howe: Thank you for listening to the Tools of Type 1's podcast on diabetics doing things. I'm Rob Howe, and every Tuesday and Thursday in 2019, we are posting the next Tools of Type 1 episode. So follow us on Instagram, hashtag toolsoftype1s, or just on diabeticsdoingthings. We will post those regularly every Tuesday, every Thursday. My favorite type 1s are answering the questions I want to know the answers to. And hopefully, you'll learn a few things as well. If you like this episode, be sure to review us on iTunes. and if you didn't like it, go ahead and let me know that too. I want to know. All the feedback is good to me. Thanks again for your time. I value that more than anything you could possibly give me. Thanks so much. Bye-bye.
About Mike
Mike Natter is a type 1 diabetic diagnosed at age nine, a resident physician in internal medicine in New York City, and a visual artist who shares medical illustrations and comics on Instagram as Mike.Natter.