Appleton is an Artist and Photographer, who has been creating art images and sculptures for over 40 years. He attended Boston University, where he studied both art and photography. After completing his studies, he moved to New York City, where he found that the diverse cultural landscape offered him great inspiration for much of his early documentary work.
Area’s such as, West Side Highline, before its massive makeover specifically offered a great platform for inspiration.
“The old rusted tracks and overgrown grass, the bright open and vastness would become negatives that would eventually fill a few three-ring binders. A love of industrial objects, the lost and found would become the work and the sculptures.”
Appleton’s work, takes the ordinary, often overlooked images, the ones you walk past everyday to another place and time, he is able to bring these images to their rightful place.
Appleton’s relationship with Diabetes,
One of the main focuses of Appleton’s current pieces, is to promote diabetes awareness by incorporating into his work different essentials diabetics need on a daily basis to survive.
After surviving a diabetic coma at the age of six, Appleton began to collect almost every insulin bottle that had gone through his system. This amounted to hundreds of insulin vials, faded syringes and old blood strips. They were all reminders of his survival through the years.
With no cure in sight, Appleton’s mission is to spread and raise awareness of diabetes through his art. Appleton hopes to inspire the millions who have this nightmare of a disease, to carry on but also to educate those who know nothing of the condition. By doing this, he also hopes to eliminate misconceptions and false hoods about the condition.
Joseph Beuys, Mark Rothko, Gerhard Richter, Andrew Goldsworthy, the Starn Twins and Shepard airey – are amongst many artists that have greatly inspired Appleton.
This month of October marks the calendar as “Talk About Your Medicines” month. The American Recall Center invited me to talk about the medicine I use. I hope that this will help to spread further awareness for diabetes.
What’s my medicine?
My Medicine is Insulin. Insulin is a hormone which is produced in the pancreas. As a type 1 diabetic, I am unable to produce insulin and must administer a synthetic engineered form into my body. It is essential that I inject insulin into my body on a daily basis. I greatly depend on it and it is vital for my survival.
“I am insulin dependent.”
My insulin therapy started over 20 years ago now and it will be with me for the rest of my life. You may or may not have gathered yet but insulin is not a cure for diabetes. As Dr F Banting once said, “Insulin is not a cure for diabetes; it is a treatment. It enables the diabetic to burn sufficient carbohydrates, so that proteins and fats may be added to the diet in sufficient quantities to provide energy for the economic burdens of life.”
Having this chronic disease means that I have no choice but to take this medicine if I want to live a healthy lifestyle. It allows me to live in general. Without it I would be extremely ill and my day to day functions would be limited.
When I was first diagnosed, without my natural insulin production, it took a matter of a week before I became a skeleton. I was weak, constantly consuming what seemed to be gallons of water and daily living became a struggle. The lack of insulin in my body meant that I couldn’t function well. “I was wasting away!”
Starting my insulin therapy impacted me greatly. I had to learn to accept it and trust that this medicine would help me be well again and allow me to be myself again. It was a big change in my life, but remembering the feeling of sickness I had felt before my diagnosis, made me want to be healthy and normal again.
How do you remember to take your medicine?
Remembering to take my medicine can be difficult at times. However after 20 years of living with this condition, there really is no room for forgetting to take your insulin. I’ve made it a priority and it has become a part of my daily routine. Having to calculate carbohydrates I consume forces me to remember to take my insulin. I won’t lie, I have on occasion forgotten to take my insulin. However, I usually remember during my first few bites of a meal and quickly give myself a bolus(dose of insulin). It really isn’t an easy job at all. It’s constant, everyday, night and day. You can’t really escape it or say, “Ok I’ve had enough” or, “oh no! I skipped that dose. Never mind I’ll take another dose tomorrow.” It just doesn’t work like that.
Where do I go for medical support?
For medical support I usually attend a Diabetes clinic. If I have any concerns I tend to reach out to the clinic and also to my GP. I am free to make contact with them during the week. Nevertheless, medical support during the weekend is limited to going to the hospital.
Advice for others
As a newly diagnosed patient about to start a course of insulin therapy. My advice to you is to remember, diabetes and insulin therapy is an enormous and daunting prospect to come to terms with. The concept that you will have to take this medicine for the rest of your life is a lot to contend with. Accepting that this is now your fate, is key to maintaining and managing your diabetes. You must make it your business to learn as much as you can about this condition and its treatment if you want to live a healthy life.
Take it step by step and try to do the basics, e.g. taking your insulin before meals, testing your blood glucose levels and taking note of what your levels are at certain times. Don’t be afraid to ask questions, consult your doctors about the insulin therapy your about to commence. Something that really helped me was to connect with other diabetics both newly diagnosed and diabetics who had been living with the condition for years.
What drug interactions must you be aware of?
When I was first diagnosed I had no idea about different drugs interacting with my insulin. It wasn’t till later in my diabetes life, that I began to understand that there are many drugs which in fact can interact with insulin, drugs such as Aspirin, oral contraceptives, anabolic steroids, thyroid medication and many more. Consulting with your GP is the best thing to do. They will be able to tell you exactly what drugs can interact with the type of insulin you are taking.
The risks and benefits of taking insulin?
The major risks involved in taking insulin are taking too much or too little. This can have a severe effect on your blood glucose levels and can cause hypoglycaemia or hyperglycaemia. Taking the correct dosage is very important.
The benefits of taking my insulin is that I am healthy. Even though I am dependant on it, without it I wouldn’t have been able to achieve many things in my life thus far. Would I be the adult that I am now without it? In all honestly I don’t think I would be the strong, determined individual I am today. This medicine has been instrumental in helping me face my condition. Without my insulin I would not have been around to encounter all of life’s challenges.
What do you wish you knew before taking insulin?
I wish at the time of my diagnosis I knew more about insulin and how it worked. Also I wish I had a better understanding of how soon my insulin/s peaked.
Taking you medicine is crucial when you are a diabetic. However, it is also very important to know more about the medicine you are taking. Don’t take it blindly without knowing more about it and how it will affect you. Being a diabetic is extremely arduous but try to stay positive, be patient, stay determined, reach out to others when you need the support and most of all remember to take your insulin.
I’d like to introduce a guest post by Erin Stelbrink. She is a Registered Dental Hygienist with 5+ years of experience as a licensed hygienist and oral health care professional. She holds a passion for researching the latest technologies and methods for providing valuable health care service and clinical treatment. Aside from clinical work, Erin serves as a product researcher and journalist for Smile Brilliant, a company providing professional teeth whitening from home and cavity prevention products.
Words from a concerned dental hygienist
Do you see your dentist regularly?
Pretty much everyone knows that it’s recommended to see a dentist on a regular basis, but unfortunately many people don’t actually follow this advice. I’m a dental hygienist myself, so I often see how bad it could turn out for those who avoid the dentist. There are patients all the time who don’t come in until they’re having major pain in their mouth. (It’s never good news, I can tell you that much.
Why you should dread not coming to the dentist
Patients neglect coming into the office for long spans of time because they just can’t seem to make it a priority. And so, the pain, when they ultimately do come see us, means something is more seriously wrong and it will be more difficult (and probably more expensive) to treat than if it had been caught earlier. I must admit it’s a very common tale where I work. But wouldn’t it be awesome if it could be avoided?
See your dentist twice a year to help prevent complications — especially for those with diabetes
The thing is, routine check-ups and cleanings at the dentist can greatly reduce the risk of developing serious dental or oral problems. Yes — dental problems can be prevented! It’s pretty great! Moreover, if you have diabetes, seeing your dentist regularly is even more important than it is for other people. Diabetes can cause a lot of oral and dental problems, so it’s essential to stay on top of your dental appointments and know your risk!
Diabetes causes dry mouth — dry mouth causes loads more problems
With uncontrolled levels of blood glucose (AKA sugar), many people with diabetes end up experiencing dry mouth. It becomes apparent to me that a patient has dry mouth if they aren’t producing a healthy amount of saliva while I clean their teeth. This is an immediate red flag since dry mouth can cause a whole list of not-fun stuff involving your teeth and gums.
This, of course, includes tooth decay, which can lead to cavities, pain, ulcers, infections and tooth loss. And, since patients with diabetes weakened defenses against infections, sores and wounds in the mouth, it takes a lot longer for them to heal from these things. If only people knew how much salvia helps guard their teeth!
A good amount of saliva is needed for oral health
Maybe you never guessed that something like saliva would be so valuable to your oral and dental health, but it certainly is. The flow of saliva in the mouth works to hydrate your oral tissues and wash away debris from food you eat so bacteria don’t overstay their welcome. Furthermore, saliva has the power to guard your teeth from plaque by neutralizing the acids before they can start eating away at your enamel! Go ahead and start thanking your saliva for saving the inside of your mouth big-time! But if you have a lack of saliva, it’s best to do something about it.
What to do about dry mouth
Since uncontrolled blood glucose levels can cause dry mouth, it’s important that people with diabetes do their best to keep those levels as steady and healthy as possible. Apart from this, there a number of treatments to try that can either act as a saliva replacement or trigger the production of it. Maybe one of these solutions will work for you!
• After eating, rinse your mouth with water
• Sip water regularly throughout the day
• Chew on gum or suck on mints with xylitol
• Use an over-the-counter self applied fluoride
• Use products that simulate saliva
• Restrict use of mouthwash with alcohol in it
• Consume less caffeine
• Use a humidifier
• Breathe through your nose
A major step toward a healthier smile
Knowing the oral health risks related to having diabetes gives you a keen edge to prevent problems with your teeth and gums. That said, nothing can replace seeing the good ol’ dentist twice a year. I think I speak for all of us dental professionals when I say, we hope to see you regularly — especially if you have diabetes!
If you have any questions for Erin or if you wish to read more of Erin’s articles? Then you can email her at firstname.lastname@example.org or find more of her work on the Smile Brilliant Blog.
I’d like to introduce husband and wife, fitness instructors, Christel (who has type 1 diabetes) and Tobias. Through their blog, TheFitBlog, they share their passion for a healthy and fit lifestyle, whist giving people the support to succeed with their fitness goals.
How did you start TheFitBlog?
Tobias and I have always had the desire to do our own thing. The summer of 2015 it all came together and we decided to take a leap of faith and make our hobby and passion our occupation. TheFitBlog is a general health and fitness site while the “Fit with Diabetes” section on the blog is my platform to discuss health and fitness from a diabetes perspective.
When I started working out more seriously, I searched without much luck for good information online on how to successfully combine training and diabetes management, so I had to figure it out on my own. TheFitBlog is my chance to share my experience and learnings with others.
How long have you had type 1 diabetes? How did you find out? What steps did you take?
I was diagnosed with Type 1 diabetes in December 1997. I’d just finished high school that summer and spent my time working in a preschool, partying hard and eating and drinking everything in sight. I displayed all the classical diabetes symptoms; hunger, thirst, sleepiness, frequent need to urinate and a slender physique. But all of that I simply attributed to my lifestyle.
At one point, my family did urge me to see a doctor, I did, and he was determined I had diabetes. I was admitted to a diabetes clinic as an outpatient and they spent the next two days teaching me about diabetes, how to take my shots, test my blood sugars and how to treat lows. First day of my diagnosis I was encouraged to never let my diabetes manage my life or to be a hindrance and I took that to heart and have lived by it ever since. Eight months later, I left for my first backpacking trip around India and I never slowed down.
How often do you work out?
Hi, my name is Christel, and I’m a workout –holic :-). I’m in the gym 6 days a week right now. However, 2016 is also a competition year for me so I’m working out as an athlete. I compete in NPC bikini competitions and have qualified to potentially take home a pro card later this year. A more normal gym schedule for me is 4-5 times a week and I think that is plenty for most people.
How do you balance working out with diabetes?
There is definitely a learning curve, but once I understood my body and how I react to different kinds of exercise, it’s actually pretty easy. When you understand how your body reacts to certain foods and exercise you’ll know how to adjust your insulin and not have to worry about lows all the time. Of course, I don’t always get it right but 95% of the time my sugars are perfect pre, during and post a workout. My advice is to take a lot of notes and find out how your body reacts to different foods and exercise and learn from it. In the long run, I find that working out makes your diabetes easier to manage, not harder.
How often do you have rest days?
Rest days are usually the hard ones for me since my insulin sensitivity goes down. I have a minimum of one rest day per week. There are some great sunset walks where we live in Santa Monica CA. It’s important to have rest days, since that’s when your body rebuilds and get stronger.
“When I work out, I’ve found that it’s much better for me to work out in the morning opposed to the evening. My sugars have a tendency to drop drastically in the night time, so I lean towards working out in the morning. Being able to stay motivated whilst maintaining good BG levels is extremely difficult.”
What time of day do you like to work out? Have you found that working out at certain times are better for you and your BG levels?
My advice is to work out the time of day that suits you best. In the morning, you’ll have less insulin on-board so you’ll be less prone to low blood sugar. If your goal is weight loss, you might even benefit from morning sessions before breakfast. I do fasting cardio in the morning and resistance training in the afternoon/evening to build muscle mass. The key is to determine the right insulin level. It will depend on what you eat, your insulin sensitivity and how aggressively you work out.
Do you use a pump or injections?
I’m one of the rare MDI / CGM combinations. Pumps are awesome, but not for me at this time in my life. It’s still an extremely valuable tool and something I recommend for everyone who starts working out. I have very good control with MDI because I’m willing to inject 10 times a day if needed and test my blood sugar just as often.
How often do you test your BG and how do you record your BG levels?
Whenever I feel I need it. So it might be 10 times a day or it might be 8. I have a Bayer meter that saves all my readings so I can just download it when needed.
How do you stay motivated whilst managing low BG levels?
I guess I really don’t think about my blood sugar in those terms. My motivation to do what I do is not affected by my blood sugars. I manage them to allow me to do what I do.
How do you correct your BG levels without ruining the hard work you’ve put in?
By learning how much insulin and food to consume around workouts I hardly ever have low blood sugars during exercise. If I do, I treat it as it is; a medical emergency. I’ll eat 2-3 glucose tablets and either have a fruit strip and continue my workout or simply go home. A few glucose tablets and a fruit strip will never ruin your progress even if you are trying to drop weight. What will derail your progress is if you treat lows with candy or sugary soda.
What advice do you give to your diabetic clients when it comes to low/high BG’s when working out?
I always have clients track their activities, food, sleep patterns etc., and then together we work on determining why and when he or she is going low to reduce the risk of it happening
“As a mother, my schedule can be pretty hectic and fitting in a work out can sometimes be impossible. I like to do quick HIT workouts for a 20- 30 minute period or target one area e.g. my abs. My goal is to be working out a lot more than I currently do.”
What advice would you give to me and to others who are struggling to achieve their fitness goals due to the hectic lifestyles or plummeting BG levels?
Even a little physical activity is better than nothing. First, decide what you want to achieve. If it’s cardiovascular health, focus on cardio. If it’s building strength, chose resistance training. Since time is a limited resource, you might have to focus your attention to one thing only.
I mainly do resistance training, because I think it gives a better return on the time I spend. Muscles help burn calories and increase your insulin sensitivity, so adding a little muscle mass is great for people with diabetes.
The reason why your blood sugars drop when you work out is that you have too much insulin in your system. So just as you learn your carb ratios over time, put in the time to get to know your insulin sensitivity after different types of workouts and adjust your insulin accordingly.
Look out for Part 2 of TheFitBlog guest post from Christel and Tobias on Nutrition. In the mean time if you want to read more about Christel and Tobias, then check out their blog at TheFitBlog. You can also find them on Twitter , Facebook and Instagram.
How important is nutrition to you? What types of food do you consume on a typical day before and after a workout and also when maintaining your BG’s?
The saying that you can’t outrun a bad diet is very much true. So nutrition is very important for me. If you are looking to make changes to your body, mood, and diabetes management, getting your nutrition right is the place to start. What you eat is actually more important than how you work out. I eat 6 small meals throughout the day consisting of low glycaemic carbs (oats, sweet potato, and rice), lean protein (chicken, fish, and eggs) and fats (coconut oil, nuts, avocado).
“TheFitBlog offers some amazing, cost effective meal plans for example the Female Fitness Program. It’s a general workout and meal plan for women but can be used by everyone, so it doesn’t mention diabetes at all, but it definitely works for people with diabetes (as it’s the program Christel used when she first started her fitness journey).
There is also an opportunity to have Online Personal Training. Christel works directly with clients and creates a custom- made workout meal plan weekly follow-ups and all the things that you would expect from a personal trainer. For Christel’s clients with diabetes, she is able to help them with diabetes management, especially when it comes to working out. “
Are there any specific foods you would advise a diabetic to have when working out?
Yes, but it depends on what kind of exercise and the individual’s goals. If you want to build strength, you need a good low glycaemic carb (oats, sweet potato, brown rice) and protein (chicken, fish, egg) before your workout and a higher glycaemic carb (white rice, banana, rice cake) and protein (whey shake or eggs) after your workout, accompanied by insulin. You actually need that insulin spike after your workout in order to feed your muscles and build strength and volume. Don’t be afraid to eat, and insulin is not the enemy!!!
“As diabetics, we are constantly counting how many carbs we’ve consumed in any given meal. A lot of us are inclined to follow a lower carb diet to keep BG levels under control.”
How many carbs do you have in a day?
Let me start by saying that I’m not a fan of no carb diets. They don’t fit my goals and I don’t think you need them in order to have good blood sugar control. My standpoint is that carbs aren’t the enemy as long as you eat healthy carbs. Eating too many of the high glycemic carbs are what’s going to mess with your blood sugar and your waistline. Right now, I’m doing carb cycling which means I have about 100 g of carbs for 2 days, then 125 g on day 3 and then 225 g on day 4. Bear in mind that that’s my bikini prep plan. If it was off-season for me, I would most likely be eating more and when I get closer to competition day, I’ll be eating less.
Do you keep a record of this?
Absolutely! I use an app called MyFitnessPal. It’s brilliant and it’s free, hurrah.
What evaluations do you conduct on a new diabetic client who wants to begin a fitness regimen?
I always have new clients fill out a questionnaire about their health, workout experience, previous injuries, diabetes control, etc. I also ask them to track their food and beverages for a few days before our initial phone/FaceTime/Skype session. This allows me to understand what their starting point is so we can discuss goals and set expectations. I want to create a plan that will get the individual the results they want but it also needs to be safe and sustainable. I’ll never promise a 50 lbs weight loss in a month and I don’t expect clients to do what I do.
How do you ensure that a fitness program is effective?
After the first meeting with a new client, I create a customized workout and meal plan. We then have regular check-ins and status updates (how do you feel, your weight, diabetes management, perhaps progress pictures, etc.). Based on the clients’ status, I will make any adjustments necessary to his/hers workout and diet. I’m also available for questions on Facebook messenger or text when needed. Everybody is different so a cookie cutter approach won’t work
“When it come to my diabetes management, I’m so fortunate to have the support of my husband. He’s there through most hypos, he’s even become quite good at counting carbs and always encourages me, when it comes to working out.”How does Tobias help you with your diabetes management, motivation and fitness?
Tobias and I have been partners in crime for 16 years now so he knows the ins and outs of living with me and my diabetes. I’m very independent when it comes to my diabetes management. For me the most important thing is that he understands that sometimes it just sucks, and I’ll complain, but I’ll get over it. He actually wrote a very sweet piece on how to support a diabetic spouse on TheFitBlog, check it out.
I want to say a big thank you to Christel and Tobias for sharing TheFitBlog with us. Christel is a true inspiration and has given me hope that I too can be successful when it comes to maintaining my fitness goals. Better understanding of my insulin sensitivity, carb ratios, learning how much insulin and food to consume around workouts and not over correcting my low BG’s will definitely not limit my ability to reach my true fitness potential.
I’d like to introduce Angelica, an entrepreneur, designer and blogger at Lyfebulb, who has type 1 diabetes.
I’ve been drawing since I was 5 years old, intrigued with studying the human form. Art from paintings and architecture has also always captivated me, along with science and film. I’ve always had a curious mind for obtaining loads of knowledge on new topics, so I research like crazy when I design or work on a new project.
I was diagnosed with Diabetes on November 6th, 1998, a couple days after dealing with painful symptoms and a final night of trauma. The few days before being diagnosed, I lost weight to the bone, threw up everything I ate, needed to pee constantly, and had horrible throat and stomach pains. After two trips to the doctor, I had a glucose of 1000mg/dL (55.6mmol/l). The next twelve months were the hardest my family and I would ever endure, especially because of a hypoglycaemic attack I got one night after not eating.
“I’ve honestly never felt like diabetes affected me, but it did affect my family.”
My mother was really traumatized after the attack and became almost obsessed with watching over me to make sure I was always ok. Sadly, everything flew past her except for me, which in turn affected my sisters. My middle sister grew up fast having to take care of our youngest sister, and my youngest sister felt alone for a couple years of not having our parents’ attention. As time passed, though, we overcame this stress and separation.
Pump or needles?
I have a Medtronic pump and LOVE the freedom, but like all diabetics, I want to be needle-free! Or at least pain free haha! The pump needle still scares me every time. Thank goodness it’s not every day.
Diabetes, Beyond and the positive impacts on my life
Diabetes has kept me mindful of my health, and taught me strength and independence. All the Diabetics I’ve met through Instagram have also inspired me to feel proud and not to give up!
My current entrepreneurial projects are: Veltimera- an ecofashionable nonprofit for animal rights, in which I’m currently designing a Fall 2016 collection to fund animal rescues.
Fashion Academy & Network- an upcoming online fashion school with courses on design to business.
Piece of SASS Swimwear- a sustainable swimwear line for all beautiful body types; and Rebel Empire Apparel- an upcoming t-shirt line based in Los Angeles.
Teamwork, organization, and persistence are the key to making these all successful one day. There is a quote that says,
That is a hard lesson that not many people understand, because all they see is the success of a company or person and not its dedicated work. Another quote that I absolutely love is
I know I definitely have already failed tons of times, but I’ve learned what not to do and have researched new ways of doing things the right way.
One tip I recommend when starting your own business is having an intense passion for what you’re working towards keeps you focused and strong. Without passion, people give up after the first failure or don’t have the drive to educate themselves in what needs to be done.
My drive and passion are animals. Ever since I became vegan, I have not stopped thinking about them. They are the reason I became an entrepreneur in 2012 and haven’t given up.
Veganism in my life
Veganism has actually made it easier for me to manage my diabetes, because most of my foods are plant based. For example- Breakfast is tofu stir-fry,
Brunch is a peanut butter banana smoothie, Lunch is a Veggie burger with fries, and Dinner is bean and vegan cheese tacos with chocolate almond milk.
I always switch my meals around, because I LOVE flavours, but I’ve managed to keep my meals constant in carb count and reduced my basals (which are hourly insulin pump administrations). I do recommend, though, if you consider trying veganism, write everything down for the first 2-4 weeks to understand your body. Everyone reacts differently to new lifestyles.
P.S. To answer any questions, I’m 100% healthy with all my vitamins and minerals, and vegetables and nuts fulfil my bodies need for protein. No, I never feel deprived; in fact, I’ve become more open to new foods, because taste has improved like a thousand times. I also transitioned to veganism over the course of 3 years, and I don’t buy organic like people might assume.
Advice to the younger, newly diagnosed, me!
You will make it through and be a great artist with lots of good friends and successful creative projects. It might be hard right now, and I know you don’t want to take your shots because you hate the needles, but think of your family. You are a warrior, and they need you.
If you want to follow Angelica’s work or have any questions for her, then you can find her on instagram @ Inspired Vegan and Diabetic with Style. You can also connect with Angelica via Facebook and Twitter.
I’d like to introduce Dr Joan St John. She is a GP / Diabetes Specialist. She is the lead for diabetes in a practice in Brent, UK. Dr Joan also has a crucial role working with Diabetes UK as a Clinical Champion.
As a GP, I have been interested in Diabetes for many years and this has been for a number of reasons: I work in an area where there are thousands of people living with the effects of Diabetes on a daily basis, I have seen how it can affect individuals, families and communities and I am passionate about educating people to live healthier lives. I try to do this whenever I can, so this might be in the GP Practice, within my role in a local diabetes service and especially in my role as a Diabetes UK Clinical Champion.
It’s about ‘Education, Education, Education’ and this could involve the person in front of me in the consulting room and their family member, or giving talks to community groups and also being involved in the education of healthcare Professionals.
I work in a Practice that has over 1,000 patients living with Diabetes. In our area, because of the communities that live there, more than 90% of the people affected by Diabetes have Type 2 Diabetes and less than 10% have Type 1 Diabetes.
The voluntary Clinical Champions role that I do for Diabetes UK seemed like a great opportunity to work with others to try to further improve the quality of care provided to people with Diabetes. The work has involved developing resources for people with Diabetes, giving talks to local groups and education events for healthcare professionals.
As someone who has lived with diabetes for 21 years, I’ve had the opportunity to have been in the care of many diabetes specialist. I’ve had mostly good experiences but also some very bad ones.You can read about my experiences with good and bad doctors here.
What do you think are the qualities one should possess, when dealing with a diabetic patient? And how do you ensure continuity, when you have new GP’s in your clinic?
I think the qualities one should possess when dealing with a diabetic patient, are those that are required when dealing with any patient
- A good pair of ears to listen with! Because I believe first and foremost it is about a conversation and dialogue between the patient and the healthcare professional.
- Specialist knowledge is important, but although every healthcare Professional should have basic knowledge, realistically, not every healthcare professional could, or would have specialist knowledge. However, the important things are that they know where to seek the specialist knowledge, or direct the patient to a specialist for specialist care
Most GP Practices try to ensure continuity by asking Patients to wherever possible, see the same Doctor for the same, or an on-going problem. In terms of standardising care, we try to ensure that the care provided is standardised, by providing training in Diabetes to new GPs or healthcare professionals in our Surgery or Clinic.
What sort of care do new patients recieve?
It would depend on what type of Diabetes you have. Care will inevitably continue throughout your life-long journey with Diabetes, but the first steps of care will be different for the two different types of Diabetes. In brief,
If you have Type 1 Diabetes then you will need to be referred urgently for specialist care to start on Insulin. With Type 1 Diabetes your body is no longer producing Insulin and you need Insulin to survive. Following this you will need to have advice about the how to manage and live healthily with your Type 1 Diabetes and insulin treatment.
Type 2 Diabetes on the other hand usually develops slowly over a number of years. It can creep up on someone so that they don’t realise that the tiredness, infections, rashes, frequent urination or change in vision, might be due to the development of Diabetes. With Type 2 Diabetes the first steps would be to explain what it is and how it has developed. We would aim to ensure that you had some structured advice and education about how to manage the condition and advice about treatment.
With both types people will need on-going advice about the condition and treatment required, monitoring of the condition and support.
What advice do you have for people or parents of children, who have recently been diagnosed?
Do not be downhearted!
There are lots of people who live healthily with this condition and there is a lot of help available. Healthcare professionals provide some of this, but given that most of the time the person with Diabetes is the one managing their condition, in a year they may spend about 3hrs with a healthcare professional out of the 8,757hours that they have to manage the condition themselves! So Amina, blogs like yours that provide peer advice, or other social media platforms can be really helpful. There are a number of local and national Charities providing help and advice for people with both forms of Diabetes and Diabetes UK run ‘living with Diabetes days’ and many other forms of support either with online, telephone carelines, or leaflets that People of all ages can find helpful.
Some of the important aspects, that I’ve learnt about managing my diabetes are, the routine blood testing, eating healthily and exercising. These are all very essential, when managing the condition. However, another important aspect of managing this condition, is being able to psychologically deal with all the challenge’s one may encounter.
What’s support is there for the psychological and emotional impact of a new diagnosis/ongoing condition?
I am pleased to say that the psychological impact of how receiving the diagnosis, and also living with this condition affects People is becoming more recognised and acknowledged by healthcare Professionals. As a result more healthcare Professionals are receiving training in how to help someone living with Diabetes make changes that the individual themselves identifies as important to them, to enable them to live more healthily with this condition.
In addition, it is the case that more diabetes services are enlisting the help of psychologists within their teams to support and enable people living with Diabetes to deal with the challenges they face on a day to day basis.
What suggestions or advice do you have for someone who has a family history of diabetes but hasn’t yet been diagnosed?
‘Prevention, Prevention, Prevention’
This is my other passion within the field of Diabetes. I know how important it is to spread the knowledge about how to prevent and avoid developing Type 2 Diabetes because there is a lot of evidence to show that this can be avoided or the onset delayed. Currently in the UK there are about 3million People living with Diabetes, but it is predicted that there could be more than 5million people at risk of developing Type 2 Diabetes. Having a family history of Diabetes means that your risk of developing Diabetes is increased, this is more the case with Type 2 Diabetes but there is also some increased risk of developing it with a family history of Type 1 Diabetes.
There are some exciting developments in the NHS, in that a national Diabetes prevention programme is being developed. This will be the first National diabetes prevention programme anywhere in the World. I back this initiative, as my experience has shown me that people would welcome not only knowing that they are at risk, but also receiving advice about how to avoid, or delay the development of this condition.
I hope this has given you a flavour of what I’m doing and what I’m about. Hopefully, you will invite me back another time so we can talk more about the Prevention, new developments and the management of Diabetes.
Thank you so much for asking me to be a guest on your blog Amina. Wishing you and your readers, All the best.
Dr Joan St John
GP with special interest in Diabetes and Diabetes UK Clinical Champion.
Thank you so much for taking the time to share with us your knowledge and experiences with treating diabetes and working within the diabetes community. I look forward to the second installment, where we can learn more about prevention, new developments and diabetes management.
I want to introduce Ashley Ng, an Australian based blogger at www.bittersweetdiagnosis.com. She is an accredited dietitian and is currently studying her PhD in the field of diabetes education in young adults.
Ashley also has an active role at the International Diabetes Federation as the President-Elect of the Young Leader in Diabetes Programme.
I’ve known Ashley since I first began Sugar High Sugar Low and we have been good diabetes buddies ever since.
Who is Ashley?
When I’m not working away, you’ll find me trying out new place to eat with my boyfriend. , I hit the gym fairly regularly as it helps me to de-stress too. I also play clarinet in two concert bands, which gives my brain a bit of a break. If I’m not doing any of those, I’d be having a snuggle with my gorgeous fur baby – Rosie the cat.
I was diagnosed with diabetes by chance. I had a stubborn sinus infection that wouldn’t go away. I had blood tests done and an oral glucose tolerance test.
Oral glucose tolerance test – measures the bodies ability to use glucose
Within one hour, my blood glucose was 22mmol/l and I felt quite ill! I was diagnosed with type 2 diabetes. Being quite young (19 years old at the time) and relatively active, my family doctor/GP wasn’t satisfied with the diagnosis and sent me to an endocrinologist for a second opinion. I had an antibody and genetic testing which both came back negative for type 1. However, my pancreas was failing to produce the normal level of insulin so now I’ve been classified as having type 1b diabetes.
However, I recently had genetic testing done for MODY and am yet to find out the results. Although, I’ve been told I don’t fit any of the common MODY strands they have already identified.
How do you stay motivated whilst living with diabetes?
I don’t know to be honest! I think it’s definitely wanting to live a long and healthy life and reducing the risk of complications. But It would be hard to do the things I love if I didn’t feel like my diabetes management is adequate.
A way I get back into my diabetes management if I feel like I’m going off track is to get a new diabetes ‘toy’. Recently, it’s been about trying a new CGM sensor. Sadly, this is something I won’t be able to afford on a long term basis. So I’ll go back to buying new PumpPeelz for my pump and meter or a new diabetes carry bag etc. Anything to keep it fun.
Bittersweet Diagnosis blog
I love to write. I first started Bittersweet Diagnosis as a personal blog about life, thoughts and feelings. But once I started writing about diabetes, I remember thinking that I should focus my blog on my experiences on living with diabetes. Initially, I mainly wrote to share with my family and friends what living with diabetes is like. Now, I’m honoured that it gets shared around the world.
There are times where I feel pressured to write a good blog post. During these instances I need to remind myself why I started writing in the first place. My friends are also very encouraging and I often hear about how my blogs have helped others develop an insight into how complicated and complex life with diabetes is.
Ashley the dietician
As a dietitian, I work with clients to develop strategies towards their goals and develop a healthy relationship with food. People like to think dietitians are the food police,
but we are much more. I help people develop a better understanding of how foods affect them, how to achieve balance in their food habits and to remind them that food is more than just calories and nutrients.
For the moment, I’ve given up on seeing patients as my current workload with my PhD and the IDF YLD is enough to keep me on my toes. But one day, I would like to set up an online practice where I will consult with people over Skype to minimise travel and the inconvenience for clients.
Advice to new patients…
It’s okay to feel like crap. It’s okay to have a cry or to be angry. My biggest advice for people who have been newly diagnosed with diabetes is not to panic. You can still live a normal, full and exciting life. Be prepared for the biggest learning curve you’ll ever experience. Remember that there is no one size fits all. It will take time to find what works for you. Diet wise, I would say to keep calm and remember you can still eat anything, but with slight adjustments here and there.
Remember that no one is perfect. While we strive to always be in the ‘green zone’ the odd day or time outside of this zone is okay. It’s frustrating and annoying to deal with but just deal with it the best you can.
Remember too, that you are never alone. There are so many people in the diabetes online community willing to give you a helping hand. All you have to do is ask.
What sorts of food do you encourage your clients to have in their diet?
Eat the foods they enjoy eating! Even if that is desserts, we will work through strategies around mindful eating to ensure we don’t over eat and we are listening to our bodies. Absolutely healthiest foods are a little bit of everything really. But if I had to choose a food group, I’d go with vegetables.
What does Ashley eat?
Ooh!!!! I just had my lunch and should’ve taken a photo because it was delicious! I had leftover home-made butter chicken with rice and veggies. My mum is a fantastic cook and she cooks extra so I get to bring leftovers to work/uni. Over the years I have lowered my carb portion by at least half and included more vegetables and dairy foods.
A typical day this week may look like this:
Breakfast – A slice of wholegrain bread with peanut butter and honey (~25g CHO)
Snack time – A tub of yoghurt (180-200g) (~20-30g CHO)
Lunch – Leftover dinner – often some sort of carb (about half a cup to a cup cooked) with vegetables and meat/fish (~50g CHO)
After Lunch – a small packet of crackers or popcorn (~15g CHO)
Dinner – Some sort of carb with lots of veggies and meat/fish (I’d eat out maybe twice a week and have a chicken Parma or a burger or something) (~60g CHO)
I drink at least 1-1.5L of water a day with many cups of tea in between! I also don’t really like fruit. But once in a while I might have an apple or some berries or something.
How do you deal with unfamiliar foods?
SWAG it! I’d like to think that as long as you have a good basic understanding of what a carb food is, you can generally estimate portions to some degree. I find Asian food to be the most challenging, particularly with the sauces that they use. When I’m feeling nerdy (not very often) I might google the dish and a recipe to get a better understanding of the ingredients used.
Young Leader in Diabetes
The YLD is a programme of the International Diabetes Federation. We serve to be a voice for all young people living with diabetes around the world. We advocate to improve the lives of people living with diabetes against issues like lack of access to medication and care, discrimination and lack of awareness around diabetes.
I’m currently the President-Elect of the IDF Young Leader in Diabetes (YLD) Programme. As part of my role, I work with the executive council of the YLD to ensure that all our Young Leaders are receiving adequate support for running and managing their diabetes project. The YLD will also work on global project such as on World Health Day or World Diabetes Day to raise awareness for diabetes and keep advocating for causes we support. In the background, the executive council works really hard to ensure that the YLD continues its survival as a sustainable program and planning for the next leadership training program.
Thank you Ashley for sharing all the important roles you play within the diabetes community, you’re a true inspiration to us all. Keep up the fantastic work.
You can keep up with Ashley on, instagram, Facebook and Twitter at Health4Diabetes
Article Ashley is featured in : New device for diabetes eliminates the need for painful finger pricking
Since today marks the beginning of Diabetes Awareness Month, what better way to kick-start the month and advocate for diabetes, than by collaborating with some of diabetes extremely influencial bloggers and advocates, to give away accessories from one of my favourite diabetes companies – Myabetic
I absolutely love the accessories available!! If you don’t know anything about the Myabetic accessories then I suggest you check out their site here.
Their amazing accessories, for me, have become the Chanel of diabetes. It has transformed the dull and sometimes invisible blood glucose case I’ve carried around with me most of my life into something that I can be proud of. On first glance, you would perceive it to a beautiful handbag or wallet and it is on closer inspection that its true purpose comes to light.
When I first heard about Myabetic accessories, I was instantly drawn to them. They were bold, chic and beautifully put together. It offers a way for diabetics of all ages, men women and children to express themselves. The dismal blacks and greys that I was once restricted to were now being transformed into something that was very personal to me. It offered many varied, vibrant and colourful choices, which made misplacing my blood glucose meter a thing of the past. Like a brand new bag, it showed my individuality and allowed me to be proud of my diabetes.
Here’s what you need to do to be in with a chance to win the Myabetic accessory of your choice:
- Go to TheFitBlog
- Click on the giveaway form
- Follow Myabetic, TheFitBlog and all the other diabetes advocates on social media.
You can follow me here:
Follow in as many places as you can and share the post with friends online.
**Giveaway runs from today the 1st of November – 14th November 2016. The winner will be drawn randomly at noon on the14th of November and contacted directly by email.
GOOD LUCK EVERYONE. I WISH YOU ALL THE BEST!