Advocating Together We Can Make A Difference

I felt very 

​honoured

​ and proud to be given the opportunity​ to

​go

 to Leinster house as part of a team Advocating for a National Diabetes Strategy with a multi-year resource plan. The work involved in getting this together in a few short weeks was a huge task but Kieran from Diabetes Ireland 

​with his experience pulled this together perfectly. 

 Together we were strong, and together we were firm

​, ​

It felt strangely powerful 

​!​

It all started after hearing about minister Harris imposing a hiring freeze on the HSE.  I was fuming followed by action. Putting my feelings about this in writing and emailing as many TDs as I could find email addresses for, yes I had a good old rant.

Frank O Rourke

​ the 

TD for my area

​ (North Kildare)​

 wrote back to me quickly and in a phone call the next day he suggested we ( my colleagues & myself ) come to Leinster House and present our case on a national level to the ministers, all of which he would invite to attend. 

​now how exciting did this sound ?

​

Yep said I, seemed like a good idea and so the plan was hatched. Not in my wildest dreams could this Advocacy Project happen with effect without professional facts, figures and backup.

​ ​

My next phone call was to Grainne at Thriveabetes for advice and then Diabetes Ireland to talk about how best to go forward with this opportunity which had literally fallen in 

​m​

y lap.

I'd been given a job with huge opportunity but

​ not 

in my Wildest dreams could I do that job, well not alone anyway.

​ ​

Kieran was the person in Diabetes Ireland I spoke with and the support I received was instant.

​ ​

Kieran enlisted the help of the Clinical Leads for paediatric and Adult services and it all started to come together.

Every single step of the way Kieran keep us in the loop and made sure what was happening was with our approval.

After only a few weeks to plan it all the pressure was on to make sure everything was covered and then finally the day arrived ! 

I met Grainne, Rebecca, and Liz at Heuston Station and together we met the rest of our team

​ ​

across from Leinster House for coffee where a last chat

​ and briefing​

 could be had among ourselves and Frank O Rourke before being brought across

​to Leinster House.

It was a very well attended meeting by TD's and Senators, and both Clinical Leads talked about the lack of Diabetes Services nationwide but particularly In the SouthEast where services seem to be particularly bad.

Rebecca and I both spoke about living life with type 1 diabetes, Rebecca from the point of view of a parent of a child with type 1 and me from an adult point of view. 

​Any​

 lack of service

​ we were experiencing in our Diabetes clinics was highlighted​.

 

I never knew before exactly what the crew at Diabetes Ireland did, I knew 

​they worked on​

 lots of 

​campaigns​

 but I'd no 

clear idea of what those campaigns​

were​

.

After today I understand a little better what their job and their role in our lives is.

​

I also understand that we as patients can shout from the rooftops advocating and raising awareness

​in our separate groupings​

 but unless we work with our peers as a united team we are unlikely to be heard by those that truly matter to our lives as people with type 1 diabetes.

​

There is no "i"

​ in the word

 team, certainly advocating as a small body will make noise but if we want changes we have to all pull together with the one agenda and as one body.

​Today was a special day and we need to say thank you so much to Frank O Rourke TD, for giving us this opportunity also Kieran O Leary and his team from Diabetes Ireland​, their patience and support was endless and invaluable, and im sure it will continue to be so as they continue to work with us and also on our behalf.

The support we recieved from our community was overwhelming as the days grew closer to the briefing and if i had a message to everyone now, it would be that there is strength in numbers, it is very important that we stand together and united as people with type 1 diabetes, to campaigne for a better and healthier future together. 

Feeling the love .......

Davina 💙

The Twists and Turns of Type 1 Diabetes - Where Do We Start?

If only there was a complete list of Do's and Dont's but unfortunately Type 1 Diabetes is not like that. It's not as simple as taking a paracetamol for a headache, sticking a plaster on a wound, drinking plenty of water before going to bed to avoid a hangover.

In fact although we all have our regime, "the Holy Grail of life as we must live it with type 1 diabetes" doesn't really exist.Yes we have our ratios, and our DAFNE type courses, but there are just so very many variables, absolutely everything we do, and everything we eat impacts on our blood glucose in different ways, all effecting our blood glucose readings at various times of the day and night and for various reasons.

I'm going to attempt to highlight some of these, but only as a type 1 diabetic, I'm not a professional. Please discuss any of the content in this blog with your diabetes team, and seek their advice in relation to your own type 1 management. This is just a guide to questions you'll need to ask.

First let me say other than not producing our own insulin causing us to be type 1 diabetics, our diabetes basically leaves us with an intolerance to carbohydrates, which by the way is sugar in another form. Most foods have carbohydrate ( carbs ) so not only do i consider the food I'm eating when I'm calculating my insulin dose for that food, I'm also considering what form that food is in. (whole, mashed, pulped, cooked etc ) because yes this makes a difference. Il also take into account what my blood glucose reading is at the time, whether I'm going for a walk soon, going to do a lot of housework, whether or not I'm sick, is the weather very hot or very cold, so it's not just eat and apple and inject xx amount of insulin. It's really about understanding your food, not just knowing it.

The all important carb counting :

We all have an insulin to carb ratio.That's the amount of insulin we take per gram of carbohydrate (carb) we have our correction ratio,
(a means of using our insulin to correct a blood glucose that's higher than our recommended guidelines) and our sick day plan (a plan to manage our blood glucose and insulin while enduring a vomiting bug or other illness. NO you don't stop injecting if your vomiting and not keeping food down) Your sick day plan is a special set of instruction given to you by our Diabetes team. If your not clear about yours then ask them for it. Its a very specific set of rules to be followed. Children, pumpers and people on multiple daily injections ( MDI ) may all have different instruction of what to do in this situation.

A food / carb EXAMPLE ONLY :

Bread roll 30 gms carbs

Insulin - carb ratio 5/1 ( that's 5gms carbs to 1 unit of insulin )

That big bread roll would mean 6 units of insulin in this example 
( 30 divided by 5 = 6 ) 

Simple Ye ?

Now let me bring you further on this journey......

Slap a thick couple of slices of my favorite cheese in that bread roll. Even toast it or melt it if you like. 

The cheese has no carbs, so it's still only 30gms carbs for what's now a delicious cheesy bread roll, however things have changed a bit now. 
But why?

My cheese has a high fat content, fat slows down the impact the carb in the bread roll has on my blood glucose (BG) I may find if i inject just as i start to eat, that after my insulin ( fast acting / bolus ) has peeked and is now becoming a distant memory that my blood glucose is still rising​! I haven't reached the magic 2 and a 1/2 hour period (insulin peek time) 
since i last injected, so 

I​ 

can't really safely inject again just yet, but still the BG numbers climb higher. So what could 

I​ 

have done differently?

Split the insulin dose ......

Using the same delicious cheesy bread roll example 30 gms carbs / 6 units of insulin.

​Il take ​3 units as I ​start eating and 3 units when iv finished. Giving the effect of the insulin longer to work. In other words it will be longer before my much needed insulin peeks and then starts to dwindle away, giving the insulin iv injected a longer period to work or lengthening its effect. (Seek advice from your diabetes team about this)

​​

Now to a sample list of foods that have this effect : 

• Pitza.
• Garlic bread.
• Chinese takeaway.
• Battered foods that are deep fried.
• Chips,
• Pasta ( in some people ).
• Ice cream.
• Milk Chocolate.
• White chocolate.
• Cakes with a butter icing or frosting

There will be other foods you'll come across that have a high fat content, these are just the ones I can think of. Everyone's diet is different.

Fruits Vs smoothies & juiced fruit :

Let's take some fruits as an example : 

1 orange 7gms carbs

1 Apple 20 gms carbs

2 pineapple rings 8gms carbs 

All containing fibre when eaten whole and much needed nutrients, the fibre content will slow down the impact of the sugar that the fruit contains, if I​ inject as instructed then im​ sorted.

Now pulp, mash, liquidise those same fruits, 

​Iv​ taken out the fibre, Iv​ still got the nutrients, but because of the lack of fibre ​Iv​ now got high speed sugar, coursing through my veins before 

​my​ insulin gets a chance to cop on.

Potatoes, 

• Eaten whole, are high fibre and impact our BG, on a sort of normal time frame.
• Eaten mashed they become a quicker carb hit, rising ​my​ BG faster than the whole potato.
• Eaten fried / chipped become high fat, impacting my​ BG a lot slower than the whole potato.

Basically ​im​ eating the same potato, so the same carbs, but in different forms, all having a different impact on your blood glucose, over different time fames.

Ice cream. 

Now this I can eat with out any rise in BG, and without insulin, BUT 2-3 hours later my BG will start a steady climb because of the fat content.

Chocolate. 

Ah yes chocolate. Now and then at 8pm watching the soaps. Now here's a real sneaky one, choose the bar. Inject the insulin dose, eat the chocolate. Delicious ...... And everything seems to be going to plan. 

2am and your awake to use the loo, you'v maybe got a headache and you test your BG. It's in the teens and I​ was 8ish going to bed, I would​
be fairly safe to blame the chocolate this time, it's because of the high fat content.

Infection / Illness / stress

Sometimes when Iv​ got an unusually high BG with nothing obvious to blame, it could be my​ first warning to an infection, a 24 hour bug, or an oncoming illness of some kind.Stress because of work, exams or just everyday life stresses.

Treatments

Even a dental local anesthetic can effect my​ BG. To either rise it or more usually drop it.I ​need to allow for this one when undergoing treatment. The dentist is guided by the diabetic, they rightly presume you know your stuff, so please​.......​ know your stuff !

Heat and Cold weather

Yes the weather eff​ect'​s my BG, but people react differently to this one. I would run low in the heat having to keep an extra vigilant eye on my BG in case of hypos.

I would run high in the cold weather, needing a little extra insulin to meet my chosen target.

Exercise

Remember when you exercise you burn off sugar first, to continue that exercise you need to compensate by replacing that sugar, which is why type 1, exercising and weight loss  can be a fruitless challenge. Special care and training is needed for marathons etc.

Hoovering, window cleaning, children running around playing all qualify as exercise.

Foot tips

Check feet daily for blisters, cuts etc daily,  keep feet clean and dry. Never moisturise between the toes. Wear socks inside out to avoid the seam rubbing the toes. (a chiropodist who is also a type 1 told me this) 

​I ​Wear 2 pairs of socks in my trainers to reduce the risk of blistering. If you notice cracks, cuts, blisters or anything else unusual seek medical advice and don't be tempted to stick on a plaster and ignore it.Take professional advice on nail cutting and removing hard skin.

Skin

Skin problems and slow healing is quite common in people with diabetes of any type.

Alcohol

Now here's a tricky one, yes there's carbs in alcohol, but we don't count them, why ? Because the day after drinking, the alcohol can drop your BG and leave you prone to hypos. It's advisable to eat a carb before going to bed after drinking alcohol. 3 alcohol free days a week is what I was advised on diagnosis and iv stuck to it.

Coffee

Now here's a dark horse if ever I found one, I get up in the morning, With a BG of maybe 5-6, I have a coffee, just a regular black instant coffee, with a small drop of low fat milk. (no insulin I hear you say) well you'd be wrong. Coffee acts like speed, stimulating the body, or more precisely the liver. 

Just over a 1/2 hour after drinking my morning fix I'd have a BG of at least 9-10 if I'm lucky (that's without injecting insulin) so my morning cuppa is always accompanied by a little insulin unless of course I start off low. If your a coffee drinker you may know what I mean.

Hormones

Hormones Of the general teenage, menopause, puberty, post natal varieties can all effect your BG. So either speak to your diabetes team or T1 people experienced in this area. I'm also pretty sure pregnancy and childbirth take their toll but likewise speak to someone who knows about these things.

Lack of sleep, trauma, worry, exhaustion the list of what effects a diabetic, ( particularly a type 1 ) is endless. Basically every part of our lives and our very being, whether it be emotionally or physically has an impact on how your body copes, therefore can have an effect on your blood glucose.

Treating Hypos - lows - hypoglycemia

We all have our favorite hypo treatment, yes you heard me our favorite treatment. Lucazade is not your only option. This is my big chance to have something I wouldn't normally get to eat, so for me it's jelly beans or jelly babies. Some use fruit juice, full sugar soda, or glucose tablets there are no hard and fast rules to which high sugar treatment you prefer to use to get those blood glucose numbers back up fast. Your diabetes team will advice you about how much of your chosen hypo fix to take, or check out the carbs and cals app or book.

WE DONT TREAT A HYPO WITH CHOCOLATE BECAUSE IT WONT IMPACT ON YOUR BLOOD GLUCOSE FAST ENOUGH TO FIX IT 

( REMEMBER CHOCOLATE IS HIGH FAT ) & TREATING LOWS NEEDS HIGH SUGAR.

Finally.

It was my Diabetes Team who said NEVER go to bed with a BG below 8, and that's something iv never forgotten and stick with to this day. 

After doing research of my own I started a lower carb diet than the diet I was previously on, substituting some of my foods for a lower carb alternative. I did this to reduce the weight I'd gained after diagnosis, to gain a tighter more manageable control, and to reduce my HBA1C.

I achieved these things and have chosen to continue with this lifestyle, feeling generally healthier with more energy.

Write out your questions so you won't forget them. Bring them to you next diabetes clinic and discuss and question those things you may not understand right now. Education and learning is the key to living at ease with your Type 1 Diabetes. 

Lack of knowledge NEVER EVER takes away the facts, the risks, or the disease.

EVERY DIABETIC IS DIFFERENT SO WHAT WORKS FOR ME OR YOU MAY NOT WORK FOR OTHERS.

SEEK - QUESTION - IMPROVE are 3 very important words when you have any type of diabetes.

• SEEK : More information than you may already have, and support from others living with type 1.
• QUESTION : Everything you don't understand.
• IMPROVE : Your knowledge, your management and your understanding of type 1 diabetes in order to improve your life.

Davina 

A Type 1 Diabetic 

​

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#TheMedia #Celebrities #PublicFigures #DiabetesAwareness #Type1Diabetes #Type2Diabetes

-- 

#TheMedia #Celebrities #PublicFigures #DiabetesAwareness #Type1Diabetes #Type2Diabetes

​

I only ​learned recently t

hat this is Diabetes Bloggers Week.

Well, I’m in then!  Today’s theme is “What would we like changed about Diabetes.”

​ If i was to pick just one topic it would be Type 1 Diabetes Awareness​

This is rather a big area but the points i think that "need to change" about Diabetes is the use of the term "Diabetes" without a type" and then how its portrayed in the media.

Many peo​ple are AWARE that there is more than one type of Diabetes.  They are AWARE that people test blood sugars and take shots.  But, even within the medical community, the world at large is rather UNAWARE of Type One Diabetes, what the symptoms are, when to diagnose Type One instead of Type Two, and what to say to us or do for us when we need help or comforting (or even friendship).

​But leaving the medical 

medical professionals now

​ and into the

 general public.  The average person knows almost nothing about Type One Diabetes unless they have already come in contact with a Type One Diabetic.  Even then, their knowledge is only as extensive as their curiosity and 

​how much information they remember from​

 casual conversation.  While Type Two Diabetes is more prevalent, because both diseases are called “Diabetes,” the presumption is that the two are equally manageable if ONLY THE DIABETIC BEHAVED.

While Insulin has the ability to save Lives it also has the potential to take lives if used incorrectly !​

Living with type 1 or type 2 diabetes is without a doubt challenging, yes for very different reasons​,​ but hold on, do we all face the same challenges in different ways ?

No matter what Type we have we will all undoubtedly have what I call "bold days" and yes some "absent moments" 

• Forgetting to take tablets 
• Forgetting to take insulin
• Injecting the wrong insulin at times ( iv done this )
• Forgetting we'v injected already and doing it again
• Eating too much of the wrong type food
• Going out without a hypo fix
• Going out without our insulin

Yes without a doubt we have all made mistakes, some small and some not so small. We beat ourselves up for letting our concentration slip, for loosening our grip and slipping up on our daily management routine.  24/7/365 is no joke and it's not for the faint hearted​, yes we get tired, we are human.

Through all this we are constantly at battle with ignorance and yes danger. We can't just ignore when people say, ah yes I know all about that diabetes.

Quoting :

• If your low or collapse 
  y​ou need insulin, right ?
• You can't have sugar or sweet stuff of any kind, right ?
• You'll die from that, right ?
• You'll have to have amputation some day, right ?
• You must have led a very unhealthy lifestyle, Ye ?
• That's because your not fit, Ye ?
• Were you very fat at some point, Ye ?
• Did you catch that from something ?

When I hear someone say these things, it's either ignore them, smile politely and let them remain in ignorance, or correct them, try to inform them of a little something they didn't know. But this brings a risk of disapproval on their part because how dare I correct them even though they were wrong.

Making the decision for me is easy, I hear it and the rest is history.Yes people make mistakes and say the wrong thing sometimes but When that statement is blatantly out of whack and comes from someone who says they are a diabetic and has a public platform of millions then letting that statement just coast on​, is not just irresponsible it has the potential to be fatal, our silence can be as bad as the incorrect statement. 

CURED ?

We have high profile people​ saying she WAS a type 1 diabetic
and is CURED she had come off all insulin.

Why haven't the rest of us done this ? 
Because it's NOT true and NOT possible.

GOING LOW AND INJECTING INSULIN ?

Be warned, this one can kill you. A person with any type of diabetes gone or going low ( it's called a hypo ) needs glucose or sugar.

The only injection to take for this is glucagen or glucagon. 

IF THE INJECTION SAYS INSULIN ON IT "DO NOT INJECT IT" YOU COULD KILL THAT PERSON.

​Every one of us who live with either ​Type 1 or Type 2 Diabetes have a responsibility if speaking about it in the media to portray it correctly or simply refrain from comment. 

The media in general have a huge responsibility when the word Diabetes gets mentioned yet we see headlines saying .... CURE DIABETES BY......

What the general public hear from the media, they believe, sure why would he have said it on national TV if it wasn't correct ? 

and ​YES​, this has been said to me....

Remember there is always an option to say " I have type 1 or type 2 diabetes and believe me it's no joking matter".

​

There is always an option to just not discuss it, blurbing out incorrect information is very damaging and when it comes from someone in the spotlight and someone with a high profile the damage is limitless. No im not giving out about someone who just does'nt know about their diabetes or who makes a mistake with the information they speak, but i am saying we as diabetics need to take responsibility for this and the media need to take responsibility as they give this a platform, those with diabetes of any kind who don't know much about it should refrain from comment.​

Our most recent incident ​flashed an insulin pen for the cameras.​

Said he gets reminded to inject when he's low. ( totally wrong info )

Apologises after his blurb gets pointed out.

Only then states what​ type of diabetes he has.​

Then goes on yet another programme to apologise profusely for his last blurb, now saying he's on insulin tablets. M​ore incorrect information as insulin can't be ta​ken through the stomach which is why we inject and pump insulin.​

It makes me wonder does that​ person know anything at all about diabetes. NO I don't agree a mistake was made on either occasion, and Yes i know he did'nt go on a TV show to create diabetes awareness, however if he was going to mention it to millions of viewers, he could at least have portrayed it correctly​ instead of pretending to be Mr Big and using it is as some kind of prop.

I think he just does'nt know what he's talking about, and is in serious need of diabetes education, but unfortunately now the public has heard him and we will live with the fall out.

If someone went on a popular TV show with millions of viewers​
and said I'm suffering from depression, cancer, Ms, or any other life threatening disease, following on with flashing equipment or medication for that condition while making a joke about it and stating incorrect facts, Would that be ok ? I wouldn't think so ......

Type 1 Diabetes 

is an autoimmune disease, nothing we did caused it and nothing we do will take it away. Our immune system has attacked an organ in our bodies as if it was a foreign object. In our case it attacked our pancreas and stopped us producing any insulin of our own. Without insulin we would die, so we inject or pump it in, to stay alive. Sugar / glucose is what we use when our blood sugar is too low, we must maintain a balance. ( it's that simple )

Type 2 Diabetes has many causes:

Being Overweight ( I don't like the word obese ) a person who never eat sugary stuff can still be overweight from eating too much breads, potatoes, pastas, pitza or fatty foods for example, and not getting enough exercise.However that's not the only thing that puts you at risk of be diagnosed with type 2 diabetes.

Other things that can increase your risk are :

• Cancer treatments
• Under active thyroid
• Poly cystic ovary syndrome
• Medical use of steroids for other conditions
• Genetics / family history

To name just a few. There are very many slim and fit people diagnosed with type 2 diabetes so it's very wrong to label all type 2s as developing it because of being fat or lazy.

• Sometimes type 2 Diabetes is managed or controlled with diet and exercise.
• Sometimes it requires oral medications to help them increase their sensitivity to their own insulin which they still produce. This is not oral insulin, as insulin cannot be taken through the stomach.
• Sometimes they need the help of a long acting insulin injection. ( Basel ).
• Sometimes they need the help of a short acting insulin with food (Bolus ).
• Sometimes they need both insulins with their oral medication.

There have been some type 2 diabetics who have completely changed their diet and exercise regime and have come off medications. This is not the same as cured, if they slip back to their old lifestyle at any point they would be reunited also with their type 2 diabetes.

A type 2 diabetic that is injecting insulin, is NOT a type 1 diabetic. They are an insulin injecting type 2 diabetic, who would be subject to carb counting and the regime much like a Type 1 Diabetic would need to follow.​

For all of the above reasons, both type 1s and type 2s have a very serious lifestyle to live, it was said to me recently that some people with diabetes, treat their condition / disease as though it was a "Badge of Courage" and I would agree with that. Those people are either​ very courageous indeed, or very stupid.

As a final thought, I would say if you find someone unwell 

and you've established they are diabetic, if you think their blood sugar is low, they are unresponsive in any way or unconscious. 

DO NOT INJECT INSULIN INTO THEM, YOU COULD KILL THEM. 

Phone for an ambulance straight away.

The only injection they can have is GlucaGen and they may,​
or may not​,​ have this with them. 

THIS HYPOKIT HAS INSTRUCTION ON THE INSIDE OF THE ORANGE PLASTIC BOX IT COMES IN.

DO NOT POUR FLUID INTO THEIR MOUTH, IT WILL JUST END UP ON THEIR LUNGS. 

Do we react strongly every time we hear diabetes light heartedly discussed ? Yes.

Do we react strongly when the wrong information is broadcasted. ? Yes.

Do we take it personally ?

I sure do because someone will quote what they heard in the media and insist,​ as it was said on national TV then it must be right.

Living a life with any type of Diabetes ​is no joke and certainly no laughing matter. We carry around with us everywhere we go, a medication that has the potential to kill if administered incorrectly or indeed if administered at the wrong time. 

Incorrect information that is broadcast in any form is not only unacceptable but its dangerous.

No im not a profesional

Im Davina a Type 1 Diabetic

​This link will you give low blood sugar or Hypoglycenia information​

http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/hypoglycemia-low-blood.html