Monday, 31 May 2010

Late Night Hyper Support
















31.05.10 - After yesterday's blood sugar success I guess I should have known it was too good to be true!!! A slightly negative view I know but positivity is not always in abundance where diabetes is concerned. I went to bed on 9.4 and low and behold I woke up at around 3.00 a.m. with stomach pains, nausea and a headache...all classic signs of a high blood sugar level (hyperglycemia). Test result = 21.6....gutted!!!
I decided to inject some extra insulin which was total guess work as I am yet to learn how to work out correction doses. When I first saw the dietician at the end of April about starting to learn to carb count she told me not to worry about correction doses for now!!!! So I guessed at an extra 8 units of Apidra and hoped for the best (BS was 13.3 when I got up this morning). Apart from feeling generally rubbish with blood sugars this high, it was also 3 o' clock in the morning which is not the best time to be wide awake!!!!
On a positive note, as I was in full hyper-mode and wide awake, I decided to log onto Facebook....once there I saw the status update of someone I have met through my recent blog reading saying that he was also wide awake but suffering with low sugars rather than high....the conversation that followed was really helpful in getting through the hyper. It was really good to be able to talk to someone who knew exactly what I was talking about....so once again I would like to express my appreciation for the new online community that I have discovered......if only I'd found it sooner!!!!!

In Pursuit of Perfection


30.05.10
YIPPEEEEEEE!!!! A PERFECT SET OF BLOOD SUGARS TODAY!!!!!!!!!
You have no idea how good it feels to have an entire day of good blood sugars (unless you are a fellow type 1 of course, in which case you will know exactly what I mean).
Woke up this morning with a 7.1 which is great (I'm usually well into the teens first thing in the morning, if not higher)but as previous experience shows, on the rare occasion that I do get a good reading before breakfast, it wouldn't necesarily stay this way, so off I went on today's 'pursuit for perfection' .
Had my 2 weetabix with 100ml milk (25g carbohydrate) and did my current ratio of 2.5 units to 10g carbs.
Two hours later and I was at 8.7 and a further 2 hours later 7.0!!!! I could have wept with shock and happiness!!! 7.0 mmol/l (or 126 mg/dL) is virtually unheard of for me and usually even if I've been at 7.0 or around that mark before breakfast, it doesn't always stay that way.
Two slices of toast, a bag of crisps and a muller light yogurt for lunch (63g carbs), two hours later = 8.2 and another two hours later and I'm still at 8.2.
Let's hope that I got my insulin to carbs ratio spot on for my dinner and that I can end the day the way I started it......on a high (mentally) but on a low (blood sugar-wise)
:o)

Affairs of the Heart


29.05.10
I've been having chest pains for the last couple of days now.......my immediate thought was not of heart attacks and cardiovasular disease but of indigestion, then I did the thing that I'm sure all GP's wish we wouldn't do.....look up my symptoms on the internet!!! This just served to scare the hell out of me with phrases like 'restricted blood flow to the heart' and 'narrowing of the arteries'.
I'm going to see my GP on Tuesday to get it checked out and tell him what I have read on the internet (I'm sure he will be thrilled with me attempting to diagnose myself and do his job for him).
NHS Direct describes my symptoms to a tee (tight, dull, heavy pain in chest which can spread to left arm, back and neck and breathlessness) and points to unstable angina (symptoms coming on even when resting and lasting up to 30 minutes) but surely I'm far too young to be having heart problems - aren't I ??!!???? Am I being a total hypochondriac??!!??
My diabetes (which has been poorly controlled for a long time) together with the fact that I am already taking 40mg of Simvastatin for high cholesterol levels and I do little to no exercise are all risk factors associated with cardiovascular disease (CVD).
Here is a little bit about CVD and diabetes:
"CVD is another of the long term complications that can affect people with diabetes as the condition progresses. Many people think that heart disease only affects the middle-aged and elderly. However, serious cardiovascular disease may develop in diabetics before the age of 30." (www.diabetes.co.uk)
"People with diabetes have an up to fivefold increased risk of CVD compared with those without diabetes. The reasons are prolonged, poorly controlled blood glucose levels, which affect the lining of the body’s arterial walls. This increases the likelihood of furring up of the vessels, forming a narrowing (atherosclerosis)." (www.diabetes.org.uk)
"Making lifestyle changes is the most effective way to prevent getting angina or, if you have angina, to prevent the symptoms getting worse in order to reduce your risk of having a heart attack or stroke.
The best way to achieve these goals is to eat a healthy, balanced diet, maintain a healthy weight, exercise regularly, drink alcohol in moderation, and avoid smoking.
This will lower your blood pressure, reduce your cholesterol levels, and strengthen your heart, which are three of the most effective ways of preventing angina and/or reducing the risk of a heart attack and stroke."
(www.nhs.uk)
I realise I'm jumping the gun massively here as I haven't even seen my GP yet and I certainly can't asume that I've self-diagnosed correctly but it does get me thinking along those lines of "If only I had looked after myself properly for all these years............"

Back to Basics


28.05.10
Today I have decided to go 'back to basics' and explain a bit about what type 1 diabetes is, how it's caused and its symptoms. I have ignored my condition for so long that I'm almost having to go right back to the start myself and re-learn a lot of things so I hope this will help me and also help people who aren't entirely sure what type 1 diabetes is to get more of an idea of what it's all about........
(http://www.nhs.uk/Conditions/Diabetes/Pages/Causes.aspx)
"Type 1 diabetes occurs because your body cannot produce any insulin which is a hormone that is needed to control the amount of glucose (sugar) in your blood.
When you eat, your digestive system breaks down food and passes its nutrients into your bloodstream. Normally, insulin is produced by your pancreas to take any glucose out of your blood and move it into your cells, where it is broken down to produce energy.
However, if you have type 1 diabetes, there is no insulin to move glucose out of your bloodstream and into your cells.
The exact cause of type 1 diabetes is not fully understood, although in most cases it is believed to be an auto-immune condition. This means it occurs as a result of your body's immune system mistaking a natural substance in your body as harmful, and attacking it.
In the case of type 1 diabetes, it is thought that the immune system attacks cells in your pancreas, destroying or damaging them enough to stop insulin production. It is not known exactly what triggers the immune system to do this, but it may be due to infection with a particular virus.
Type 1 diabetes tends to run in families, so there may also be a genetic cause for the auto-immune reaction."
The symptoms of diabetes are: Being very thirsty constantly, weeing all the time (more at night), being very tired, losing weight, blurred vision and slow healing of any wounds that you may have. The symptoms are usually very obvious and develop quickly.
My symptoms were extreme thirst, I can remember always going out of lessons at school to get a drink from the water fountain. Obviousuly, as I was drinking so much, all that liquid had to go somewhere so I was going to the loo about 100 times a day (not quite but thats how it felt at the time) and at night I would have to get up at least 4 times for the loo. Needless to say, with getting up so often in the night I was exhausted and never had any energy. Another thing I remember really clearly is that my appetite was virtually non-existent....my Mom would put a meal in front of me and I would have a few mouthfuls and then push the rest of the food around my plate. I don't remember this part so much but I think this is what made my Mom realise something was wrong.....I lost a hell of a lot of weight. As I say, I don't specifically remember that part but looking back at photos from before my diagnosis I can see how thin and ill I looked.
The treatment for type 1 diabetes is insulin. This can be with either injections or an insulin pump (did I mention I'm getting a pump??!!?? He he). Insulin is a hormone made by an organ in our bodies called the pancreas. The function of insulin is to help our bodies use glucose for energy. The 3 main places that are usually used for injecting are stomach, buttocks and thighs. I have mainly used my thighs for years and years and have now got a build up of insulin deposits under the skin (also known as lipohypertrophy) which can affect the way that the inulin is absorbed and in turn can alter its effectiveness and affect blood sugar levels. This is why it is important to rotate injection sites. I am now trying to use my stomach for a while to give my thighs a rest and to give the lumps of insulin chance to disperse.
I think I've covered all of the most basic stuff there (I hope you are still awake!!!). I hope that's explained it all a little bit and at least shown that type 1 is not something that you get because you have eaten too many sweets as a kid.......which is one of my main pet hates about some people's idea of what diabetes is....but I will save that for another day!!!!! :o)

Support


27.05.10
Today I have felt really positive and determined. This is mainly due to the new found support I have come across on the many blogs, forums and Facebook groups I have recently been looking at, I never realised all these blogs and groups even existed - but then again I've never been interested enough in my condition to go out there and look for them. It's fantastic to know that there are so many people going through the exact same trials and tribulations that I am.
After all these years with diabetes I am finally facing up to my condition and the fact that theres so much help and support out there is so encouraging.
I'm going to be going along to the first meeting of the Midlands Young Diabetics (MyD) group in Birmingham on 29th June which will be really interesting and I can't wait to meet up with some people who know exactly what it's like to deal with the big D on a day to day basis.
My sugars have been great all day today which I am really pleased about. I started the day in a positive frame of mind and maybe that helped to keep me on an even keel....who knows, but I'm going to bear that in mind and maybe a bit of positive thinking can go a long way!!!! I know it's only one day but that's how I think you have to deal with diabetes........one day at a time.
:o)

Limited Joint Mobility


26.05.10
No, I'm not praying for a cure for diabetes in this photo!!! It's to show the limited joint mobility I have in my hands. This is also known as Diabetic Cheiroarthropathy (DC) (now there's a mouthful.....try saying that after a few glsses of rose!!!).
As always, here is a proper explanation of it taken from the internet as they can usually explain things much better on these websites than I can......... :o)(http://www.diabetes.org.uk/Guide-to-diabetes/Other_associated_conditions/Musculoskeletal_Conditions/Limited_joint_mobility/)
"Limited joint mobility is a type of rheumatism that causes the joints to lose their normal flexibility. Although most common in the hands (where it is also known as diabetic cheiroarthropathy), limited joint mobility can also affect the wrists, elbows, shoulders, knees, ankles and, in some cases, the neck and lower back.
A classic sign of cheiroarthropathy is not being able to press the fingers together tightly in a palm to palm ‘prayer sign’. The affected fingers stay permanently bent (as shown in my photo above).
Although in itself limited joint mobility is usually troublesome rather than painful or disabling, it is closely associated with microvascular complications of diabetes - nephropathy (kidney disease) and retinopathy (eye disease - which I have already got and had several extensive laser treatment sessions for).
It is thought that about a third of people with diabetes have some degree of limited joint mobility. Like most complications of diabetes, good blood glucose control will help guard against it, as well as aiding recovery if it has already developed. Your healthcare team may be able to recommend exercises that will help restore some flexibility. Sometimes people are given steroid injections into the affected area and, in more extreme cases, where it is affecting a person’s ability to do day-to-day tasks, surgery may be required."

The Upper Limb Clinic also has some useful information: (http://www.theupperlimbclinic.co.uk/diabetic_cheiroarthropathy.htm)
"Diabetics have a higher incidence of hand problems than the general population. The reasons are not well understood but possible factors include: Abnormal accumulation of proteins in the tissues. This particularly involves collagen, which is the key contributor to the strength of tissues including skin, tendons, and ligaments. The composition of collagen is slightly altered, which can make it stiffer than normal.
Loss of blood flow in the tissues (ischaemia). Diabetes is complicated by abnormalities of the small blood vessels (micro-angiopathy). This is responsible for some of the most serious complications of diabetes, such as eye problems (retinopathy).
Diabetic stiff hand or diabetic cheiroarthropathy often causes a general sensation of "stiffness" or "slowness" in the hand. There is often some real loss of mobility in the joints, particularly the middle finger joints. This makes it difficult for you to bend the fingers right into the palm or to straighten them fully.
The condition is characterised by a number of specific problems. All are seen in non-diabetics but they are more common in diabetics. These can occur singly or together.
Flexor tenosynovitis is due to a thickening of the tissue lining the tendons that bend the fingers. This tissue is present from the wrist to the finger-tips. Thickening causes swelling of the palm and fingers. Rings may feel tight and the hand may ache. The palm and fingers may be tender to pressure. Tenosynovitis contributes to the finger stiffness. The symptoms are often worse in the night or on awakening. This is because fluid collects in the arms whilst you are asleep and inactive. When severe, it can cause a clicking sensation and even catching or "triggering" of the tendon.
Carpal tunnel syndrome is due to compression of the median nerve within a tunnel comprising a "U" shaped collection of bones with a tight ligament at the top. This causes 'pins and needles' in the area supplied by the nerve (thumb, index, middle and ring fingers). The condition is mainly caused by the tenosynovitis that squashes the nerve as it swells. It may also be contributed to by neuropathy (see 'Loss of blood flow' above).
Dupuytren's contracture is a thickening of deep tissue (fascia), which passes from the palm into the fingers. Shortening of this tissue causes 'bands' which pull the fingers into the palm. Once established, the background stiffness will persist and cannot be cured."

So there we have it.....you are now clued up on another lovely complication associated with diabetes!!!!

Bad Diabetes Day


25.05.10
Bad day diabetes-wise!!! Frustration has got the better of me today and I have had one of those days where I ignore my diabetes!!!!! I had years and years of ignoring it and thats a hard habit to break so I do still have the odd lapse where I fall off the wagon!!!
Not much else to say but I will make sure I get back on the quest for perfect blood sugars tomorrow!!!!!

Soon to be a thing of the past......


24.05.10
Multiple Daily Injections (MDI) a few facts.....
MDI requires you to give a fast acting (bolus) insulin with each meal (3 times a day) and a long acting (basal) insulin once a day. I have been on MDI for a number of years with different types of insulin. Currently I am on Apidra which is the short acting (bolus) insulin before meals and Lantus before bed which is the long acting (basal) insulin. The basal insulin gives a background level of insulin over 20 to 24 hours and the bolus insulin is given just before a meal.
MDI can mean 1460 injections a year. Meanwhile, insulin pumps require an infusion set change only about every 3 days, or 122 insertions a year.
I think that's one of the things I'm most looking forward to about getting a pump......feeling less like a pin cushion!!! If people ask I usually say the injections don't really bother me but if I think about it properly......yes, they do bother me, a lot!!! Only having to stick a needle in myself once every 3 days instead of 4 times a day will be bloody fantastic!!!!!

Carb Counting Frustrations


23.05.10
Had a lovely day enjoying the sunshine today (lets hope the summer is finally here and doesn't only last a week!!)
Had everything I needed....ice cold diet coke, my sunglasses and a good book....and all the usual diabetes related paraphenalia of course - glucose tablets, cereal bars, injection, blood testing meter, carb counting books, food diary!!!!
Had a BBQ in the evening at my Mom's. I was really looking forward to some yummy food but then came the bit where I had to count the carbohydrates in what I was about to eat.....I'm not sure if it's because I'm fairly new to carb counting or what but I found it really difficult to work out what I was going to eat. What if I work out my insulin ratio according to the carbs I intend to eat and then don't eat as much as I thought I was going to???!!!! Then I will have taken too much insulin and could have a hypo.....I must admit I also got a bit frustrated to say the least when everyone else started to tuck into their food and I was sitting there consulting my carbs book and trying to look at everything that was on the table/BBQ and decide what I was going to eat, needless to say my food got cold which made me even more frustrated with the whole thing. I'm sure I will get used to it in time but for now, I'm struggling with this new way of doing things!!!!

Too Hot = Too Low

22.05.10
Glorious sunshine today!! Had a lovely day out with family and dogs...tested sugars and counted carbs throughout the day and nothing higher than 11.0 and nothing lower than 7,9. Ate my evening meal then 2 hours later disaster struck......HYPO (Hypoglycemia). Sugar level had gone down to 3.8 (although I would have guessed it was much lower from the way I felt). I was sweating, shaking, feeling weak, had blurred vision, was struggling to speak properly and was overcome by this intense craving for food and wanting to eat anything and everything in sight!!!! When this hunger hits theres nothing you can do to resist it and now I'm paying the price....stomach ache, feeling sick and way too high blood sugar levels!!!!! So although I LOVE this gorgeous weather I do also have to curse the high temperatures for contributing to my low blood sugars!!!!
"In very hot weather insulin is absorbed more quickly from the injection site, so to avoid hypos you may need to monitor your blood glucose more frequently and adjust your diet or insulin dosage." (http://www.diabetesincontrol.com)

Insulin Pump


For those of you who don't already know, this is what an insulin pump looks like when attached....unfortunately, my stomach won't look anything like as flat as the one in the picture, but this gives you the general idea of how it will look!!! Ha ha!!!
What is an insulin pump I hear you ask.........
"An insulin pump is a small device about the same size as a pack of cards, which looks similar to a pager. Inside is a reservoir containing your insulin, which is attached to you via a long piece of thin tubing. At the end of this tubing is a needle or cannula inserted under the skin, enabling the insulin to flow into your body. The pump is not automatic, but is programmed to deliver insulin constantly, at varying rates which you determine. This means that you no longer have to give yourself injections." (Description taken from the website 'Insulin Pumpers UK' www.insulin-pumpers.org.uk)

Necrobiosis Lipoidica Diabeticorum


This rather attractive image shows a skin disorder called "Necrobiosis Lipoidica Diabeticorum" (NLD) which I have got on my legs. Here comes the lengthy 'blurb' about what it is.......
NLD is a very uncommon condition and many healthcare professionals may never have seen it before. It is an inflammatory condition in which shiny, red-brown or yellowish areas (lesions) develop in the skin, usually on the shins.
Only one in three hundred diabetics have necrobiosis lipoidica. It is three times as common in women as in men.
NLD follows damage to the fibres that give the skin its strength (collagen fibres). Some think that this is due to changes in the small blood vessels of the skin.
It is not contagious or cancerous, but there is a small risk of skin cancer developing.
Usually there are no symptoms apart from the rather unsightly appearance of the discoloured areas. However, the skin in areas of NLD is often very thin, and painful ulcers are not uncommon, especially after minor knocks. When ulcers develop, they can take a long time to heal.
Patches of NLD usually start as one or more small, red, slightly raised areas on one or both shins. Much less often, similar areas may develop on other parts of the legs. These lesions grow slowly and may join up to form larger, flatter, irregularly-shaped areas, usually with a well-defined, red border and a shiny, yellowish centre, with visible blood vessels.
Unfortunately, there is no effective cure for NLD. With time, the inflammation gradually improves, leaving scarred skin, which is permanent.
Treatment results are unpredictable and sometimes disappointing. Injections of steroid into the inflamed parts of necrobiosis lipoidica can bsometimes help. Strong steroid creams or ointments, sometimes covered by a plastic film, may help areas that are spreading.
So there you go......now you have the answer to why I NEVER get my legs out!!!! He he he!!! :o)

'Walk the Extra Mile' for Diabetes UK

19.05.10
On a positive note, I have signed me and my other half, Gareth (and our 2 dogs) up for a sponsored walk ('Walk the Extra Mile') organised by Diabetes UK. We will be walking 5 miles on 12th September at Lickey Hills Country Park in Birmingham. We have done these walks for the last 2 years at different locations. This year I have set up a fundraising page on the Diabetes UK Challenge website so that people can sponsor me online. I am also promoting the event on my Facebook page so that I can hopefully raise more money this year than in previous years. Five miles may not seem like much but for me (an exercise phobic) it will actually be quite an achievement!!! If you would like to sponsor me you can visit my fundraising page on the following link: www.diabeteschallenge.org.uk/challenge/becswalktheextrami...
Thank you!!!!

Ouch!!!


19.05.10
Fingers quite sore today. After 19 years of pricking my fingers to do blood tests I don't usually feel it but I think because I've started testing a lot more lately (6 - 8 times a day) it's starting to hurt a bit sometimes.....

Frustration!!!


18.05.10
Another frustrating reading for today!!! Before dinner 8.6, two hours later....22.2 (supposed to be between about 5 and 9)!!!!!! This is the sort of thing which makes me want to give up and stop trying to get my sugars right!! Whats the point when my sugars are high whether I eat sensibly or whether I eat crap!!!! I ate the exact same evening meal last night and took the exact same amount of insulin and my sugar levels did not go up to ridiculous levels, so what was so different about tonight I wonder!!!???!!!

Cravings!!!


18.05.10
Mmmmmm....choooooooocolate!!! Why do I always want what I can't have!!!!! Having particularly bad cravings tonight but managing to resist so far.......
Frustrating day blood sugar-wise.....3.7 before lunch then 2 hours later went up to 14.1 for no apparent reason :o(

Current Kit


This is my current array of diabetes related medication and 'stuff'......wonder how much it will change once I'm on the pump!!!

Re-education


Time to re-educate myself I think!!! After so many years of neglecting my diabetes it's finally time to sort myself out and re-learn everything I need to know!!

Sunday, 30 May 2010

Food Diary......


The dietician has asked me to start doing a daily food diary recording what I eat for each meal, the amount of carbohydrate in the food and the amount of insulin I gave myself. I also need to test my blood sugars before, 2 hours after and 4 hours after meals. This is to see whether the insulin ratio I am using is correct. I started with 2 units of insulin for every 10 grams of carbs I will eat.

New Way of Eating


Success at the hospital with the dietician!! From now on I will be counting the grams of carbohydrate in all my meals. It's a pre-requisite for getting a pump that I am able to successfully count carbs and then work out the amount of insulin I need. Sounds a bit complicated at the moment but I'm determined to get my head around it!!

First step on the insulin pump journey!!


Ok, so it's a boring photo, especially for the first one but it's an important one to me as it shows my referral letter from the GP's and the date of the appointment with my dietician which was the first step on my journey......28th April 2010

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