Tag: BGL

The itch that won’t quit

From time to time, when I change my infusion site it itches like mad. We’ve all had that itch that just won’t stop. For me, its the site where my insert has been stuck to my body for 2 or 3 days or even a freshly inserted infusion set. It itches and itches and I really have to try my best to resist the urge not to scratch it to death. From the moment it makes contact with my skin or from the moment I remove it, the itch becomes unbearable.

When removing the insert, it can also prove to be very difficult as the insert is extremely sticky. It clings to my skin for dear life and I sometimes find it difficult to separate it from my body. What makes it even harder are those awkward new sites you decide to try out. You transform into a performing Cirque du Soleil acrobat whilst manoeuvring your body to get it in the right spot.

As for a new insert, ripping it off a brand new site would be an absolute waste (especially since diabetes accessories are so costly) and for those old tatty insert’s that just won’t let go, you just want to tear them off!!

After removing the insert, the skin underneath reveals a raised surface, slightly irritated and now, finally, it is able to get some air and it just seems to itch even more.  A grey sticky adhesive coats the area where the insert once sat and resembles someone who hasn’t moisturised their skin for days.

I remember having itching issues from time to time when I was on multiple daily injections (MDI) but not as much since I’ve been an insulin pump user. I suppose when you introduce something foreign on to your body that isn’t supposed to be there, it can cause a number of potential of problems. Several aspects of insulin pumping can cause skin irritations or allergies for diabetics. Causes may include the Teflon cannula, the metal needle, the site adhesive or adhesive materials, and even the insulin itself. When I was MDI, my itching was mainly due to the overuse of certain sites and the metal needle.

When it comes to my itchy insert sites, the truth is it happens very rarely and I haven’t really been able to pinpoint the direct cause of the itch. So, for now, I think I’m just going to try my best to keep rotating my sites, moisturise those sensitive sites (after 22 years I’ve got quite a few) and just continue to keep my skin well moisturised and maybe even try a protective cream to create a barrier between my skin and the inserts to reduce any irritation. With everything that diabetes throws at me I try my best to work it out and make it work. Although I get an itch from time to time, I’ve accepted that it is a part of MY diabetes and that’s ok. I’m very lucky to have a pump and I can deal with a little itch now and again.

Amina xxx

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A few things you didn’t know about Frederick Banting

Today, November 14th marks one of the most important days in the diabetes calendar, World Diabetes Day. On this day, we remember one of the most prominent figures in diabetes, Sir Frederick Grant Banting, the man responsible for co-discovering insulin, as a source of treatment for diabetics in the early 1900s.You can read more about it here.

© Mary Evans Picture Library / SZ Photo / Scherl

© Mary Evans Picture Library / SZ Photo / Scherl

Although, you may know of his work surrounding discovery of insulin, there is however much more to him than just his involvement with diabetes.

Here are a few facts about him:

  • First World War – Sir Frederick Grant Banting, served in both World War I and World War II. He was wounded during the First World War and received the Military Cross for “distinguished and meritorious services in time of war,” for attending to injured soldiers for up to 17 hours, even though he was badly injured himself.
  • Second World War -During the Second World War,  his aircraft crashed. The pilot died instantly. As a passenger on the plane, he was wounded and also died from his injuries and exposure on the following day, February 21st, 1941.
  • Personal Life – Sir Frederick Grant Banting was married twice to Marion Robertson in 1924 – 1932 and married Henrietta Ball in 1937 – 1941. In his first marriage, he had a son called William Roberson Bill Banting 1928- 1998.
  • Featured in a Comic – Banting was featured in a comic book by the
    Corporation of America. He appeared alongside other famous historical figures.

    comic-2comic-1

  • Aviation – Due to Banting’s interest in aviation he was in charge of research done on behalf of the Royal Canadian Air Force (RCAF). He researched phycological issues faced by pilots flying aircraft’s as well as blackouts experienced by these pilots.
  • Artist – Banting became an acclaimed artist, joined painter A.Y. Jackson and travelled around Canada painting iconic Northern landscapes and the Canadian Rockies.
  • Google – If you haven’t seen the google search bar today, then here’s a little peek.google-banting

 

 

 

 

 

HAPPY WORLD DIABETES DAY EVERYONE

AMINA XX

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Neonatal Diabetes Mellitus

Neonatal diabetes mellitus is a form of diabetes that occurs in the first 6 months of life. NDM is a very rare condition and affects one in 100,000 to 500,000 live births. A result of having this condition means elevated blood glucose levels occur. This condition can often be confused with Type 1 diabetes due to the early advancement of the condition. However, type 1 diabetes usually affects individuals after 6 months of age.

In some cases of NDM, the condition is permanent and is known as Permanent neonatal diabetes mellitus (PNDM). However, for others affected by the condition, the disease is temporary and disappears completely during infancy. The condition can reappear in later stages of life, this is known as Transient neonatal diabetes mellitus (TNDM).

What is the cause?

There are specific genes which are responsible for the development of neonatal diabetes mellitus. Here are a few of thos genes:

  • KCNJ11 gene: is important for the regulation of insulin and an inherited gene. This gene is the most common in cases of PNDM and is known to affect the protein 2. It usually affects children between the ages of 3 – 6 months old.
  • ABCC8 gene: is involved in multi-drug resistance. With NDM a mutation in this gene has been observed in children from the age of 1 – 3 months of age. It is a rare mutation but also affects individuals suffering from Type 2 diabetes. This affected gene causes PNDM.
  • GCK: Glucokinase which is responsible for identifying how high the blood glucose level in the body is. It is able to detect the presence of glucose (glucose sensor) for the pancreas. If the blood glucose levels increase in turn the level of insulin increase. This affected gene glucokinase (enzyme), although rare, it causes PNDM and affects babies a young as 1 week old.
  • IPF1; also known as PDX1: This gene is responsible for maintaining and developing the pancreas as well as beta cells maturation. The affected protein is insulin promoter factor 1, this mutation also brings on PNDM, although it is rare it affects babies after 1 week of birth.

 There is also a gene called, PTF1A, FOXP3 (present at birth), IPEX syndrome (sometimes present at birth), EIF2AK3, Wolcott-Rallison syndrome (present at 3 months). All these gene mutations result in PNDM.

Here is a list of some of the affected genes which result in TNDM (transient neonatal diabetes mellitus):

  • ZAC/HYMAI (present from birth to 3 months)
  • ABCC8 (present from birth to 6 months)
  • KCNJ11 (present from birth to 6 months)
  • HNF1 β (beta); also known as HNF1B (present from birth to 6 months)

The availability of genetic tests allows for the easy detection of these mutated genes. This will also impact the treatment that should be given to the infant suffering with the condition. Research has proven that infants who are suffering from this monogenetic diabetes can be treated with oral diabetes medication instead of insulin injections. However, genetic testing isn’t offered to everyone and people interested in being tested must fall under certain criteria.

Amina xx

Neonatal Diabetes Mellitus  – how Jack was spared insulin injections through genetic testing

Wordless Wednesday #6

Happy Diabetes Awareness Month Friends! My aim this month is to try and spread as much awareness for diabetes as I can.  As someone who advocates for diabetes, I want to continue to share the correct message about what it truly means to live with this condition.

JDRF have created an amazing tool which helps diabetics calculate some of their personal daily diabetes stats. I wanted to share my stats with you so you can have an insight into what my life with this condition has been like and what it has taken for me to still be here living a healthy life style.

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This is a rough calculation as there wasn’t an option to enter how many injections you took per day. In my case, I went from 2 injections a day to 5 injections a day in my teens, therefore the number would probably be a lot higher.

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These calculations are for my time on an Insulin Pump – 7 years and 5 months.

 

If you want to calculate your own or your loved ones footprint then click here.

 

Amina xx

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Sick Days!

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Having a cold can be awful, but a cold combined with diabetes is even worse. It messes with your sugar levels making them difficult to manage. Blood glucose levels can become extremely high. These high BG levels are due to a release of stress hormone which occurs when the body is fighting an illness. Glucose is produced in abundance making BG levels sky-rocket.

This weekend I’ve been fighting a cold. I always try to be prepared for cold viruses but the truth is you can never really be prepared. I’ve realised that sometimes the plan can completely fall apart. Usually, I struggle with very high BG levels when I have a cold.  However, this time,  Instead of high BG levels, I experienced a combination of extremely low blood glucose levels and a few high BG levels. So I’ve literally been “yo-yo’in” all over the place.  PFFFFFF!!

Last night, after hours of trying to correct my BG level, I made the decision to completely suspend my pump because my BG level would not go any higher than 4.2 mmol/l, even whilst my pump was suspended. It remained on 4.2 mmol/l and then started to drop again. It was not until I administered a Glucagon injection that I was able to finally reach a BG of 6.0 mmols/l, at which point I was so exhausted that I passed at 3am until this morning.

Even though my BG levels have been fluctuating, I’ve still tried my best to follow a few steps to maintain some level of control with my sugars.

Here are a few things I do:

  • Regularly monitor my glucose levels
  • Check for ketones if  my sugar is high
  • Drink a lot of water to dilute the glucose in my blood and also to keep myself hydrated.
  • If I continue to experience high sugars then I make a slight adjustment in my basal rates by first using the temp basal function on my pump. I usually increase my temp basal initially by 20%,over two hours, whilst continuously monitoring my BG levels. It’s probably wise to seek advice from a doctor with this if you haven’t discussed a sick day plan for your insulin. Also, when I was on multiple daily injections, if my BG rose above 13mmol/l then I’d increase my dose by units for each injection. If it went over 22mmol/lk then I would increase my dose by 4 units per injection. ((Please seek advice from your doctor before you do this))
  • Even though I can’t really taste much and I don’t feel like eating, I still force myself to eat something.
  • Although high BG levels are prone, make sure you still have an up to date Glucagon injection in cases of Hypoglycaemia.

Amina xx

Non- diabetic but you’re affected by Hypoglycaemia!!

I deal with hypos on weekly basis. Hypoglycaemia and diabetes go hand in hand. These attacks occur when blood glucose levels are too low. For me, this usually happens when I’ve taken too much insulin, not eaten enough food, eaten too late or depending on the type of exercise I choose to do that day. For example, cardio or HIIT (high-intensity interval training) all cause my blood glucose level to drop.

However, non -diabetic hypoglycaemia is a very rare condition which affects individuals who aren’t suffering from diabetes. These individual’s experience hypoglycaemic episodes resulting in the same symptoms that a person with diabetes would experience.

So what are some of the symptoms one can experience?

Some of these symptoms include:

  • Feeling weak
  • hungry
  • Breaking out into cold sweats
  • Feeling anxious
  • Dizzy
  • irritable
  • confused
  • Difficulty being able to articulate
  • Feeling shaky
  • Nervous

My first encounter with this condition was during my final year of University. I met a veterinarian surgeon in the USA and at first, I thought that she was diabetic just like me. She always carried glucotabs with her and was always ready with a snack. She used words that I always found myself saying when my sugar drops such as,

“my sugar is dropping”, or “my sugar is low”.

So I just presumed that she was diabetic too. I proceeded to ask her if she was diabetic too? But to my surprise, she told me that she wasn’t diabetic and in fact, she was a non-reactive hypoglycaemic.

A non-diabetic individual can experience two types of hypoglycaemia:

  • Reactive hypoglycaemia which happens a few hours after consuming food
  • Fasting hypoglycaemia ( which occurs before the consumption of any food)

Potential causes of Reactive Hypoglycaemia:

  • The presence of Prediabetes or a family history of diabetes.
  • A deficiency in enzymes which make it difficult for the body to break down foods you consume.
  • Other possible reasons are some types of stomach surgeries, which makes food pass into the small intestines rapidly.

Potential causes of Fasting Hypoglycaemia:

  • Over indulgence in Alcohol (especially binge drinking)
  • Illnesses which affect the heart, liver or kidneys
  • Low levels of hormones such as growth hormone, glucagon, cortisol and epinephrine.
  • The presence of pancreatic tumours that are capable of producing insulin or similar hormones which have the effect of lowering blood glucose levels.
  • Medication such as antibiotics, quinine (used to treat Malaria), pentamidine (used to treat Pneumonia) and also pain suppressants can all effect the body’s ability to regulate insulin release into the blood.

How do people manage their non-diabetic hypoglycaemia? 

Take a look at these video by youtube vlogger : blogsoidontforget as she goes through the ins and outs of living and managing the condition.

Treatment for non-diabetic hypoglycaemia really depends on what the cause may be. Seek advice from your doctor, take note when you experience these episodes and also how you feel during those times.

 

Amina xx

Insulin Pump Therapy Pros and Cons

Before I embarked on my journey, with an insulin pump, I had been on multiple daily injections (MDI) for almost 15 years.  It wasn’t until I began to learn about insulin pump therapy that I truly grasped how different the two were.

With MDI, I feel less training was given in order for me to manage my diabetes. I didn’t learn how to carb count or even have an understanding of what insulin sensitivity was. The main focus of my diabetes management was to administer my insulin (my doses were worked out by the doctor and diabetes nurse, based on my blood glucose readings) when I needed to take it and checking my blood glucose levels.

It was only with insulin pump therapy that I began to have a better understanding of my diabetes management. I had to undergo a process of training before I was given free reign with my pump.  I had to learn how the pump worked and in doing so, I had to develop my understanding of carb counting, insulin to carb ratios, insulin sensitivity, and basal rates. All of which, I have, to be honest, I had no idea what it even meant. I think this is because the nutrition and diabetes management were explained primarily to my mother but this information was very basic and she very much had to figure a lot of it out for herself. This then carried on into my transition from the children’s hospital to the adults clinic.

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The insulin pump, I think isn’t for everyone, it takes a lot of work to make it work. Diabetes management can be improved but it also takes the individuals being able to understand the ins and outs of their condition, how foods interact’s with their body as well as their sensitivity towards insulin.

There are many benefits, as well as problems which can arise due to wearing an insulin pump.

Some of these benefits include:

  • No more MDI: A sense of freedom from having to inject daily. At one point in my diabetes life I was taking 5 injections a day and I think that was one of the most challenging things I’ve ever experienced. It worked well with my sugars and control but it tied me down in so many ways. Let’s just say the insulin pump came at the right time.
  • Data Collection: The insulin pump is able to store a lot of data and when downloaded a clearer picture appears as to what blood glucose levels may be doing at certain times. With my pump (Animas vibe) it allows you to see how much insulin may still be on board in your system which on some occasions has helped me avoid a lot of hypos. There is also stored information on how much insulin is being administered daily over several days. If you can’t remember if you’ve bolused or not, then the pump also has a stored history bank which tells you when you last bolused.
  • Doses: Meal time boluses can be planned out in accordance with the amount of carbohydrates you may consume for that particular meal.
  • Sensor: The pump combined with a sensor, you can see blood glucose levels recorded every 5 minutes over a 24 hour period in graph format.
  • Ease of mind: receiving insulin doesn’t involve dialing up a pen and then finding the perfect spot to inject. It’s as simple as pushing a few buttons and insulin is delivered to you.
  • Cost: This only applies to my UK readers, but insulin pump therapy here is free! However, if you want to use a sensor then this is something that you will have to pay for yourself (which can get pretty costly).

Problems can also arise when it comes to being attached to an insulin pump.

Some of these problems include:

  • To Tube or not to Tube – I’ve been hooked to many a door handle and had my insert ripped from my body (Not nice at all). I’ve had to learn how to conceal my tubing in a way in which it won’t be affected by my surroundings. So the question is, do you choose a pump with tubing or not?  The decision is entirely yours. I suggest if you do choose a pump with tubing then take precaution, keep the tube concealed well under your clothes. There are so many cool diabetes undergarments that can be used to keep our pumps and tubing safe. One of my favourite undergarments for men, women and children is a Swedish company called AnnaPS

  • Wear and Tear – Protect your pump! I think the picture below explains my reasoning for this.

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  • Changes: The insulin pump does require that you change your insert every 2 – 3 days when the insulin cartridge is running low. This is something that you get used to, it has to be done so you get it done!
  • Ketosis: With pump therapy, long-acting insulin isn’t needed. Quick acting insulin is the only form of insulin used. I’ve had occasions where there have been occlusions in the pump tubing during the night and because there is no long-acting insulin available, it has caused my sugar levels to rise at a rapid rate. Acting and reacting quickly when the problem is spotted is essential to getting the blood glucose back in range and avoiding ketones in the urine.
  • Breakdown: Pumps are just machines and they can malfunction. I’ve had many a time when my pump has malfunctioned. One of the worst case scenarios was when I was on holiday, I noticed a crack in my pump and salt water had entered the pump, destroying the battery. My pump wouldn’t come on and was making all sorts of noises but thank god I took a spare (please remember to do that if you go on holiday).
  • Rotate: Remember to rotate you infusion sites as it can irritate the skin where the adhesive sticks to your body.
  • Control: Of course we want to have better control when we first start pumping. However, this doesn’t happen straight away. It took some time for me to understand more about the pump in relation to my body. Your control will start to improve but it won’t be immediate. You have to work on it to achieve better control.

If you are thinking of starting up on an insulin pump look at both the pros and cons involved in managing your diabetes with this technology. Be prepared to work hard at it and most of all be patient with it, you may not get the results you’re after straight away. Nevertheless, don’t give up on it, you’ll get there eventually.

Amina xx

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When I became a featured artist for VIDA

VIDAFASHION2Recently, I was contacted by a company called VIDA, after they saw my artwork on my blog and on Instagram, they asked me if I’d like to collaborate with them and design my very own fashion apparel.

I was completely excited, what an opportunity! I was going to be able to showcase my artwork, design fashionable apparel, in collaboration with VIDA all on my very own online shop. Amazing!

So who are VIDA?

VIDA’s story is that of the rich, interconnected world we live in — the story of contemporary life and mindful, global citizenship.

 – VIDA

VIDA is a Google Venture-backed fashion e-commerce platform that brings designers and makers together from around the globe, to create original, inspirational apparel in a socially conscious way.

VIDA gives designers the opportunity to turn their artwork, photography, or sculptures into products like scarves, tops, pocket squares, shawls etc. For someone like myself, who loves to transfer my sketches into graphic drawings, this was a great platform to develop and share my artwork. My artwork is an interpretation of my life with diabetes. It gives me the opportunity to advocate for the condition. I hope that people will become inspired by my designs and develop a better understanding of my perspective on diabetes.

We believe beautiful products should create beauty every step of the way.

-VIDA

The designers creative flare is then matched with makers to create these products.

Besides being able to share my designs with the world and advocate for diabetes, what I love about VIDA, is the opportunity they give to others. For every product made, VIDA offers literacy programmes to the makers of the products in Karachi, Pakistan.  The literacy programme allows individual makers to learn how to read, write and develop their maths skills. This is a fantastic prospect, which gives makers a chance to have a stable income and also expand their knowledge. Therefore, I decided to create my own shop with some of my artwork here

As a designer for VIDA, I was able to really design the pieces I wanted to appear in my shop. I selected everything from the design I wanted to use, to the colours I would use and finally the fabrics.  VIDA were so supportive and were always ready to help me when I needed help.

Below you can see a few of my designs 🙂

8needles

1balloons

3boarder

My collection went live yesterday and you can now pre-order Sugar High Sugar Low designs. My collection is still very small but as more items are added it will continue to grow.

I will leave you with this fantastic video from VIDA.

Thanks for stopping by

 

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

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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

Guest Post: Angelica Chavez

Anglica1I’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.

Anglica2Fashion Academy & Network- an upcoming online fashion school with courses on design to business.

Anglica6Piece 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.

Angleica3Teamwork, organization, and persistence are the key to making these all successful one day. There is a quote that says,

Anglica9

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 

Anglica8

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, Anglica7

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. Anglica4

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.

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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. 

 

 

 

 

 

 

 

 

 

 

 

Guest post: The Fit Blog Part 1

I’d like to introduce husband and wife, fitness instructors, Christel (who has type 1 diabetes) and Tobias. Through their blog, TheFitBlog, they share CNT1their 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.Untitled-11

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.”

Untitled-10

 

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.”

Untitled-12

 

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.

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

Life’s Blessings

So let me start by apologising to my readers for being away from my blog for the past few months. A lot has happened since I last posted but i’m back and I hope to be posting more frequently.

Life is amazing and can take you on so many different paths.  My life took a turn and I was very blessed to have a healthy baby girl

mami susu handSumayah sleeping

As you may or may not know diabetes and pregnancy is not so straight forwards. Diabetes is constant, twenty four seven, seven days a week, three hundred and sixty five days a year and every single second of the day. There’s no break! Now let’s throw pregnancy into the mix. Every worry, stress, discomfort and anxiety I have with just the diabetes alone was trebled. I no longer just had the responsibility of just managing myself and my diabetes. I was now caring for this precious life growing inside me. This gift which was now my responsibility. On top of all of this I also had to make sure my four year old son was cared for and entertained.

Although this was my second pregnancy, it was completely different to my first. In terms of how my sugars behaved, my insulin requirement during the pregnancy etc.  With my first pregnancy I definitely stressed myself out mainly due to blood sugar levels and I found that this time it was no different.  I think it’s a natural feeling to have in the beginning considering how important this journey is.

I’ve learnt to think of it in this way. I have to be able to create the best environment, the best condition for my baby to have the best start in life. Good sugars, good control, being vigilant, being involved in this whole process from the beginning to end and a lot of prays equals a healthy baby. God willing.

I also realised that even though stress is a part and parcel of the pregnancy it is still crucial not to let the stress take over completely. Stress can definitely interfere with sugar levels and I know that all too well. I had to remind myself of this and although still being vigilant I also had to let go of the worry a little and leave it in god’s hands.

beachThanks to my brother for sending me this picture during my pregnancy of his trip to Mexico. It was a great de stress tool. Also long deep breaths and sleep when I could fit it in.

 

I can honestly say that this pregnancy journey was extremely challenging. However the end result makes every emotion I felt, every difficulty I went through worth it. To all the D mums currently on this journey or about to start this journey. Be patient, stay strong and be positive. Try your best and remain stress free.

 

 

Amina xxx

Get creative with diabetes #3 – This is to the mum’s

PARENTHOOD & DIABETES

 

This is a shout out to us “the diabetic mums”

The mum’s who live each day in constant turmoil with this ever so perplexing condition,

The mum’s who carried you for nine months,

Stressed about their sugars,

Concerned that they may swing too low or too high,

Ever so fearful for their unborn child.

The mum’s who give their all, their love, their support,

The ones who are right there through every blood glucose check fighting for your campaign (The D).

This is to the mum who cried and struggled all night with her sugars, but is always up the following day ready to greet you with a smile.

The worrying mum who worries inside, without a sign she remains positive and strong.

She waits calmly, patiently for that number to appear, ready to take action in an instant.

This is to the mum’s who, persist, stays determined and are very passionate about their D.

They feel no need to hide it or be embarrassed by it.

They share their knowledge, their life and experiences.

They educate one, they educate them all.

This is to the mum’s, who long after they’ve said their good nights and tucked you up in bed,

Come back and linger about you,

Glancing at your pump and inspecting your sugar level, all in hope that their little one is doing well.

This is to the mum’s who still fight for your D even now that you’re gone.

This is to the mum’s, who don’t like to get involved,

Aren’t open to talking about the D

Their expressions says I don’t care or it’s all your fault.

However deep down inside they want nothing more than to see that you’re healthy and well.

This is the mum’s who give priority to other things besides their D.

Neglecting and forgetting themselves, they suffer in silence too afraid to ask for help in fear of what people may say.

And

This is to the dad’s with or without D who’ve loved, feared fought for us and been the bravest of them all.

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

#Wordless Wednesday~ What’s in your Mary Poppin’s bag?

This is my first wordless Wednesday post and it was inspired by one of my fellow D bloggers a1-Conceive! In her post “The day I lost it at the grocery store…”, she mentioned how us D ladies usually have to carry huge bags so huge that in fact they resemble Mary Poppin’s bag in size. So the pictures below show my MP bag today and its content.

bag1

insidethebagnumbers

1)Lucozade 2) Makeup 3)Glasses 4) Inserts and syringes 5) Novorapid Insulin and Glucagon 6) Purse 7) Peanut boys books 8)Blood glucose machine 9) Car Keys 10) Key chain  11) ohhh and the little green car that belongs to my peanut boy.

MORE WORDS THAN PICTURES OPPS

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.

Get creative with Diabetes #2

PrintWithout Me

It’s strange symbiosis we share
I who lift you up, morning noon and night. Yet you’d rather live without me

You’re provider your protector, your shield from an everlasting sleep.
Yet you’d rather live without me.

All I ask from you in return is a few moments of your time. To let me run through you’re veins. To be a part of you, yet you’d rather live without me.

By Maryam Abdullahi- Mahdi

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…………………………….

My first hypo!

PrintLet’s face it you can never really be ready for that first “hypo”. “What was to come?” Although I’d read about the symptoms, I could never have imagined the way it would affect me. I wasn’t really prepared for the feelings I was going to experience. The most frightening thing about it all was that I didn’t even realise, that I was already beginning to go through some of these symptoms. In all honesty, I wasn’t sure! I had nothing that I could measure against and confirm that it was a hypo.

This was my first hypo experience!

Initially I felt hungry. But I just thought, “maybe I was just hungry.” Lunch was nearly ready so I waited patiently. I didn’t feel that I needed to alert my mother. “was it a hypo, should I say something?”.  Believe it, or not, my first reaction wasn’t to go and check my BGL. Although you’d think “well why didn’t she just do that?”. But remember I was a child of 11 and this was the first big responsibility I had ever had. A responsibility which I was still familiarising myself  with. I can only put it down to my inexperience and being new to my diabetes.

Unknowingly as my symptoms progressed, I felt and realised, that these were some of the symptoms I’d read about, “Perhaps I was having a hypo”. I remember stumbling over to my mother, feeling very upset, sweating profusely and telling her, “I think I’m having a hypo.” Her reaction was instant. She sat me down, gave me a sweet drink, which I gulped down straight away. She seemed to be moving at the speed of lighting. She tested my BGL, and we both looked down in shock as my blood glucose meter read 2.1.  In my mind I thought, “is that right?”  At the time,  I just knew that this was way below the normal level.

I felt absolutely awful, I was unable to do much for myself. My clothes were soaked from sweating and for the first time in my life I felt so unlike myself. I was confused by what was happening to me and was unable to move as fast as I would like to.  I quickly ate the lunch my mother had prepared. It took a few minutes for the sweet drink and then the food to take effect and for me to feel a little like myself again. Coming out of the hypo my tongue tingled, my hands shook and I was really exhausted. In my mind I thought,

“So this is what a hypo is? I must have been hypo’in for a while!”

It was a scary thing to go through for first time.  I can only imagine what it was like for my mother watching me go through this first hypo.  Even now,  hypo’s can still be very worrying and scary. My first reaction to feeling hungry or dizzy,  is to test my BGL as soon as possible. This allows me to decide whether it’s my BGL or if I’m just hungry. It’s really important to recognise at least one of your symptoms. If you don’t have symptoms, keeping a close eye on your BGL ‘s  is the only way to do it. Teach the people around you,  and make them aware of your symptoms and how they can help you. I can’t stress how vital this is.

How to treat mild and severe hypo’s?

  • The first thing I usually reach for is  a bottle of Lucozade. But any energy drink  or sweet sugary drink is fine. I consume 50mls, which increases my BGL instantly. The great thing about Lucozade, is that it taste great, its easy to consume and they recently started doing more flavours.

lucozade

  • Although my BGL raises instantly, in order to keep it stable I frequently follow up with some form of carbohydrate i.e. a banana, a slice of bread, raisins or dates etc.
  • I’ll  check my BGL at least an hour after my hypo.

I always carry some form of sweet drink with me (usually Lucozade, as they come in a smaller bottle and are perfect for carrying in a bag). I will also keep some gluco tabs or gluco juice handy. GlucoTabs are fast acting chewable dextrose tablets, which contain 4g of glucose and can be used to treat mild hypo’s. They also come in two great flavours (orange and berry). Gluco juice is a caffeine free shot-sized sugar boost that can also help to treat mild or moderate hypo’s. Each bottle contains 60 mls of juice, containing 15g of fast acting carbohydrates.

When hypo symptoms persist and a person is either unable to treat themselves, or they are  unconscious. Glucagon injections are used to treat the severe hypoglycaemia. This is a hormone which helps to increase BGL. When glucagon is injected, it is absorbed into the blood stream. The glucagon moves to the liver and encourages the liver to release glucose into the blood. The effect of glucagon isn’t immediate, it usually takes between 10 -15 minutes to raise BGL’s back to a safe level. I’ve never had to use the glucagon injection, as my hypo’s have never been as severe as this. However I always keep a glucagon injection in the house, for when I might need it.

glycogon

Your views

What was your first hypo experience like? How do you treat yours? If you’re not diabetic, have you ever observed a diabetic during a hypo, or been involved in anyway to help them etc? Because I have no experience using the glucagon, what are your experience’s of using one?

x Amina

Hyper or Hypo!

HYPO vs HYPERAs a Type 1 diabetic, I am all too familiar with high and low blood sugars. It’s a constant struggle to keep levels within a good range. When I think about it, diabetes and controlling BGL is quiet a scary prospect. People without diabetes may not realise the difficulty of managing their sugar levels, because the body does this automatically.

On a daily basis I’m faced with the complexity of managing, my sometimes unpredictable blood glucose levels. I’ve learnt that there are many factors which can impact blood glucose level (BGL) such as, eating too much, or not eating enough, eating on time, how much exercise I’ve done, stress, too little, or too much Insulin. It is extremely important to keep a close eye on what I’m eating, the Insulin I take and most of all my BGL. It all ties together!

What is Hyperglycaemia (Sugar High)?

sugar high

Hyperglycaemia – this occurs when blood glucose levels increase above 11mmol (200mg/dL) and circulate in the blood stream. High BGL’s over a period of years can lead to many type of serious complications. I will touch on these complications in another post.

Symptoms

In the weeks prior to my diagnosis, I began to experience symptoms which were consistent with chronic hyperglycaemia. I will just outline a few of these symptoms.

  • FatigueTiredness which I can’t even begin to explain. If I had to explain this, it would feel like running a marathon, with no water, under the scorching sun and no breaks. Absolutely zapped of energy! Then you’ll probably have a rough idea of the sort of exhaustion I feel.
  • Polydipsia – This is a frequent and uncontrollable thirst. (Hence the need for my huge 2L bottle which was permanently attached to my hip before my diagnosis.
  • Polyuria – Frequent Urination. I was permanently glued to the toilet. It was all day and night. From what I can remember, it was probably between (20- 30 times ) in a day.
  • Dry Mouth – My mouth was always dry. No amount of liquid eased this feeling.
  • Fruity taste – This is a very strong and almost sickly fruity taste, which resembles a really sweet pear. This is a sign of ketone’s.
  • Blurred Vision – My eye sight changed and I needed to wear glasses. Which I then wore for 2 years straight.
  • Weight loss Diabetic Ketoacidosis (DKA), this arises when there is a shortage of Insulin in the body. The body in response to this, lack of insulin adjusts and begins to burn fatty acids whilst producing acidic ketone bodies. My appearance changed rapidly. I’m naturally quiet a tall and slim figure so you can only imagine what I looked like.

What is Hypoglycaemia (Sugar Low)?

PrintHypoglycaemia – A hypo is triggered when blood glucose levels fall under 4 mmol/L or (72mg/dL). This fall occurs when, too much insulin is given or too little food is consumed.

My Hypo symptoms:

Hypo symptoms vary from person to person. Some diabetics have very few to no symptoms at all. My symptoms, and the way they happen have changed throughout the years. The biggest change was during my pregnancy. Its really up to the individual to learn their symptoms so that they can act quickly when they find themselves in this situation. However I’ll give you a general break down of the way my symptoms usually occur.

  • Initially I may feel hungry or dizzy – this hunger feeling is an urge to eat something quickly, for me it’s usually something sweet.
  • This is then followed by a change in my mood. Which can range from feeling irritated, angry, and I have even found myself getting upset over the smallest of things. At that moment in time, everything is blown out of proportion. I really believe that emotions, such as anger which may not be in a person’s characteristics may be brought to the surface, or exaggerated because the person is in a hypo state.
  • Change in temperature – Usually I will feel extremely hot. ”Over heated!” Almost like I’ve been made to stand in a sauna for hours. At this point I break out in a sweat.

If my symptoms progress:

  • “The shakes”. I am unable to stop my hands from shaking, followed by a tingling feeling on my tongue.
  • Concentrating on one thing at a time can feel really confusing. I develop the ”one track mind” and I tend to fixate on what is being said, with a need to defend myself, even if it isn’t directed at me.This quickly turns into silence, as I feel myself crashing. Unable to speak, and move, trying to preserve the last bit of energy I have left.
  • ZERO energy – to the point of collapsing.
  • In extreme cases diabetics are known to go into ‘diabetic coma’s’ and even have seizures . I have never experienced this and pray that I never do.

PrintOccasionally I’ve had hypo’s during the night. This is known as ”nocturnal hypoglycaemia”. I usually wake up in a confused state, feeling absolutely exhausted, with a piercing headache, damp clothing and sheets due to sweating.

Dealing with these symptoms can definitely be frustrating and testing at times. The huge responsibility, that comes with accepting my condition, whilst trying to manage it to the best of my ability is terrifying. I can’t say that any one symptom is more severe than the other, as the feeling of each one is severe in itself. As the hypo progresses the earlier symptoms are enhanced. Finding the right balance between food, exercise, and insulin will give you the best of BGL’s on one day. Then on another day this perfect balance becomes irrelevant, causing BGL’s to be disrupted. It really is a daily battle, one which can make other things seem so trivial. As hard as it can be,  I try to remember this,

“my rules of encouragement”

  1. ‘Push’ for the best results for you
  2. Try to stay strong
  3. Be determined to reach and keep within that normal range
  4. Do what you’re supposed to do, ie test sugars levels, eat well, take your insulin, exercise (find something active that you love and can maintain).
  5. ‘Overwhelmed’ don’t suffer by yourself 
  6. Stay positive
  7. Remember a down day is normal. Everyone has their down day!

“Take responsibility and control of it, before it controls you.”

I’d love to see your perspective in the comments! What symptom’s do you have? How do they progress? Have they remained the same throughout your time with diabetes? Any Type II diabetics have you experienced any symptoms? If you’re not diabetic, have you ever experienced being with or around someone who has suffered a hypo/hyper? Are you able to recognise that the person is experiencing a hypo/hyper? Maybe by a change in their mood, expression, or the way they are talking etc?