Tag: Diabetes mellitus

Sugar High Sugar Low: Preparing for pregnancy

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

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

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

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

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

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

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

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

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

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

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

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

Amina xx

World Diabetes Day – Insulin discovery

© Mary Evans Picture Library / SZ Photo / Scherl

© Mary Evans Picture Library / SZ Photo / Scherl

Since I come from a science background. I thought that this year for World diabetes day I would concentrate on one of the major breakthrough’s in diabetes. The breakthrough which stands out in my mind and is very close to my heart is the discovery of insulin by Dr Frederick Banting and Charles Best. Without this life changing discovery, let’s put it this way I probably wouldn’t be here today. I wanted to show my appreciation and write a post dedicated to these men.

Frederick Banting was a Canadian scientist, born on 14 November (World Diabetes Day) 1891 in Alliston, Ontario. His list of achievements stacks up high. In 1916, he received an M.B degree and was able to join the Canadian Army Medical Corps during World War 1. During the war, besides being wounded badly, he continued to help the sick and injured.

When the war ended in 1919 he returned to Canada and was awarded the Military Cross. He also became a medical practitioner for a short time. Until he returned to Toronto to study orthopaedic medicine.

1919-1920, he was resident surgeon at the Hospital for Sick Children, Toronto. He did this whilst continuing his general practice, teaching orthopaedics and anthropology part-time at the University of Western Ontario in London.

*The Insulin breakthrough*

In 1923, Frederick Banting along with his assistant Charles Best discovered how to extract insulin so that it could be used on patients suffering from severe diabetic ketoacidosis (DKA). If you aren’t aware of the research you can have a look at the step by step documentation of the research carried out on http://link.library.utoronto.ca/insulin/timeline-frames.html

Dr Frederick Banting was presented with a Nobel Prize in Physiology in 1923 along with Dr. JRR MacLeod, Professor of Physiology at the University of Toronto.  His assistant and co-founder of insulin “Charles Best” was not recognised for the hard work he had contributed in the research. Dr. F Banting decided that he would share his award money with Best. According to the Nobel Prize,” as of September 2011, Banting, who received the Nobel Prize at age 32, remains the youngest Nobel laureate in the area of Physiology/Medicine.”

The Canadian government gave Banting a lifetime annuity to work on his research. Banting married Marion Robertson in 1924; they had one child, William (b. 1928). This marriage ended in a divorce in 1932. He was then knighted by King George the V in 1934 and became Sir Frederick Banting.

Banting and Best went on to work at the Banting and Best institute in the University of Toronto. Today this institute is known as the BBDMR. Dr. F Banting went on to work on other aspects of research such as, silicosis, cancer, and the mechanism of drowning and how to counteract it. In 1937 Banting married Henrietta Ball.

Dr F Banting reenlisted in the Royal Canadian Air Force during World War II. There he severed as a liaisons officer between England and North America. In 1941, he was involved in an air crash and regrettably he met his demise.

I’ll be forever grateful to Banting and Best for their astounding breakthrough. This discovery has helped many people suffering with diabetes and is definitely the biggest breakthrough in my eyes in the diabetes world.

Words of Sir Frederick Banting:

 “Insulin is not a cure for diabetes; it is a treatment. It enables the diabetic to burn sufficient carbohydrates, so that proteins and fats may be added to the diet in sufficient quantities to provide energy for the economic burdens of life.”

 

The curious Peanut boy

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

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

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

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

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

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

Amina xxx

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

Get creative with Diabetes #2

PrintWithout Me

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

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

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

By Maryam Abdullahi- Mahdi

Hope for a cure!

ONE DAY I WOULD LOVE TO SAY I HAD DIABETES

Since I was diagnosed, I always hoped that one day I’d wake up to the news of diabetes being cured. For now this is a prospect that I can only dream about. Type 1diabetes has been with me for 19 years and the truth is, until they find a cure it will always be a part of my life. I pray that, one day I will be able to say “I had diabetes” and “it affected me in this way and that way, but I now no longer have it”. I’ll be Amina and although my diabetes will be long gone. It will be like a scab, pick away and all I’ll have left of it will be the memory of our time spent together. I will be able to function just like everybody else. No blood glucose checks before meals, no insulin pump, no insulin and no need to correct my sugar. Diabetes free, I will be.

Print

I strongly believe that one day there will be a cure for diabetes. I may not be able to benefit from it, but maybe whatever cure they develop will help others affected by this condition. I know that there has been and there currently is a great deal of research being done to try and eliminate this horrible condition.  Just to outline the current research that is  being done:

1. Diabetes Research Institute Foundation – have developed a cell based therapy, that works by transplanting insulin producing islet cells and they have been able to restore natural insulin production in patients involved in clinical trials.  Patients have been able to attain insulin independence and experience normal blood sugar levels. A lot of these patients have lived without any insulin for a long period of time.

They have now gone further with this research and are currently trying to develop what is known as the BioHub (mini organ) which is able to function like a normal functioning pancreas. This BioHub will contain thousands of insulin producing cells and be able to know what blood sugar levels are and then administer the correct insulin required instantly.

2. Melbourne researchers, Professor Len Harrison, Dr Esther Bandala-Sanchez and Dr Yuxia Zhang – have identified an immune protein that has the potential to stop or reverse the development of type 1 diabetes in its early stages, before insulin-producing cells have been destroyed.

For all the type 1 diabetics like me who have had the condition for a longer period of time, this is not an option for us. Newly diagnosed T1D’s are more likely to benefit from this treatment. Click on the following link to read more about how this research works. http://www.sciencedaily.com/releases/2013/05/130520104932.htm

3. Matthias Hebrok, Ph.D, University of California, San Franciscohas developed a stem-cell-based strategy which is able to boost the immune system in mice. Click on the following link to read more about this great research. http://www.sciencedaily.com/releases/2013/05/130516123650.htm

4. Tech engineers and Emory University clinician – have made a significant first step with newly engineered biomaterials for cell transplantation that could help lead to a possible cure for Type 1 diabetes. Please refer to the following link. http://www.sciencedaily.com/releases/2013/05/130509154554.htm

Today’s news 10/06/2013

5. Researchers from the University of Cambridge, have developed the ‘closed loop’ device. This device is able to monitor blood glucose levels minute-by-minute and uses infrared technology to relay this information to an Insulin pump attached to the patient’s body, which then delivers the correct amount of insulin into the blood stream. http://www.diabetes.co.uk/news/2013/Jun/first-ever-home-trial-of-artificial-pancreas-for-diabetes-treatment-96325905.html

 

In order for more research to take place and for us to hopefully be successful in finding a cure for diabetes, organisations and research institutions need more financial support. If you’re able to help please refer to some of the links below or look for a diabetes charity of your choice.

Diabetes UK – https://www.diabetes.org.uk/Donate/

Diabetes Research Insitute (DRI) – https://www.diabetesresearch.org/Support-BioHub

Diabetes.co.uk – http://www.diabetes.co.uk/diabetes-charity/donate.asp?id=duk

Type 1 diabetic on Metformin

metformin extraType 1 diabetic? CHECK

Insulin dependent? CHECK 

Taking Metformin?  ERR CHECK

Yup your vision isn’t failing you. I’m a type 1 diabetic on Metformin. I started to take metformin over 4 years ago alongside my insulin pump therapy. I began to notice that my insulin basal doses seemed to be increasing steadily on a monthly basis. In fact my basal doses had more than doubled over a course of 4 months.

So what is Metformin?

Metformin – is a drug, which is usually used to treat type 2 diabetics.  It is commonly given to type 2 patients who are overweight, obese and with normal kidney function. It is also used to treat gestational diabetes and polycystic ovaries.

“So why do I take it?”Metformin1

I wasn’t overweight or obese and I maintained a good healthy weight for several years. So why did I need it all of a sudden?  It just made no sense at all. Being the scientist that I am, I started to look for different research papers which might be related to metformin and type 1 diabetes.  A lot of the papers I came across only made mention of type 2 diabetics taking this drug due to insulin resistance.

Wikipedia states that, Insulin resistance (IR) is a physiological condition in which cells fail to respond to the normal actions of the hormone insulin. The body produces insulin, but the cells in the body become resistant to insulin (through changes in their surface receptors) and are unable to use it as effectively. Beta cells in the pancreas increase their production of insulin, further contributing to hyperglycaemia. This often remains undetected and can contribute to a diagnosis of Type 2 Diabetes.

Could it be that I’d developed some sort of insulin resistance specific to type 1 diabetes? HMMMM!! As I delved deeper, I came across a paper which talked about insulin resistance occurring in type 1 diabetics.  Just like type 2 diabetics, type 1 diabetics are also known to suffer from insulin resistance. Metformin had been mentioned as a drug which was able to lower the amount of insulin required, by helping the body move and use the insulin more efficiently.

So maybe in my case the insulin from my insulin pump wasn’t being used and moved around my body efficiently!

I decided to make an appointment to see both my diabetic doctor and nurse to see what they thought, without telling them the extensive research I’d done. After a lengthy conversation they also came to the conclusion I might be Insulin resistant and suggested that I try Metformin. They explained all the past and recent research done, the success people with both type 1 and 2 diabetes have experienced with this drug.

So I thought,” why not, what’s the worst that can happen?”

Initially, I started to take (500mg metformin, prolonged release tablets), once a day with my evening meal. Almost instantly I noticed that the amount of insulin I had needed prior to metformin began to reduce. I was then advised to increase my dose to (500mg prolonged release twice a day) with my evening meal.

I started to experience different side effects. Some of the good side effects were, my HbA1c dropped from 7.9% to 7.0%. I dropped a few pounds and my insulin requirement continued to decrease drastically. Some of the unpleasant side effects were, severe abdominal pain followed by gas and severe upset stomach, which would then settle after 24 – 48 hours. Later I realised that this was down to sometimes forgetting to take my tablet. So if you make the decision to take metformin, remember not to skip your dose.

I began to think this drug really was amazing! It was reducing my insulin intake, my HbA1c was fantastic and I was in even greater shape than I was before. This all became extremely important because my husband and I had made the decision to try to conceive. When I finally conceived, I continued to take metformin for the first 4 months of my pregnancy. I then stopped taking it completely until nearly a year after my pregnancy. I’ll go further into this when I do my post on diabetes and pregnancy.

As a type 1 diabetic, if you’re considering metformin, I’d definitely recommend talking to your doctor first. “Do your own research, prepare questions to ask your doctor. Be prepared!” After all it is your body. You must remember that, we all react to medication in different ways and you may or may not have the same results that I did. However, I strongly feel that the metformin played a great part in reducing my HbA1c and also more than halving my insulin basal dose. Perhaps the metformin combined with other factors such as eating a low carb diet, exercising and eating healthily, which I was doing prior to taking metformin helped to achieve good results with the drug.

Work your sites

© Dmitry Lobanov - Fotolia.com

© Dmitry Lobanov – Fotolia.com

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

“ROTATION IS KEY “

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

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

No rotation = lumpy bumpy body

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

Fat hypertrophy also known as hypertrophy or insulin hypertrophy.

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

So what sites can we use?

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

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

sites

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

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

Site Rotation tips

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

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

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

Which are my best sites you ask?

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

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

Changing the “insert” before it needs to be changed

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

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

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

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

*CDC – Centers of Disease Control

 

Avoid retinopathy

Let’s prevent retinopathy

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

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

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

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

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

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

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

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

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

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

6.      I always try to eat healthy.

.   Stay Active. Get that blood circulating

8.  I always attend my annual diabetes check ups.

9. Look after your feet

ClearlyHealth

Don’t complicate it! Part 1

DIABETIC COMPLICATIONSAVOID, AVOID, AVOID!!!!!

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

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

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

“Complications with a capital C”

Complication number 1

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

Illustration of hemorrhage in retina - Diabetic Retinopathy

© Sophia Winters – Fotolia.com

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

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

There are different types of retinopathy

1. Background Retinopathy (or non- proliferative retinopathy)

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

2.  Maculopathy:

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

3. Proliferative:

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

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

To be continued…………………………….

HbA1c!!!

HbA1c WHAT'S YOURS

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

Let’s start with a few basics!

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

“So what did it all mean?”

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

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

 

Hb + Glucose = HbA1c

 

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

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

What should your HbA1c be??

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

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

 

My current HbA1c = 7.4%  57mmol/mol

My dream HbA1c = 5.0%   31mmol/mol

Pregnancy HbA1c = 6.4%  46mmol/mol

Print

 

Amina xx

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

My first hypo!

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

This was my first hypo experience!

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

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

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

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

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

How to treat mild and severe hypo’s?

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

lucozade

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

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

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

glycogon

Your views

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

x Amina

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.

What is Type 1 Diabetes?

What is Type 1 Diabetes?

Type 1 diabetes occurs due to a lack of the hormone Insulin in the body (Insulin is  produced in the pancreas). When food is ingested this lack of Insulin causes blood glucose levels to rise as the glucose builds up in the blood stream.

©Clearly Health

TAKE CONTROL OF YOUR DIABETESBeing diagnosed with type 1 diabetes meant that I had to accept the dreadful truth that I now had this for the rest of my life and that I was now Insulin dependent.

There are two options for Insulin treatment. Either by injection or Insulin pump therapy. When I first became diabetic I only had the option of injecting therefore  I started my insulin treatment with injections, injecting twice a day. But as I grew,  my body required a lot more insulin. So my twice a day dose was then increased to five times a day. I asked myself, ‘How was I going to do five injections a day?’ I had only just got the hang of having to inject twice a day Print

pensAs difficult as I thought it was going to be, I remained calm and positive about the new situation I found myself in. I said to myself, ‘Amina you have no choice. It’s either you take control of this condition by taking five injections a day or succumb to it and let it control you.’ Despite my apprehensions,  I  remained on five injections a day for many years. As doubts crept into my mind again,  I remember thinking I was going to be taking five injections a day  forever (which seemed like a long time). During August 2009,   I was contacted by my diabetic healthcare team to tell me that my insulin pump had arrived. It couldn’t have come sooner! Print

pump

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.