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.

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!

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!

antibiotics :(

By Mathew Hipwood

Somehow I have ended up with ulcerated tonsils, these are quite uncomfortable as the base of my tongue constantly rub on them. My doctor has prescribed antibiotics to limit infection, apparently I'll probably get tonsillitis on top, joy.

I've discovered that I am hopeless at remembering to take tablets, and the timing of them as well. I'm supposed to take them an hour before food or on an empty stomach but I'm so caught up in timings for blood tests and insulin peaks that I usually totally forget.

On the bright side he also changed my basal insulin prescription to the new Sanofi Avensis Solostar disposable pen. I'll report back once I have had a couple of nights use out of it.

"At this point, she's only two or three mintutes from death" - Scotsman Medical Matters Article

By Scott Gillan

Scotsman Medical Matters Article

A nice article that has some good points from someone who's partner has type 1.

Fat Burning?

By Tom Pewter

As my first post I find myself seeking advice. I attended the DAFNE course at the end of last year and the new regimen seems to have been working. I have been happier within myself, suffering less ups and downs of hypos. However, a company funded health assessment last week showed up something I knew has not improved. After carrying out the cycling test whilst linked up to a heart monitor the results showed that whilst my fitness is at a good level I need to improve my metabolism. One chart displays the source of where my muscles get their fuel from, as a combination of sugars and fats. My muscles draw most energy from sugars which is no good if I want to use exercise to control my weight. I tend to exercise over 40 minute periods rowing, cycling  or running or playing squash. To avoid lows I have found that I need to start off slightly high, sometimes with a small amount of insulin and then take occasional sips of Lucozade. Once the food source is used up I frequently have a low that necessitates stopping and resting while I load up on Lucozade again.
How do other people overcome this problem? A round of golf or a long bike ride includes carrying a veritable picnic. How can I burn fat and not residual sugar in the muscles?

Other info sources

I wonder what other blogs people read regularly? Here's my list, not in any particular order:

http://diabetesupdate.blogspot.com/
http://www.proteinpower.com/drmike/
http://high-fat-nutrition.blogspot.com/
http://weightoftheevidence.blogspot.com/
http://lowcarbohydrate.net/blog/3
http://www.healthcentral.com/diabetes/c/17/
http://www.healthcentral.com/diabetes/c/5068/

Nicky.