Category: blood sugar levels

It’s all Diabetes at the end of the day!

monday-3

Feel free to add to the list.

Just remember friend’s, stay determined, be positive and don’t let diabetes stop you from being able to do the things you want to do. Yes, it’s a challenge, but you are more than capable of overcoming it. Struggle through it and you’ll soon discover how much stronger you have become.

Sending love and support to all the carers giving their all to help their loved ones fighting this ever so demanding condition and from one person with diabetes to another, keep on going xx

Amina

Je suis fatigué of the monthly P

Sorry guys this one is for the girls. This is one aspect of life that doesn’t affect your diabetes, but for us girls we are faced with the not so pleasant monthly, painful and uncomfortable period. Diabetes, as you know can be absolutely crazy at times, when you are stressed, fatigued, ill, let’s just say a lot of things can affect your BG levels. So let’s now throw in the monthly period we girls go through.

PERIOD-2

 At different points in the menstrual cycle, BG levels can be affected. It can differ from person to person and for me, it has always been a challenging time. However, since I had my children, I’ve noticed that my need for insulin fluctuates a great deal at different times within a single month. Sometimes, I need more insulin and sometimes I need a lot less. My insulin requirement severely decrease. Why? I have no idea! Could it just be down to my body changing after experiencing pregnancy? Hormones? Who knows?

As a side note – This also reminds me of when I was going through my teenage years and all the changes I had to make in my insulin regime. Back then I was MDI taking two injections a day which then increased to five injections a day. Anyway, that’s a whole other post entirely.

As frustrating as it has been, I’ve had to deal with this extra struggle that comes with diabetes. At first, the patterns in my sugars were very hard to detect and I suffered from a lot with low BGs. It seems as if, my body just needed a lot less insulin at that particular time. Initially, I must admit I did suspend my pump at certain times just to try and avoid those lows. However, with a lot of hard work, I’ve managed to , when I needed to make changes to my background basal rates.  The only real way to do this is to watch what your sugars are doing. I had to write them down and try to find patterns over several months and then compare patterns from month to month. It was crazy!!

So what did I find out?

Week 1 of any month – This is usually the normal week and most stable week. BG’s are close to perfect.

May 2016 Week 1 Sunday 1/5/2016 Monday 2/5/2016 Tuesday 3/5/2016 Wednesday 4/5/2016 Thursday 5/5/1016 Friday 6/5/2016 Saturday 7/5/2016
BB 5.2 4.4 5 4.4 4.8 4.4 3.9
AB 6.4 7.9 6.2 6.6 8.5 8.7 9.9
BL 4.8 5.8 4.3 5.2 5.9 5.3 6.5
AL 6.6 8 7.6 7.9 8.8 7.6 8.4
BD 4.2 4.3 4.8 4.1 4.6 5 4.7
AD 8.3 9.3 8.8 7.9 8.5 7.4 8
BB 7.2 7.1 6.9 7 7.9 6.5 7.1
DN 6.7 6.5 5.8  6.8

Week 2 (before the P) This is when things start to get a little tricky and I notice a slight change in my sugar levels. My BG levels start to drop and at this point I have to decrease my basal rates. My pump (Animas Vibe) has a great setting which allows me to reduce or increase the basal rates by a percentage. So Initially, I reduce my basal rates by – 20%, which did nothing, so I then took it down by a further -40% which really helped to stabilise my BG levels.

May 2016 Week 2   Sunday 8/5/2016   Monday 9/5/2016 Tuesday 10/2016 Wednesday 11/5/2016 Thursday 12/5/1016   Friday 13/5/2016 Saturday 14/5/2016
BB 4.2 4 4.9 3.6 3.8 6 3.9
AB 5.8 6.3 5.7 7 7 7 8
BL 3.8 4.3 3.9 4 2.8 3.7 4
AL 5.6 7.4 6.8 6.7 9.9 7.6 7
BD 4.2 3.2 3 4.2 3.6 3.4 3.9
AD 6.5 10 7.7 7.5 7.2 6.8 6.9
8.3 9
BB 6 7.9 5.8 7.7 6.1 6 7.1
8 8
DN 4.4 3.5 5.5 5 3 4.1 5.2

Week 3 – (week of the P) – This week all chaos breaks loose on a BG level. Regardless of the changes, I’d made in week 2, I continue to experience severe lows which means I have to  decrease my basal rates even further. I do this by using the percentage setting again. First, I reduce it in increments of 10% until I’ve reduced it by -60%. This eventually seems to stop the frequency of low BG levels.

May 2016 Week 3 Sunday 8/5/2016 Monday 9/5/2016 Tuesday 10/2016 Wednesday 11/5/2016 Thursday 12/5/1016 Friday 13/5/2016 Saturday 14/5/2016
Changes in BR Changes in  BR Changes in BR Changes in  BR
BB 3.3 2.8 4.2 4.8 5 5.7 5.5
AB 4.8 5.9 6.4 7.5 7 7.5 7
BL 2.4 3.8 4.7 5 5.5 5.9 5
AL 6.6 7.4 7 6.9 7.4 7.7 7
BD 3.2 3.8 4.4 5.5 5.9 6 5.6
AD 5 6 7.2 8 7.3 8 7
BB 3.7 5.1 6 7.9 6.2 6.9 6.4
8
DN 2.2 4.3 3.1 4.2 4.6 6.5 4

To completely stabilise my BG’s I must then reduce my insulin sensitivity factor( ISF)  and insulin to carb ratio(I:C). My ISF is usually 1U will reduce my BG by 6mmol/1. During this week, I drop it to 1U of insulin reduces my BG by 1mmol/1. My, I: C ratio of week one is 1U: 6g (of carbohydrates), during week 3 this is doubled to 1U: 12g.

In general, during this week I feel hungrier and more exhausted than ever.

Week 4 – This week usually means that I have to increase everything, basal rates, ISF and I: C ratios. My BG levels spike beyond belief. I have to increase my basal rate setting by +60%, drop ISF back to 1U : 6mmol/l and I:C ratio back to 1U : 6g.

May 2016 Week 4 Sunday 8/5/2016 Monday 9/5/2016 Tuesday 10/2016 Wednesday 11/5/2016 Thursday 12/5/1016 Friday 13/5/2016 Saturday 14/5/2016
Changes in  BR Changes in BR
BB 12.8 8.2 8.5 7.9 6.1 5.5
AB 11.8 10 9.4 16 8 6.3 6.5
BL 8.8 8.4 7.5 3.3 6.6 6 5.3
AL 11.5 8.9 7.9 15.9 7.9 7.2 6.8
BD 7.9 12.6 9.1 4 6 5.8 5.6
AD 15 9.8 8.8 12 7.8 7.9 7.4
BB 9.1 14 10.3 11 7.7 6.9 6.5
DN 12.6 12 8.6 9 7 6.5 6

I suppose for those who have no clue about the work both I and my pump have to do to manage this condition, then you can really see how beneficial it is to me. I well and truly appreciate my pump and I am so lucky to have it.

I really think that the drastic fluctuations were due to possible pregnancy hormones which still existed in my system. I really don’t know, it’s just a guess. I decided to do a detox to try and flush out my system and I thought that maybe it would help to get me back into a more normal BG crazy diabetes management routine. After the detox, I noticed a change in the way my BG’s behaved. They weren’t as crazy as they had been and there was definitely a great improvement. I also took it a little further and started to:

  1. Work out more and maintaining a more regular routine
  2. Tried to get more sleep – which is hard as a mama of two but my body definitely needs and benefits from it.
  3. Eat more clean/watch my portions etc
  4. I do detoxes from time to time to flush out my system.

With all these changes I’ve been able to cut down my basal rates to just having two programme setting for the month. One for the week before and during my period and the two weeks after my period.

It’s a tough one girls but it has to be done. Close monitoring of those BG is really the only way to figure the unpredictability of those sugars on a normal week without a period. So it becomes even more crucial during the menstrual cycle.

This is yet another aspect of the crazy life of a diabetic!

 

Amina xx

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Testing your day time basal rate

Sometimes it becomes necessary for you to be able to tweak your basal rates. During times where you maybe more active, during periods of stress and for the girls during that time of the month, you may be more prone to either lower or higher BG levels and this of course requires some adjustments in basal rates.  

Being able to adjust my rates isn’t something I’ve learnt overnight. It has taken me many years and a lot of time to understand my diabetes.Believe it or not I am still learning, when it comes to my own body and how it functions and reacts to different changes. Also I utilise my diabetes team when I can and get their input which sometimes can be a completely different perspective to my own, or most of the time they are in agreement with the changes I want to make. They are there to support you, so use them when you need them.

There are a few simple rules which I follow before I make changes to my BG. I ensure that,

  • I have not had a hypo in the last 24 hours ( of course if your having frequent hypos you probably have too much insulin in your system. You should definitely seek medical advice.)
  • I’m not feeling unwell
  • I am not due to have a set change
  • I’m not going to be more active than I normal would be.
  • I’m not more stressed than I would normally be.

 

Testing your daytime basal rate

daytimebasal1

daytimebasal-rate2

daytimebasalrate3

daytimebasalrate4

daytimebasal5I usually end the test with my evening meal. Look carefully at your BG readings for the day and make adjustments. If you’ve noticed an increase or decrease in BG levels, then adjust the basal rate about an hour or two before the change in BG levels were first noticed. Adjust the basal rate by 0.05 or 0.10 units/hr either up or down depending on whether your BG levels were too high or too low.

Although, these are the steps I take to make adjustments to my basal rates, please make sure you consult with your GP (diabetes team) before you make any changes to your rates.

Amina xx

Listen to your body

Something I realised after my diagnosis was, I had to really start to listen to my body and try my best to understand what was happening to me.

body1The body is a complex system which does everything from help you move your arms, fight infections and even process the food we eat on a daily basis. It is able to constantly give you signs and signals which lets you know for instance that you’re coming down with something or if in fact the problem is more deep rooted. Without a second thought, your body breathes for you, pumps blood through your veins, just to keep you alive. It’s pretty miraculous!

In the case of diabetes the body also gives us signs. Signs which allow us to begin to recognise symptoms of lows, highs, falling or raising BGs. Even before my diagnosis, my body was giving me warning signs, showing me that something wasn’t right. Whilst experiencing the symptoms of thirst, constant urination, tiredness and the weight loss, these were all indications that something was happening.  This is why diabetes awareness is so important.  For me, with the knowledge my mother had of diabetes, I was able to survive and begin my diabetes journey.  Many people, who have no diabetes awareness and aren’t able to recognise any of the symptoms may not be as lucky as I was.

When we’re affected by things like stress, exercise or hormonal changes, we are able to begin to understand so many things.

In the case of low BG’s, I’ve had to make firm decisions in my mind that I am actually having a hypo and  then act on it in that moment. I’ve had to train my mind to distinguish and realise that a high BG is a high BG and a low BG is a low BG. It’s not easy but with time we begin to get a grasp on some of the warning sign we experience.

 Learning and listening to these signs are crucial to recognising future symptoms which will occur.

The human body is even more amazing in that we have been given five senses which guide us, as we traverse through the world around us. Our senses are able to send messages through the brain, with the help of the nervous system to deliver messages to us. These senses include: Taste, Touch, Smell, Sight, and hearing.

I strongly believe that we also have a sixth sense. (No I don’t mean seeing dead people lol).  This sixth sense i’m reffering to is our intellect. It is the sense which helps us understand so many thing including our physiology. For we diabetics, being able to differentiate between a low or high BG level sensation/s becomes quite critical, because let’s not forget these are medical emergency after all. In some cases we experiences low or high BG on a daily basis, whilst trying to obtain that number in the ideal range. It is an endless cycle of sustaining and monitoring. We check our BG, we bolus and we eat.

Strengthening your consciousness and being aware of your physiology is an advantage in that it will allow you to have a better comprehension, when changes arise due to BG levels.

You can begin to listen to your body by training your mind to make you more mindful of the signs you personally feel, before, during and after BG level changes. Identifying these symptoms will help make you even more responsive in the following hypo/hyper events to come.  I know that symptoms can vary and even change with time but what is important is being aware of what is happening to you in these moments.

Action, repetition and  finally recognition

When we experience any symptoms related to BG levels changing, our brain is able to create a memory of these symptoms we’ve experienced. This process is known as Recognition Memory.

Recognition memory is the ability to recognise previously encountered events, objects, or people.

brain

When we re-experience a certain BG related symptom, the brain is able to match a previous occurrence of the event happening beforehand. This then becomes an indication for us to know that we’ve experience this feeling before.  It’s becomes familiar and we know that we’ve gone through it in the past. We’re then able to recall this memory by accessing details related to that memory.

 Since we all know symptoms can vary from person to person, sometimes we miss a symptom because in fact maybe it’s a new memory which the body has never experienced before. Therefore, when this happens, it will be the first time the brain makes a memory of the event happening. If the event occurs again, it will then go through the recognition memory process to let you know that you are in fact familiar with this event taking place.

In the past I’ve experienced low BG’s were I don’t have any symptoms and remain in the low for a long time. However, this was mostly during my pregnancies, when there were so many changes occurring in my body. Nevertheless, even when I wasn’t aware of the symptoms and found myself in the middle of very severe lows, I still made a mental note of how I felt in those moments. This helped me to learn how to treat them and achieve a more normal BG level.

Hypoglycaemia unawareness can occur after living with this condition for many years. Constant lows can interfere with the release of stress hormones, which occurs when BG levels drop too low.  Stress hormones encourage the release of glucose. The liver secretes a hormone called Glycogen, which is decreased in people with type 1 diabetes after several years of living with the condition.  If glycogen isn’t being released then BG levels will remain low because the stress response isn’t producing any glucose to elevate the BG level. Therefore you remain in a low state for longer.

Tips to avoid hypoglycaemia unawareness

  • Test frequently to be more aware of dropping BG’s.
  • With the help of your diabetes team make adjustments to your Basal rates to try and avoid low BG’s occurring.
  • Develop an understanding of how to get those low BG’s back up and in range.

The next time you have a low or high BG try your best to be aware of what is happening to you in that instant.  Think about what you feel beforehand, during and after the hypo. Make a mental note and acknowledge the feeling you go through. Even if you have no initial symptoms and find yourself in the middle of a low, during the hypo you still experience certain feelings so try your best to be aware.

What methods do you use to recognise that your BG is low or high?

HyPoS

Many-types-of-hypos

Hypo’s can be very unpredictable and can affect everyone in different ways. Here are a few of the hypos i’ve experienced.

  • Stuck: My train of thought just remains paused on the last thing I was doing, the last thing I was thinking about or the last thing I was talking about. I find multiple ways to talk about the exact same thing over and over again.

 

  • Mrs Jekyll Mrs Hyde: I have a complete change in mood. I become completely enraged. I definitely become more vocal and extremely irritated. The strange thing is, I can hear myself but can’t stop myself. I have no control over what I’m saying.

 

  • Zombified: This is the type of hypo, where I can’t do anything at all for myself. Thank god this type of hypo has only hit me a few times. I usually have an outer body experience, whereby I can hear everything that is being said to me but I can’t respond in sentences. My brain, my mouth and my body just won’t coordinate, so instead I produce a sounds which resembles that of the living dead lol.

 

  • Is it me Or is it hot in here?: With this hypo, I feel as if the temperature in the room is above 30 degrees Celsius and raising. What follows next is me asking other people in the room, “Why it’s so hot?” Again I can become quite vocal.

 

  • Pins and needles: My BS level has come back up very slowly and what I’m left with is my tongue feeling as if it’s tingling and numb.

 

  • Where did that hypo come from? I decide to check my BS level and it’s extremely low but I feel absolutely fine.

 

  • Clean teeth no more:  I’m ready for bed, I spend my time brushing my teeth and then check my BS level only to find out its low.  This then means I have to eat or drink something to bring it back up pfff!

 

  • Puke fest: With this hypo, I want to eat everything in sight. Resulting in everything been served up together. In that moment anything goes. Jam + a sprinkle of cheese + some gummy bears, a sip of juice, a bite of that pear, oh crackers with Nutella. JUST ANYTHING TO BRING THAT SUGAR BACK UP!!This is something I’ve been working hard to try not to do, because it just means serious rebound BG’s later on.

 

  • Ride, Ride, Ride, Ride, Ride it out! This the new me, where I sensibly correct my BG with 15g of fast acting carbs. These days I usually go with raisins or fruit strip. Honestly, I just try not to over correct the low too much. Although the feeling of waiting for that low BG to come up is awful. I’ve really been trying to hang in there and let it come up without over eating and sending my BG through the roof.

 

  • I’m convinced that I’ve mastered Korean: With this type of hypo, I’m usually watching a Korean drama (Kdrama) and can completely understand it word for word. FYI, I’m still only a beginner when it comes to learning Korean. I watch a lot of K dramas but I guess my brain has stored a lot more than I think it has. Hmmmmm! This has also happened with other languages I’ve learnt or heard.

 

  • Beating drums: I start with a mild headache and then it develops into a severe migraine. My heart is also beating. Is it the usual beat? I have no idea but I can definitely hear it and it’s louder than ever.  

 

  • Le vache qui rie (The laughing cow): Let’s just say, I find everything funny. Whatever might be happening, it just becomes funny. SHSL you’re a total loon!

 

  • Pass me that towel please: This is the type of hypo, where I’m sweating profusely, as if I’d been dunked in a swimming pool a few times and come out dripping wet.

 

These are just a few of the hypos I’ve experienced over the years. What type of hypo’s have you experienced?   

Amina xx

Snow day tips!

Yesterday, I was discussing the seasons with my son and now that it’s March we’d soon be able to see flowers blooming. However, this morning, we woke up to this!

snowfall

I love a bit of snow but I always have to take into consideration, how the colder weather will affect my BG levels. In most conditions, whether it’s hot, humid or cold, my BG levels always drop. So I knew I had to prepare myself, especially since I had the morning school run to do (which also meant I’d be driving) so yet another reasons to make sure my BG levels were under control. With all of this in mind, I’ve put together a list of tips on how to manage BG levels in the colder weather.

Test, test, test don’t guesstimate:
The cold weather can definitely affect your levels, so always remember to check your BG levels often. Frequent testing will allow you to avoid any high or low BG levels. Test before you leave the house. When I drive, I always make sure my BG is around 7mmol/l so today I started at 7.8mmol/l.

A few hours after school run……..

BGMETER

Stay warm:
Make sure you’re dressed in warm clothing. Wearing gloves will help to keep your fingers warm so that when you need to test your BG level your fingers aren’t completely frozen. Try to warm them up before testing so you are able to get enough blood. Although I had gloves on this morning, my hands were still a little cold, so I used the car heater to warm them up. Also make sure you wear comfortable and warm shoes with a good grip that will protect your feet and keep them warm to ensure good circulation. Keep your feet well moisturised and check them regularly for any cuts or cracks etc.

Glucose:
Make sure you take some form of glucose with you when you leave the house. Choose glucose that will not freeze in the car. You need something that is easy to access in case of a low BG. I have a secret draw in my car where I hide snacks and juice boxes just etc. Just in case my BG decides to drop.

Protect your insulin and devices:
Just like hot weather, the cold weather can also affect your diabetes accessories. If you wear an insulin pump, wear the pump close to your body, under layers of clothing. In extreme weathers, insulin can break down and become ineffective. Also make sure your BG meter is in its case. I usually wrap it in a towel, if I’m travelling in the car for a long period of time in the cold.

Stay active:
The cold weather can make you want to just snuggle up in a nice warm blanket with a hot cup of tea or coffee. Nevertheless, you should try to keep yourself active during these colder temperatures. When you move around it will help to keep BG levels lower even when the weather isn’t a factor. Just because its cold and snowing outside doesn’t mean you can’t enjoy the weather. I like to play in the snow with my children, building snowmen and throwing snow balls.Exercise is key!

snowboots

Cutting back:
Because my BG levels like to drop, this usually means I have to adjust my basal rates. If you notice a change in your levels then contact your healthcare team so they can help you adjust your rates.

 

Amina xx

 

A BS kinda day!

*BS  as in  Blood  Sugars*

Unless you are a diabetic or a person who has a loved one who suffers from diabetes, you may have no idea what diabetes is all about. How constant it is and in actual fact, how life threatening it can be. It is a hard condition to manage and you may not even consider the daily vigilance an individual needs to have, in order to keep a tight reign on their blood glucose levels.

I thought the best way to develop an understanding of what day to day living with diabetes can be like, was to give you a glimpse into the sort of days I can have. Every day is unpredictable.

SHSL-BLOOD-SUGARS

So here goes

December 15th–  I decided to pick a random crazy day, so you can truly see how up and down sugars can be. The day starts with the night of the 14th.

 10:37pm – Blood sugar reading – 6.5mmol/l 

The perfect Blood sugar reading to go to bed with. After a heavy pasta dinner that night, I’m pleasantly surprised. I usually aim for a BS between 6.5 -7 mmol/l  before heading off to bed.  Although 6.5mmol was a great reading, it’s become a habit to always make sure that i’m prepared for any lows in the night. It saves me from having to make that journey down the stairs, or disturbing my husband. Although he say’s,  “he doesn’t mind”. I sometimes feel bad that I’m disturbing his sleep too, but if I really can’t make it I do ask him.

Nighttimehypo

I head off to bed and a few hours later I reach a point in my sleep, where I’m fighting to open my eyes. I’m using every last bit of energy I have to try and get myself up. It isn’t just the feeling of being tired and not wanting to open your eyes. It’s a real struggle, one which means your draining every last bit of energy you have in your body. I tend to have this feeling, when I’m hypoing, but you can never be too sure so I decided to check my blood sugar level.

02.36 am – Reaching for my blood glucose meter I feel very weak. My pj top is soaked. It’s definitely a hypo. Thank god I brought up all those goodies the night before. I check my sugar level and low and behold, I’m having a pretty low low.

Blood sugar reading – 3.4mmol/l

To correct my low blood sugars I usually give myself  15g of fast acting carbs. This usually comes in the form of Lucozade (which by the way isn’t so great in the early hours of the morning).

But this is diabetes, being forced to wake up in the middle of the night to eat or drink something, when all you want to do is sleep. I dare not just go back to sleep!

So, after having my Lucozade I waited 15 minutes, I sat on the edge of my bed in my sweaty pjs. NICE! I watched the time as it ticked by slowly.

The thing about hypo’s are, they can make you feel quite ravenous.  In that momment, you’d do anything to get back to feeling more like your usual self again. Knowing that the food consumed will allow me to return to this normal state, sometimes I am guilty of consuming more than the 15g and waiting for my BS to increase.

Resisting an over correction is one thing but on that night I found I wasn’t able to wait the full 15 mins without checking my BS level again. 7 minutes later, at 2.43 am, when I tested my BS I got a reading of   3.4 mmol/l. Hmmm it hasn’t budged yet!!!

Do I wait till I reach the 15 Mins?

Nope!  I go straight for the apple and satsuma.

02.55 am  – And  yes I’ve  finishedboth fruits in record time. BS reading  is now 4.0 mmol.l. Great finally its starting to come up! I wait a little bit longer and test my BS at 3.30am 5.0 mmols/l. Maybe I was safe to go back to sleep now. At this point I’m feeling even more exhausted than ever.  In a sitting position I rest my head against the headboard and fall into a very deep sleep, until my alarm goes off at 6.30am.

 

07.31 am – BS reading before breakfast 6.0mmol/l

  

The rest of the day went a little something like this….

13.09 BS reading before Lunch

17.10 BS reading before dinner

22.32 BS reading a few hours after dinner.

This was definitely a rebound BS.

*Rebound otherwise known as the Somogyi phenomenon. This sometimes occur when the BS level drops very low and then rebounds very high, causing a high BS level.*

I’m happy to report that after a crazy couple of hours my sugar settled and fell more in the normal range again. PHEW! So just remember, the next time you see me looking all tired, or I make mention of feeling exhausted. It’s possible that I had a crazy night like this one.

Thanks for stopping by  Amina x

Insulin gone bad

insulin

How do you know if your insulin has gone off? Does it smell bad? Does it look bad?

The question of insulin being off is indeed a preemptive one. Of course, there are certain ways to examine the insulin, but still one can never be completely certain that, the insulin being used is in fact ok to use. There are a few precautions that can be taken to make sure that the insulin isn’t ineffective. These steps are:

(1) Always checking the expiry date on the vial. Is it expired or not?

2) Is it cloudy in appearance with clumps that don’t disappear even after rolling the vial in between your palms?

3) Did you store it in a very hot or very cold environment?

(4) Does the insulin look stringy?

(5) Has it changed colour?

A few other things to consider, which could affect the performance of the insulin are:

(6) Has the insulin vial been opened for more than 28 days, stored either at room temperature or in the fridge?(depending on which insulin type you have,  the number of days differ)

(7) Has the rubber on the vial been punctured several times, due to only small amounts of insulin been used?

If all checks are made correctly, then it will help you avoid using insulin that has gone off.

So, what do you do, when you think you’ve made all these checks and the insulin seems fine? Of course you use it just like I did a few weeks ago…..

I decided to change my pump site and used an unopened vial I had left over from my Summer vacation. As usual, I inspected the vial to make sure that it was still in date, that it was not cloudy in appearance with clumps and I knew that it was stored in the fridge.

During my vacation, I transported my insulin in a Frio bag. When I arrived at my destination it was significantly hotter so I then put my vials directly from the Frio bag into the fridge. Keep in mind the FRIO bag can be used for up to 52 hours and it will maintain the temperature that the insulin vials need to be at.  However, when I initially went to put the vials in the fridge, it seemed warmer than it should be, so I adjusted the dial and waited . The fridge cooled down so I put my vials inside. This one vial was never opened and remained in the Frio bag and then in the fridge throughout the entire vacation until I returned home.

I changed my site, bolused, had my breakfast and off I went to take my son to school. I came home, checked my blood sugar and it was  9.5mmols/l.

Hmm! Ok,  that’s great for a workout.

I worked out and what usually happens is that my sugar will drop. In this case, my sugar was 16mmol/l. I decided to give myself a bolus to bring my sugar level down. I waited and tested it 15 minutes later, only to find out that it had now jumped to 20mmol/l. I then thought that maybe it was the site, where I had put my insert and that maybe I should change it. So, that’s exactly what I did.  I got a new insert, syringe and used the same vial of insulin. (At the time I didn’t realise that the cause of my high sugars was in fact due to this insulin vial.) I changed my site and decided to bolus again to bring my sugar down. I waited a further 15 minutes and checked my sugar level, which now read a shocking 25mmol/l on my blood glucose meter.

What on earth was going on?

It wasn’t until then that I had the thought that, maybe this vial of insulin wasn’t good. I  decided to do my checks again.

(1) I looked at the expiry date 07/2017. It was in date so that wasn’t the problem.

(2) It was stored in the fridge and the fridge is in good working order and it was kept at the right temperature. Plus I’d transported it correctly throughout my vacation.

(3) It wasn’t stringy.

(4) It hadn’t changed colour.

(5) The vial had not been opened and therefore it still had the orange cap on it and of course it did not have any punctures in the rubber.

(6) I took a good look at the insulin, it seemed ok. I then decided to take a good look at the vial whilst holding it in front of a light and then I realised it was cloudy with a few small clumps in it. I then rolled the vial a few times in between my palms and the clumps remained . The insulin had gone off, which would explain my crazy high blood sugars. I throw the vial away immediately. I didn’t quite understand, when the vial had, had a chance to go off. I had taken all the necessary measures to ensure it would be ok, but I guess it must have been affected at some point.

To bring down my sugar I took a syringe and a new vial of insulin and injected 6mmol/s directly into my leg. I checked my sugar after 15 minutes and it had started to fall and it had come down to 23mmol/l. It then took nearly the entire day of bolusing and checking my blood sugars before they came back into a range that I’d concider good. I felt absolutely drained from all the elevated blood sugars I’d experienced that day. I had ketones in my urine, but thank god they slowly disappeared as my sugar came back down.

If you suspect that your insulin is indeed ineffective after doing all the checks, I would get rid of the vial immediately and open a new one. Remember, once a bottle of insulin is opened, not all insulin has the same open expiration date. For example Novorapid, once opened must be thrown away after 30 days for a 10mL cartridge and 28 days for a 3mL cartridge and penfill.

 Amina xx

 

 

 

 

 

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MIA, Diabetes and life

Hi guys

It’s been a while since I last wrote a post. I’ve totally been MIA lately due to a lot of different things happening in my life at the moment, some things are D related and others are just the usual day to day life occurrences.  Anyway maybe we’ll get into that at another time.

In terms of my D,  one of the things I’ve been trying my best to do is to get a much tighter grip on my blood glucose (BG) levels and in turn my HbA1c. I’m pleased to say that I was able to take my HbA1c down from 7.5% to 6.4% YAY!!

As a diabetic, I know all too well that when it comes to diabetes it doesn’t affect all diabetics in the same way.  By this I mean, we can’t all use the same basal rates, count and eat the same carbohydrates and even take the same insulin doses in order for our diabetes to be well controlled. Unfortunately,  it’s a lot more complex than that.  I’ve found that with my diabetes and getting things to work it is all determined by trial and error.

What is this you ask?

I think most diabetics and even the professionals (who help us diabetics with our blood glucose (BG) levels and insulin calculations) all use this method. This method works by basically trying something out to see if it works. If it works I stick to it, if it doesn’t then I shift numbers, tweak ratios and rates etc. 

So what have I been doing to keep my dreaded and sometimes tedious BG levels under control?  Here are a few things I’ve been doing:

Exercise:

I really do believe that exercise is necessary when it comes to managing my diabetes. I usually work out at least 4 to 5 times in a week, however when I first started working out I started with a realistic and manageable goal of 2 days a week for at least half an hour at a time. I started with a little Zumba and one of my favourite Youtubers Cassey Ho.  I found that I started to enjoy it and besides it giving me a great deal of energy it also helped with my overall BG control. Initially my BG level dropped quiet frequently and I had to make sure I consumed more carbs to maintain a good level.  However my insulin requirement started to decrease across the day and I found in general I just needed to reduce my basal rates, increase my insulin to carb ratios and give myself a smaller bolus after meals. During my whole working out transition I had to use the trial and error method and a lot of consultations with my diabetic doctor to see what would work best with my BG.

Coconut water: I started to drink coconut water after I found that caffeine in general wasn’t a good option for me and my BG levels.  You can read about my experiences with caffeine and coffee in particular (here). Once I started drinking coconut water my cravings for coffee seemed to reduce a great deal. I started to find that every time I drank coconut water my energy levels were boosted. The days I didn’t have any I noticed I definitely had less energy than normal.

There are so many benefits to drinking coconut water. Here are a few of those benefits:

– It hydrates the body even better than water

– It is rich in dietary fibre, enzymes, vitamin C, minerals such as magnesium, potassium and amino acids.

– It is also very low in calories and cholesterol

– It speeds up the metabolism

– A weird thing I found out about coconut water is: If you wanted to bathe in coconut water it would be really great for your skin (hahaha never tried that one)

-It also boosts the immune system, which is a bonus for us D’s as our immune systems are generally a lot weaker. Actually since I started drinking it I haven’t had a cold.

-Because it’s a natural product it’s safe to drink during pregnancy and breastfeeding and is also safe for younger children.

Matcha Tea:  I’ve been drinking Matcha tea now for a few years. Matcha is a finely grinded green powder made from green tea and is used in Japanese tea ceremonies. It’s highly nutritional and has very high antioxidant content.  I love Matcha and in relation to my diabetes I usually try to drink it at least 3 times a week. When, I’m having a day where my BG levels are constantly dropping or if they remain higher than I’d like. It seems to stabilise my levels and usually it gets it back into a normal range.

Low carb diet: Eating a lower carb diet has really helped me manage my BGs better. I still consume carbs but I try not to have more than 300g of carbs a day.  I’ve found my BG levels are much more stable and easier to control.

Dairy: I recently discovered dairy and I aren’t the best of friends. Unfortunately I have become lactose intolerant. I noticed that whenever I consumed any dairy products, I would see a spike in my BGs. After I stopped consuming products with dairy  in it, I stopped having these spikes in my BG levels and also my digestion seems to be working a lot better.

Eating right for your blood type: I’ll have to write a separate post just on this, to explain what this is all about. In the meantime there is a book by Dr Peter J.D’Adamo which goes into detail called “Eat right for your type”.  He has also written a book based on diabetes called “Diabetes and fighting it with the blood type diet”.

De-stressing: I really do believe this is also a major factor when it comes to BG levels. Any stress these days seems to have an effect on my BG levels.  I try to take myself away from the daily stresses of life and make time for just me.  Selfish you might say but it makes for a better Amina, mummy and wife. Plus my BG levels really seem to like the little time I give back to myself. (I’d definitely suggest doing this)

Finger pricks: Finally I’ve been testing my BG levels a lot more frequently on a daily basis. I now try to test at least 8-10 times a day, sometimes more which gives a really accurate picture of what is happening with my BG levels. I was using the Dexcom sensor which I found was really beneficial when it came to my BG levels. However it was only for a short period of time and after using it I hope that it will be something that I can fund and use in the future.

I really feel that all these things put together have contributed to getting my BG levels and HbA1c in better control. However these things seem to work for me, it may not be the same for you. I also had to consult my doctor and nurses frequently when trying out these options. I’m always willing to try new things if it means tightening my BG control. I’d love to hear of anything which you’ve found helps you in your overall diabetes control.

Thanks for stopping by

Amina xx

No strips and expired strips!

As a T1D I know how important it is to have blood glucose strips which aren’t out of date, an expired strip could potentially give me the wrong blood glucose reading. Let’s face it that number that appears on the meter is so important, because as a diabetic I live by the numbers which appear on my meter. It allows me to confirm whether I have a low, high or a good blood glucose level (4-7 mmol/l).  Depending on what the outcome may be I can then act by either treating my low, high or just do nothing but record my level. Knowing my BGL’s are of great importance and it is just as significant as my insulin. My insulin and test strips are pivotal to me being able to manage my diabetes to the best standard possible. Unfortunately I can’t say that I’ve always had an abundant number of strips available or never been faced with expired test strips. I’d be lying if I said that has never happened to me.

That night I realised I used expired blood glucose strips……………..

I was woken one night because I just didn’t feel right. I felt as if my sugar was high. I reached for my blood glucose meter and realised I’d run out of strips. Actually I knew I didn’t have that many strips available the night before and had used the last one before bed. Therefore I checked in my usual back up strip storage places and couldn’t find a thing. My next move is always to go to my other blood glucose meters (x1) and see if there might be any strips in there. Yup I found nothing! So I decided to dig out some old meters (how I did this half asleep I do not know). By the way I have one really ancient meter with no battery and the other was the same as my (One touch Ultra Easy).

I opened up the case for the meter and (bling) I’ve never been so happy to see blood glucose strips and a full tub of 25 strips.  Without even looking at the expiry date I grabbed a strip, pricked my finger and tested my BGL.

HIGH

“WHATTTTTTTTTTTTTT?” OK I felt that way so at least I’m able to recognise my high symptoms.

I don’t know about any of the other T1D’s but the very few times I’ve had a reading that just says high or low on my meter, I totally freak out and want to correct it right then and there! I corrected it with a bolus and then I gave it 30 minutes to see if it would come down. I drank some water because strangely enough that seems to help too. Anyway finger prick number two, I expected the reading to be lower. My meter then produces another reading of

HIGH

“WHAT!! WHY HASN’T IT COME DOWN?”

I actually started to feel a lot better but then silly me instead of trusting how I was feeling.  I then corrected again! I waited another 30 minutes and at this point I started to feel a little low. It just made no sense. I then decided I’d go and wake my husband up who was actually already on his way to me.  I got him to test his BGL which read

HIGH

Side note: My husband isn’t a diabetic so really his BGL should have been within the norm.

I quickly checked the expiry date on the tub and saw that it was out of date by a year {{shock horror}} so all my readings had been incorrect to start with. I couldn’t do anything but at this point I felt as if my BGL was extremely low so I treated it slightly and waited until I felt OK. It was already morning I stayed awake and went to pick up my prescription as soon as the pharmacy opened.

My advice to all the diabetics who use test strips. Please make sure you have sufficient strips and strips which aren’t expired. This experience was extremely scary for me and an experience I’d rather not find myself in again. Having strips and strips that aren’t out of date is so crucial!

Has anyone else ever found themselves without strips or used expired strips without initially knowing? I’d love to hear your experiences.

Thanks Amina  xx

The beeping D ……

As you may know I recently started a sensor trial, which started off really well. I got my sensor fitted everything was running smoothly until I decided I was going to go to the supermarket.

First supermarket trip

The moment, I stepped into the supermarket doors.

BEEP, BEEP, BEEP, BEEP, BEEP! (Anti-theft alarm)

Of course I totally ignored it and kept walking, there were so many people going in and out of the supermarket.

Major Side note: I was coming into the supermarket and in any case it’s not in my nature to shop lift.

I continued with my shopping, arrived at the till, paid for my goods and went through another set of alarms (WHICH WENT OFF).  I looked around because, that surely was not me! So I kept on walking. I reached the exit and walked through the doors with a herd of other people (YES the alarm went off again)! Still oblivious I continued to walk towards the car and go home.

“Wow those alarms were going off a lot. I wonder why?”

My second supermarket trip

Off I go to the supermarket nice and early to pick up a few things.

Side note: I love going to the supermarket nice and early. Its empty and I can just pop in and pop out. Job Done!

I reached the entrance and BEEP, BEEP, BEEP, BEEP!  OK I was the only one walking through, was that me? The guard just nodded and smiled so I smiled back and continued walking in. Shopping done and paid for. I approached the first alarm, BEEP, BEEP, and BEEP! No that was definitely me that time. I decided to turn around and go back to the lady at the till to make sure there were no tags in my bag. The lady checks and finds no tags. She encourages me to just go through. BEEP, BEEP, BEEP! That now confirmed that it was me beeping.

So embarrassing! I had a feeling that perhaps it was something to do with my sensor. I was totally dreading going through the exit alarms so I decide to let the guard know I was wearing a sensor and it might possibly go off as I go through the alarm. I showed him my receipt and my pump just in case he didn’t believe me. Off I went!

BEEP BEEP BEEP BEEEEEEEEEEEEEEEEEEEEEEEEEEEEP!

I continued to use the sensor but I just felt that whenever I tested my BGL it wasn’t even close to the numbers on my pump. After 12 days the sensor totally failed and produced an error message that read ERROR 0.

sensor fail

After 5 hours the sensor remained like this so I decided to call Animas (they are so helpful) and I ended up having a lengthy conversation with them. The lady I spoke to asked me several question and tried to get the sensor running again. However she finally said, that the sensor had failed and that I should remove it all together. When I removed the sensor it was bent and had barely pierced my skin. I also mentioned my beeping every time I went through the supermarket alarm. She said that it’s possible that the transmitter may have been faulty. I gave her the codes on both the sensor and transmitter and I was sent new replacements the following day.

I then restarted my sensor trial and I’m now on day 5, no errors or false readings. My BGLs have been spot on when I cross reference them with my BGL on my BG meter. I’m starting to see a clearer picture of what my BGLs are doing and have been able to make adjustments in my basal rates. It still needs some fine tuning but I feel I’m finally starting to iron out all the lows.

Has this (the beeping) ever happened to anyone else? Or have you ever had a faulty transmitter or sensor in general?

 

Amina xx

Omipod or stick with the Vibe??

The other day, I found out that my warranty on my Animas Vibe had actually ended and it was just a continuation of my previous pump (Animas 20/20). So essentially I have been walking around without any warranty for the past 3 months.

WHHHHHHHHHHHHHHHHHHHHHHHHAT!

Anyway! I’ve been given the option of either getting a brand new Animas Vibe or an Omnipod. I’m well aware of what both pumps can do. However I wanted to get your views on which pump would be the better option for me to go with? Or you’re experiences with either pump. I like my Vibe it’s small and easy handle but I also like the idea of the Omnipod as its cable free, I can check my BGL’s on there too and it seems more advanced than my current Vibe.

How does the Omnipod work with the Dexcom G4? Would I need a receiver?

I would appreciate any feedback you can give me to make my decision a lot easier.

*BTW I and other UK WordPress users have been having a lot of trouble using WordPress due to the Internet Watch Foundation blocking WordPress. Although the block has been lifted, some of the WordPress servers are still black listed by ISP’s. On some days I can log on to my blog and access my blog posts. On other days I can’t access a thing. 

Thanks Amina.

 

Cyborg for a month or perhaps longer :/

As a lot of my readers may know I’m from the UK. As a type 1 diabetic living in the UK all my diabetes care and expenses are paid for by the NHS (National Health Service). This means that all my diabetes equipment, my insulin pump, my test strips, my blood glucose machines and even any prescriptions are all free. Actually all diabetics in the UK should have a medical exemption card which makes all their prescriptions free.

Sorry all my T1Ds who I know go to hell and back with their insurance companies and supplies. That’s another additional fight towards diabetes.

I currently have the Animas Vibe which has CGM (continuous glucose monitor) capability. However since I’ve had it I haven’t had a sensor like the Dexcom G4. This is because my diabetes centre have not been able to secure funding for me, until today. YAY!

dexcom g4

* The sensor is supposed to only last 7 days and at this point the sensor session times out. However after talking to Dexcom I was told that the sensor can last between 10 -14 days. The sensor session can be started again and sometimes last a lot longer than 14 days.

I’ve been given the CGM sensor for a month. Now that I’m aware that the sensor won’t last an entire month i’m going to aim to keep this fist sensor on for two weeks. I’ll be documenting my experience with the sensor and my BGL over this month. As I said funding is limited therefore sensors are few, this also means that every two weeks I’ll have to return the sensor to the diabetes centre and get a new one fitted. If I wanted to have the sensors as a more permanent thing I’d have to fund it myself.

 I feel I need to explain why I of all the T1D’s was able to get a sensor.

Since I had my little boy I’ve progressively suffered with severe hypos, especially during the night. For all you T1Ds out there,  you know what night time hypos means. Diabetes is a scary thing to have to deal with on a daily basis, without having to deal with extreme lows in the night. For the non-D’s this means that I can be up several times during the night when others are fast asleep, checking my BGLs in fear of them dropping too low. These lows can cause what we call a rebound (this is when the low BGL rebounds up and you end up with a very high BGL reading). The sensor will allow me to catch some of these severe lows.

Here’s a breakdown of costs:

  • Transmitter and Receiver and cables £975 and they usually last between 9 – 12 months. To replace this it cost £325
  • A box of 4 sensors costs £250. Should last between 10 -14 days, sometimes longer
  • To buy one sensor costs £62.50 plus P & P = £7.50

So if I was to go with the transmitter, receiver and the box of 4 sensors that would mean I’d have to spend £1214.50 to start the whole process. Plus I’d have to factor in the cost of the transmitter and receiver breaking down so all together it would cost £1539.50. One good thing is that I’d get a VAT exemption, so that good ha! It’s definitely something to think about.

For now I’ll see how this trail period goes before I make a decision.

Happy Pumpdexi’ing  lol!

Diabetic Mathematics! Mathebetics….

I really and truly hated maths when I was in school, it’s quiet ironic that now my life revolves around numbers, equations and ratio’s. Initially my understanding of diabetes and numbers was zero. Insulin units, bolus, what?? I was totally clueless… As the years have gone by I’ve developed a much better appreciation for these numbers and how they work in relation to diabetes.formula math

“It’s hard to believe how essential these numbers have become.”

Being a Type 1 diabetic numbers are all around me from the moment I wake up in the morning to check my blood glucose level to the time I go to bed. I sometimes wish I could just tuck into that slice of chocolate cake without having to calculate how much insulin I’ll need beforehand to maintain good blood glucose levels. Or if I find the motivation to do a workout that I don’t have the worry of my BGL’s plummeting to the point of no return. Of course this doesn’t happen, I usually have to set my insulin pump (basal rates) at a much lower rate and most of the time I have to either suspend my pump or detach it completely. You won’t believe that even that doesn’t prevent my BGL’s from dropping.

Let’s face it, numbers are a part and parcel of my everyday life. I sometimes feel like a hawk gazing, waiting for the correct numbers to appear. In my case, to appear on my blood glucose monitor. The moment I lose focus of these numbers, I’m unable to tame them and keep them within my control.

Understanding carbs, glycaemic indexes, Insulin to carb ratio (I: C), Insulin sensitivity factors (ISF), can get very confusing. Being able to understand them is extremely important in my diabetes management. For the non-diabetics who are probably thinking what is she talking about, let me explain how numbers have such a huge impact on my life with type 1 diabetes.

Numbers/ terms I need to know to be able to manage my diabetes

  • Blood glucose levels (BGL): This is exceedingly important to a diabetic. Having a good BGL and keeping it within a healthy range of (4.0 – 7.0mmol/L// 72mg/dL – 127mg/dL) will help the individual have good control of their condition. HbA1c values will in turn reflect this management.
  • Bolus: This refers to a dosage of fast-acting insulin which is given with every meal.
  • Combo bolus: This refers to a dosage of fast acting insulin which is administered via an insulin pump over a period of time. For example a 12U bolus is administered over a 2 hour period. I tend to use the combo bolus to avoid my BGL rising too high or too low. I’m able to test my BGL during the time to see what level I’m at and either end the combo bolus or let it continue to administer the insulin.
  • Basal Rates: With an Insulin pump this is a dose of fast-acting insulin which runs in the background. It is continuously being pumped in small quantities and is able to cover the production of glucose from the liver.
  • screen shot
  • Carbs or Carbohydrates: Are an ideal source of energy which comes from certain foods. There are both simple (sugars, fruit, and milk) and complex (bread, pasta and potato) carbs. Carbohydrates are easily converted into glucose in the body. Most foods that we eat contain carbs. As a diabetic, carbs and carb counting has become very crucial in my diabetes management. It allows me to calculate the number of carbs per meal and with this I am able to figure out how much insulin combined with my blood glucose level at the time that I might need to keep my BGL at a steady (normal) level.

I started to learn about carb counting through my nutritionist and my diabetic nurse. I attended mini lessons on how to count carbs and even attended a lecture over a 3 weeks period. After I completed the course I had a mini test to see if I had grasped the information. I was given a book with several tables which contained foods and how many carbs each food contained. I was then given an example of someone’s day and I had to calculate how many carbs they’d consumed over that 24 hour period. I will show you an example of my day and counting carbs in a future post.

  • I: C RATIOS: Allows you to determine how much insulin you’ll need as a bolus dose to help the body metabolize, the amount of carbohydrate you’ll be consuming in a meal or a snack. My currently I: C ratios is 1U to 3g, this ratios was much higher especially during my pregnancy.

image (2)

For example, my ratio is 1:3 so I need 1 unit of insulin for every 3 grams of carbohydrate that I eat.

  • ISF (Insulin sensitivity factor): is a calculation used to determine how much 1 unit of insulin will reduce blood glucose level over a period of time. An example of how ISF is calculated based on my numbers follows:

My total daily dose of insulin (basal and bolus = TDD) is 50. Correction factor formula is 100 / TDD

= 100 / 50

= 2

Therefore, one unit of rapid acting insulin should lower my blood glucose by 2mmol/L over a 2 to 4 hours period.

  • IOB (Insulin On Board): This is the amount of insulin which is active in the body. I find that this sometimes isn’t that accurate, so I try not to solely rely on it.
  • Glycaemic Index: This is a measure of the rate at which blood glucose levels are able to rise after eating a particular type of food. Different foods and the way they affect the BGL can fluctuate. The glycaemic index (GI) allows me to approximate how many grams of carbohydrate minus fibre within a food are able to raise the BGL after eating. GI uses a scale from 0 to 100. Pure glucose works as a reference point, and is a given a GI of 100. The higher values are given to foods which increase BGL rapidly. Here is an example of the GI scale and foods associated at each level.

Low GI (55 or less) – Lentils, peanuts, soy, oats, rye, most vegetables, most sweet fruits (mangoes, peaches, strawberries and blue berries)

Medium (56 -69) – banana, whole wheat, raisins

High GI (70 and above) – white rice, white bread, bagels, potato’s

Once you know the GI and the amount of carbohydrates it contains you will also be able to determine the Glycaemic Load (GL) using the following equation.

GL = GI/100 x Net Carbs

For example: ½ cup serving of raw carrots, which have about 8.6 grams of available carbohydrates and a GI of 45.

45 X 8.6 = 387

387 / 100 = 3.9

I hope this post has helped you understand why numbers have become so important to me and my daily battle with diabetes. It’s another added bonus to diabetes. It can be overwhelming at times especially if the numbers you’re getting aren’t ideal. I always try my best to stay positive about it all and if I really can’t figure it out I have so many wonderful people in my life who I know are always there for me.

This blog has helped me reach out to others dealing with the constant battle of diabetes and with others who have loved ones who are suffering with diabetes. I’ve learnt that I’m not the only T1D who can sometimes have dodgy numbers one day and then everything can change just as quickly. I do my best and that’s all I can do.

I wanted to share a few other diabetes related numbers. I got this idea from a great blogger Life or something like it . I was supposed to tell her my numbers but decided to include it in this post.

How many finger pricks I’ve done since I was diagnosed? This is based on an average of 6 pricks a day. Roughly 41, 500 pricks

How many injections I’ve done since I was diagnosed?

I was on 2 injections a day for 5 years = 3,640

I switched to 5 injections a day for 11 years = 20,020

Insulin Pump – I’ve been on the Insulin pump for 3 years now. It’s really hard to calculate how many times I’ve changed my insert, but let’s base it on an average change of every 3 days which = approximately 365

My total number of injections/inserts =24 025

That’s a lot of numbers.

Thank you for stopping by  Amina xx

What is it about coffee?

Kaffee

© ram69 – Fotolia.com

Coffee  커피  قهوة  café Kaffee コー​​ヒー

Is coffee good or bad for diabetes? Hmmm!! This is a question I‘ve been asking myself ever since my blood glucose levels (BGL) started to wreak havoc.

As a child coffee was always painted in such poor light. It was something I was never allowed to have. I was told it would stunt my growth and that it was really bad for me. All the adults around me were drinking it so why was it such a bad thing? The smell it produced was amazing, it made me curious. “What was it like? Why was it so bad for me?” What made even less sense was that I was allowed to have milky tea, which made me happy because all the adults were drinking it too.

Side note: I also love a good cup of tea. Tea however doesn’t seem to affect me in the same way that coffee does.

As I grew I started to drink coffee, I’d drink one or two cups every week. I loved a good cup of coffee. It didn’t hurt me or affect my diabetes in anyway so I continued to drink it. Since I married my husband (who is a mega coffee drinker), I’ve drastically increased my consumption. My one to two cups every week increased to two to three cups in a day “shaking my head”. But I “love” coffee!!! Recently I began to realise that maybe coffee doesn’t love me back.

Every time I’d drink a cup of coffee I noticed that it increased my BGL with no sign of coming down. Also if I ever ate after consuming a cup of coffee my BGL’s would increase even more, forcing me to correct it with a bolus (insulin correction) to bring it back down.

I decided to do some reading about coffee and its possible effects on type 1 diabetes. A lot of the articles and papers I read were very confusing. Some of the articles would express how beneficial coffee was to diabetes and other articles would point out all the wrongs with coffee and diabetes. I think the reason for this conflicting information is because, coffee contains several types of chemicals and some of these chemicals are beneficial whilst others potentially aren’t. This is due to the fact that caffeine is able to impair insulin sensitivity.  In a person with type 2 diabetes this will increase BGL slightly, however with a type 1 diabetic BGL will increase a great deal and will require a bolus to reduce BGL.

FYI: coffee has many benefits it contains polyphenols which have been known to prevent illnesses such as type 2 diabetes. It also contains many nutrients such as magnesium and chromium. The nutrients have been known to improve insulin sensitivity. (Note to self I better get some magnesium and chromium supplements)

According to 2011 “Breast Cancer Research” studies show that coffee contains numerous phytoestrogens, which are chemicals found in plants that sometimes act like the hormone estrogen in your body. The role that phytoestrogens play in your body varies, however, with some mimicking estrogen and having the same effects as this hormone and others blocking estrogen’s effects. Coffee appears to have both varieties and factors like its preparation method, filtering or boiling may influence how much of each type you take.

After all my reading, I made the decision to give the coffee a break and do a detox (I will do a more detailed post on my detox in the future), to cleanse my system and also to truly find out if it was the coffee that was affecting my blood glucose levels. I actually stayed away from all caffeine during the detox, so no tea as well. During the detox my BGL remained stable (no crazy lows or highs).  After two weeks of detoxing I slowly reintroduce the tea first and my BGL continued to act as it did during the detox.

I then reintroduced the coffee to see what would happen. I decided to only consume 1 cup of coffee every day in the morning. The first 2 days of drinking the coffee caused my BGL to rise beyond belief.  I would always have to correct with a bolus.

Was this the end of my coffee drinking days? L

I did some more reading and found a few articles which mentioned that a regular high caffeine intake has been linked to better insulin sensitivity. I decided although my BGL had been rising, that I would increase my consumption to 2 cups a day.

Day 3, the strangest thing happened. That morning I started my day with my usual routine of BGL check (7.2mmol/l) and my usual cup of coffee. I then checked my BG after an hour and to my surprise my BGL was within the normal range (4mmol/l – 7mmol/l). What did I do differently? Nothing at all!

My BGL continued to stay in the normal range so I had my second cup of coffee that evening.

Then day 5, my BGL started off in the normal range and then they began to drop almost after every meal. I struggled to get them up and it took a lot of glucose/carbohydrate consumption to get it within a normal range.  Day 6 and 7 were pretty much the same. I had to have my emergency hypo kit to hand all the time.

Week 2, I decided I would go back to having my 1 cup of coffee, once a day in the evening. This seemed to slow down the hypos. I guess that everything in moderation saying does work out after all.

Another side track: I then found out I was pregnant and I completely stopped drinking coffee all together. After my little peanut arrived I made the decision to breast feed so I stayed away from coffee for almost a year. Plus the pregnancy and breast feeding brought a whole new set of hypo issues. My insulin sensitivity increased so much that my rates were nearly zero. My I: C (insulin to carb ratios increased) and ISF (Insulin sensitivity factor decreased), but I was still having hypos especially in the night. Naughty me I admit I even detached from my pump at times. As a matter of a fact even after the pregnancy my BGL’s lean towards the lower side. This is something that I’m working on with my diabetic team.

To answer my initial question, is coffee good or bad for diabetes?

I definitely think that coffee has an effect on BGL’s. In my case too much coffee increased my BGLs. After the detox and reintroduction of coffee my BGLs still seemed to rise. An Increased consumption of coffee resulted in a decrease in my BGL’s.  However I feel that the pregnancy may have been playing a big part in it all.

After a few years I’m now back to drinking coffee and I try to limit it to 2 cups in a week or less. I do find that on the days I drink coffee my BGL can drop  especially in the night. This month I’ve been really good and so far only had 4 cups. I don’t think I’ll ever totally give up on coffee but I will definitely moderate the amount of coffee I’m pumping into my body since it seems to have some sort of effect on my BGLs. Overall my nocturnal hypos have decreased.

Does coffee affect anyone else in this strange way or any other strange way? Diabetic or non-diabetic. Or is it just me? Hahaha

 

The insert that bled

20130514-210204.jpgDon’t you just hate it when it’s time to change your insert (pump insert), you find the perfect site and in goes the insert. Only to find that your perfect site isn’t so perfect after all. It aches with every move you make. It’s impossible to sleep on and it’s just so uncomfortable.

This is the situation I found myself in the other night.  After changing my insert, as painful as it felt. I decided to ride it out till the morning. Then, silly me with my busy schedule I continued to suffer with this insert until the evening. I finally came to my senses and I thought, “No it has to come out”.

I detached my pump and went to remove my insert only to find, blood pumping out of my arm and from the insert. Could this be the reason for my weird blood sugar readings those past two days. Possibly, probably, now I think about it, most definitely.

This mini post is a reminder to me to not put myself in this situation again. The pain, discomfort  and not to mention the ample amounts of tissue I used to mop up my arm really  wasn’t worth it.

Happy pumping !!Print

Work your sites

© Dmitry Lobanov - Fotolia.com

© Dmitry Lobanov – Fotolia.com

By sites I mean, injection and insulin pump sites. The site, where a needle must pierce the skin to allow insulin to be delivered into the body. As a type 1 diabetic, this is something which can’t be avoided. Whether you’re using an insulin pump or injecting, it’s really important that you rotate the sites you use.

“ROTATION IS KEY “

After many years of injecting, and now using an insulin pump. I must admit at times I do get comfortable with using certain sites on my body. It’s very easy to slip into the “bad” habit of using the same sites over and over.

Print“It gets comfortable! It’s easy to manage. It doesn’t hurt. If I try a new spot will it bleed? Will I have to redo it? Let’s just stick with the thigh today.”

No rotation = lumpy bumpy body

Over use of sites will stimulate the development of lumps. These lumps often seem soft and grape like at the site of injection. The proper term for these lumps are,

Fat hypertrophy also known as hypertrophy or insulin hypertrophy.

These lumps are a build up of extra fat deposits, due to the site being used too often. The Insulin injected isn’t able to flow around the body freely. The way insulin is absorbed is changed, and is unable to circulate as it should do. Therefore making it more difficult to keep blood glucose levels on target.

So what sites can we use?

Here are a few of the sites which can be used when attaching an insulin pump or when injecting with injections. Also refer to the picture below.

  • Stomach
  • Bottom
  • Waist area (love handles)
  • Thighs
  • Backs of upper arms

sites

When I use to inject 5 times a day, the frequency of lumps and bumps occurring were very common. I changed the size of my needles to the (novoFine 0.3 x 8mm needles) to help to prevent these lumps. Even though I was “rotating my sites”, and I now had “these finer smaller needles” I would still develop small bumps under the skin. I found that exercise helped to get rid of these lumps.

Now that I’m using an insulin pump the occurrence of lumps and bumps are far fewer. I try not to leave my insert on a site for more than 3 days ( *this also happens to be the maximum recommended time by the *CDC). After this point, I find that my skin does become raised and bumpy.

Site Rotation tips

“Monitor those blood glucose levels (BGL’s), because literally your life depends on it.”

As time goes by you will start to realise which sites are better for the best BGL control. Talk with your diabetes team and see if their suggestions are good for you.

  • Avoid injecting or placing your pump near your belly button, or near any moles or scars. Tissue in these area are usually a lot harder. Therefore insulin absorption will be a lot slower.
  • Try to use your outer upper arm, this part is a lot fattier. Placing an insert or injecting in this site is difficult, so when I put on an insert I press my arm against a wall to attach it.
  • Thighs – avoid inner thighs, because it could be more painful!
  • Change insert every 2 -3 days and change needles after every use!
  • Make sure the area you are going to inject or attach your pump to is clean.
  • Don’t get comfortable. Don’t use the same sites. Work that body! Avoid those unsightly lumps and bumps
  • Get your sweat on. Try to find an activity that you can maintain and most of all enjoy!

Which are my best sites you ask?

Well, the best sites for me have changed throughout the years. I try my best to avoid my thighs and stomach area (when I was on injections these were my favourite sites). By frequently injecting in those site it has left me with a few small lumps, but being active has helped to reduce and even get rid of the lumps. At the moment, I’ve found that the upper backs of my arms and my derrière region are great for the best blood glucose levels and my overall control. I have no idea why this is. It’s just right for me right now. Everyone’s best sites are different. It’s up to you to figure out which site is best for insulin absorption.

“Remember to rotate your sites, avoid those lumps and bumps on your skin, and find the best sites for you to be able to achieve the best blood glucose levels.”

Changing the “insert” before it needs to be changed

insert 1-This pictures to the right is a insert from different angles. The Picture towards the bottom is the piece that is inserted into my skin. The tubing is connected to my insulin pump.

There are times, when I attach my insert and it just won’t stay put, It doesn’t feel comfortable or it is stuck to me like glue. These all result in me having to change the site. These are a few examples of when I may have to change my insert.

  • Accidentally rubbing my hand over my insert and detaching it. I need to replace it.
  • Creaming my hands and skin and I start to feel my insert peeling.
  • As I attach the insert I get a sharp pain, followed by blood coming through the tubing of my pump. I need to replace it.
  • In the middle of the night, my pump has a fit, because there is an occlusion in the tubing.
  • Time to replace my insert and it just won’t come away from the site. AHHH!

Have you ever had lumps and bumps? Which sites are best for you? Do you get comfortable with certain sites? What do you do to stay active and get rid of those lumps?

*CDC – Centers of Disease Control

 

Test your sugar girl!

Blood glucose  levels = diabetes management

BE HEALTHY KNOW YOUR BGLA major aspect of being able to manage my diabetes is to regularly test my blood glucose levels. This involves inserting a test strip into a blood glucose machine, pricking my finger to draw blood and applying my blood to a test strip.

Testing blood glucose levels (BGL)  is a way for a diabetic to gauge what sort of  levels they are working with. For someone without diabetes this isn’t necessary,  as the body is able to keep the levels in a healthy range automatically. The body produces insulin and allows glucose to be released as energy.

What are the healthy ranges you ask?

In order for me to explain the levels a bit better. Please refer to my table below.

 Type Before Meal  2 hours After Meal
Non diabetic 4.0 – 5.9mmol/L Under 7.8 mmol/L
Type 1 4.0  -7.0mmol/L Under 9.0 mmol/L
Type 2 4.0 – 7.0mmol/L Under 8.5 mmol/L

For a person without diabetes, a normal blood glucose level usually ranges between 4.0mmol/l (72mg/dL)  – 6.1mmol/L (110mg/dL). After a meal, blood glucose levels may increase for a short period of time up to 7.8mmol/L (140mg/dL). With Type 1 diabetes there is the risk of blood glucose levels either raising (Hyperglycemia– this is when an excessive amount of glucose circulates in the blood) or dropping (Hypoglycemia – this is a  diminished amount of glucose in the blood.)

After years of testing, it’s something that you don’t really get use to. For me, it became something that I had to do, even though at times it can be painful, it can leave marks and has hardened my finger tips. The harsh reality is,  that it is a crucial part of being able to manage your diabetes.

How I manage my blood glucose levels

From the very beginning (at the age of 11), I tried as much as I could to take and record my BGL by myself. This was something which was encouraged during my time in the hospital and also at the diabetic clinic. However my parents supported me with this, but never pressured me. I felt comfortable to check my BGL and even inject in front of them and my siblings. They continued to except me for me, and never made me feel any different to them regardless of my condition.

Throughout my 19 years as a diabetic, I’ve gone through my fair share of blood glucose machines. There is such a wide variety of blood glucose machines out there. Most blood glucose machines work in the same way. In the sense that you get a blood sample and a blood glucose result in the end.My first blood glucose machine was big and bulky, required a large sample of blood and  took much longer to produce a blood glucose reading. I was advised by my diabetes team to test my glucose before and 2 hours after my main meals. My blood glucose levels (BGL) would then be recorded in a log book like this.

log book 3

The log book  allowed me to make notes of my insulin doses for that day, week etc. Also any general notes I wanted to jot down could be written in there. Now that I use an insulin pump my log books have changed and I tend to test a lot more frequently.

LOG BOOK

My blood glucose machines now are a lot more advanced and allow me to study the data a lot more closely. I enjoy formulating patterns and occurrences in blood glucose levels etc. (I think this is just the scientist in me). However, it does help me make changes or suggestions to my diabetic healthcare team during appointments.

The right machine

Here are the machines I’m using at the moment.

BGL MACHINE1

It’s always good to have a backup machine. Choosing the right machine is extremely important, because essentially it will allow you to know what is happening with your BGL and help  you to keep within a healthy range.  Personally, I prefer something that is small, easy to carry and requires a small blood sample.

Some insulin pumps, like the (Animas vibe) have the capability to continuously monitor blood glucose levels. These continuous CGM (Continuous Glucose Monitoring) glucose sensors are connected to the body and work with the insulin pump to retrieve blood glucose results. With the BGL’s retrieved, the CGM is able to formulate graphs. This comes in handy when it isn’t possible to test i.e. during the night, early morning, during a workout etc. The CGM is able to alert the user when blood glucose levels are increasing or decreasing. I hope to get my CGM sensor soon and will definitely share my experiences using one.