#Diabetes Managing My Type 1 Diabetes - Things I Do

#Diabetes Managing My Type 1 Diabetes - Things I Do

Picture From Harvard Medical School Literature

I have had Type 1 Diabetes for Over 35 years and currently take 6 injections of various insulins per day. despite what some people and physicians may feel is a high level of insulin use, I currently have none of the life limiting complications associated with long term diabetes.  I used to think it was luck! but as a disability support assessor and assessment centre manager for 10 years I came to realise that it was not luck, but a solid understanding of my body, its needs and my Diabetes.

Please Note:

I Have Never Suffered From Diabetes

Like Any Killer, I Give It Respect And We Co-exist

The views expressed here are my own and an aid memoire to myself in how I manage my own Type 1 Diabetes,  I do not prescribe anybody do what I do and recommend they make up their own minds and control their own Diabetes.


I have decided to add my Diabetes Mentor blog to my fixed1t blogs account as I have neglected it for a number of years. The main reason for the neglect was that it had a different logon and google+ account which meant logging out of fixed1t on Google then logging back in again as vis-versa. Sadly for me this was like keeping a guitar in its case rather than having it on a guitar stand by your favourite chair, the effect is that after a small number of times you do nothing with it.

fixed1t tip: If you have a guitar in a guitar case you are most likely not using it (too much set up hassle) so get a cheap guitar stand and set it up where its accessible when your waiting for the kettle to boil etc and you will start using it again and love it.

I have also moved all of the my diabetes related and medical self help posts from my various fixed1t blogs into my Diabetes Mentor blog.  Why? well all of them relate to me and are therefore relating to my 36 years of living with Type 1 Insulin Dependent Diabetes.

I also plan to be more active on this Diabetes Mentor blog, in an effort to 'give back' for the 36 years of relatively good health I have had despite my diabetes and not following all medical instructions after working out myself what was best for my body and my life.

I Have Never Suffered From Diabetes

I have always worked with it and around it to manage the obstacles the condition could have applied to my lifestyle,  in this way my Diabetes it has:

Not Prevented Me From Doing Anything I Wanted To Do

Please be aware there is some adult content in this blog.

I hope you find it useful, feel free to ask questions about diabetes and I will try and give you an honest answer as to how I deal with such situations.

#Diabetic Hypo Treatment Urgent Warning - Lucozade High Energy

#Diabetic Hypo Treatment Urgent Warning - Lucozade High Energy

I have had Type 1 Diabetes for Over 35 years and currently take 6 injections of insulins per day and currently have none of the major complications associated with it.

I Do Not Suffer From Diabetes

But Like Any Killer I Treat It With Respect

The views expressed here are my own and an aid memoire to myself in how I manage my own Type 1 Diabetes,  I do not prescribe anybody do what I do and recommend they make up their own minds and control their own Diabetes.

This video is an Urgent Hypo Treatment Warning to Diabetics and carers 

I am doing this video to make people aware that all the Lucozade Glucose / Carbohydrate drinks are no longer the same.

The New Lucozade flavours no longer contain the High Glucose levels of the Original Lucozade and are therefore ineffective at treating Diabetic Hypo's where a small glass of the original orange coloured clear Lucozade, was enough to alleviate the Hypo Symptoms with 5 - 15 minutes.

Also, these low energy Lucozade drinks are ineffective in stacking carbohydrates prior to diabetics undertaking heavy work, a technique I have always used before exercise, sex or in the event of illness.

Please read each bottle carefully before use.



#fixed1tDIABETESmentor

My Diabetes - Film 'Broken' starring Tim Roth ( Most Realistic Diabetic Portrayal I've seen on film)

Nearly every movie I have ever seen with a character with diabetes was awful verging on dangerous.

The typical scenario is some major event is going down e.g. a planes crashes in the desert where the is no water and certainly no carbohydrate,  and everybody is desperately trying to find the insulin to give to the 'hypo' diabetic... argh.. it would kill them quite quickly by hypo seizures, coma etc.

As I say to my friends and colleagues, if you find me in difficultly give me carbohydrates, if I perk up in 15 mins then all is well if I don't then the slightly higher sugar can be dealt with later.  Don't ever give me insulin or let me take it without testing my blood.

Don't the medical advisers to these corporations know anything about diabetes.

Then a month or so ago a close friend who also works with people with disabilities asked me to watch the British film "Broken" as she wanted my opinion.

At last a great film with an almost accurate portrayal of diabetes.

The story is quite simple with the portrayal of 'normal people in normal life' and an 11 year old insulin dependent diabetic girl called 'Skunk' (newcomer Eloise Laurence) who lives with her brother and single parent father (Tim Roth)  in an english cul-de-sac.  Like all of us we don't get to pick our neighbours and Skunk is living next to the school bullies.  Skunk also has a neighbour with a learning disability who she treats with kindness and respect, so what could go wrong?

I found the movie gripping, its portrayal of how normal life is for Skunk despite her diabetes was really positive, and the local boy with other difficulties is no harm to anybody.  But then lies and discrimination from the bullies and ignorance and intolerance cause everything to rapidly spiral out of control with devastating consequences.

I thoroughly recommend this as a film.

Here is what Amazon UK

and Amazon USA

This video deals with some adult themes so you may not be suitable for younger children, so I suggest adults watch it first before showing the kids.

Please let me know what you think if you watch it.

Malcolm

My Diabetes - How I Deal With Eating Out

Having explained the difficulties I have experienced with eating out the question is what I have done to try and avoid the pitfalls.  The thing to remember is that its only the carbohydrates that are the issue and have to be taken in balance with my insulin.

If its a night out my partner wants to do with her golf friends that she knows will have no real meal time, then I gracefully decline.  It's nice for the non-diabetics to have a normal mealtime without having to worry about me eating on time.

If I want or need to attend then:

• I eat my carbohydrate allowance as a meal before going out. This is usually something very really simple, fish fingers and oven chips. 
• I then attend the meal and eat everything that doesn't contain carbohydrates in the main course.
• Quite often I get to eat some of the pudding, as it often arrives several hours late and about the right time for my mid evening snack.

As always I carry 3 or 4 biscuit bars (12 - 15 carbs) in my pockets and a bottle of lucozade in the car.  I always carry more carbs than I need for the event so that in the event of a breakdown etc I know I have enough to take me through to the next lunchtime. 

There have been many times when I have been told categorically that the meal will be on time, and that we will be sat down to eat by 7pm only for the fickle finger of fate to step in and mess things up.  So although I often end up paying for a meal I don't get to eat all of, its worth it for my health and my peace of mind.

Learning Points

• Unless I'm cooking the food it may be late
• My urgency has the potential to be an emergency if not planned for
• I don't expect other non-diabetics to understand and even if the do they may not be in control
• I always carry plenty of food and never leave the house without it
• As soon as I get home I test my blood and if its high I taken an extra few units of short acting insulin to bring it back down gracefully

Exercise, Blood Sugar and Blood Pressure

Even before I was diabetic I knew that after a long run, I would look pale round the eyes despite having a red face and my hands would tremor.  This is hypoglycaemia in a non diabetic brought on by my burning of all of the bodies reserves too quickly for my body to break down its fats and other substances in the liver and muscles into usable glucose.

If I was not diabetic my body would reduce its insulin production and releases glucose for the remaining insulin to use when I start to exercise.  Insulin is like a catalyst your body needs it to break down sugars.  However as a diabetic on insulin my insulin level will be constant so if I do anything that requires extra energy, and I need to balance it with extra sugars.

Playing Squash

Before I became diabetic I liked the occasional game of tennis or squash.  I'd arranged to meet somebody, book a court, turn up with a bottle of water and play and afterwards I would have a sweet snack.

As a diabetic I can't do this:

1. To play squash I must either reduce my insulin (to prevent me burning to much carbohydrate), this requires forward planning. 
2. Or I drink a high carbohydrate drink before, during and after the game.

Okay thats seems simple enough, choose 1 or 2.  Unfortunately its not that simple.  In both cases diabetic control depends heavily on the reliability of your partner and the time of day of the game,

In both case if my squash partner doesn't arrive on time then I will have to begin exercising myself, i.e. go for a run in order to make up for the lack of a game.

All of the doctors have always told me to reduce my insulin before sport or heavy work that brings me out in a sweat.  I do this only very very occasionally, the reason is quite simple people are unreliable and get caught in traffic, forget or possibly decide not to bother to play.  I may also decide not to do the heavy work if the weather is too bad.  With little insulin in my blood my sugar will go high, and stay high for a long time.

So I tend to have a small mouthful of lucozade just before a game or heavy work and another just as it progresses.  For squash I am ready, if they don't turn up I have a modest bit of exercise to do, to get my blood sugar down.  If they do turn up i'm ready to play.

I also noted from observation, that with the reduced insulin plan it took me longer to recover and I noticed little in the way of physical benefits.  Whereas taking my normal insulin and topping up with high carbohydrate drinks to exercise, feels like watching a Popeye cartoon with spinach (if you don't know about Popeye type it into youtube).  My muscles swell and become more toned and my recovery time is vastly improved and my stamina lasts for days.

Warning, playing with my insulin level is not for the faint hearted and I acknowledge it can be dangerous, so I always have carbo's in my pockets and check my blood levels before and after sport for the some time.  Also tell the other person what you are planning to do and what to do if you start talking nonsense and falling around.

Learning Point

Reducing my insulin allows me to do exercise without lots of extra carbs

Eating or drinking extra carbs allows you to do extra exercise

Doing neither can lead to hypo if you exercise, or high blood sugar if you don't

TBC

My Diabetes - Angry Diabetic When Eating Out

For me, over the years,  the thing that has been guaranteed to make me edgy and angry is eating out.

I have lost count of the times when we have gone to eat out with friends. colleagues or strangers and it doesn't go to plan. The reasons are really simple for non-diabetics:

• they don't need to worry about when they eat
• they don't need to worry about what they eat
• they don't need to worry about how much they eat
• they don't need to worry if they arrive late
• they usually want to go to the bar for a chat and drink
• they usually want to wait until everybody has arrived before ordering
• they don't need to worry how long they take to ponder the wine list
• they don't worry too much over how long it takes for the food to arrive

It usually goes something like this:

• we make sure those organising the meal out  know I am a diabetic, and we agree a time when we will be sat down and eating, for example 8pm
• we agree that everybody will meet in the bar by 7:30pm
• we agree we will order at the bar and be seated with starters by 8pm

Alas, the reality is often:

• virtually nobody has arrived by 7:30pm 
• by 8pm people are just arriving and are chatting at the bar
• by 8:30pm we are still missing people
• eventually everybody has arrived by 9pm and we go to sit down

As I diabetic I've been in a dilemma for 1 hour, should I eat an extra biscuit whilst waiting for the others or will they be here as they promised.  If I eat and extra biscuit I will have to leave some of the expensive food on my plate or risk having a high blood sugar.

So at 9pm we are seated at the table, then the fun begins:

• Everybody wants to discuss the menu, should I have x, y or z
• Then the huge wine debate breaks out
• before we know it, its 9:30 as we place the orders

The issue we now have is the restaurant which was relatively empty at 8pm with quick kitchen response times is now running flat out with delays.  It's 10pm before the food arrives and I've been getting increasingly annoyed with the situation for the past 2 hours.

Unfortunately those that don't know me most likely think I'm a grumpy person without knowing that if we had one stuck to the plan of 7:30 meet 8pm eat we have all been happy.

Of course due to the extra carbohydrates I've eaten due to the delays and my blood sugar rising naturally as my lunchtime insulin has long since disappeared. When the food arrives I have no idea how much carbohydrate, garlic and other blood sugar changing herbs are in the food.  One thing I can be certain of is my blood will be high by the time I get home. 

Learning Points:

• non-diabetics can eat when they want and there is nothing I can do to change it
• with the best will in the world people get delayed
• some people are naturally always late
• I can never tell how long the restaurant will take to serve me
• I have no idea what the carbohydrate level of the food is

This is a lot of unknowns.  Also, I have had a 32 year joke with Debbie, wherever we sit in a restaurant for some reason I am always the last to be served. LOL  Therefore, if I am invited out to an important meal I have to think very carefully in advance how you are going to deal with the delays.

Luckily as an insulin diabetic, if I test my blood and it is high, I can give myself some extra short acting insulin to bring it back down in a few hours. Then begin my normal routine.

TBC

My Diabetes - What did I do to try and avoid diabetic hypos

In reality it is impossible for me to avoid ever having a hypo, the real question is how can I lessen the chance of having a 'severe unexpected hypo' which would require the help from others.  What I quickly realised was that the most important thing to do was to discover 'My Hypo Early Warning Signals' so I could prevent a mild hypo from becoming something much worse.

The way I went about this was to make the conscious decision to become more aware of my internal self and my body. Before I became diabetic I didn't pay that much attention to my body. I knew:

1) If I was tired, I slept.
2) When I was hungry, I ate
3) If I ate bad food, it made my ill
4) If I I ran a long distance, I became stiff
5) If I stubbed my toe, it hurt

These were all the normal things, but I knew I had to go further.

So for a short period I kept a note book and gradually I began to notice things:

1) If I had to get up in the night to go for a pee
  --> my urine test at breakfast showed high sugars
2) If I woke up in the morning with a basketball bladder
  --> my urine test at breakfast showed high sugars
3) If I woke up in the night soaked in a cold sweat
 --> I was experiencing a night hypo and need to drink a high glucose drink
4) If I woke up in the morning with a tiny cold penis
  --> my urine test at breakfast were blue and very low
5) If I had an extremely full bladder and hadn't drank much
  --> my urine test at showed high sugars
6) When I broke out in a cold hypo sweat I smelt a kind of musk on my skin
 --> I was going hypo and needed to eat
7) If the images before my eyes started to get blotchy like looking through cloth
 --> I was going hypo and needed to eat
8) If my lips started to tingle and my chin became cold and numb
 --> I was going hypo and needed to eat
9) If I started to look red face and get a headache
  --> my urine test showed high sugars
10) If my calfs and thighs started to feel like they were full of treacle
  --> my urine test showed high sugars

This observing becomes a form of biofeedback, from evidence and feelings I very quickly became aware of my body and its needs and the signals it gave me when it was in distress.

Learning Point:

If I wanted to be in control of my diabetes, I had to know what it did to me and how those things, felt, tasted and smelled.

The most import thing I learned was:

The hypo is not my enemy trying to cut me down, its a friend warning me that I need to do something to prevent things getting worse.

TBC

My Diabetes - My First Hypo

My first hypo occurred just over an hour after the nurse left.

As she had not explained the warning signs and symptoms of a hypo and it caught me by surprise.  I had assumed that as my blood sugar was so high it would take ages to come down, but it didn't as I'd been starving myself for days.

I got up to go to the bathroom a felt a little unsteady on my feet.  Then I began to notice, what I have become to realise, are my warning signs of a hypo:

1) A cold sweat was breaking out on my arms and hands
2) The my back and my neck were soaked with this cold sweat
3) My hands were trembling and sweating
4) My lips began to tingle and my chin began to go numb
5) My penis had apparently disappeared to who knows where and was so tiny and cold it was a fiddle to urinate.
6) I began to get more light headed and feel like I was going to faint.
7) When I got back to the room Debbie asked me how I was and I said a bit faint.

Luckily, we were sharing the house with nursing colleagues who took one look at me and said, wow matey your looking very hypo.  One of them ran over to the nearby shop and bought a large bottle of lucozade(high glucose drink) and gave me medium size glass to drink and a 4 bar kitkat which I miraculously place in my mouth and devoured in a few bites.

I felt awful for around 15 minutes, and then suddenly like a switched had been switched back on I was fine, like nothing had happened.

My learning points:

1) Always have at least one bottle of high glucose energy drink or glucose tablets or chocolate with you or within reach.
2) Always make sure that you have appropriate levels of carbohydrate food available before you inject any insulin.
3) If you start to feel faint or dizzy sit down immediately, do not wait to fall over or faint as this could lead to serious injuries or may incapacitate you.
4) Always tell others if you start to feel unwell.

TBC

My Diabetes - My Diabetic Diagnosis

From 1977 - 1980, I trained as a Registered Mental Nurse, and had come into contact with people with diabetes, I had learned something of the history and I knew a little about the signs and symptoms. In September 1980 I became an undergraduate of Behavioural Sciences at a UK Polytechnic.

The summer of 1981 was warm, and therefore I did not immediately notice that I was drinking more than usual.  However, as the summer turned to Autumn I realised that I was beginning to look thinner than normal after having a flu jab and was drinking a lot.  I'd also found a local store that sold 'Cream Soda' a sweet drink from my youth and had begun drinking it in the summer heat to quell my thirst, but it appeared to make it worse.

By early October I really felt like I was 'dying of thirst' and it came to a head when I was in a local cafe that specialised in very large pots of tea. Shortly after it arrived on the table and without thinking I picked up the milk jug tipped it into the pot and started drinking from the pot. Debbie my partner was with me, and she looked at me and asked what was I doing and was I going to leave any for her?

I looked at the jug, looked at her and said, I have no idea what I am doing but I think I have must have diabetes mellitus.  Suddenly it all made sense.

In the school of nursing we'd been told that in the old days before urine test reagents (tablets), certain nurses and patients would taste a sample of the diabetics urine, and the sweeter it tasted the more severe was the patients hyperglycaemia 'excessive sugar in the urine'.  Knowing this trinket of knowledge, I excused myself and went off to the bathroom placed my finger it my stream of urine and tasted it. It was sweeter than the sweetest Honey and smelt heavily of the sugar puffs breakfast cereal.

I came back to the table and told Debbie I have diabetes. It was a Friday and we went straight to the Polytechnic doctor and told him what had happened and said I have diabetes mellitus.  He was polite but dismissive and said it was most likely an infection or reaction to a recent flu jab.  After some discussion he agreed to take blood or urine sample and said I was to come back the following week, and it was nothing to worry about.

By time we got back home I had urinated an embarrassing number of times and I noticed my legs felt literally like they were filled with treacle and my eyes were a little out of focus.  I said to Debbie, I don't like this I need to flush the sugars out of my bloodstream and so ate very little in the way of carbohydrates over the weekend and drank lots of water.

By Monday I was still urinating a lot, due to the large quantity of water I was drinking.  As I had very little in the way of carbohydrate intake, my urine was tasting less of sugar. When I went into the Behavioural Sciences department there seemed to be a bit of a panic on and asked a member of staff what was going on.  She informed me that they had been looking for me since Friday, that they didn't have my address and the doctor needed to see me urgently.

In the Doctors surgery, he informed me that my blood sugar on the Friday was way past coma levels and he was amazed I hadn't collapsed into coma.  I explained to him that I'd eaten virtually no carbohydrates all weekend, that I'd drank nothing but water and it was a three hike up hill from the surgery to my residence.

He took some more blood and urine, and arrange for a nurse to visit me that afternoon to give me Insulin.

My Learning Points:

1) My excessive urination without excessive drinking was an early warning sign that me kidneys were trying to flush something out of my body.

2) My excessive thirst on a cold day when I hadn't eaten lots of salty things or taken any anti-histamine tablets meant my body needed the fluid.  As my thirst was accompanied by excessive urination then it told indicated to me that I may have diabetes.

3) Tasting my urine is a quick, simple and not at all unpleasant test.  Urine is mostly sterile unless you have urine infection.  Also due to the sensitivity of the tongue to salt and sugar you need only the tiniest amount.  Normally urine is salty and insipid and never sweet if its sweet it shows the presence of sugar.

4) Had I not taken immediate action of reducing my carbohydrates to virtually nothing and drinking water, my blood sugar when have continued to rise causing me serious problems.

5) My prompt action prevented me from needing to be hospitalised with the condition.

TBC