Getting Used to an Insulin Pump

Some Native Wildlife

Some Native Wildlife

In case you hadn’t realised Deanne, the Young ‘Un and I went to Australia for a month in March. This was partly to show the toddler off to the in-laws (Deanne is from Australia originally), partly because we hadn’t visited for five years and partly so we could all have a month off work/nursery and relax bit. I took the advice offered at the last Nottingham Type 1 Diabetes Group meeting by Dawn, she was rather handily (for me) talking about travelling with Diabetes. The main thing I was interested in, which she did actually mention was the fact that when she’s changing time zones she leaves her pump set on UK time until a few days have passed and she is more or less over the jet-lag. That may not be exactly what she said but that’s what I made it out to mean so that’s what I did.

The day of departure came and our bags were packed. My hand luggage obviously contained the requisite number of bags of Jelly Babies, a recently purchased Frio Insulin Travel Wallet (another suggestion from Dawn, thanks Dawn!), many, many infusion sets, insulin cartridges, blood test sticks and lancets and all the other Diabetes rubbish that we need to take when we go overseas. We arrived at Birmingham in plenty of time, which was lucky ’cause we had off site parking and had a bit of a job finding it, but then we got on the bus and it dropped us, with all our bags outside the main departures door at the airport.

The plane ride over was fine, although the service on the Birmingham to Dubai leg of the flight was less than we had hoped for, they (Emirates) hardly offered anything in the way of drinks (not talking alcoholic here, just water/soft drinks/etc.) and when the food eventually came they didn’t clear the trays up until about an hour later, which when you have a two year old makes doing anything in the already limited space available to you quite challenging.

Twenty odd hours after taking off we arrived in Perth. It was a bit of a change from the UK, it was about tea time when we arrived, eight or so hours ahead of the UK and the temperature was around 26 degrees (centigrade) when we left the airport. It was nice!

We actually went on a mini holiday the first few days we were there, drove a couple of hours south to Busselton which is a kind of hot version of Weymouth, only it’s nice! Being a bit further south the weather was nice but not too hot and we spent a lot of time going to chocolate shops and playing on the playground at the place we were staying at, it seemed to tire Deanne and myself out more than it did the Young ‘Un.

When we got back to Perth we had the important and serious task of meeting up with family and friends which included going to lots of parties and spending a lot of time sitting in coffee shops by the river. It was hard work! My control was relatively stable even though I was eating some pretty strange food. Certainly a lot better than the previous trip I had five years before where I was neither carbohydrate counting or dose adjusting (also didn’t have a pump at the time). Admittedly I had a few high blood sugars, seemingly for no reason although I worked out afterwards that it was actually due to ice cream cones which apparently had an awful lot more carb’s in than I was expecting (like 80 instead of 40 grams that I was guessing).

Me at Diabetes WA

Me at Diabetes WA

Anyway, once I had sorted that out everything went much better, I had a relatively low number of hypos and most of my blood sugars were below 12 with the exception of a few after meals out, however that happens to me in the UK too so it was nothing to do with being away. I even managed to do some Diabetes Web-Monkeying while I was away, I found a few bits and pieces in local papers and magazines which I posted on-line when I got the chance and also decided I’d go visit the local branch of Diabetes WA to find out what it’s like being Diabetic in Australia.

The main difference seems to be the fact that they don’t have a National Health Service, like what we do! Instead you have to take out health insurance which then covers the cost of a large percentage of the things you need as a Diabetic, e.g. needles, insulin, etc., etc., etc. They were very forthcoming and I in turn offered them some advice on how we use Twitter, Facebook and other on-line resources to keep in touch with people. It was interesting to speak to some people on the other side of the planet who have the same everyday problems and annoyances that we have over here.

After being on an insulin pump for over a year now my Diabetes certainly seemed to be a lot easier to manage and although I had highs and lows the way the pump adjusts them down and up again seems to be a lot more natural and my body seems to respond well to that, I don’t feel ill for hours after a high result and I don’t keep dropping and rising all day long like I did previously. I also feel like I can eat whatever I want while away and have almost got the hang of guessing carbs well enough to keep me fairly straight and narrow without needing to refer to my Carbs & Cals book all the time.

Now however I’m home again, in fact we got back about a month ago now and it’s taken me all this time to get this written down what with one thing and another including a Little ‘Un with chicken-pox, work, getting the house back to a manageable state after being away for a month and all those things you have to do upon returning from a long holiday.

The main difference between this trip to Aus’ and holidays I’ve had in the past is that whenever I’ve been overseas in the past I worried almost constantly about my control and about getting high or having hypos from having strange and exotic foods and experiences, this time however I didn’t worry, partly due to the pump, partly due to the fact that I have become a lot more confidant in controlling my diabetes with a pump than I ever was with injections and I guess mainly because when you have a toddler to look after you spend more time worrying about them than you do yourself!

We’ve already booked our next holiday in fact, we’re headed for Barcelona in the not too distant future, is there anything I’ll be doing differently because of my experiences down-under? Well no, the time away just went to prove to me that I am coping as well as I can with a chronic (/annoying) illness and all I need to improve even more is further practice. Which you only get by living it and doing things which you want to do rather than worrying about what might happen!

…Influenza!

Deanne and I have both had the flu (must be proper flu not man flu as she has had it as bad as I have) since Tuesday this week which has meant all the clever stuff I was planning on posting this week (honest) has gone out of the window. Thankfully we’re on the mend…finally, however as my brain still hurts and I need to get myself back in order I thought I’d just post the first scene I wrote for a book I started in 2005 that only ever got up to about three and a bit thousand words before I realised I had more important things to think about at the time, like getting a better job and stuff!

It was going to be a thriller about a diabetic guitarist in a rock band who got framed for the murder of one of his bandmates but I didn’t really have a plan after that, which is probably one of the other reasons it fizzled out! There are a few sweary words in it so please excuse that. Anyway, it’s not much but here you go…


The first thing I notice is that the back of my hand feels warm, and sort of slimy.  I look down.  My vision seems to follow the movement of my eyeballs after a couple of seconds.

It’s my left hand and its red, the hair on my arm is stuck to my skin.  I think the phrase I’d be looking for is ‘caked with sweat’ but currently I don’t seem to be geared up for thinking.

My temples are throbbing, as my brain starts to restart I realise that I’ve had a hypo.  It must have been quite a bad one otherwise there wouldn’t be blood.

The sweat is fairly normal but I must of cut something or there wouldn’t be blood, either on my hand or…bloody hell, on the carpet.  That’s going to be a bugger to clean up when I’ve come round properly.

There is a slightly more immediate problem though.  I’m lying on the floor in my bedroom but none of my limbs seem to be coordinated enough to actually carry me towards the kitchen.

I’m thinking the only reason I’ve come round is because of the adrenalin pumping round my body from whatever injury it is I’ve given myself.

I can reach the drawers from where I’m laying, I manage to turn myself over enough that I can use both my arms and my legs to lever myself into an unsteady upright position.

I’m definitely not stable but thankfully the kitchen is just down the corridor and the corridor isn’t too wide!

I make my way along by propping myself up with my arms on either side of the passageway.  I’m sure I look pretty dumb, but for one thing there’s no one here to see me and for another I wouldn’t care if there was.  In fact I wouldn’t be like this if there was somebody else here!

I meander through to the kitchen.  The adrenalin seems to be doing its job because by the time I get there I can almost stand of my own accord again.

I reach into the fridge while supporting myself with my hand on the bench.  I take the orange juice out with one hand and tip the carton back so it pours in to my mouth.

I never like the feeling of the raw cardboard against my lips.  I should probably cut the container so the top layer of waterproofing doesn’t rip off like that.

I don’t know how much I drink, I finish it though.  ‘Ah crap!’  My first words after hypos tend to be colourful metaphors of the four letter variety.

I put some bread in to the toaster and push the knob down, guess I need to wait until it’s done…


Two possibilities are that you will:

A. Think that is okay!

B. Think it is utter tosh and that you won’t get those few minutes of your life back in which case my work is done as I have been bed bound four out of the five days of this week and will personally definitely not get them back 😛

Have a good weekend.

Better Man

Better Man by Pearl Jam

Better Man by Pearl Jam

In case you’re wondering I’m feeling much better today blood sugar wise.

Time 24hr Blood Glucose in mmol/l
06:47 6.6
10:46 9.2
15:29 5.3

 

Okay so I haven’t done half as many blood tests but I’ve had a pretty crazy day at work and because I haven’t been massively high or low I haven’t needed to thankfully!

Anyway after yesterdays misery I thought I’d better remind you all that most days are quite good once you’ve got the hang of this Diabetes thing and that it’s not such a bad affliction when you come to think about it.

For many people it’s a wake up call that they need to look after themselves (Hi Gareth if you’re reading this!) and for others it just makes for a much more stable life.

Not writing much today as I am still having a busy day and have better things to be getting on with :-S

By the way, should I find it cute or worrying that my 22 month old son can say “blood test”???

…and just in case you are wondering Better Man is a Pearl Jam song which is very nice!

Up and Down

Up and Down

Up and Down

Having an odd day today – Control wise!

These are my blood test results since midnight:

Time 24hr Blood Glucose in mmol/l
02:30 31.7
05:02 27.0
07:01 23.8
11:32 13.2
13:00 7.8
14:26 2.9
15.11 3.9
16:17 2.9

Let me give you a bit more information…

Deanne and I had a nice meal together last night after we’d put the Young ‘un to bed, it consisted of Pizza, Garlic bread and then a wonderful chocolate Torte all from Waitrose (other supermarket chains are available!) I made some frankly random guesses about the carbohydrates but did do a bit of checking up afterwards and thought I’d massively overestimated. But as it turned out I hadn’t!

I woke up at 2:30 ish needing to go for a wee (sorry too much info.) but I also felt pretty ropey so decided to do a blood test as well, the 31.7 was not what I was expecting, usually my highs only go up in to the 20s even if I’m ill (which I suppose I might actually be).

I didn’t consider that my infusion set may not be working properly because frankly it was half past two in the morning and I wasn’t really thinking straight. So I stayed up and watched some six-s-side and beach volleyball on TV as it was on when I turned on the telly. I did the next blood test at 5 and was a bit shocked to find out I’d only gone down by 4.7 mmol/l. so I did another bolus and went back to bed.

Got up this morning and realised there was probably something up with the infusion set so I changed it (it was due today anyway) and waited to see what happened. Had my lunch at half eleven and was still 13.2 the pump gave me a couple of extra units bolus to get my blood sugar down!

It worked. The rest of this afternoon my blood sugar has been rock bottom and I’ve been eating Jelly Babies like there is no tomorrow.

I don’t feel particularly unwell, although I’ve had such an up and down day that it’s hard to say for certain and what I’ve eaten hasn’t been massively different to normal so I really have no idea what’s caused it.

I’m not asking for sympathy, advice or even acknowledgement from anyone I just thought it might interest those of you who are more newly diagnosed that even after 35…nearly 36 years of doing this I can have a bad day. I’m not trying to depress you all just reminding you and all of those who support and live with you that you can never take Diabetes for granted.

…and on that cheerful note I’ll sign off for now 😛

 Thought I’d (belatedly) post the meeting minutes Alex sent round on here so everyone can see them and doesn’t have to keep them in their e-mail for future reference! Here you go:

Minutes February 7 2012 

Quick round up of the minutes:

  • Firstly, a big welcome to our new members – we had plenty of you this time. I hope you enjoyed the meeting, and that you keep in touch and come again. If you need to know anything, please do get in touch and we’ll try our best to help
  • Jez thanked Beckie from Diabetes UK for coming to talk to us about the rebrand, and about the ‘research and connect’ event she’s planning for April
  • We’ve had a donation of £10.48 from a lady who sells Phoenix greetings cards and gives us 10% of profits from sales through the group. Phoenix Trading sell really nice greetings cards, wrapping paper etc please look at Sandra’s website www.phoenix-trading.co.uk/web/sandradavey or ask me if you’d like me to send you a copy of the catalogue
  • We also had a donation of £3.76 from Dan, who went busking in Nottingham on World Diabetes Day last November. Thank you and well done, Dan – give us more notice this year and we’ll come to support you!
  • Beckie Sharpe spoke to us about Diabetes UK’s recent rebrand. If anyone would like a copy of the handout of Beckie’s presentation, please let me know
  • After coffee, Dawn spoke to us about her life and travels with type 1 diabetes. This was fantastic, very interesting, and proved that life with diabetes is no barrier to living life how you want to. Thank you so much, Dawn. The frio wallets that Dawn told us about can be found at www.friouk.com or even better, from www.hypodiabetic.com, which is run by my friend Tim who runs a support group for young(er) people in London with type 1 diabetes.
  • Next meetings: a social on Saturday 26 May, 7.30pm, at Via Fossa, a ‘formal’ meeting on Tuesday 12 June, 7.30pm, YMCA ICC and also Tuesday 2 October, 7.30pm, YMCA ICC. Agendas for formal meetings to be announced closer to the time. We’ll also have a social sometime in July/August, so watch this space…
  • Finally, well done to the Globetrotters (Lesley and Victor), Haydn, and Paul, who all won wine on the raffle, and commiserations to Yvonne for winning Jez’s wooden spoons.

90 Years and Counting

So, 90 years (and a few days) ago they managed to treat their first Diabetic patient with Insulin. Excellent! In honour of this I am not going to write very much myself but rather quote some other, more intelligent, people.

I thought it might be a good time to look in to how the discovery of insulin was made so here is a complete rip off from Wikipedia for those of you that can’t be bothered to type insulin in to the Wikipedia search:


An article Frederick Banting read about the pancreas peaked his interest in diabetes. Research by NaunynMinkowskiOpieSchafer, and others suggested that diabetes resulted from a lack of a protein hormone secreted by the Islets of Langerhans in the pancreas. Schafer had named this hormone insulin. Insulin was thought to control the metabolism of sugar; its lack led to an increase of sugar in the blood which was then excreted in urine. Attempts to increase the supply of insulin in patients were unsuccessful, likely because of the destruction of the insulin by the proteolyticenzyme of the pancreas. The challenge was to find a way to extract insulin from the pancreas prior to it being destroyed.

Moses Barron published an article on experimental closure of the pancreatic duct by ligature which further influenced Banting’s thinking. The procedure caused deterioration of the cells of the pancreas which secrete trypsin but left the Islets of Langerhans intact. Banting realized that this procedure would destroy the trypsin-secreting cells but not the insulin. Once the trypsin-secreting cells had died, insulin could be extracted from the Islets of Langerhans. Banting discussed this approach with J. J. R. Macleod, Professor of Physiology at the University of Toronto. Macleod provided experimental facilities and the assistance of one of his students, Dr. Charles Best. Banting and Best began the production of insulin—already discovered in 1916 by Romanian physiologist Nicolae Paulescu—by this means.


(Stop reading now if you’re squeamish!!!)

This is quoted directly from the Nobel Prize website:


In October 1920 in Toronto, Canada, Dr. Frederick Banting, an unknown surgeon with a bachelor’s degree in medicine, had the idea that the pancreatic digestive juices could be harmful to the secretion of the pancreas produced by the islets of Langerhans.

Banting and Best with a diabetic dog Banting, right, and Best, left, with one of the diabetic dogs used in experiments with insulin.
Credits: University of Toronto Archives

He therefore wanted to ligate the pancreatic ducts in order to stop the flow of nourishment to the pancreas. This would cause the pancreas to degenerate, making it shrink and lose its ability to secrete the digestive juices. The cells thought to produce an antidiabetic secretion could then be extracted from the pancreas without being harmed.

Early in 1921, Banting took his idea to Professor John Macleod at the University of Toronto, who was a leading figure in the study of diabetes in Canada. Macleod didn’t think much of Banting’s theories. Despite this, Banting managed to convince him that his idea was worth trying. Macleod gave Banting a laboratory with a minimum of equipment and ten dogs. Banting also got an assistant, a medical student by the name of Charles Best. The experiment was set to start in the summer of 1921.

The Experiment Begins

Banting and Best began their experiments by removing the pancreas from a dog. This resulted in the following:

  • It’s blood sugar rose.
  • It became thirsty, drank lots of water, and urinated more often.
  • It became weaker and weaker.

The dog had developed diabetes.

Banting and Best's laboratory Banting’s and Best’s laboratory, where insulin was discovered.
Credits: University of Toronto Archives

Experimenting on another dog, Banting and Best surgically ligated the pancreas, stopping the flow of nourishment, so that the pancreas degenerated.

After a while, they removed the pancreas, sliced it up, and froze the pieces in a mixture of water and salts. When the pieces were half frozen, they were ground up and filtered. The isolated substance was named “isletin.”

The extract was injected into the diabetic dog. Its blood glucose level dropped, and it seemed healthier and stronger. By giving the diabetic dog a few injections a day, Banting and Best could keep it healthy and free of symptoms.

Banting and Best showed their result to Macleod, who was impressed, but he wanted more tests to prove that their pancreatic extract really worked.

Extended Tests

A dog and a cowThe new results convinced Macleod that they were onto something big. He gave them more funds and moved them to a better laboratory with proper working conditions. He also suggested they should call their extract “insulin.” Now, the work proceeded rapidly.

For the increased testing, Banting and Best realized that they required a larger supply of organs than their dogs could provide, and they started using pancreases from cattle. With this new source, they managed to produce enough extract to keep several diabetic dogs alive.

In late 1921, a third person, biochemist Bertram Collip, joined the team. Collip was given the task of trying to purify the insulin so that it would be clean enough for testing on humans.

During the intensified testing, the team also realized that the process of shrinking the pancreases had been unnecessary. Using whole fresh pancreases from adult animals worked just as well.


So apparently it was a fairly gruesome bunch of experiments that gave all of us Type 1 Diabetics our lifeline!

Of course science has moved on a lot in the intervening years, for one thing most insulin is synthetic now and cultured in labs rather than being harvested from animals, thankfully most of the changes have brought enormous leaps in understanding and control for those of us sans-insulin. As the saying goes things can only get better!

Looking Ahead

Looking Forward

Well, new year new me! Actually that’s a lie I’ve not made any kind of resolutions and I don’t intend to change anything in particular, however I am quite excited as to what the next 12 months might hold for myself and all the other Diabetics in the world.

Personally I think the most exciting short term news is the fact that there are some serious jumps being made in CGM, that’s Continuous Glucose Monitoring, technology at the moment, I’m hoping that by the end of this year or not long  after we are going to be seeing the first commercially available CGM enabled Insulin Pumps, that is Pumps with a continuous feedback loop that monitors your BM and adjusts your insulin intake to compensate.

Of course like most scientific developments this could actually take a lot longer than it should and will need proper sign off by whoever the governing bodies are, however it will certainly be a big step, when available, to giving us Type 1s a fairly normal life (minus the obvious infusion set changes and being woken up in the night when your pump battery runs out, etc.)!

Next of course are the ongoing promises of some kind of genetically engineered “cure” for Diabetes, as far as I can make out at the moment the scientists are looking at a number of ways of doing this, for instance putting beta cells in one way membranes which carbs can get through but white blood cells can’t so they pump out insulin without getting destroyed. Another one is fiddling about with your existing biology to regrow the cells in your pancreas that do all the hard work (that they don’t at the moment). This is much further off and I think of all the things happening the First thing I mentioned here the “Artificial Pancreas” is probably most close to fruition and also most exciting for all of us.

The Notts Type 1 Diabetes Group is also steaming on with various members doing various exciting things, the next of which is apparently some kind of video performance thing (sic.) by the committee members prior to the next meeting but I’ll tell you more about that when I’ve had some more details myself. Also just a quick aside, I apologise for not updating the web pages, however it does tend to be a darn sight easier and less disruptive updating Facebook and Twitter so I tend to do those most often and leave the website for if there is anything specific that is worth putting on it!

Personally this year is quite a big one as Deanne and I have a trip to Australia for a month coming up in the not too distant future, the reasons behind this are several-fold but it’s mainly to show the Little-‘Un off to the in-laws, but while I’m there I think I might look in to what’s going on Type 1 Diabetes wise as it is always interesting to get a different perspective on things.

Other than that it’s business as usual, work is busy, life is packed with things to do including childcare, housework, open mic’ nights and attempting to write a novel. Apart from that of course it’s a breeze.

Look after yourselves in 2012, do lots of blood tests, eat well, drink well and most importantly have lots of fun!!!

🙂

Happy (ever so slightly belated) new year!

%d bloggers like this: