Tag: blood sugar

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.

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  • 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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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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Myabetic Giveaway 1st November -14th November 2016

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

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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.

myabetic7-red-girlWhen 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.

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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!

 

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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Fighting Diabetes One Sugar at a Time

Hey! Friends! I’m so excited to share my new T-shirt collection with you.

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The “Fighting Diabetes One Sugar At A Time” T-shirt, was created to spread and raise awareness for Diabetes. It aims to include those who want to learn more about the condition, give thanks to those who tirelessly support and stand by us night and day and most importantly this T-shirt is for my fellow diabetic sufferers, who battle with this condition daily. I want to support and encourage you and let you know that I’m right here with you going through those same struggles.

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With my artwork, I want to make a bold statement about diabetes. I want people to truly understand, what it means to live with this condition. I feel that I will be able to reach further afield and advocate for diabetes, even more, allowing others to develop a better understanding of the condition.

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As a diabetes blogger, I feel the responsibility to spread the correct message to my followers. Blogging allows me to, share the battles I’ve faced, as well as the many steps I take to deal with the condition. It is extremely important that people are more aware of diabetes, its symptoms, and complications.

The T-shirts will only be available for two weeks and I will be giving a percentage of the proceedings to a diabetes charity of my choice. So, if you like what you see and want to show your support or show how proud you are of the things you’ve achieved regardless of this condition. Then click here and reserve your Tee.

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You can also follow me on: Instagram  Twitter  Facebook

 

Thank you for stopping by

Amina xx

 

My T-shirt was featured on Printsome. Click here to check it out.

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

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Feel free to add to the list.

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

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

Amina

Guest Post: Appleton

INTRODUCING

APPLETON

 

Appleton undercover

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.”

All a Board

All a Board

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.

South Bound

South Bound

 

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.

 

Some-times-you-have-to-Spell-it-out.

Some-times-you-have-to-Spell-it-out.

 

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.

Cool Blue Designer Insulin

Cool Blue Designer Insulin

Joseph BeuysMark Rothko, Gerhard Richter, Andrew Goldsworthy, the Starn Twins and Shepard Fairey  – are amongst many artists that have greatly inspired Appleton.

Thank you Appleton for sharing your truly inspirational pieces. Your creativity has motivated me to continue to share my experiences with diabetes and I know that it will also inspire many others living with this awful disease. I’m also convinced that, it will reach many others who have yet to learn about this condition.

Connect with Appleton @   www.AppletonArtWorks.com @appletonpictures (instagram)

 

Amina xx

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Finding your comfort

Comfort between you and the needle

Administering insulin, whether that be by injecting or by bolus through an insulin pump, is just another one of the thing we (diabetics) need to do on a day to day to keep on surviving. Taking that first injection is such a huge step.comfortneedle It is the moment that you are able to find that inner courage to get the job done. It’s a new prospect that is extremely daunting and scary. You know you must do it but you also don’t want to stick a needle into your leg.

 This is your new beginning. Your new life. You’ve found the bravery to inject and it’s over.

Those moments (which feel like forever) between injecting the needle into your skin, are awful but you’ve now progressed to a new level of courageousness. You’ve reached a new level of comfort. You’ve moved past the initial fear you had of taking that first injection.

 I’m not saying that the second time becomes any easier. However, what it does mean is that you’ve developed a better understanding. You now know what to expect on your next needle encounter.

You find the strength to get through it. You’re that much stronger, that much braver, you’re in control of this awful condition. You’re amazing! 

Even if you’re not quite there yet, don’t worry you’ll get there (you must), just keep trying and you’ll get the hang of it. Keep on it and don’t give up. Formulate a routine and try your best to maintain it.

The second level of comfort

Once you are able to inject yourself and you become content with your routine, you then have another barrier to face. This barrier is that of being able to do your injection or bolus in the presence of others and where ever you desire. This may take some getting used to, for both you and the people around you. However, it shouldn’t be something that you hide from them.

This condition is a part of you and just like you must get used to it, so must they. Don’t be embarrassed and don’t you dare be ashamed. I’m sorry but if you’re loved ones have a problem with it, that’s on them. You shouldn’t be forced into a corner or another room, out of sight just so they don’t see you injecting. You need all the support you can get in the initial stages and throughout, but everybody has to get on board.

The way I looked at it when I was diagnosed was, although I was the one directly affected by the condition it also affected my family. They had to make adjustments in their lives too and that also meant being accepting of me performing my daily duties as a diabetic, which included, blood testing, hypoing, injecting, everything. It was also now a part of them too.

 I was very lucky to have a very supportive family, who never made me inject away from them. In fact as I’ve grown and developed with my diabetes comfort,  in order to be a bit more lady like, I’ve had to remember not to inject at the dining table when I’m sat with a table full of family members lol. After all I’m not a little kid anymore. Who am I kidding, I was doing it throughout my teens into my twenties and actually just the other day. I really am not fussed when it comes to being bothered by the people who don’t want to see me injecting. It goes as far as, going out to a restaurant and reaching into my bosom to get my pump out to bolus. If people want to stare then so be it.  If they want to ask questions then I’m poised and ready.

Car park experience

A few months ago, I was sitting in my car in the supermarket, when my pump started to beep. The cartridge was empty. I decided to change my insert since I had a spare insert and insulin in my bag.  I proceeded to change my insert (in what I thought was the privacy of my car). Then I was confronted by a lady in the car park, staring through my window, shouting because I was changing my pump in the car park. I was completely shocked but finished putting my insert on and came out of the car to talk to her.

She expressed her disgust for what I was doing. So I asked her what she thought I was doing. She presumed that I was taking drugs or something along those lines. Even though I was furious, I paused for a moment whilst I listened to her shouting and carrying on and then I took a deep breath and explained what I was actually doing. She, of course, was completely gob smacked and apologised profusely. However, she did thank me for teaching her more about diabetes. Despite feeling annoyed by the initial accusation, I felt she benefited from the situation and it became an opportunity for me to educate someone who wasn’t aware of what  diabetes is.

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Although, this was my experience I know there are many others who may have or may be struggling to find their comfort to inject or bolus freely in front of others. I’ll say one thing, it is very important that you do find that comfort when it comes to this condition and doing the frequent daily task of bolusing or injecting. This life style may be new to you or you may have been living with it now for some time and still haven’t discovered your comfort (I’d hope you’ve found it at least with yourself). You need to search within yourself and find out what you’re comfortable with. Become comfortable with your routine, testing blood sugar levels and injecting at meal times. Once you have the confidence in yourself, within your own space, then you can help the people around you adjust and understand diabetes better. You’re new to this life style but so are your family or friends.

I know how overwhelming the initial encounter with this condition can be. However, I’m sure for the people around you too, seeing you experience the things you must now experience is also very daunting for them. The injecting, blood testing and hypo’s are but a few to mention.  They are all frightening things to deal with.

As the diabetic, we don’t really get to see other diabetics in the same situations we go through. When my siblings and I were younger, we saw my cousin hypo’in even before I was diabetic and it was an upsetting thing to witness.  Nevertheless, even though it was terrifying to watch, I realised how hard it must be for her to live with diabetes experiencing changes in her body which were out of her control.

If your family or friends are shocked by seeing you inject or bolus, then I think that’s something that they have to work through.  They should experience being in your presence whilst you inject/bolus and with time they can then find the strength within themselves to accept the things you must do, the things you have no choice but to do. Shunning you is probably the worst thing that they could do for you and your mental wellbeing. You shouldn’t be embarrassed and neither should they.

Most of all they shouldn’t treat you any differently. They should just support you knowing you’re doing the right thing for your health. With time, I hope they will develop a deeper understanding of this condition and not be afraid or in denial that you in fact have diabetes.

Amina xx

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

Listen to your body

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

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

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

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

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

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

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

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

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

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

Action, repetition and  finally recognition

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

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

brain

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

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

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

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

Tips to avoid hypoglycaemia unawareness

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

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

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

Guest Post continued: The Fit Blog Part 2- Nutrition

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).

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“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, Untitled-14but 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 carbUntitled-16 (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.”Untitled-18How 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.

Amina xx

A BS kinda day!

*BS  as in  Blood  Sugars*

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

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

SHSL-BLOOD-SUGARS

So here goes

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

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

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

Nighttimehypo

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

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

Blood sugar reading – 3.4mmol/l

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

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

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

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

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

Do I wait till I reach the 15 Mins?

Nope!  I go straight for the apple and satsuma.

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

 

07.31 am – BS reading before breakfast 6.0mmol/l

  

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

13.09 BS reading before Lunch

17.10 BS reading before dinner

22.32 BS reading a few hours after dinner.

This was definitely a rebound BS.

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

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

Thanks for stopping by  Amina x

Insulin gone bad

insulin

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

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

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

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

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

(4) Does the insulin look stringy?

(5) Has it changed colour?

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

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

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

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

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

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

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

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

Hmm! Ok,  that’s great for a workout.

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

What on earth was going on?

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

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

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

(3) It wasn’t stringy.

(4) It hadn’t changed colour.

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

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

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

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

 Amina xx

 

 

 

 

 

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The Good, The Bad and the Ugly!

stethoscope

We all know that when it comes to managing our diabetes, how essential it is to have a good doctor or consultant. During my time living with this condition, I can honestly say I’ve had less than a handful of good doctors. By “good” doctor I mean a doctor who will converse with you and not talk at you. A doctor who will give you advice whilst listening to your suggestions because after all you’re the one living with this condition on a daily basis. A doctor who takes your appointment just as seriously as you do and doesn’t make it a joke. A doctor who is just as dedicated as you are in helping you achieve something out of that 20, 30, 40 minute appointment. A doctor who actually cares about you and doesn’t scrutinise every low or high BG reading they see written down.

As a child I had great doctors, who explained everything to me and my parents and made me feel at ease. It wasn’t until I was moved to the adult diabetes clinic (which by the way was very daunting at 18), that I actually started to experience first-hand what dare I say a” bad” doctor was. Ever since I started at the adult diabetes clinic, I’ve had doctors who haven’t taken my appointment time or me very seriously. They were quick to point fingers, didn’t want to hear anything I had to say and personally I think they weren’t right for me or my diabetes.

I dreaded every appointment and would leave the appointment without any new ideas on how to work towards managing my diabetes even further. My time had been wasted and all I had to work with was negative and useless facts. On a positive note, I must say the nurses have always been a very strong support system in the clinic and in most cases they were better than the doctors I’d met.

I was also very fortunate to experience good doctors during my pregnancies, which is a completely different ball game. The doctors during my pregnancy set a very high standard, which made me fearful to return to the doctors I had previously. They were thorough, patient, caring, everything you’d expect from a good doctor. Nevertheless, before I was transferred back to the adult diabetes clinic, I decided to talk to the diabetes consultant. He helped me get through my pregnancies and knew all about my concerns when it came to finding the right doctor. He recommended a new doctor who was due to start at the diabetic clinic, so I went with it. When I finally got to meet this new doctor, I was extremely anxious because I had no idea who I’d get.

“Would it be the good doctor or the bad doctor?”

Well, I’m glad to say that this time I got a great doctor. He introduced himself and then instead of asking me a million and sixty question about my diabetes, I could tell that he had read my files. He’d looked at the notes beforehand and knew exactly where I was up to. Great! No silly questions like,

“When did you become diabetic?”

He did however ask me to present my sugars and my BG meters. He downloaded all the data and I waited for his reaction to some of my low lows and high high’s. I braced myself for a good telling off, but nothing came. He made notes and really studied my BG levels. Then would you believe we had a conversation about where and how we could tighten things up. He didn’t say, “Why was it so low here? “Why was it high there?” or “What did you eat here?” We all know that sometimes we can’t even remember what we ate the night before, let alone that Wednesday night six months ago.

So far so good. I gave him a thumbs up!

We went over everything from blood results, to trying out different setting on my pump, to exercise. We covered everything. What I really liked, is that he set out a goal for the following appointment. We discussed basal testing (this is the background insulin) at certain times where my sugars were a little crazy and to not freak out and over bolus (give myself too much insulin) when I see my BG going too high. I left my appointment feeling like I had achieved something out of the time. It wasn’t time wasted like it used to be. I felt determined. I was going to meet the goals he had set out for me. I was going to do it, not for him but for me!
To be continued…………

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I usually have a few questions I ask myself when I’m meeting a new doctor. Will this doctor help me on this difficult road I’m on? Or will he make my journey that much harder?

Here are a few of the things I ask myself:
– Is the doctor empathetic: Does this doctor try to understand what I am feeling and experiencing, physically and emotionally and can he/she communicate that understanding to me?

– Is the doctor forthright: Can this doctor tell me what I need to know so I am able to understand everything clearly?

– How respectful is this doctor: Does the doctor listen and take my comments seriously and works with me?

– Is this doctor caring and patient?

– Is this doctor thorough, conscientious and persistent?

– Does this doctor have substantial diabetes knowledge? For example, current events, CGM sensors, blood glucose meters and pumps etc? Because what’s the point in talking to a doctor who doesn’t even understand how the pump functions?

If you’ve not figured it out yet, having a good diabetes doctor is extremely important when it comes to managing your diabetes. I do believe sometimes you have to experience the bad before you are able to know what is right for you. I hope at least that my post will help you when it comes to finding the right doctor for you.

Thanks for stopping by
Amina xxx

 

Talk about your medicines month

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.

Amina xx

Sugar High Sugar Low: Preparing for pregnancy

Before conceiving I had a lot of things to contemplate such as being fit, healthy, eating well, having tight control of my blood glucose levels and most important of all achieving at least an A1c of 7.0%. Both diabetes and pregnancy combined have their own unique challenges. I knew that I would have a lot of hard work ahead of me.pregnancy tagcloud pictogram

My diabetes appointments are usually quarterly at the diabetic centre. My previous appointment showed that my A1c was 7.5%, so I decided to visit my diabetic team and inform them of my plan, as I did with my first pregnancy. The diabetic nurse retested my A1c and after two weeks I found out my A1C was actually 7.3%. Blood glucose control is vital during pregnancy because if you can imagine even before you’re aware of your pregnancy, your baby’s brain, spinal cord, heart and other organs have already started to form. This totally freaks me out because without tight control I could have possibly affected the way in which my child developed.

I was given the opportunity to have a trial run of the dexcom G4 sensor for a month which I talked about in my post, “Cyborg for a month or perhaps longer”.

Dexcom G4is a continuous glucose monitoring (CGM) sensor which is inserted into the body and is able to give blood glucose readings every five minutes. The sensor automatically transmits this reading to my insulin pump (Animas Vibe) and creates a graph. With my insulin pump I am able to set an ideal blood glucose range. If my blood glucose level goes above or below this range my insulin pump alarms to alert me of either an increase or decrease in blood glucose level.

My trial run actually went on for longer than a month and it was during that time that I conceived. My pregnancy journey had started and with my team we made the decision to continue with the CGM during this pregnancy. To start with the CGM really helped me achieve tighter control and a better understanding of patterns occurring at certain times in the day. After a month my A1c had dropped to 6.4%.

By week five of my pregnancy I had developed severe morning sickness. I was a complete mess. I had no appetite, I lost a lot of weight and I needed far less insulin. My insulin requirement continued to decrease during the next few weeks. The morning sickness continued and to make matters worse my CGM didn’t seem to want to cooperate. The readings on my insulin pump compared to a finger prick reading was completely different. It stopped picking up low and high blood glucose levels. It just did the complete opposite.

I was able to change my sensor and transmitter  a few times but unfortunately every time I got a new one the same problem occurred. No matter where I placed the sensor on my body it would react in the same way. My diabetic doctor seemed to think that it could possibly be the pregnancy hormones interfering with the sensor. I went one step further and decided to contact Dexcom with regards to this. They were unable to conform if this was a possibility or not. I was told that no research has ever been done on the effects of pregnancy hormones and the accuracy of this sensor.

My doctor asked me if I’d prefer to go without the sensor and I agreed to go without it for the duration of my pregnancy. I began my rigorous blood glucose testing and on some days I’d test up to fifteen times.

logbookHaving good control minimised risks such as miscarriage and birth defects. My pregnancy was able to progress well almost as if I did not have diabetes. Four months into my pregnancy I managed to achieve an A1c of 5.7% and it remained that way throughout the pregnancy

With the help of my antenatal diabetes consultant I was able to plan my target blood glucose range so that my blood glucose could be as close to normal as possible during my pregnancy. We also discussed and looked in detail at basal rates, insulin to carb ratio’s and insulin sensitivity. I was able to be in contact with him on a daily basis and then I attended the diabetic antenatal clinic every week. In actual fact I was very lucky to have had a team of people accessible to me which consisted of x3 diabetic midwives, x2 OBGYN’s x1 antenatal diabetes consultant and a dietician. I also still had contact with my diabetes team from before my pregnancy. I WAS VERY LUCKY!

Another important factor with diabetes and pregnancy is the health of your eyes. I had to have my eyes checked every trimester by the Eye hospital to make sure that no changes were occurring. A month after the birth of my first child, I developed changes in my eyes which then corrected themselves strangely enough. However it is routine for diabetics to have regular screenings during their pregnancy here in Manchester.

Preparing for pregnancy and the pregnancy itself was extremely difficult. I had moments when I felt stressed out, happy, anxious, nervous and mostly worried. Regardless, I felt that patience and maintaining a serene demeanour was definitely key to having a healthy pregnancy and ultimately a beautiful healthy baby.

Amina xx

Let’s make it happen together!!!

1.  Push for the best results for you

2.  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 

STAY POSITIVE

6.  Remember a down day is normal. Everyone has their down day!

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

Answers to test your knowledge

SUGER CUBE WITH GLASSES

1. 1923

2. Leonard Thompson

3. 2007

4. Type 1 diabetes

5. decrease in blood glucose level

6. A lack of insulin, fatty acids being burnt  and the production of ketones

7. 347 million however i think this number may have increased a little.

8.  Happiness

9. 1962 by Leland Clark and Champ Lyons

10.  With diabetes bad days are a part and parcel of the condition. I’ve learnt that I am able to overcome these bad days, sometimes with difficulty and sometimes with ease. Keeping a positive outlook about the condition and having strong support around me has really help me learn how to cope with these difficult moments.No matter what I always find a way to get through it. I won’t let myself be defeated!

The curious Peanut boy

My 3 year has a very inquisitive mind and could absolutely drive you mad with the millions of questions he can come up with. isa scooterHe never wants to hear the straight forwards answer. He always wants the answer with detail. He loves learning about new things and is absolutely obsessed with everything from Space, to Volcano’s and the sea. His favourite subjects of discussion right now are the human body and my diabetes.

I’ve never felt that I have to hide my diabetes from anyone and it has never been a secret to my son either. He is very use to seeing me changing my inserts, playing with my insulin pump, pricking my fingers and he’s even found strips I’ve dropped in some place or another. If I’m guzzling down a sweet drink, he’ll ask me, “Mami is your sugar going low, low, low?” He’s very brave and has come to understand that in situations where my BG is dropping, that I need something sweet. He’ll run to my “special” cupboard of sweet goodies and bring a whole selection of foods and drinks. Of course he’ll wait patiently, smiling his biggest smile, waiting to get his sweet or sip of my drink hahaha! 

I guess right now he’s just taken a strong interest in my diabetes. Instead of just being an observer he wants to get involved and help me with anything diabetes related. He has even asked me a few times to test his blood glucose level and is starting to understand what a good number and bad number is. He’s even asked me if he can insert my insert. On many occasions he’s been with me at my diabetes appointments, taking it all in.

I recently made the decision to teach him how to dial my husband’s number, family members and even the emergency services. Just in case I may need any of them and he is the only one there. Thank god this has never happened and I pray I don’t need him to call anyone in an emergency. Surprisingly enough I ask him from time to time if he remembers and he recalled every instruction and number I gave him. He never ceases to amaze me.

Being a mother with diabetes I feel that it’s very important that my son knows about my condition and doesn’t feel ashamed or afraid of it, but instead that he knows every aspect of it. His recent curiosity and approach to diabetes makes me very proud. He has a great deal of awareness of what diabetes is and how it affects me. Now that he has taken an interest I try my best to include him in what I do on a daily basis. If he has any questions I always give him a good answer. He now knows that although he doesn’t have it the lady in his life (his mami) does. I’ve come to realise that although it affects my life ultimately it also has an effect on his life.

I really hope that other mothers and fathers with diabetes will be able to read my post and not feel that they have to hide their condition from their children. Include your children and don’t feel ashamed to share this aspect of your life with them.

Amina xxx

No strips and expired strips!

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

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

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

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

HIGH

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

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

HIGH

“WHAT!! WHY HASN’T IT COME DOWN?”

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

HIGH

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

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

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

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

Thanks Amina  xx

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.

Diabetic Mathematics! Mathebetics….

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

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

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

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

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

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

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

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

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

image (2)

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

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

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

= 100 / 50

= 2

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

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

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

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

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

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

GL = GI/100 x Net Carbs

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

45 X 8.6 = 387

387 / 100 = 3.9

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

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

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

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

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

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

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

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

My total number of injections/inserts =24 025

That’s a lot of numbers.

Thank you for stopping by  Amina xx

The insert that bled

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

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

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

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

Happy pumping !!Print

The invisible Diabetes

When I first meet someone, I don’t introduce myself as, the type 1 diabetic, who has an insulin pump and pricks her fingers between six to eight times a day.

To look at me, you’d just see Amina. The girl, who stands at 5ft 6 and 1/2 inches tall. The girl, from the northwest, with a strong manccunian twang. Always trying to smile, but sometimes frowning. Sometimes boring others to tears with her talk of science.photo (1) Never missing an opportunity to mention the latest K drama she’s engrossed in that week.

The girl, that works out from time to time, the mother, the wife, the part time gardener. Most of all, the girl who tries her best to stay patient and positive at all times, because the one thing you don’t see about me, is “My diabetes”.

Type 1 diabetes is a chronic illness. However, it isn’t something that is visible to the human eye. I don’t have any external apparent scars, or disfigurements which would indicate that I have a life long illness, or that for every day for the past 19 years I’ve been fighting, this never ending battle of diabetes. Some days I feel fine. Sometimes I find, I have the perfect blood sugars in the morning, and then it all changes just as quickly, limiting my day to day activities.

invisible

To my surprise, I recently discovered that quite a few people who I know, had no idea I even had diabetes. Some of these people, I went to school with and others I’d worked with. Although it may be invisible to others, for me, the one living and fighting each day to stay strong and healthy, it is more visible than ever. It is a part of my life, but not the only thing in my life. It has grown with me, matured with me, been there with me during the good and bad. It has moulded that part of me that makes me, me.

Even when experiencing low or high blood sugars, it still isn’t visible. My appearance to others might be that I’m absolutely fine. The people close to me, who have experienced me, during these times, may be more receptive to my symptoms, than others. They may understand that my ramblings, my shift in mood, might be a low or high blood sugar. Even still, it sometimes still isn’t that obvious. I may actually just be rambling like I do, or I may be angry about something. It doesn’t always mean I’m having a hypo. OK most of the time it does, but there’s that small window of a time, in which I’m just expressing my feelings.

LOVED ONE:  AMINA! DID YOU CHECK YOU’RE SUGAR?

ME: NO, WHY? (ANGRY TONE)

LOVED ONE: ARE YOU HAVING A HYPO? I THINK YOUR SUGAR MIGHT BE DROPPING!!

ME: (GETTING ANGRIER, BECAUSE IN THAT MOMENT MY THOUGHTS ARE JUMBLED. I FIND MYSELF RESPONDING WITH), MY SUGARS ARE JUST FINE. IT’S NOT MY SUGAR, IT’S YOU! JUST LEAVE ME ALONE. THIS WILL THEN MAKE ME CHECK MY SUGAR.

During a hypo I feel antagonised, and always seem to pick a fight or defend myself. Something as small as asking me about my blood sugar during that moment can become a fixation and can be blown out of proportion. I become increasingly frustrated, words become confused,  and I feel a strong need to express my  emotions.

The truth is, without suffering from this condition, it’s hard to really understand the internal effects that those lows and highs have on me. The weakening and almost debilitating feeling, which accompanies the shift in blood sugars, just can’t be put into simple words.

I’ve even found myself in situations where I have had to prove my condition and the way I’m feeling to others, because they aren’t able to physically see my diabetes.

This first happened to me when I became diabetic. I started high school and one of the lessons we all had to take part in was P.E (Physical Education). I’d gone for several weeks without having any hypos at all.  All teachers we’re made aware that I was diabetic, well so I thought. Then, it just so happened that the day I had a hypo we had to do cross country running. This involved running around our huge school grounds about 8 to 10 times. For someone who loved to run it was a killer. The race started, and off I went. As hard as it was, I always seemed to be one of the ones at the front of the race.  Lap 6, “I got this!” I continued on and all of a sudden, I started to feel myself slowing down. I realised that my sugar was dropping and that I had to pull myself out of the race. As I ground to a halt, I heard in a loud tone, “AMINA, why aren’t you running?” It said. I turned, it was the teacher. I started to walk towards her at this point she was shouting at me. Asking me why I’d stopped?

“Miss”, I said. “I can’t go on anymore”. Her expression said it all. Almost disgusted by my words, she told me to go back to the race. Which is when I decided to say, “I’m diabetic.” “no go back to the race!”, she said.  “stop telling lies to get out of this race”. At this point I collapsed to the ground, begging her to let me go inside to get my emergency hypo supply.

One of my close friends, who knew I was diabetic, came towards us. “Are you ok Amina?” She asked. ” Is it your blood sugar?” she asked. “yes”, I said. She ran past the teacher and went to grab my emergency hypo supply. The teacher was shocked!

She did finally believe me and apologised for not listening. She wasn’t aware that I was diabetic and really did think I was making up an illness to get out of the race. From then on, she had supplies for me and always made me bring my emergency hypo bag out with me.

This story is a true example of how invisible diabetes is. The moral of the story is, that you should never take a person at face value. If someone tells you they aren’t feeling well, diabetic or not , never doubt them because their outwards appearance may not reflect what is going on internally.

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Work your sites

© Dmitry Lobanov - Fotolia.com

© Dmitry Lobanov – Fotolia.com

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

“ROTATION IS KEY “

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

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

No rotation = lumpy bumpy body

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

Fat hypertrophy also known as hypertrophy or insulin hypertrophy.

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

So what sites can we use?

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

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

sites

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

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

Site Rotation tips

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

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

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

Which are my best sites you ask?

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

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

Changing the “insert” before it needs to be changed

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

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

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

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

*CDC – Centers of Disease Control

 

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…………………………….

HbA1c!!!

HbA1c WHAT'S YOURS

HbA1C! When I first became diabetic I had no idea what this even meant. I just knew that every 3 to 6 months I would have blood taken from my arm. This blood sample, which seemed like gallons of blood, would then come back to me, a few weeks later in a percentage format. The doctors and my parents seemed happy and that made me happy. “I felt a sense of achievement.”

Let’s start with a few basics!

The blood stream is made up of red blood cells these red blood cells contain haemoglobin or Hb. Red cells can live for 8 – 12 weeks before they are replaced. Hb carries oxygen in the blood from the lungs and then to the rest of the body.

“So what did it all mean?”

As I developed a better concept of science and my diabetes, I began to understand, that this HbA1c was an average measurement used to identify the level of control I had maintained over a prolonged period of time.

HbA1c occurs when haemoglobin binds (Hb) with glucose in the blood stream. The glucose and the haemoglobin molecule form a glycated haemoglobin molecule.  This is known as A1c or HbA1c.

 

Hb + Glucose = HbA1c

 

Someone without diabetes produces normal levels of glucose and therefore produces a normal level of glycated haemoglobin (HbA1c). The more glucose in the blood stream, the more haemoglobin A1c or HbA1c in the blood. Higher levels of glycated haemoglobin in diabetics would suggest poor blood glucose level control.

These high levels of HbA1c are associated with diabetic complications such as retinopathy (eye complications)  and neuropathy (nerve damage). There are many other complications, which I will touch on in my next post. HbA1c levels do not ensure that complications will develop or will not develop. However it has been proven, that having good control and a good HbA1c will reduce the chances of these complications arising.

What should your HbA1c be??

  HbA1c in mmol/mol (new unit) % HbA1c (old unit)
Non diabetic  30 mmol/mol 4.90%
Diabetic 48 mmol/mol 6.50%
Diabetic prone to hypoglycaemia 58 mmol/mol 7.50%

HbA1c testing in diabetics depends on the individual and how well they control their blood glucose levels.  A diabetic prone to hypos, but is trying their best to achieve tighter control on their diabetes, HbA1c test is carried out every 3 months.Once the individual is able to control and retain good control, HbA1c testing should then be carried out every 6 months. Since I had my son, I’ve suffered a great deal with low blood glucose levels. Currently I have my HbA1c tested every 3 months, due to my nocturnal hypoglycaemia. This is something I’m working hard to get rid of and maintain a good level of control, as I always have.

 

My current HbA1c = 7.4%  57mmol/mol

My dream HbA1c = 5.0%   31mmol/mol

Pregnancy HbA1c = 6.4%  46mmol/mol

Print

 

Amina xx

——————————————————————————————————————————————————

If you have bad control, or perhaps your HbA1c wasn’t so great the last time.Its not the end of the world. Stay positive and please don’t give up. Keep on striving for a better HbA1c. Use your diabetes team and get them to help you. However you must help yourself first by, taking regular notes of your sugars and create a picture of what is happening with them. The only way to make changes and achieve a good HbA1c is to take the steps to control your blood glucose levels.

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?

Test your sugar girl!

Blood glucose  levels = diabetes management

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

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

What are the healthy ranges you ask?

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

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

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

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

How I manage my blood glucose levels

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

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

log book 3

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

LOG BOOK

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

The right machine

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

BGL MACHINE1

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

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

My Diabetes……

How it all started

At the age of 11, I was diagnosed with Type 1 diabetes. The symptoms were very subtle to start with. Sheer exhaustion was the first to hit me. My mother began to question ”why was I always tired?” I went to the doctors and was told I was anaemic and needed iron tablets. I took them but still the tiredness continued. A few weeks later, the symptoms came on rapidly over a course of a week. I was constantly exhausted, carrying 2Litre bottles of water around with me unable to quench my never ending thirst. Waking up several times during the night became routine and not to mention the drastic weight loss which occurred over that week. I was a walking skeleton!!

Diabetes is a common trait with the women in my family which made both me and my mother more aware of some of the symptoms at the time. Knowing some of these symptoms are really important as it can affect anyone of us and it may make a difference in saving someone’s life. But to this day, I still believe that the little knowledge and experience we had helped us take action which helped me get the treatment that I needed.

My diagnosis at such a young age was a great shock and difficult to understand at first. I knew that I had to accept and deal with it if I wanted to be healthy. I can honestly say that I’ve had a great support network from my family, friends and some of the nurses and doctors. On the other hand, even with their support I’ve still had my ups and downs and ultimately I’ve realised that it’s my diabetes and my responsibility. I’ve learnt that my condition is something that I shouldn’t hide from or be ashamed of, but something that is a part of me but does not define me. Living with type 1 diabetes, even with its difficulties, I can definitely say that it has taught me the virtue of patience and being patient.

Diabetes UK have a campaign which is designed to raise more awareness for Type 1 diabetes. Its called 4T’s.

4Ts A4 Poster

Please click on the highlighted link above, print and post the poster somewhere so everyone can see it and learn these symptoms. Thank you.