Just One of my Days with #Type1Diabetes to #StayWell

L

I wish I could explain to people what living a type 1 Diabetes life is like and make them understand.

Some personal sad news threw me into a line of thinking from the past recently​, and a door I had firmly closed, ​sort of got unlocked so I could re-hash and see again the stuff I so badly​ wanted to keep buried.

The result of this was a few days of kit-Kats and a large Cadburys Puddle, a new bar, big, and packing some serious comfort.

Yes I injected the appropriate amount of insulin to cover anything I'd eaten but because of the high fat content in my chosen treats, long after the novo rapid ( basel ins​ulin ) had​ peeked and finished its job my blood sugar was 

still​ climbing at a steady pace. Yes I corrected, but no I couldn't stop the climb. 

​ ​

Hitting an 18.2 is no joke at 3am when you've gone to bed on an 8 and​ no matter what I did I could'nt​ seem to fix it. The result ? A serious hangover feeling and all the effects and results of high blood sugar.

So my next day bl​ood glucose started on 12.0 BG. Now I kno​w this is self inflicted to a point, yes I fed myself but my Type 1 ​D​​iabetes wasn't self inflicted in any way.

This was how my day went :

• Injection no 1 was at 8am to correct that 12.0 and then it was back to bed to sleep it off after a coffee and some paracetamol
  ​ for that bloody awful headache.​
   
• Injection no 2 was at 11am to correct what had now become 12.2 BG, still no food yet​, I'm determined to start the drop before i actually eat.
• Injection no 3 was at 2pm, 6.5 BG so its lunch time.
• Injection no 4 was at 5.30pm a correction for a 10.2 BG
• Injection no 5 was with dinner BG was 5.2 and holding steady.
• Injection no 6 was to cover supper
• Injection no 7 was lantus - Basel insulin.

All this was about 10 finger pricks, before my CGM (continuous glucose meter ) arrived, and 7 injections ​but this was a relatively good day because i knew what was causing the problem and i did manage to correct it​.

Not being well, stress, upset and other medications means a much more difficult situation to try to control and manage, these things are not self inflicted, they are beyond our control and as long as they are actively playing a part in our lives​, they continue to play a part in our diabetes and ultimately our blood glucose, making managing our diabetes and our daily routine more difficult.​

The food planning, clock watching, and carb counting is relentless, the carbs & cals app is always with me ( on my iphone )​ and my handbag and bedside locker stash of jelly beans is always kept topped up. 

Leaving the house there's always a rice cake or two with an apple  put in my handbag along with the BG meter pouch which carries ​my blood glucose meter, test strips, a finger pricker, lancets, an insulin pen, needle tips, and a small container ​(​for the used strips, lancets and needle tips.)​

 

The all important hypo kit,  GlucoGen, is also brought, well it's no good in the fridge at home if I collapsed when I'm out.

No I don't bring a bottle of any kind of fluid because it doesn't fit in the handbag, I might leave it down, walk away and so get separated from it and that just wouldn't do at all.

I "​TREAT"​ with jelly beans, now that's treat a hypo ( low blood glucose ) not treat,​ as in having a treat. Jelly beans are like tablets to me and I take :

• 1-3 if I'm in the high 4s. 
• 3-5 if I'm in the low 4s.
• 5-6 if in in the high 3s, 
• 6-9 if I'm in the low 3s

​Basically the amount or dose differs and depends on what my BG (blood glucose) reading is.​ A​ny lower than those (3s) and it's party time, ​I jus​t scoff rather than count​. 

Thinking is gone out the window so I have a tube that carries a certain amount of jelly beans so when I say scoff it's not a big bag or anything like it, it holds about 20 in total or (​36 - 37 gms carbs)​ to a t1 like me.

12 jelly beans has aprox 22gms carbs in them so each 3 represents a treatment of 5.5 gms carbs.

• 6 = 11 gms 
• 9 = 16.5 gms
• 12 = 22 gms

The aim of this is to catch it early and treat with no more than 6 jelly beans the overall effect is when 

I'm very low, although in one​ sense I'm out of control, I'm actually still in control, if you see what i mean.

Back in the early days when I used fluid to treat, I'd just drink, and I would always drink too much, 

carrying measured drinks was'nt an option​, and seriously​, ​who carries a fluid measure with them. 

Imaging measuring out fluid in a moving car while disoriented during a hypo, or carrying several small containers of fluid, Ridiculous right ?

Once I'm all packed, then il do one last BG check to see am I ok to head out and how long I have before the next action plan of food and insulin.

​ 

A​h yes i remember the days when i just walked out of the house without a second thought about food, or anything else for that matter. Every moment of every day is a decision now that has to be made​.

• Will I have that scone and coffee with friends?​
• ​Will i go for that nice long walk?
• Will i get get into spring cleaning ?​ 

​So its prick, check, calculate, decide, then either inject, treat or leave​ for the moment......

Some days everything goes to plan, but on other days it doesn't and for no obvious reason. There are also days when I just get sick of it all and just do what I want regardless of the numbers, but yes still inject the insulin, just not be quite so strict.

On these days I always end up regretting it because that sick feeling is so hard to shift and once iv upset the delicate balance of blood glucose numbers and insulin it's so hard to get it all back on track and even when I do it takes even longer to actually feel well again.

Bedtime is another tricky one, 8 is a good number for me to go to bed on ( i​ts what was recommended to me ) ​by my diabetes team.

• any lower and I might go low through the night, 
• any higher and il wake high in the morning and start the day correcting from the day before. 

So it's check about an hour before bedtime, if I'm below 8 il work out just how much to eat to bring my blood glucose (BG) up to 8 + ish, then inject my lantus ( that's Basel, or long acting insulin ) and go to bed.

However if I check an hour before bedtime and I'm over 8 already it's either no supper, or I can eat supper and inject ( bolus ) for that food. Still taking the lantus (Basel) at bedtime..

Either too low or too high going to bed is not a good idea. 

• High has long term risks and makes me feel really awful
  ​ with the addition of a blinding headache.​
• Low, I could hypo through the night and wake up feeling really awful, or worse again just sleep through it.​

​Its always on my​ mind that​ a bad hypo could kill me so my fear of sleeping 

through a hypo is very real.

This was just going on a sort of typical day, but absolutely everything we do and go through any day effects what our blood glucose readings will be.

• If your trying to lose weight. 
• If your training for a marathon, or 
  some other event that involves physical exercise.
• If the weather is very hot or very cold.
• If ​your pregnant.
• If your going through hormone changes.
• If your ill in any way.
• If your stressed or upset.
• If you'v had a bad shock.
• If you'v had a couple of glasses of any kind of alcohol the night before.
• If your extremely tired for any reason.
• If your routine is broken.
• If you have an anesthetic even a local one for a dental procedure.
• If your taking medication for an illness ( ex steroids ).
• If you change your diet.

After living as a Type 1 Diabetic for a period of time these things become sort of automatically thought of, as we cruise on through any day in our lives. It becomes our normal, still a challenge every day, but a little less mentally time consuming. No im not complaining or even looking for any kind of sympathic groan........

However what i would like is for :

• Consideration when i say no thanks.
• Id like understanding when i say im tired.
• ​Id like not to have to explain why i need to stay home sometimes.
• Id like, not to be thought of as fussy, when i insist on a bottle of diet 7up as a mixer for my drink and when i wont eat high sugar foods and deserts.
• Id like not to be called unsociable for living the life i must live​.

Id really love if people understood why my brain gets so tired sometimes that it just cant cope with any more stuff.

I wish they could see a plate of food like i do with, portion size and carb content first, calculations and insulin second, and then see that plate of truly delicious, lip smacking, finger licking food that i finally see when theirs is half gone already.

I also wish they didn't rob the food off my plate because they have finished theirs already, because that food they are robbing has already been accounted for with the insulin iv injected. Seriously some day someone will lose a finger and Im guessing nobody will understand when it happens........

This is how a meal looks to someone with Type 1 Diabetes:

Dinner as i see it 34gms Carbs 

And for Desert as i see it: 36 gms Carbs

                                                       

Total for this meal, calculated before eating, if i was to eat this it is 70gms carbs and now id work about how much insulin it will take to deal with it.

Just my thoughts on a day in life, living with Type 1 Diabetes.

Davina

Type 1 Diabetes & The Golden Prick Award

Type 1 Diabetes & The Golden Prick award !

Living with type 1 or type 2 diabetes in isolation from others who live the same mathematical, clock watching, tightrope as we do, it's easy to just let things slip, and before you realise whats going on your sitting in your endo's office explaining how your HBA1C is so high, to someone with their head slightly tipped to one side and trying to wear their best sympathetic smile while nodding in acknowledgement of what we are saying, as they listen to the endless supply of lies we feed them. The chest infection we had, the steroids that our stupid GP prescribed, the dog eat my meter and I didn't have a spare ( yes Iv heard that one ), the flu shot made me as high as a kite ...... For weeks ! ( Iv used this one ). 

The truth is that sometimes we just get sick of it all. Sometimes when your the only one in a group of non diabetics it's hard to do what we're supposed to do. We all need to fit in, however,  constantly fitting in, will leave us "long term" in trouble because of the diabetes complications that lifestyle can lead to. 

Sitting with non type1 friends, and whipping out the meter, the strips, and the finger pricker as we proceed to do a blood test there and then, so we know what insulin is needed for the food we'r about to eat, can be met with gasps, awkward silences or disapproving looks. It's not like we can do it all under the table. It's a fiddley business.

For this very reason it's good to mix with others who have the same lifestyle as you, TOTAL understanding, comfort, support, information and help, all serve to make living with any type of diabetes just a bit more bearable.

There's not a week goes by without someone in one group or another, either totally excited with a HBA1C result, or in other cases totally floored by their result. No matter what the BG meter result says on the many occasions through the day that we test, it's the big exam that's all important and a decent result feels like recognition of a job well done. I seriously think a little trophy or reward should be standard at a diabetes clinic. 

I actually stood in my garden one day in spring, after cutting myself on a Rose thorn, to save myself from yet another finger prick I grabbed my meter and tested my BG. I hear you, I hear you, relax, hygiene etc, but at that moment i was going low, I saw an opportunity not to have to prick my finger and I took it.

Most people would wash it, disinfect it and plaster it, all I could think of was "free & effortless blood" all ready for use. In my world any blood is a potential test.

My well pricked fingers don't always donate and a good squeeze is sometimes necessary. One day there I was wearing very pale pink, all dressed up and ready to leave the house, one quick check I thought. What I got was a shower or blood that shot across the kitchen and all down my clothes.

So it's off with the dress, and out with the disinfectant to clean the floor, the counter top, the tiles and anything else that got it. Quick check ? Ye right ! The joys of well used fingers.....

Lick or wipe ? Are you kidding me ? Think of this. Your out, all dressed up and you need to check your BG because you don't feel right. 

Your low, now honestly do you fiddle around looking for tissue, getting blood on clothes ? 

Or do you lick and desperately search for something sugary before it's too late ? 

Remember when you answer the above questions "low & thought" rarely happens, unlike "low, instinct & automatic" when survival is all that matters.

That was life before my CGM so now it's testing every 12 hours to calibrate my medtronic guardian, finally my finger tips are beginning to feel a bit more like normal, and the alarm goes before I get to the brain dead stage.

For all that my poor fingers have been through Id like to win or at least be nominated for the "golden prick" award. 

Davina 

Introduction to Dia Newsdrop

Introduction to
Dia Newsdrop with a side order of insulin.

Type 1 Diabetes, Type 2 Diabetes, do you remember the day you first heard these words as a diagnosis after feeling sick for a while ? Well I can remember it well ..........

My head went straight into overdrive, so many questions, so much confusion in my mind that day. How ? Why ? No ...... Check again ! NO I can't do this, followed by silence, because I just couldn't think of what to say, and then came the tears, lots and lots of tears, no tissues used, this called for a tea towel !.

No this was not depression, it was grieving, and boy did I grieve, in every sense of the word. But in my usual fashion I picked myself up and decided to grab this vicious beast and do what I could to house train it.

I look back now and smile to myself when I think of how confident I felt as I joined the many groups and forums related to all types of diabetes and the appliances and medications used to manage the condition, but no one ever told me that Diabetes was also a language and not a language I spoke.

Terms like MDI, BG, subcutaneous, infusion sites, CGM, hypo, ratios, bolus, basel, trends, exchanges, tubing, meters, ketones, corrections, calibration, hba1c, carb counting, and then there were the needles 4mm 5mm 6mm, the appliances, on any given day these terms were just part of an average conversation between people and I had no idea what they were talking about.
With Googles help I wasn't long taking a crash course, so I could ask relatively intelligent questions in order to learn a bit more than just basic information.

It was then that I learned our online community is vast, with information and support that is second to none.
I somehow thought our hospital teams would have every single bit of up to the minute information. I now can't even figure out why or how I could have thought up this Gem, when it clearly takes lots of time online, and on social media daily to hear all about what's new, what's available in Ireland in reality, and what's only in our dreams.

Enter Dia Newsdrop where we will publish a news blog, monthly with any new information we have,

that our diabetes community might be interested in.

Follow or Subscribe Free of course and you should receive this by email,

and let's face it nowadays everyone has an email address, haven't they ?

31st March is our first issue.

Davina

Diabetes

Diabetes Information

Diabetes affects people from all walks of life - from the very young to the very old - and is now considered an epidemic by the World Health Organisation (WHO).

What is diabetes?

Diabetes occurs when the sugar (glucose) level in the blood is too high. 
This happens when the body is not burning up carbohydrates properly due to a defect in the pancreas, the gland that produces insulin.  Insulin is the hormone which keeps blood sugar levels within the normal healthy range.  Diabetes may be present either when no insulin is made or when insulin is made but not working properly.

There are two types of diabetes - type 1, formly known as insulin dependent diabetes, which usually occurs before the age of 35, but can
happen at any age in reality, as Type 1 Diabetes is an autoimmune
disease, there is no known cause and no cure.
A person with type 1 diabetes makes no insulin and therefore needs to inject insulin to regulate blood sugar levels and remain healthy.  

Type 2 diabetes (non-insulin depdendent diabetes) more commonly occurs in adults after the age of 40 and is 
extremely common in old age.  In this case, the person with 
diabetes makes some insulin.  Usually associated with 
being overweight, but can also be caused by other medical conditions and medications,  this condition responds well to weight loss through dietary regulation.  Sometimes weight loss is not enough and tablets are required to help the person's own insulin to work or additional insulin may be required.  This type of diabetes is also known as adult-onset or maturity-onset diabetes.

With an average of seven years between onset and diagnosis, the earlier the condition is detected the easier it will be to manage.  Early
detection gives the ability to protect against heart attack, stroke and vision loss which is due to high blood sugar levels over years.

Symptoms of Diabetes

Symptoms of diabetes vary in intensitiy but may include:

• Lack of energy
• Tiredness
• Excessive thirst
• Frequent passing of urine
• Weight loss - in the region of 7-14 pounds
• Blurring of vision
• Recurrent infection

Diabetes is detected by a simple blood test that detects how much glucose is in the blood.

The onset of type 2 diabetes is gradual and therefore hard to detect.  
Some people have few early symptoms and are only diagnosed several years (3 - 12 years) after the onset of the condition and in half of these cases various complications are already present.

Risk factors of Type 2 Diabetes

Some people are more at risk of developing diabetes than others.  The known risk factors inlcude:

• A family history of diabetes, Being overweight (80% of people with diabetes are overweight)
• Age (the likelihood of developing diabetes increases with age)
• Lack of physical exercise
• Having had diabetes during pregnancy or having had a large baby

In Ireland, it is estimated that there are 200,000 people with diabetes with many unaware. The majority of these people will only be  diagnosed through an acute medical event of the complications of long term untreated hyperglycaemia. A further 200,000 people have impaired glucose tolerance or "pre-diabetes" of which 40% will develop diabetes in the next 5 years if lifestyle changes are not made.