Diabetes - expert blog

Keeping Teenagers on track by Neil Walden

We all know that adults don't always obey the rules, but teenagers make a habit of it!  "Why ??" is the constant question posed to parents who want a record book to be filled in regularly, or who try to limit sweet foods consumed after a hypo to reasonable limits, instead of amounts which will produce a blood sugar in excess of 20mmol/l.

Teenagers push the boundaries in every area of life and teenagers with diabetes can be even more manipulative.  A fussy teenager can refuse to eat his dinner and then demand another kind of carbohydrate from that provided by his parent, "otherwise I will have a hypo and die!" Life can be very challenging, but then we were all teenagers once, so maybe this is pay back time? Mind you I didn't have diabetes until much later, so I never put my parents through this kind of test.

Blogs moved

The diabetes blog pilot has been relocated to talk.nhs.uk.  Please follow that link to read posts and comments.

Sensitivity to insulin

Neil Walden

Most of us know that the general advice we receive from doctors and DSNs is just that - "general" and based on the "average" person with diabetes. However this completely well intentioned advice does not cater for the huge variations in individual responses to food and insulin. For instance when monitoring carbohydrate intake before a meal we all have different responses to certain types of carbohydrate as has been noted by several correspondents. Add to this variable response to insulin and you have a heady mix of factors!

I recently had a review of my progress with DAFNE with my DSN where it was suggested that I might need to consider changing to 0.5 dosing since I seem to be very sensitive to insulin, so that correcting for a snack of say 2.5 carbohydrate units by injecting 3 units of Humalog can be too much sometimes (except when it isn't of course on one of those days and it is too little!)  I do get quite a few hypos, or at least above the DAFNE recommendations (8 in the past two weeks). I have considered the alternative of using an insulin pump, but to me it seems more of a hassle than 6-7 injections per day.  It is all down to personal preference I guess and I would still need to carb.count, plus programming the pump and all the associated stuff. 

I would be pleased to hear from other people who are very sensitive to insulin, so that we can share experiences and helpful tips.

I reckon that we should establish an ongoing forum to discuss the kind of issue we have raised during the currency of this blog because a lot of valuable insights are emerging.

Been a while since my last update

By Mathew Hipwood

Had a few ups and downs, the usual rollercoaster of living this sugary existance but the major change in my life has been packing in the day job and going back to uni to study Nursing. I am enrolled on a Graduate Diploma in Nursing at BCU doing the adult branch of nursing.

I go on my first placement on monday the 9th at a local hospital, excited and nervous!

The uniform is quite smart and not too "clunky" if that makes sense which makes the whole thing easier. The only downside being the yellow eppaulettes I have to wear, the girls get yellow piping.

I've been signed off on basic life support, manual handling and (haha) injection technique.

Roll on monday!

Also as promised in an earlier entry I have my thoughts on the Sanofi Avensis Solostar pen, its a huge improvement over the Autopen 24 I was using before, the action is nicer with more control over how quickly a dose is administered, I can dose in 1 unit increments and can dial back if I make a mistake with dialing it up.

Also it looks much cooler. This is an important consideration! Purple and grey is much nicer than the sickly blue I had before.

Blood testing strips

Hi Trinkwasser. Thanks for your comments. I did look at see those BBC news articles and yes, they are pretty scary. I do think though that whether or not you are type 1 or type 2 (or neither!) testing is pretty much the foundation to managing your diabetes. That along with what you said about knowing what to do to ensure that your blood levels, FBG etc levels are okay, helps. I guess it's also about education and being educated to manage it and know what to do if there is a problem. You sound like you have it pretty well sussed which is great.

Hello Everyone!

By Lisa Gough

Hi bloggers! I'm Lisa and I guess you know a bit about me from my bio! Hope everyone is okay? I'm looking forward to 'chatting' with you all. Not totally sure where to start but I do have a question for you fellow bloggers - has anyone had problems getting their blood testing strips? I am limited to two boxes even when I ask for more (even if it is just three!). I test over four times a day (have a few bad hypos and lost my warning signals) so get through loads. My Diabetic Consultant has written to my GP and this still hasn't changed the surgery's attitude to strips, as well as Diabetes UK. Has anyone else encountered this and if so, did you get anything changed and how? How many testing strips does everyone else get given when they put in for a repeat prescription?  I saw Rachelle's email about Type 2 diabetics who self test getting anxious and depressed and to be honest...it's no surprise!!! Although it's good to keep a check on blood sugars, it does make you a bit paranoid and I don't know about anyone else but you stand there waiting for the meter to give the result hoping that it isn't too high (or too low!). If it is too high you then have to decide whether to inject a bit more or wonder what it was that you ate that made them go high. It's ongoing so I can totally understand why people get depressed. I am a Service User Representative for Diabetes UK and one of the things that kept coming up in the discussions and meetings was that there isn't any psychological support for people diagnosed with diabetes and we all felt it was something that was needed to help people come to terms with it. Not everyone will need it of course but it should be offered. Well..sorry to go on a bit! Hope I haven't bored anyone! Am off to enjoy the rain and the joys of supermarket shopping!

What I ate today...

by Nicky Moxey

I only tested after supper today, but my meals were pretty good, blood glucose wise, today;

Breakfast: linseed porridge, green tea
Mid-morning snack; green tea, piece of Wensleydale and cranberry cheese, approx. 1oz
Lunch; 4 small pieces of spare-rib in homemade BBQ sauce, plus homemade coleslaw (leftovers from yesterday's supper), coffee
mid-afternoon snack, Ryvita and butter, more tea
Supper; cauli cheese, sauce made with a bit of cornflour, lots of bacon involved too. Had rhubarb sweetened with Splenda and a bit of custard for pudding; glass red wine. Coffee. I hour reading, 4.7 :-)

Too much home-made stuff for me to be bothered to work out nutrient count - I use a planner called Kathleen's Diet which I paid for, but there's a good freebie online at www.fitday.com
I expect I'm somewhere near the 1800-2000 calories and 50-70g carbohydrate that I aim for.

Now I need to go and do some weightlifting - and maybe put in some time on the air-walker. I'm getting a cold, and I haven't felt like taking my ears outside today.

Nicky.

Interesting article

I came across an interesting article on low carbing the other day - well worth a read.

Article from Nutrition and Metabolism site

Nicky.

Does T'ai Chi chop diabetes?

In the news this week: 'T'ai Chi may help diabetes'

According to the Daily Mail, a 12-week programme of t’ai chi caused the blood sugar levels of people with type 2 diabetes to drop "significantly" by 8% and bolstered their immune systems.

The Daily Mirror also covers the story, saying that the practice of t’ai chi could cut blood glucose or improve how the body processes it. It adds that t’ai chi could boost the immune system through increasing fitness and “the feeling of wellbeing”.

NHS Choices went 'Behind the Headlines' to dig deeper into the story and uncover if in fact this is fact!

To find out what the results were, please refer to http://www.nhs.uk/news/2008/04April/Pages/DoesTaiChichopdiabetes.aspx.

What do you think? Please give us your comments.... 

By: Community Editor

One year on..

I have been diagnosed with type 1 diabetes for a whole year today. Its gone quickly!

I've gone from struggling to cope with hypoglycaemia and juggling dosage/exercise/timimgs to doing quite well. My HBa1c is steady at <6.5% and I have maybe one or two mild hypos >3.0 a week which is a marked improvement and periods of hyperglycaemia are rare now.

I'm pleased with how I'm coping lets hope it continues!

Now to convince my Dr that 300 needles is not enough in one prescription!