Tag: Diabetes mellitus type 1

Dr Faustman’s vaccine for Type 1 Diabetes

They say, that there is a vaccine that can not only halt type 1 diabetes in its tracks but also that it has the ability to reverse the condition.

When I first read about this vaccine, it really did sound too good to be true. Could it be the cure we’ve all been waiting for? Or, is this yet another diabetes research breakthrough which amounts to nothing? This vaccine has been depicted as a “promising vaccine”, an “ideal vaccine”, a truly effective treatment.

But what is this vaccine and does it, will it really work for someone like me?

This vaccine, would you believe, has actually been around since the 1920’s. It was first cultured by Albert Calmette and Camille Guerin at the Pasteur Institute in Lille, France.The Bacillus Calmette-Guerin otherwise known as (BCG) vaccine has been used to cure Tuberculosis and Bladder cancer and has been very successful.

It has been used in trials ( in both mice and humans) to show its impact on Type 1 diabetes, with positive results so far. The research is being carried out by Dr Denise Faustman, MD, PhD and her main focus is to carry out trials on individuals who have had diabetes for five years or more. She has targeted adults between the ages of 18 to 60 to determine how effective this vaccine will be in reversing type 1 diabetes.

Associate Professor of Medicine Denise Faustman is conducting a study of a decades-old TB drug that reversed diabetes in mice and has shown promising results in an initial human study. Jon Chase/Harvard Staff Photographer

To understand why this vaccine was chosen, we must first consider how Type 1 diabetes occurs in an individual.

We live in a world full of germs, viruses, bacteria and toxins (invaders). The immune system plays a huge role in protecting us from these possible harmful microbes. When harmful invaders try to infect us, the immune system is able to first sense the presence of these invaders and then it is able to destroy any foreign cells.

With Type 1 diabetes, the immune system confuses its own cells as foreign cells.  Attacking and destroying healthy beta cells. This is known as autoimmunity or self-attack! Type 1 diabetes is then, in fact, an autoimmune disease and NO it’s not caused by eating too much sugar. It’s so much more complex than that.

So what role does the BCG vaccine play?

The BCG vaccine would possibly be able to halt or reverse the beta cell deterioration in individuals who have the condition. It would conceivably reduce the amount of insulin needed or remove the need for insulin completely.

The way in which vaccines usually work are, a less potent version of the vaccine is injected into you and it allows the immune system to build up immunity against potentially threatening viruses. In a sense, your body becomes stronger and more capable of dealing with any bigger potential threats.

With Type 1 diabetes, the immune system produces antibodies which are capable of killing off beta cells. The vaccination would be used to encourage the immune system to see the beta cells as no longer being harmful which will then allow cells to grow and repair whilst avoiding a decline in beta cells. Hence a healthy production of beta cells like a non-diabetic individual.

Type 1 diabetics are deficient in the hormone TNF (Tumour Necrosis Factor) which is able to produce good T-cells and reduce the presence of bad T-cells. These bad T-cells are responsible for encouraging the immune system to terminate healthy beta cells. The BCG vaccine would be able to increase levels of the TNF hormone whilst potentially removing bad T-cells.

During the trials BCG doses were administered to patients which resulted in an increase in TNF levels, removing bad T-cells which will then allow the immune system to function as it would in a person without diabetes.

Dr Faustman has said, “BCG is definitely modulating the immune system.”

This is only the beginning and there is still a lot that has to be researched. I have so many questions:

– What dosage would be required to make the reversal process successful?

– Would it really be permanent?

– Would I have to have continuous vaccinations and how frequently would this need to happen?

– Would I still partially need to take any insulin?

– What would the long-term effects of taking the BCG vaccinations be?

As someone who keeps up to date with all the diabetes research and advances in diabetes. I must say that this one does sound very promising. However,  I remain sceptical because you must understand that there are so frequently many different research projects surrounding diabetes which have been labelled the possible next cure for Type 1.

Even still, I remain hopeful, I remain positive that one day one of these research projects will succeed and finally bring to light the cure we’ve all dreamt of. We’ve come such a long way from the times when having diabetes was an automatic death sentence. Without the discovery of insulin, and the endless hours of research executed by Dr Frederick Banting, where would we be today?

I won’t give up on that cure! I continue to pray that, one day it will come. As they say, “Nothing worth having comes easily” 

I will definitely keep following the progress of this vaccine and hopefully, I’ll have something great report when they next showcase their research findings.

Amina xxx

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The itch that won’t quit

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

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

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

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

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

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

Amina xxx

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A few things you didn’t know about Frederick Banting

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

© Mary Evans Picture Library / SZ Photo / Scherl

© Mary Evans Picture Library / SZ Photo / Scherl

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

Here are a few facts about him:

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

    comic-2comic-1

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

 

 

 

 

 

HAPPY WORLD DIABETES DAY EVERYONE

AMINA XX

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Neonatal Diabetes Mellitus

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

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

What is the cause?

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

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

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

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

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

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

Amina xx

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

Wordless Wednesday #6

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

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

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

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

 

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

 

Amina xx

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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

The iLet (Bionic Pancreas)

Throughout the years, we’ve seen many advances in Diabetes technology. From the Insulin pumps, to the Freestyle Libre and so many other amazing technologies.

The most recent and major development is that of the Bionic Pancreas. This long-anticipated technology is able to completely manage an individual’s diabetes by tracking blood glucose levels, controlling insulin doses, as well as administering glucagon to individual’s when they need it.

 The Bionic Pancreas represents so many great things and has the potential to ease the immense amount of pressure faced by diabetics and carers. It could give users, a sense of, physical, emotional and physiological freedom from the day to day struggles and anxiety diabetes self-management presents.

The Bionic Pancreas is able to mimic a healthy pancreas, allowing for the normal release of liver enzymes as well as cellular metabolism.

The initial model included a few different components; a smart phone, a sensor, and two pumps. The sensor is able to take a snapshot of an individual’s blood glucose readings, sends information to a smartphone device, which then communicates via Bluetooth signals to two pumps (one containing insulin and the other containing glucagon). Insulin and glucagon are administered when the individual is in need of it just like a normal functioning pancreas would.

Bionic Pancreas

Bionic Pancreas

More recently, a single handheld device called the iLet was developed. This device contains both insulin and glucagon and is able to acts in opposition to each other, when food is consumed and in turn when blood glucose levels increase or decrease. This giving the diabetic suffers a more stable blood glucose reading.

Within the iLet there still exists 3 components all combined into one device:

  • Continuous glucose sensor (sends glucose levels wirelessly to the device)
  • Mathematical algorithms which determine and make therapeutic decisions based on a person’s age and weight.
  • The algorithm is able to make suggestions every five minutes, 24 hours a day, giving a total of 288 daily decisions for each person’s insulin and glucagon requirements.
  • Built in pumps to deliver insulin and glucagon (a weeks’ worth of insulin and glucagon)
The iLet

The iLet

As exciting as this new technological innovation is, I feel a level of uncertainty when it comes to handing over complete control to this device. Having to trust in this device is going to be a huge hurdle for me.

After all, the iLet is still only a machine! A very sophisticated machine made up of carefully calculated algorithms but a machine nonetheless. Machines break, machines malfunction, as I have experienced with my insulin pump.  Also, for the past 21 years, I’ve been in charge of all the day to day decision making, when it comes to this condition.

However, as a pump wearer, I must remember I had to face the similar and very daunting task of deciding whether or not I should remain on multiple daily injections (MDI) or take that leap of faith and trust in this new technology.  The thought of using a pump at the time was both thrilling and frightening. Putting part of my diabetes management into the hands of a machine, being attached to a wire and insert, whilst carrying around the insulin pump, completely terrified me. I realised then, how accustomed I was to my MDI, although I had lived with the arduous task of managing MDI, it was as simple as injecting and then putting it away. With the pump, it meant I had to be attached to it constantly.  

Nevertheless, for me, the main focus and one that allowed me to accept the idea of wearing a pump full time, was the possible improvement I might have in my diabetes management. Also, at the time I was expecting my first child and I wanted to have the best control possible. I was given the opportunity to have a trial run. With it on I could see the vast improvement it made in my blood glucose control as a whole. It was then, that I decided to plunge into the deep end and take a chance with wearing the pump full time. Since then, I have never looked back

My control is much tighter than it was on MDl. The thing’s I feared, like having  a wire and inserts attached to me, have all now become intertwined in my life. It has become my new “norm” and although I am connected to it 24/7, it has without a doubt liberated me.

And now, in the absence of a cure, the iLet has given me another glimmer of hope. I am now more open to the idea of being able to free myself even more from the struggles I face with this condition. It isn’t much different to the wearing a pump. Yes, it’s much bigger and more complex but I personally would be willing to trade in my pump for an iLet, if that meant that I would have better BG control, even better HbA1c results, less stress and the pressure to maintain good control and the possible reduction of developing diabetic complications.Then I embrace it fully!

Although I’m very much sold, there are a few things I must take into consideration.

  1. Being connected to the iLet, doesn’t mean that my job of managing my diabetes is over.
  2. I will still have to monitor the device and calibrate it twice a day, as it will be a necessity for me to enter my blood glucose levels before meals.
  3. Inputting information such as meals I plan to consume before I consume them is going to be part of the day to day running of the device.
  4. I anticipate error messages occurring
  5. Changing batteries and inserts.
  6. Insulin and glucagon cartridges will need to be refilled weekly.

We must remember that this device will still very much need our input and it will only be there as an aid. It will give us a much clearer depiction of how our blood glucose levels work in conjunction with different types of foods, exercise and stress at different times. Most importantly, it will give us a reprieve from the constant monitoring we do night and day. The pump has given me a degree of  freedom and I feel that this will be greatly amplified when, god willing, I get the chance to experience using the iLet.

My experience with the pump has allowed me to be more open to this new technology. This sophisticated innovation will undoubtedly be welcomed and I guarantee it will change the lives of so many type 1 diabetics worldwide.

 

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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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Diabetes Blog Week 2016 – Tips and Tricks

 

Since today Is the final day of the #DBlogWeek, I wanted to share some of the tips and tricks I use to not only keep my diabetes in check but  to keep going.

Positivity Tips and Tricks

Try, try, try and try again to do the best that you can do for yourself. You are worth it and you deserve to be ok. You can do things regardless of your condition. You are so much more.

Maya-Angelou

This beautiful quote by Maya Angelou really rings true for me. It is the way in which I have tried to do things in my life. Whether that be, my diabetes or even attempting new and challenging tasks. Whatever it may be, I always push to do that thing to the best of my capability. Especially, when it comes to diabetes, we have no choice but to try our best no matter how hard it may be. I’ve found that, it is within that struggle, that I am able to become much stronger, wiser, capable and ultimately more in control. From my diagnosis to now, this is how I’ve managed myself and my diabetes.  After all it is mine and no one else’s.

 Make a list of all the thing you want to achieve when it comes to being in control with diabetes. What do you want to achieve? It could be testing your BG more frequently, or working out more. Whatever it maybe, just write it down and keep striving to reach those goals. #Youcandothis

better-things

A little positivity goes a long way. You can read my post on ways to remain positive here

Finger Pricking good

image

So this is the state of my fingertips, after 21 years of BG testing. They are so hard and calloused that I’ve now taken to doing my finger prick in the palm of my hand. You know the meatier part of your hand. It’s great for getting enough blood each time I do it but it can be quite sensitive. The tip here is, you need to set your finger prick to a lower setting to avoid the constant flow of blood and try to alternate the sites you choose to prick.

For a good blood supply, wash your hands (wash your hands anyway to make sure you’re not testing that sticking jam you just touched) under warm water.

Working it out

trainners

When working out, you need to figure out when is the best time for you to actually workout. How is your BG affected at different times of the day? What does different types of exercise do to your BG levels?  A recent thing I learnt about myself and working out with diabetes is that morning times are one of the best times for me to do my workouts. This is usually in the form of some sort of cardio or HIT workout, before I consume any breakfast.

After a workout I usually follow with a breakfast which has some protein and carbs in it. There are many benefits to consuming carbs. One of which is, it helps to replenish the muscle glycogen that is burned during a workout. Carbs aren’t the enemy, everything in moderation is good!!

Food

I cook a lot, using fresh ingredients daily. It’s a good way of knowing exactly what you’re consuming.

When it comes to take outs, you don’t completely know what goes into the food and usually it causes huge spikes in my sugars.

If you’re not a great cook or you don’t have enough time, you could prepare your meals in advance for the week and freeze it.

The world is vast my friend, go out there and enjoy it!

DSC01106

Don’t panic!! You’re going on holiday for god sake. Relax and think about the holiday not just on your diabetes. Organise yourself and everything will be ok.

When you travel make sure you have a copy of your prescription with you, just in the unfortunate event that you lose your medication or you require more.

Before you fly, contact the airline and let them know that you are diabetic and will be carrying medication with you.

 DO NOT PUT ANY OF YOUR MEDICATION IN YOUR SUITE CASE, which will then goes into the hold. This could freeze your insulin and essentially spoil it. Always keep it with you.

Double up on the amount of supplies you may need and if you’re travelling with someone, then give them some of the supplies to hold for you.

If you’re a pump user, don’t forget to take a spare pump. Contact your provider at least a month in advance and they will provide you with a loaner pump, as well as a letter that states you’re a type 1 diabetic.

Remember to detach from your pump on take-off and landing, as the pressure in the cabin can cause insulin to be primed through the tubing and into you.

I would definitely recommend purchasing a FRIO bag to store your insulin in, it’s great. It keep the insulin at the right temperature.

Network and be happy

I’ve said it before, I’m going to say it again. Network with others, at your diabetes clinic, at different events, and of course online. It is a great way to connect with others people experiencing the same things you might be. It’s a fantastic form of support.

fighter

Keep on fighting, keep on smiling, and don’t give up. I know how difficult diabetes can be, but it isn’t impossible. Keep trying, keep track of it and with time you will make progress. Work hard and find the inner strength I know you have, to be able to take control of it and everything it comes with.

 shine

Amina xxx

Testing your day time basal rate

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

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

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

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

 

Testing your daytime basal rate

daytimebasal1

daytimebasal-rate2

daytimebasalrate3

daytimebasalrate4

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

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

Amina xx

Guest Post: Angelica Chavez

Anglica1I’d like to introduce Angelica, an entrepreneur, designer and blogger at Lyfebulb, who has type 1 diabetes.

I’ve been drawing since I was 5 years old, intrigued with studying the human form. Art from paintings and architecture has also always captivated me, along with science and film. I’ve always had a curious mind for obtaining loads of knowledge on new topics, so I research like crazy when I design or work on a new project. 

I was diagnosed with Diabetes on November 6th, 1998, a couple days after dealing with painful symptoms and a final night of trauma. The few days before being diagnosed, I lost weight to the bone, threw up everything I ate, needed to pee constantly, and had horrible throat and stomach pains. After two trips to the doctor, I had a glucose of 1000mg/dL (55.6mmol/l). The next twelve months were the hardest my family and I would ever endure, especially because of a hypoglycaemic attack I got one night after not eating.

“I’ve honestly never felt like diabetes affected me, but it did affect my family.”

My mother was really traumatized after the attack and became almost obsessed with watching over me to make sure I was always ok. Sadly, everything flew past her except for me, which in turn affected my sisters. My middle sister grew up fast having to take care of our youngest sister, and my youngest sister felt alone for a couple years of not having our parents’ attention. As time passed, though, we overcame this stress and separation.

Pump or needles?

I have a Medtronic pump and LOVE the freedom, but like all diabetics, I want to be needle-free! Or at least pain free haha! The pump needle still scares me every time. Thank goodness it’s not every day.

Diabetes, Beyond and the positive impacts on my life

Diabetes has kept me mindful of my health, and taught me strength and independence. All the Diabetics I’ve met through Instagram have also inspired me to feel proud and not to give up!

My current entrepreneurial projects are: Veltimera- an ecofashionable nonprofit for animal rights, in which I’m currently designing a Fall 2016 collection to fund animal rescues.

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

Anglica6Piece of SASS Swimwear- a sustainable swimwear line for all beautiful body types; and Rebel Empire Apparel– an upcoming t-shirt line based in Los Angeles.

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

Anglica9

That is a hard lesson that not many people understand, because all they see is the success of a company or person and not its dedicated work. Another quote that I absolutely love is 

Anglica8

I know I definitely have already failed tons of times, but I’ve learned what not to do and have researched new ways of doing things the right way.

One tip I recommend when starting your own business is having an intense passion for what you’re working towards keeps you focused and strong. Without passion, people give up after the first failure or don’t have the drive to educate themselves in what needs to be done.

My drive and passion are animals. Ever since I became vegan, I have not stopped thinking about them. They are the reason I became an entrepreneur in 2012 and haven’t given up.

Veganism in my life

Veganism has actually made it easier for me to manage my diabetes, because most of my foods are plant based. For example- Breakfast is tofu stir-fry, Anglica7

Brunch is a peanut butter banana smoothie, Lunch is a Veggie burger with fries, and Dinner is bean and vegan cheese tacos with chocolate almond milk. Anglica4

I always switch my meals around, because I LOVE flavours, but I’ve managed to keep my meals constant in carb count and reduced my basals (which are hourly insulin pump administrations). I do recommend, though, if you consider trying veganism, write everything down for the first 2-4 weeks to understand your body. Everyone reacts differently to new lifestyles.

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P.S. To answer any questions, I’m 100% healthy with all my vitamins and minerals, and vegetables and nuts fulfil my bodies need for protein. No, I never feel deprived; in fact, I’ve become more open to new foods, because taste has improved like a thousand times. I also transitioned to veganism over the course of 3 years, and I don’t buy organic like people might assume.

Advice to the younger, newly diagnosed, me!

You will make it through and be a great artist with lots of good friends and successful creative projects. It might be hard right now, and I know you don’t want to take your shots because you hate the needles, but think of your family. You are a warrior, and they need you.

If you want to follow Angelica’s work or have any questions for her, then you can find her on instagram @ Inspired Vegan and Diabetic with Style. You can also connect with Angelica via Facebook and Twitter. 

 

 

 

 

 

 

 

 

 

 

 

Guest Post 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).

Untitled-15

“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

Guest post: The Fit Blog Part 1

I’d like to introduce husband and wife, fitness instructors, Christel (who has type 1 diabetes) and Tobias. Through their blog, TheFitBlog, they share CNT1their passion for a healthy and fit lifestyle, whist giving people the support to succeed with their fitness goals.

How did you start TheFitBlog?

Tobias and I have always had the desire to do our own thing. The summer of 2015 it all came together and we decided to take a leap of faith and make our hobby and passion our occupation. TheFitBlog is a general health and fitness site while the “Fit with Diabetes” section on the blog is my platform to discuss health and fitness from a diabetes perspective.

When I started working out more seriously, I searched without much luck for good information online on how to successfully combine training and diabetes management, so I had to figure it out on my own. TheFitBlog is my chance to share my experience and learnings with others.

How long have you had type 1 diabetes? How did you find out? What steps did you take?

I was diagnosed with Type 1 diabetes in December 1997. I’d just finished high school that summer and spent my time working in a preschool, partying hard and eating and drinking everything in sight. I displayed all the classical diabetes symptoms; hunger, thirst, sleepiness, frequent need to urinate and a slender physique. But all of that I simply attributed to my lifestyle.

At one point, my family did urge me to see a doctor, I did, and he was determined I had diabetes. I was admitted to a diabetes clinic as an outpatient and they spent the next two days teaching me about diabetes, how to take my shots, test my blood sugars and how to treat lows. First day of my diagnosis I was encouraged to never let my diabetes manage my life or to be a hindrance and I took that to heart and have lived by it ever since. Eight months later, I left for my first backpacking trip around India and I never slowed down.

How often do you work out?

Hi, my name is Christel, and I’m a workout –holic :-). I’m in the gym 6 days a week right now. However, 2016 is also a competition year for me so I’m working out as an athlete. I compete in NPC bikini competitions and have qualified to potentially take home a pro card later this year. A more normal gym schedule for me is 4-5 times a week and I think that is plenty for most people.Untitled-11

How do you balance working out with diabetes?

There is definitely a learning curve, but once I understood my body and how I react to different kinds of exercise, it’s actually pretty easy. When you understand how your body reacts to certain foods and exercise you’ll know how to adjust your insulin and not have to worry about lows all the time. Of course, I don’t always get it right but 95% of the time my sugars are perfect pre, during and post a workout. My advice is to take a lot of notes and find out how your body reacts to different foods and exercise and learn from it. In the long run, I find that working out makes your diabetes easier to manage, not harder.

How often do you have rest days?

Rest days are usually the hard ones for me since my insulin sensitivity goes down. I have a minimum of one rest day per week. There are some great sunset walks where we live in Santa Monica CA. It’s important to have rest days, since that’s when your body rebuilds and get stronger.

“When I work out, I’ve found that it’s much better for me to work out in the morning opposed to the evening. My sugars have a tendency to drop drastically in the night time, so I lean towards working out in the morning. Being able to stay motivated whilst maintaining good BG levels is extremely difficult.”

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What time of day do you like to work out? Have you found that working out at certain times are better for you and your BG levels?

My advice is to work out the time of day that suits you best. In the morning, you’ll have less insulin on-board so you’ll be less prone to low blood sugar. If your goal is weight loss, you might even benefit from morning sessions before breakfast. I do fasting cardio in the morning and resistance training in the afternoon/evening to build muscle mass. The key is to determine the right insulin level. It will depend on what you eat, your insulin sensitivity and how aggressively you work out.

Do you use a pump or injections?

I’m one of the rare MDI / CGM combinations. Pumps are awesome, but not for me at this time in my life. It’s still an extremely valuable tool and something I recommend for everyone who starts working out. I have very good control with MDI because I’m willing to inject 10 times a day if needed and test my blood sugar just as often.

How often do you test your BG and how do you record your BG levels?

Whenever I feel I need it. So it might be 10 times a day or it might be 8. I have a Bayer meter that saves all my readings so I can just download it when needed.

How do you stay motivated whilst managing low BG levels?

I guess I really don’t think about my blood sugar in those terms. My motivation to do what I do is not affected by my blood sugars. I manage them to allow me to do what I do.

How do you correct your BG levels without ruining the hard work you’ve put in?

By learning how much insulin and food to consume around workouts I hardly ever have low blood sugars during exercise. If I do, I treat it as it is; a medical emergency. I’ll eat 2-3 glucose tablets and either have a fruit strip and continue my workout or simply go home. A few glucose tablets and a fruit strip will never ruin your progress even if you are trying to drop weight. What will derail your progress is if you treat lows with candy or sugary soda.

What advice do you give to your diabetic clients when it comes to low/high BG’s when working out?

I always have clients track their activities, food, sleep patterns etc., and then together we work on determining why and when he or she is going low to reduce the risk of it happening

“As a mother, my schedule can be pretty hectic and fitting in a work out can sometimes be impossible. I like to do quick HIT workouts for a 20- 30 minute period or target one area e.g. my abs. My goal is to be working out a lot more than I currently do.”

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What advice would you give to me and to others who are struggling to achieve their fitness goals due to the hectic lifestyles or plummeting BG levels?

Even a little physical activity is better than nothing. First, decide what you want to achieve. If it’s cardiovascular health, focus on cardio. If it’s building strength, chose resistance training. Since time is a limited resource, you might have to focus your attention to one thing only.

I mainly do resistance training, because I think it gives a better return on the time I spend. Muscles help burn calories and increase your insulin sensitivity, so adding a little muscle mass is great for people with diabetes.

The reason why your blood sugars drop when you work out is that you have too much insulin in your system. So just as you learn your carb ratios over time, put in the time to get to know your insulin sensitivity after different types of workouts and adjust your insulin accordingly.

Look out for Part 2 of TheFitBlog guest post from Christel and Tobias on Nutrition. In the mean time if you want to read more about Christel and Tobias, then check out their blog at TheFitBlog. You can also find them on Twitter , Facebook and Instagram.

Amina xx

Snow day tips!

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

snowfall

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

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

A few hours after school run……..

BGMETER

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

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

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

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

snowboots

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

 

Amina xx

 

Let them in!

How do you even begin to explain to your children, what diabetes is? It’s extremely important for them to know, but how much is enough?

My eldest has always been curious about my diabetes and all the technology I am so lucky to have. Isasmiling

He has many interesting questions;

“Mami, How’s does my body know how to produce insulin and yours doesn’t?
“What is Insulin?”
“What does insulin do?”
“When your sugar goes too high, what’s happening inside your body?”
“How does my body know when to stop giving me insulin, when I’ve eaten something?”

Which really helps me explain diabetes better and with ease. I try my best to answer his questions, as simply as I possibly can. Confusion and worry is the last thing you want, especially when you’re trying to enlighten a 6 year old about diabetes. Now I’ve come to think about it, I wouldn’t want to confuse anyone. There’s already enough confusion when it comes diabetes.

It’s not an easy job, but who said it was going to be? The fact that he is even asking, shows me that he has an interest in what is happening with me, me, his mother.

The way I look at it is, his questions are an opening, an opportunity for me to show him this side of me. He’s at that age, where he questions everything. He wants to know more. The short answer isn’t good enough. He wants to know every last detail. However, I still approach the ‘diabetes’ subject in a gentle way.

He’s observed me countless times changing my insert and knows that when I prick my finger, I’m in fact checking my sugar level. He’ll watch and wait for the numbers, close his eyes and say, “I really hope it’s a good number mami.” (Heart break) He now also knows that I’m looking for the best number range to appear on the screen of my BG meter.

What truly amazed me the other day, was when I was having a hypo. I made mention that I was feeling hungry, so he asked me if I wanted him to get my BG meter so I could test my level. So I said, “Yes ok”. I pricked my finger, applied the blood to the strip and he wait to see what it read. It was 4.2 and most likely on its way down, considering the way I was starting to feel. Before I could even get up, he’d ran to the kitchen and brought back a box of juice from my goody draw and said, “Here you go mami.”

Recently, he asked me if he could test his BG level, which totally blew me away. He is a very sensitive soul and extremely squeamish when it comes to cuts and blood, so I was shocked that he even asked. Of course, I completely jumped on this opportunity to explain to him what was required to test a BG level. Then, I asked him if he was ready he said, yes. I pricked him, he flinched a little bit and then smiled. We quickly put the blood on the test strip and he waited with excitement to see what numbers would appear.

Isabgtesting

I praised him for being such a brave boy and he responded with, “mami, I don’t know how you do this every day.” I smiled at him, trying not to cry up a storm and I just explained to him that it was something that I had to do. Just like sleeping and eating, are the things we all need to do. He replied with, “but this is harder and you’re very brave mami.” (Heartbreak)

 

Now my 2 year old, as young as that might seem has also started to develop a very basic understanding of me having to always check my BG levels and change my insert. From the moment she was born, she’s been observing me, pricking my fingers and most likely hearing the familiar beeping sounds, being emitted from my pump.Untitled-3

Her favourite kiddie show is doc Mc stuffin’s and there’s a theme song. “Time for your check-up”. How do I explain this, she’s a child, who plays a doctor who fixes broken toys by finding a diagnosis. Yes I watch it too hahaha!

Moving on……

This morning, she ran to find my BG meter and reminded me, that I needed to do have a check-up. I laughed! She stood there with a huge smile on her face, while waiting eagerly for me to do it. Usually, when she sees blood she’ll say, “Ouch!” However, this time she just watched. Another thing she has taken to doing is, asking me if I’ve done a check-up when were sat down to a meal. When this happened for the first time, I realised that she had made the connection between me eating and testing my BG.

See already her understanding is developing!

They both amaze me because they aren’t frightened to be around my diabetes. It’s become quite normal for them to see me change my insert or test my BG. They have the understanding that it is a part of me and I think that they are alright with that. As they mature, they’ll develop a further understanding and in turn they will have a better understanding of my daily lifestyle.

isaandsusu

Word of advice….

If your children are asking you about your diabetes, don’t be afraid to explain it to them. Be open and honest with them, let them in. You’re important to them, if not one of the most important things in their lives. Even if they aren’t asking questions, you can always start by mentioning little things, giving them snippets of your life.

diabetesluvones

Although, this is an experience about me and my family, this can be related to anyone in any relationship. If they are asking questions, answer them as simply as you can. Once you’ve opened that door of conversation, the questions will come thick and fast. But don’t panic! Don’t give too much detail at once and scare them to death. Stay positive when expressing things to them, which will allow them to absorb the information with confidence and know that things are ok with you. Diabetes awareness starts at home. Just think the knowledge you pass on to your loved ones, could potentially help another person in the future.

Please comment below and let me know your stories and how you’ve explained ‘diabetes’ to your loved ones?

Amina xx

Change is Inevitable

When you are first faced with a diagnosis of diabetes, it’s a very hard process to come to terms with. The realisation that this condition is now with you for the rest of your life, is indeed a very tough thing to confront.

Many emotions such as, anger, denial, and self-pity are but a few emotions which are bound to present themselves. Just remember this is quite normal and you must give yourself the time to deal with these emotions. However, what you must also consider is, change is inevitable. This is happening now, it can’t be pushed to one side in hope that it will disappear.

“Diabetes has always been a challenge for me. It has never been easy. Every step of the way, for the past 21 years, I’ve had to fight my way through everything it has thrown in my direction.”

quote-1

Developing an understanding that things are going to change is key.

It’s all new. I know and I know you’ve never experienced this before, but you must give it your best shot, to remain healthy.

Once you put in the effort, this new change in your life will start to become your new norm.

Don’t resist it because, it will definitely take control of you. You need to be on top of it.  If you’re having a hard time adjusting, don’t struggle by yourself. Look for and get support from people close to you. I found that the online community was a great place to start. Things that I was struggling with, I was able to get through it, with their support. They were just like me (diabetic) and that was enough for us to have an instant connection. They could really relate to me and had an understanding of what I was actually going through.

Family are a are great source of support too, even though they may not understand it quite like another diabetic. Remember, they have nothing but love for you and want to help you in whatever way they can. So don’t shut them out. It’s new to them too, but I can assure you they are ready and willing to help you. Use your medical team e.g, doctors, nurses and dieticians, whoever you can reach out to. They should be there to help you.

Be patient my friend, you are stronger than you know you are. Stay determined and try your best to accept this new change in your life. Turn it into something positive.

You can do this!!

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…………

________________________________________
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

 

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.”

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

PARENTHOOD & DIABETES

 

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

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

The mum’s who carried you for nine months,

Stressed about their sugars,

Concerned that they may swing too low or too high,

Ever so fearful for their unborn child.

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

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

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

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

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

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

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

They share their knowledge, their life and experiences.

They educate one, they educate them all.

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

Come back and linger about you,

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

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

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

Aren’t open to talking about the D

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

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

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

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

And

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

Amina xx

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!

Test your Diabetes knowledge!

SUGER CUBE WITH GLASSES

Just a few questions to jog your memory with all things diabetes. See how many you can get!

1. When was insulin first discovered and extracted for the use in diabetic patients?

  • 1880
  • 1923
  • 1946
  • 1825

2. What was the name of the first patient treated with insulin?

  • Thomas Smith
  • Leonard Thompson
  • Jonathan West
  • James Collip

3. Which year was World Diabetes day recognised by the United Nations?

  • 2007
  • 1995
  • 2000
  • 1997

4. I am an autoimmune disease I attack beta cells in the pancreas, not allowing my victim to produce insulin. What type of diabetes am I?

  • Type 1.5
  • Type 2
  • Type 1

5. Hypoglycaemia is a term used to refer to:

  • An increase in blood glucose level
  • A stable blood glucose level
  • A decrease in blood glucose level

6. What is diabetic ketoacidosis (DKA) a result of?

  • Eating too many sugary foods which result in high blood glucose levels
  • A lack of insulin, fatty acids being burnt  and the production of ketones
  • Too much insulin in the body

7. How many people worldwide have Type 2 diabetes?

  • 600 million
  • 347 million
  • 2.5 million
  • 425 million

8. Which of these symptoms is not a symptom of untreated diabetes?

  • Fatigue
  • happiness
  • Frequent urination
  • Thirst

9. When was the first blood glucose meter invented ?

  • 1928
  • 1962
  • 1968
  • 1970

10. Think of one positive thing you’ve learnt from your diabetes and please share those positive thoughts with me.

I will post the answers later today.

Amina xx

World Diabetes day!! 14th November 2013

WORLD DIABETES DAY 141113

Hi guys

Today is World Diabetes day!!!

I don’t know why but this day has always made me happy, proud and at times sad. On a daily basis I am reminded of my condition and the battle I go through, and I think that World diabetes day gives others the opportunity to remember diabetes. It is also a day whose popularity grows each year by the millions of diabetes campaigns and the wide spread awareness which is shared with the world. However, it’s a day which makes me sad because it reminds me of some of my loved ones who are no longer with us and suffered with both T1 and T2 diabetes. I feel that World diabetes day really allows us all to come together and acknowledge the effects of this lifelong condition.

This February will be my 20th year living with diabetes. When I was first diagnosed, I couldn’t have possibly looked forward and pictured this day and the person I’ve become because of my diabetes. At the time I knew I had a difficult journey ahead of me but I could never have imaged how difficult it would have been. I’ve never taken a day for granted and always try my best to control my diabetes and live a healthy life.

This World Diabetes Day I’ve decided to set out a few goals for myself for the following year.

 

– I would love to maintain a tight control on my blood glucose levels and in turn keep my HbA1c at 6.4% if not lower.

-Always stay positive about my diabetes especially on the difficult days.

-Continue to blog and raise more awareness about diabetes whilst sharing my experiences with the world.

– Keep up the exercising and eating healthy

-I was unable to take part in my JDRF run this year because I was extremely ill. So next year I’m aiming to take part in it.

Thanks for stopping by

Amina xx

MIA, Diabetes and life

Hi guys

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

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

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

What is this you ask?

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

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

Exercise:

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

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

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

– It hydrates the body even better than water

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

– It is also very low in calories and cholesterol

– It speeds up the metabolism

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

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

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

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

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

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

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

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

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

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

Thanks for stopping by

Amina xx

Cyborg for a month or perhaps longer :/

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

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

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

dexcom g4

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

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

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

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

Here’s a breakdown of costs:

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

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

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

Happy Pumpdexi’ing  lol!

Diabetic Mathematics! Mathebetics….

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

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

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

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

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

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

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

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

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

image (2)

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

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

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

= 100 / 50

= 2

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

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

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

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

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

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

GL = GI/100 x Net Carbs

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

45 X 8.6 = 387

387 / 100 = 3.9

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

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

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

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

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

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

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

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

My total number of injections/inserts =24 025

That’s a lot of numbers.

Thank you for stopping by  Amina xx

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.

Print

Get creative with Diabetes

Since, I didn’t get a chance to join in on the Diabetes blog week. I wanted to post this creative piece, which I had already prepared a while ago.

The moment I realised,

I RUN ON INSULIN

The Bond

Where would I be, without my insulin pump?

My constant supply, my night and day.

My everything, my all, the strength by my side.

My companion and I, we struggle, we stride, yet we continue to survive.

You who I can depend on, I will defend you, always on your side.

You endure, my highs, my lows, with no word, no sighs.

You are forever committed to me, for as long as I stay devoted to you.

What would life be, without your endless support?

Every day a new challenge, we fight, we fall, yet we’re still standing tall.

Oh How I envy you sometimes, looking all so poised and refine.

Memory takes me back, to when me and mine would work just fine.

Connected we will stay, till the end of my days

Me and my insulin pump.

By Sugar High Sugar Low

 

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…………………………….

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.