Patterns, pitfalls and playing the game

Sometimes diabetes seems understandable, logical, reliable almost. But not today.

The times I find diabetes hardest to deal with are the times when it just doesn't seem to be playing the game. When it takes it into its head to change the rules every day that week. When you never know what you are supposed to be doing because what happened yesterday isn't happening today.

I'm fortunate in that I don't seem to get ill very often, but I'm just coming out of a cough/cold thing which, unusually for me has pushed my blood glucose levels right up. Suddenly my total daily dose of insulin rose by about 50%. I kept things in check, more or less, for the few days it lasted - but knew that when things began to return to normal I'd have to back-off the extra insulin sharpish or I'd end up running low most of the day. That day, it seems was yesterday. I felt hypo much of the morning. I ate lots of extra carbs. Today I tried normal doses and went to the gym. Felt a little low mid-morning and had a couple of fruit pastilles. At lunchtime I was 12.0 (216). WHAT?! But I've not eaten anything like the extra I did yesterday (when I continued to putter along on the edge of hypoland despite all the sweets and biscuits I scoffed) AND I've only had half my standard 'gym day' extra carbs AND I tested after the gym and was fine AND AND AND...

So I stomped around and got all cross. And Jane had to bear the brunt of it. And I'm sorry.

These are the times when diabetes gets me down. These are the times when I know I am a nightmare to be around. These are the times I wish I could control myself. These are the times when I am most grateful for the love and support of my family. Especially Jane. I could not do this without you.

M x

6th Annual D-Blog Day - 6 things

No, I'd not heard of it either.

But today I saw lots of Twitterchatter from members of the D-OC (that's the Diabetes Online Community dontcha know) about D-Blog Day. Apparently this November 9th is the 6th annual D-Blog Day part of Diabetes Awareness Month (November) which includes World Diabetes Day (November 14th). It's a chance for the wide variety of people across the world who write about their experience of living with diabetes to post thoughts on a shared theme.

Thanks to Holly (Arnold and Me) whose post/tweet explained the background and inspired me to post something myself. The topic for this year's D-blog day is "6 things you want people to know about diabetes". Here goes:

1. Yes I can eat that.
   
   
2. Despite what you have seen in the movies, in TV medical or cop dramas and/or read in the papers, a diabetic who is trapped in a burning building/runaway train/hostage situation does NOT need Bruce Willis to abseil through the plate glass ceiling to deliver a life saving insulin shot in the next 30 minutes. Insulin is important. Yes. And I'll grant that lack of insulin is lots trickier for pumpers, but for anyone on old school MDI the missed insulin shot would more likely result in the slightly less dramatic 'getting a bit grumpy' or possibly 'needing a wee' if it went on for a bit. Life threatening it ain't. Not for a good while anyway.
   
   I understand it is rather frustrating that insulin which is all glamorous and full of dramatic potential should let you scriptwriters and journalists down in this way. Missed insulin doses for a diabetic will lead to hyperglycaemia (high blood glucose) and long-term this increases the risk of all sorts of nasty complications. The time-critical one that you are thinking about would be hypoglycaemia (low blood glucose). That's the ole 'diabetic coma' you'd read about on Wikipedia. Unfortunately though, abseiling in to deliver a small carton of orange juice just doesn't have the same ring, does it? Especially since the hostages are confined to the canteen full of cakes and sugar sachets. Sarcasm aside, it concerns me that on at least two separate occasions this year I have heard news stories that a diabetic fell ill because life-saving insulin was not administered while they were hypo. So COMPLETELY wrong! Really people it is not that hard! Insulin sends BG levels down. Carbohydrate (eg sugar) pushes them up. In an emergency down = bad, up = much safer.
   
   
3. Nothing about diabetes is straightforward.
   
   
4. There is more than one type of diabetes. And people develop all types of diabetes for all types of reasons. Despite the headlines, the causal link between being overweight and developing type 2 diabetes is far from clear. There are thousands of clinically obese people in the UK, but only a smallish proportion of them develop any type of diabetes. And some who develop type 2 are normal weight or underweight. Weight can be seen as a risk factor, but whether the developing t2 diabetes triggers the weight gain, or the weight gain and other genetic predispositions trigger the t2 diabetes is still not really understood. For the last time: You can't 'catch it' from eating too many sweets.
   
   
5. Structured education about carb counting is essential for anyone taking insulin. No really.
   
   
6. Everyone's diabetes is different. This is the real kicker. What works for one will get another in all sorts of bother. Different foods affect each diabetic slightly differently. An average daily carb intake that one would find perfectly acceptable would be impossible for another to manage. The insulin activity profile on the company website is only an average and your bodies response to it may well be measurably different. Some people will suffer from strange reactions and differences in the way their metabolism works for all sorts of reasons. Dawn phenomenon, somogyi, circadian rhythms, changes in temperature, stress, menstrual cycle (not me obviously)... Any or all of these things can wreak havoc with your BG levels, basal requirements, bolus ratios. See no. 3
   
   It's no wonder we diabetics sometimes give our care teams a hard time for the slightly woolly advice or suggestions they offer. If you've ever had really good, spot-on, tailored advice from your clinic, DSN or consultant you should congratulate them. They've taken all the thousands of possibilities (including errors and omissions in the information you have given them) and somehow managed to navigate through that maze of confusion to give you some advice you can actually use. Hurrah for them! Give them a hug at your next appointment. They deserve it.