Tag: HbA1c

Are children not getting the recommended diabetes checks?

imageWhen I was a child, I remember having several check-ups every time I’d attend my diabetes appointments. After my diagnosis my check-ups were every 3 months and then it became every 6 months. These checks covered everything from, cholesterol testing, blood tests, feet check-up. Both of these tests would also be checked at my GP surgery once a year.  My eyes were tested at my opticians, annually.

Nevertheless all the results from these check-ups would then be sent over to my consultant at my diabetes clinic. Every appointment the doctor would have the most recent results from these check-ups. Appointments moved swiftly and results were explained in as much or as little detail needed. Any concerns or advice were given and time for listening was also given. Everything was in order and none of my check-up were ever missed.

However, a recent study of children ages 12 to 24 with diabetes, attending paediatric diabetes units in England and Wales proposed that, nearly 75 % of these children are not getting the necessary health checks.

70 % of these children are in fact type 1 diabetics, who are insulin dependent and require these check-ups to be carried out at least annually, routinely and efficiently.

From the study, data was collected from 27, 682 children and young people, which outlined that only 25.4 % of these children (ages 12 to 24) were having the seven recommended annual checks.

 “Guideline from NICE (The National Institute For Health and Care Excellence) state all children with diabetes should have their blood sugar levels checked every year and those over the age of 12 should also have six other health checks.”

These checks for this age group should include:

  • Measurement of growth
  • Blood pressure
  • Thorough eye tests, examining the backs of the eyes in detail
  • Cholesterol testing
  • HbA1C
  • Feet check-ups
  • Kidney function

The study also found that, from this age group (children age 12 to 24 years old), those who were considered to have “excellent diabetes control” of 7.5mmol/l, had in fact risen to 15.8mmol/l in 2012 and then by 2014 -15 this had risen even further to 23.5%.

These results are extremely disturbing and it clearly shows that there is a failure within the basic support and care of children and young people living with diabetes. These check-ups should be routine and frequent enough so that both the patient and the doctor are aware of the patients diabetes management.

As alarming as these results are, the report carried out also showed that at least 98.7% of these children in this age group had their HbA1c tested. However, only 23 % had started to increase their chances of not developing complications due to poorly managed diabetes.

On the other hand, the most frequently missed checks amongst children age 12-24, involved foot examination, eye screening and cholesterol testing.  All these tests are crucial when it comes to managing diabetes treatment and the regularity of these tests being done will only aid in the detection of any signs of diabetes complications or any damage being done to organs. Detecting signs for complications such as (blindness and kidney damage) early could potentially help to avoid or lessen the effects of the complication and if treatment is necessary then it can be administered at an early stage.

The study also showed that children from poorer areas were found to have worst HbA1c test results whilst children in more prosperous areas were found to have better HbA1c results.

Bridget Turner, director of policy and care improvement at Diabetes UK, said, “There remains considerable variation in the level of care provided. This is very worrying because if children and young people are not supported to manage their diabetes well in early life, they are more likely to be at risk of debilitating and life threatening complications in adult life such as amputations, blindness and stroke.”

Since the report, The NHS (National Health Service) are working to improve the delivery of effective integrated diabetes services with the help of clinical commissioning groups across Wales and England.

I hope that future reports will show that children within this age group suffering with diabetes are being taken care of and not going without these fundamental check-ups, regardless of their economical status.

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.

11205719_1649089618645467_318194775_n

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. 

 

 

 

 

 

 

 

 

 

 

 

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

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.

Don’t complicate it! Part 1

DIABETIC COMPLICATIONSAVOID, AVOID, AVOID!!!!!

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

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

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

“Complications with a capital C”

Complication number 1

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

Illustration of hemorrhage in retina - Diabetic Retinopathy

© Sophia Winters – Fotolia.com

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

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

There are different types of retinopathy

1. Background Retinopathy (or non- proliferative retinopathy)

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

2.  Maculopathy:

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

3. Proliferative:

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

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

To be continued…………………………….

HbA1c!!!

HbA1c WHAT'S YOURS

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

Let’s start with a few basics!

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

“So what did it all mean?”

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

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

 

Hb + Glucose = HbA1c

 

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

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

What should your HbA1c be??

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

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

 

My current HbA1c = 7.4%  57mmol/mol

My dream HbA1c = 5.0%   31mmol/mol

Pregnancy HbA1c = 6.4%  46mmol/mol

Print

 

Amina xx

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

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