Category: complications

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

Are children not getting the recommended diabetes checks?

imageWhen I was a child, I remember having several check-ups every time I’d attend my diabetes appointments. After my diagnosis my check-ups were every 3 months and then it became every 6 months. These checks covered everything from, cholesterol testing, blood tests, feet check-up. Both of these tests would also be checked at my GP surgery once a year.  My eyes were tested at my opticians, annually.

Nevertheless all the results from these check-ups would then be sent over to my consultant at my diabetes clinic. Every appointment the doctor would have the most recent results from these check-ups. Appointments moved swiftly and results were explained in as much or as little detail needed. Any concerns or advice were given and time for listening was also given. Everything was in order and none of my check-up were ever missed.

However, a recent study of children ages 12 to 24 with diabetes, attending paediatric diabetes units in England and Wales proposed that, nearly 75 % of these children are not getting the necessary health checks.

70 % of these children are in fact type 1 diabetics, who are insulin dependent and require these check-ups to be carried out at least annually, routinely and efficiently.

From the study, data was collected from 27, 682 children and young people, which outlined that only 25.4 % of these children (ages 12 to 24) were having the seven recommended annual checks.

 “Guideline from NICE (The National Institute For Health and Care Excellence) state all children with diabetes should have their blood sugar levels checked every year and those over the age of 12 should also have six other health checks.”

These checks for this age group should include:

  • Measurement of growth
  • Blood pressure
  • Thorough eye tests, examining the backs of the eyes in detail
  • Cholesterol testing
  • HbA1C
  • Feet check-ups
  • Kidney function

The study also found that, from this age group (children age 12 to 24 years old), those who were considered to have “excellent diabetes control” of 7.5mmol/l, had in fact risen to 15.8mmol/l in 2012 and then by 2014 -15 this had risen even further to 23.5%.

These results are extremely disturbing and it clearly shows that there is a failure within the basic support and care of children and young people living with diabetes. These check-ups should be routine and frequent enough so that both the patient and the doctor are aware of the patients diabetes management.

As alarming as these results are, the report carried out also showed that at least 98.7% of these children in this age group had their HbA1c tested. However, only 23 % had started to increase their chances of not developing complications due to poorly managed diabetes.

On the other hand, the most frequently missed checks amongst children age 12-24, involved foot examination, eye screening and cholesterol testing.  All these tests are crucial when it comes to managing diabetes treatment and the regularity of these tests being done will only aid in the detection of any signs of diabetes complications or any damage being done to organs. Detecting signs for complications such as (blindness and kidney damage) early could potentially help to avoid or lessen the effects of the complication and if treatment is necessary then it can be administered at an early stage.

The study also showed that children from poorer areas were found to have worst HbA1c test results whilst children in more prosperous areas were found to have better HbA1c results.

Bridget Turner, director of policy and care improvement at Diabetes UK, said, “There remains considerable variation in the level of care provided. This is very worrying because if children and young people are not supported to manage their diabetes well in early life, they are more likely to be at risk of debilitating and life threatening complications in adult life such as amputations, blindness and stroke.”

Since the report, The NHS (National Health Service) are working to improve the delivery of effective integrated diabetes services with the help of clinical commissioning groups across Wales and England.

I hope that future reports will show that children within this age group suffering with diabetes are being taken care of and not going without these fundamental check-ups, regardless of their economical status.

Amina xx

D related disappointment!

On Saturday, I had a routine eye check at the Eye hospital. As a type 1 diabetic having regular eye tests and making sure your eyes are in tip top shape is the best way to Printavoid any complications which might occur.

Side note: I never miss an appointment I usually have my eyes checked every 6 months to a year with the optician. Then every year since I had my son I usually attend the eye hospital for a routine check-up.

So I made my way to my appointment, the doctor checked my eyes thoroughly and proceeded to tell me that I have “*small changes” in my eyes.

WHAT?? was my initial response ( in my head ) I wanted to shout it at the top of my voice, but me being me I remained calm and maintained my compose. I mean how could this even be happening? My HbA1c is good, well 7.5 is good right? I suppose I can definitely get it tighter and I’m all over my blood sugars day and night. What more could I be doing?

He then proceeded to tell me that it was nothing to worry about and that the changes were too small to be a concern.

“Oh is that supposed to make me feel better!” Well it didn’t!

For me any change is a bad one, especially when those changes are occurring in my eyes. Well this shocking news pretty much set the tone for the rest of the day. I felt disappointed in myself that this was the result I was hearing.

Side note: I’ve had small changes before just after I had my son, but they corrected themselves plus my HbA1c was at 6.4, so I’m hoping and praying that this time they will correct themselves one again.

Being able to connect and talk to others type 1 diabetics (T1D) is something I feel that has been lacking throughout my 19 years with diabetes. I can only say I know less than a handful of other T1D’s in my town, which is really sad.

My family have always been great with trying to understand my diabetes and make me feel better when I’m having a bad D moment. However I sometimes feel that they could never really fully understand it.  I love them very much and will always appreciate all the advice and the help they can give me.

Recently twitter has become a place where I can go to and vent about D related issues and non D issues too. It has helped me immensely and I’ve been able to connect with so many other T1D who are going through similar things to me. They just get it and can relate to the highs and lows that diabetes brings.

Yes I’m worried, I’d be lying if I said I wasn’t, but  I have to stay positive. I’ve had some great advice from my family and other T1D which I’m planning to implement. I know that these changes aren’t my fault and that I’ve been diabetic now for a very long time. The most important thing is that I continue to try my best and maintain as good a BGL as possible.

My Plan of action

  • Keep on checking my BGL throughout the day. I recently started using an app called mySugr (https://twitter.com/mysugr) and it has really helped me keep a closer eye on my blood glucose levels. It has some great features and I can take it with me wherever I go. Also I had the opportunity to use a CGM sensor recently and I’m hoping to get one on a more permanent basis. I believe it will help me a great deal.
  • Hopefully getting a tighter grip on my BGL will also reduce my HbA1c. I’m aiming to get it down to 7 and then after that I’ll try to get it back in the 6’s again.
  • Some great advice I got from https://twitter.com/nrycroft was when I count the carbs I eat, I should try to calculate how much insulin I need based on my experience with that carb rather than depending solely on what the text books might say. If I’m able to generate almost like a map of the portions of carbs I eat, using the trial and error method I will hopefully be able to figure out how much insulin I’ll need to take every time I eat that carb.
  • Continue to work out. Working out definitely helps my BGL.
  • Try to connect with more T1D in my town.
  • Stay positive

If anyone else has any other advice I would really appreciate it.

Thanks for stopping by Amina xx

 

*Please refer to my previous post: https://sugarhighsugarlow.com/2013/04/24/diabetic-complications/

*Small changes or background – This is the most common type of diabetic retinopathy and many people who have had diabetes for some time will have this early type. The blood vessels in the retina are only very mildly affected, they may bulge slightly (microaneurysm) and may leak blood (haemorrhages) or fluid (exudates). As long as the macula is not affected, vision is normal and you will not be aware that anything is wrong. Your retinal screening test will keep a close check on these early changes and ensure that any signs of progression to more serious stages of retinopathy are detected early.

Avoid retinopathy

Let’s prevent retinopathy

How can we avoid these complications? Here are some of the steps I try my best to take to avoid complications.

1.      BLOOD SUGARS, BLOOD GLUCOSE LEVELS, BLOOD SUGARS. Get them as tight as possible. Stay within the target levels.I can’t stress how important this is. I try to test my BGL at least 8 – 10 times in a day.

Type 1 diabetic (adult) before meals should be aiming for 4-7mmol/l

Two hours after meals try to aim for less than 9mmol/l

Type 1 diabetic (child) before meal should be aiming for 4-8mmol/l

Two hours after meals try to aim for less than 10mmol/l

2.      HbA1c, A1c = Try to get this between 48 – 58mmol/mol (6.50% – 7.50%)

3.  Make sure blood lipids (fats) are in a healthy range.

4.      Get your eyes tested, every 6 months to a year. Let’s avoid any complications occurring.

5.      If you have high blood pressure, get this checked frequently.
125/80 (healthy range)

6.      I always try to eat healthy.

.   Stay Active. Get that blood circulating

8.  I always attend my annual diabetes check ups.

9. Look after your feet

ClearlyHealth

Don’t complicate it! Part 1

DIABETIC COMPLICATIONSAVOID, AVOID, AVOID!!!!!

This is what I think when I see, or hear  diabetic complications.

One of the reasons why I stress the importance of having good blood glucose levels and HbA1c control, is to avoid complications caused by diabetes. These complications can affect the eyes, the nerves, the kidneys, muscles and the heart. This is something which worries me a great deal. However my worries, drive me to want to have  better, tighter control of my blood glucose levels.

Complications are less likely to develop and are not as severe with diabetics who have good blood glucose level control.  If I can put in the effort to have the best control that I can, these complications are less likely to arise.

“Complications with a capital C”

Complication number 1

Retinopathy –  This is one of the complications which totally freaks me out.This complication causes damage to the retina. All diabetics are at risk of developing retinopathy, whether they control their diabetes by diet, tablet or insulin. There is a much greater risk, if your diabetes isn’t controlled well, if you have high blood pressure and if you’ve had your diabetes for a prolonged period of time.

Illustration of hemorrhage in retina - Diabetic Retinopathy

© Sophia Winters – Fotolia.com

Poor control and high blood glucose levels will cause retinopathy to occur. Over a period of time these high blood glucose levels, will affect the small blood vessels in the retina,  causing them to become inflamed and damaged without the patient’s knowledge.

Blood vessels burst causing haemorrhage and swelling. Blood leaks to the back of the eye (in the picture above, this is represented as spots near the vessels) and oxygen is unable to enter the retina. This results in the growth of abnormal blood vessels on the surface of the retina.  Without treatment, retinopathy continues to progress, eventually leading to blindness. Having good blood glucose control and ultimately a good HbA1c, will help to reduce the risks caused by retinopathy.

There are different types of retinopathy

1. Background Retinopathy (or non- proliferative retinopathy)

In this initial stage, many people do not notice any changes in their vision. These early changes are reversible and do not affect vision.  Diabetics must have regular eye checks to prevent these early stages progressing to a more serious stage of retinopathy. If this early stage occurs, it can be detected and monitored closely.

2.  Maculopathy:

Glucose build up in the eye and damages the small blood vessels in the retina. Diabetics can develop a condition called macular edema. Damaged blood vessels leak fluid onto an area of the eye called the ‘macula’. This part of the eye allows you to see fine detail.  With maculopathy the macula becomes swollen and can causes vision to be become blurred.

3. Proliferative:

As retinopathy develops, the retina becomes deprived of a good blood supply, due to damaged blood vessels. This causes blood vessels to proliferate (or grow). Due to a lack of oxygen in the retina and as the eye tries to repair itself.  This causes new brittle blood vessels to grow in the retina. These new blood vessels can bleed and grow rapidly. If this isn’t treated quickly it can cause vision to be clouded, resulting in a damaged retina. In severe cases this can cause retinal detachment, and glaucoma.

There are 3 main treatments used for diabetic retinopathy, which have been effective in decreasing the loss of vision.These treatments include,

To be continued…………………………….