Getting Used to an Insulin Pump

Posts tagged ‘Insulin’

Let’s Have A Party!

Xmas Pump

Xmas Pump

You might have noticed it’s getting a little close to the Crimbleton holiday period, which is nice, a week or two off work and food, drink, presents and family time for most of us. With this in mind I thought I’d just give a quick update on a few things.

  1. Don’t forget it’s the NottsType1 Xmas do at Fat Cat’s in the city centre this coming Saturday (the 15th of December). If you happen to be the sort of person who uses Facebook then you can tell us you’re coming here. If not just roll up and start imbibing. There will be the customary blood tests at ten o’clock, highest BG wins, plus we’ll probably have some kind of long drawn out discussion about the merits of drinking and bolusing.
  2. If you went along you’ll know this already but last weekend was the inaugural-probably-to-be-Annual NottsType1 Quiz Night at the The Willow Tree Pub in West Bridgford. According to those who attended the night was a roaring success. Personally I think it may have been some kind of set up as Sam won and she doesn’t even live in Nottingham, however the night managed to raise us £158.00 which isn’t bad and may go some way to allowing us to continue to hold our meetings and events and frankly do the stuff we would like to do.
  3. Web-Monkey attended a pump clinic yesterday, not as much fun as it sounds! The topic was festive eating and it mainly consisted of lots of Type 1’s guessing how much carbohydrate was in Christmassy fare like mince pies, etc. A useful exercise and handy because it meant Web-Monkey could invite all those people to Saturday’s knees up too so we might just get some unfamiliar faces turning up.
  4. The first “Travels with my pancreas” story has been submitted to Alex, if you have no idea what I’m talking about it was suggested some while ago that the NottsType1 group produce some kind of publication on holidaying in far flung places with Diabetes, without giving too much away the tale is called “How I Met Your Mother” and is about five thousand words long. If any of you are interested in doing something like this and becoming a famous writer, published author, target of others’ derision then get in contact with us and get writing,
  5. In case I’m too lazy to write anything else before the 25th, have a Happy Christmas.

See you all on Saturday.

Toothbrush, Boots and a Memory Man

Boots The Chemist...and whatever else they do these days!

Boots The Chemist…and whatever else they do these days!

When I have a shower in the morning I tend to leave my insulin pump in my dressing gown pocket and then plug myself back in as soon as I’m dry and have something to clip it on to again. You may wonder why I’m telling you this, don’t worry hopefully it’ll become more obvious as the events of today unfold!

I was busy doing some important stuff at work this morning and I’d not bothered making any lunch as I thought I’d have a quick trip away from my computer to Boots in town to grab something. Because it had been busy I hadn’t done a  blood test since breakfast time.

So, one o’clock arrived and I headed out in to the frankly unpleasant weather, swiftly walking the five minutes or so in to try and avoid getting too damp. I got to Boots, picked a “”Delicious” Cheese & Pesto Pasta Salad”, a packet of healthy-ish crisps and a bottle of Diet Coke, then I headed over to the dental bit ’cause I need a new head on my electric toothbrush. I paid up and left heading in to the Victoria Centre to find somewhere to sit and have my lunch.

First thing I did was look at the food I had bought to see how many carb’s I needed to wind up on my pump, I was a little upset to find that Boots have re-branded their “”Delicious” Cheese & Pesto Pasta Salad” so it doesn’t actually tell you what the carbohydrate content is. After searching all over the packet many times I resolved to guess at the contents and adjust after getting back to a computer that I could look it up on (Web-Monkey without his own smartphone – funny I know!).

I did a blood test, as I always do before eating. I was a little surprised to find my BM was at 15.6mmol/l. “Hmm, that’s a little odd” I thought, that new bread must have a lot more carb’s in than it says on the packet. Anyway I wound up the CHO and hit the bolus button to which I was greeted by a “communication error” message. I cancelled out and tried it again and it did the same thing. Then I had one of those moments when you realise what the problem actually is. I patted myself down and realised that the reason I was getting a communication error was because my insulin pump was about two and a half miles away in my dressing gown pocket at home!

I ran back to work, carrying my carbohydrate-camouflaging salad, crisps, drink and toothbrush heads, grabbed my keys from my bag, excused myself and ran to get the bus home.

I got home in a little under fifteen minutes, which isn’t bad going, surprised Deanne who works from home on a Monday, plugged myself in and did a blood test, I’d dropped a little to 15mmol/l, which must have been a mix of the residual insulin and the running to get the bus. Gave Deanne a quick peck on the cheek and ran out the door again.

Getting back to work I looked up the “”Delicious” Cheese & Pesto Pasta Salad”, (56 grams in case you’re interested), wound up the total on my pump and bolused as quickly as I could.

Sadly after being unplugged for about six hours my blood sugar hasn’t yet normalised and I suspect if anything I’ll get a sudden drop at about six o’clock this evening.

When I had sorted myself out to my own satisfaction I posted a message on the Boots UK Facebook page, and to give them their due they actually told me they would look in to a way of including all the details on the back of the packet, you can see my overly sarcastic posting and their responses here if you’re interested.

Anyway, it was a stupid thing to do and closely aligned with last weeks stupidity of bringing my insulin to work ’cause I knew it would run out before the end of the day but forgetting to bring a cartridge in which to put said insulin!

All in all I seem to be having a couple of slow brain weeks, I’m hoping it won’t last much longer!

Ooh, Pointy!

When I was at the clinic the other week for my annual pump check up I asked if I could try a different infusion set, because my stomach looks a little like it has a bad case of acne from the places where the needles have been. My pump is an Accu-Chek Spirit Combo and I’ve used the TenderLink infusion set since I got it because I thought having the bit that sticks in to me at an angle rather than at 90 degrees would be better for e.g. when I was playing volleyball and such like.

Anyhoo, I was given the only one they happened to have a few of laying around which was the Ultraflex, this one has a needle which goes straight in to you but is much shorter and (I think!?!?!) thinner than the TenderLink. Anyway I got four of them and so I used them over the previous couple of weeks, then last night I went back to the old standard.

I have put a picture of both below, the old one on the left and the new one on the right and I just wanted to say that the old one now feels like trying to stick Cleopatra’s Needle in to myself. Sadly I have about three or four boxes of the TenderLinks left and I don’t believe in needlessly sucking money out of the good old NHS so I’ll use them up first but when I next give those nice people at Roche Diagnostics a call I’ll be changing my standard order to the FlexLink infusion sets!

Accu-Chek FlexLink Infusion Set

Accu-Chek FlexLink Infusion Set

Accu-Chek TenderLink Infusion Set

Accu-Chek TenderLink Infusion Set

Ban(ne)d

Tomorrow night I’m trying out with a band, they want a guitarist and I kinda play guitar…badly, or at least I used to about four years ago. Here’s a picture to prove it:

Me, Playing Guitar!

Me, Playing Guitar!

As I say I’m a little out of practice and probably need a few go’s before I can actually play along with their music so I’m hoping they’ll be patient.

Anyway last time I lived the rock ‘n’ roll lifestyle I was using a pen to inject four or five times a day, I didn’t do carb’ counting and I frankly managed my diabetes by crossing my fingers and having a lot of hypos and highs so I’m hoping it’s going to be a bit easier what with all this modern technology I’ve managed to persuade the medical establishment to supply me with.

However What I do have now is of course plugged in to my belly 24/7 and also has a three thousand quid piece of kit hanging off me, this is why I’m going to have to think carefully about my set-up before I head out of the house tomorrow night. I think I’m due an infusion set change tomorrow night so I’ll probably do that before I go, this means I need to pick a spot…and a side of myself that will cause the smallest inconvenience in terms of catching cannula on sticky out bits of guitar or continually rubbing said guitar over infusion set and causing discomfort.

Further to this is of course the fact that I have experienced most things which come up in every day situations since getting the pump, however I haven’t stood up for a couple of hours with a frankly rather heavy guitar (I own one of these now) which weighs about nine pounds, that’s about four kilo’s if you’re a youngster! Also there’s the unpleasantness of hefting guitars, pedals and even worse amplifiers up and down stairs to practice rooms and back to your car afterwards.

So with all these things considered am I having second thoughts about going tomorrow night?

Don’t be silly,  I’ll just do a lot of blood test before, during and after and hope Im lucky enough not to stab a finger so it hurts when I press the strings down, if I do I’ll just have to live with the pain. I’ll just make sure they are all aware that if I play particularly badly it may be a mixture of nerves, not having practised properly for about three years and low blood sugar all combined in to an ear splitting wall of feedback and noise. Or maybe that’s what they want???

Wish me luck 😉

Wait for Me!

Some Food

Some Food

Today I am going to talk about something which nearly all of us Type 1 Diabetics have to endure, namely the discomfort that can be caused by eating with other people!

Some Plates

Some Plates

You meet your friends at a nice restaurant, or even just a pub or café for a bite to eat, you exchange pleasantries, hug kiss and generally try to think of funny things to say, you settle down at your table then pore over the menu until everybody has decided who’s going to have the crab, lobster or chicken nuggets. The waiter sidles over and takes everybody’s orders.

After twenty minutes and a couple of drinks you all breathe a sigh of relief as the food emerges from the kitchen, smelling like something you’d be quite happy to eat, of course the plates aren’t all brought out at the same time and invariably the last plate will be that of the Diabetic at the table.

You make a random guess at the amount of carbohydrates contained in your aubergine surprise, obviously failing to take into account the spoonfulls of sugar in the sauce, you grab your blood test monitor out of your bag, unzip the little case, attempt to prime the jabber, realise you need to put a new cartridge in, scrabble about in your bag again until you find another one, replace it then stick a blood test stick in to the monitor, only for the monitor to error out with some unhelpful message like “E3” or “LoTemp” or some such. Finally you get it working, stick yourself and bleed on to the blood test stick.

 

“2.3 mmol/l”

 

“Rubbish!” You go back in to your bag to find out your open packet of Jelly Babies has spilled and so you rub a couple of them on your trouser leg to get the fluff off before eating them. Finally you dial up the carbohydrate guestimate for what you’ve actually been served by the restaurant and inject/pump it in. You look up from your little world of Diabetes management and realise that at least one of your party has just finished a particularly amusing story concerning their trip to Beirut, another is just finishing their flambéed mushroom stroganoff and you’re just starting your meal.

Such is the life of the pancreatically challenged!

Of course this is a (possibly) exaggerated account of events as they often seem to occur but I’m sure I’m not the only one of us to always start eating after everybody else at the table. So what would I like to happen?

Well I’m not (that) selfish so I’m not after making everybody else wait until I’m done before they start eating, for one thing their food would probably be cold. I guess the main thing I want is not to feel like I’m always playing catch up, to be fair I could probably overcome a few of these problems by being better prepared and checking the state of my kit before going out, etc. however I’m not that well organised and so that is unlikely to happen.

What I would really like is not to have to think about it. “That’s never going to happen,” I hear you say but I’ve noticed a lot of articles on line recently about Continuous Glucose Monitors attached to insulin pumps and adjusting doses without interaction therefore I think it’s only a matter of time before my wish comes true and I’m able to just stick stuff in my mouth without having to faff about with little electronic devices.

Come on scientists, you can do it. If not for me then at least for my poor wife and son who have to eat with me at least once a day and endure my complaining and then watch as I try to inhale my food to catch up. To them I offer my most sincere apologies and keep my fingers crossed that the boffins get this sorted sooner rather than later!

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!

Here’s Looking at You Diabetics!

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!

Christmas is Coming

Oh Dear :-(

I Ate Too Much!

Well it’s less than two weeks until the big day…and when I say “the big day” I mean “the day where you stuff your face until you need a bit of a lie down”! Previously at Xmas I have had problems because as well as having a large meal…at least twice throughout the day…and alcohol…I have also never managed to resist the urge to snack between meals forgetting of course that I am Diabetic and therefore need extra insulin to cope with all the extra pummelling I am giving my poor stomach and digestive system.

However that was before I was on an insulin pump and knew quite so much about carbohydrate counting and how insulin is related to blood sugar and carbohydrate intake. Now I am fully conversed in ratios of insulin to blood sugar and carb’s, also “Mr Pumpy” (I’ve never actually found a decent name for him, still open to suggestions!) does a darned fine job of doing all the complicated calculations for me so all i really need to know now is that I have enough blood test sticks and how much carbohydrate is contained in whatever the next thing I am going to put in my face.

So…does that mean I am going to have a really well controlled seasonal feast this year?

Well, probably not. Getting the guestimates right takes years of practice and it gets a bit hard to remember what you’ve already eaten after the 4th mince pie so “I’m sure just one more won’t hurt” becomes a kind of self fulfilling pronouncement of blood sugar doom!

Unusually I am not heading down to Dorset this year to stay with my Parents, instead they are coming up to visit us so at least I will be in my own house surrounded by food I can easily calculate the carbohydrates of and without too many things that someone has made that I do not have easy access to the recipe for.

I do though feel a lot more confident this year and know that if I do have any wildly turbulent blood sugar episodes that at least after an hour or two I can be back on track and ready for another round of charades.

Advance Australia Fair

Diabetes Australia

Diabetes Australia

We’ve recently booked our tickets to go to Australia next year, the main reason for this being that Deanne is from Australia and all her family (and by extension my in-laws) live there, in Perth to be precise. Therefore the only ones who have met the Little ‘Un face to face are his Nana and Aunty Donna who came over last year just after he was born. So we’re going to go visit and show our boy off to all his relations. “Sounds nice” I hear you think (didn’t I mention I’m telepathic?!?!?) but with a trip to Australia come a number of  Diabetes related challenges:

1. Time zone

2. Heat

3. Food

4. Routine

5. Supplies

I have been over there before but never with an insulin pump so I’m going to have to relearn some of my coping mechanisms. For point 1. I think it shouldn’t be too much of a problem, rather than a big bang I think I’ll do a phased time change altering the time on my pump by two or three hours starting the day we leave. The time difference is around eight hours so it’ll take a few days to normalise but the jet lag usually takes that long to get over so this might even help that process…

UPDATE… I had my checkup at the hospital and my consultant suggested that it would be simplest to set my basal rate back to the original setting of half a unit an hour and see how I get on, can change it to the right time zone after a few days when my body has caught up or leave it if it seems to be working then!…END OF UPDATE

For 2. it’ll be autumn over there when we go and so the temperatures should be between 30° and 24°, which is obviously a darned site hotter than it is over here, even in the middle of summer! ThereforeI’ll have to keep a close eye on my control and possibly drop my basal and meal rates depending on how I go.

3 is only really a problem if I do what I have done in the past and snack between meals, however I seem a lot less inclined to do that now I’m on an insulin pump as I know the slightest amount of carbohydrate can send me sky high, so I’m guessing I shouldn’t have too much of a problem as I just give myself more insulin if I’m eating more food.

The difficult one of course is number 4. While I may not do the same things every day I do generally have a fairly standard list of things that I do, both inside and outside work, being on holiday is more like a weekend, only for a whole month or so. I guess we’ll have a routine of sorts as with a 2 year old child you can’t really help it but even so it’s not the same as being at home.

Finally I have to do some forward planning which, frankly, I’m a bit rubbish at. For number 5 I have to make sure I have plenty of infusion sets + cannulas, insulin, blood test sticks and lancets, batteries for the pump, batteries for the monitor and to be honest probably loads of other things I’ve forgotten about at the moment. This means I need to contact and probably have an appointment with my GPs surgery in order that they will allow me to order, e.g. twice the number of things to normal, as well as ordering new stuff from Accu-Chek in enough time to actually have them arrive (when no one is in the house as per normal) then have enough chance to go to the post office collection depot to pick the stuff up which was delivered while there was no one at home because we both work…as I would imagine is the case for most people. “Not too much of a problem” you think (see I’m doing it again) but did I mention that I’m not a good organiser and only tend to remember these sort of things at the last minute.

On the bright side I’ve added an appointment to my calendar at work which will keep reminding me so hopefully that’ll be enough to actually get me to remember to make a call to Accu-Chek and an appointment with the doctors!

Anyway, aside for all that and any worries I might have about travelling with a two year old and adjusting my regime for foreign climes I’m actually pretty excited really, the other two times I’ve visited Perth have been brilliant, admittedly one was to get married and the other was to attend a wedding so you’d expect it to be relatively cheerful, but even so I feel a lot more confident about my Diabetes these days and hope that it isn’t a misplaced sense of confidence!

In Bruges

Choco Story - A Chocolate Museum

Choco Story - A Chocolate Museum

We spent last weekend in Bruges in Belgium, a really nice place with lots of history and architecture and chocolate, all of which were nice!

The holiday got off to a positive start although the young ‘un was a bit unsettled on the trip over. We went by train from Nottingham to St. Pancr(e)as to Brussels and then caught another train to Bruges itself. It was quite a long trip what with all the waiting around for connections, he was really well behaved though.

Things were fine until we got there and got settled in then I did a blood test and it turned out I was 19.6 mmol/l…Oh dear, the next couple were higher at 19.9 then 21.3, in the morning I tested three times between half six and half eight and didn’t get under 10 on any of them. This was when I decided I’d change my insulin, infusion set and cannula, the next test I did two hours later at 10:40 was 3.3 so I’m guessing my suspicion was right and something was up with some aspect of my pump or my insulin.

The next day went pretty well and with most of my results being around 6 then on Monday another good day, I put it down to eating ice cream and chocolates!

Funnily enough the 23rd (Tuesday) was also pretty good but I did have one test out of the ordinary at 17.4 while travelling on the train again, I was worried that the Eurostar was having some kind of negative effect on my pump but my worries were unfounded as the next couple of tests were around 4.

Yesterday was our first full day at home and I came to work, dropping the little ‘un off at nursery, I decided that I would be good and start redoing fasting blood glucose tests so I started at 12 o’ clock and got the following results:

6.9 mmol/l

6.9 mmol/l

6.0 mmol/l

5.3 mmol/l

6.7 mmol/l

7.1 mmol/l

I figure this is close enough to no change for me to leave it alone so I will do my morning tests again next and then something which I have been putting off and off which is night time.

I’m pretty certain I need to do these as I am having more insulin at night than I need for my supper in order to get my BMs about right in the morning, I think this means that at some point at night my blood sugar is going up and therefore I need more insulin, working this out shouldn’t be too hard it just requires that I get up through the night and do blood tests every couple of hours.

Anyway I’m signing off again now, sorry about my lack of communication recently but I’ve been doing some coursework for a thing I’ve been doing at work, however I’ve finished this now and therefore will hopefully get a bit of spare time back in order that I can start putting a few more updates on here again.

A Long Afternoon

A Big Clock

When's Home Time???

This afternoon has been a very slow one to pass, as you can probably tell from the title I’ve given this post, however on the bright side it’s nearly over now!

Part of the reason it has seemed long is ’cause I’m doing some frankly not super-interesting stuff, however the other reason is that I have been quite low twice, a 3.3 mmol/l at 13:35 and a 2.7 mmol/l at 15:16. “Why so low” you ask? To be honest I have no idea, I had my lunch at about 11:30 in the morning (a habit I picked up many years ago when I worked with my Dad) so the one o’ clock test was two hours after lunch and then the three o’ clock one was after a particularly dull meeting.

Because one of the team bought in some gingerbread men I also had one of those after the last couple of Jelly Babies, at 7.8 grams of Carbohydrate it’ll hopefully be enough to keep me going without sending me sky high.

Anyway I thought I should give a quick update on how life is going as I have been a bit busy at work lately and not really had the time to craft my prose on all things Insulin Pump.

It’s been over four months now since I first got plugged in, it has been  a fairly steep learning curve since day one but it is now a part of my normal day to day life and doesn’t really cause me any problems as far as changing  the infusion set or filling up and putting in a new vial of insulin (which I just had to do at my desk at work!).

My control is obviously only as good as my guessing of carbohydrates and for the most part it doesn’t seem to be going too badly, for instance I had a HbA1C test a while back which tells you how your blood sugar average has been over the previous three or so months and it came out at 7.0 mmol/l. This is fantastic and I believe the best result I’ve ever had for one of these.

I’ve also pretty much come to terms with doing exercise while plugged in, at volleyball now I tend to eat about 12 jelly babies (around 60 grams of CHO) over the course of a two hour training session and that seems to keep my blood sugar fairly steady.

I still haven’t got round to doing all my fasting blood glucose tests, partly because I have been lazy but mostly because it is hard to guess when a good date will be for waking up every two hours in the night when you have a hectic lifestyle and a 15 month old baby, however I really must try and do at least one before my appointment to see the consultant in September in order that I can get as near as possible to perfect. I know almost certainly that my blood sugar goes up at some point in the night because when I  wake up in the mornings I tend to be hovering around between about 8 and 14 mmol/l, even if I haven’t eaten anything prior to going to bed with a 5 mmol/l.

Of course whatever happens I am still Diabetic and therefore my control will never be perfect but all that means is that there is always room for improvement and work on my control.

I feel like I’m rambling now so I’ll bid you adieu and write again some time soon when I’ve gathered my thoughts.

One last thing, I recently wrote a short article for the Nottingham’s NCT (the UKs largest charity for parents) Newsletter, I have scanned this in and posted it here if you are interested in reading something totally unrelated to Diabetes that I wrote!

 

In the words of the Cat: “what is it?”

Insulin and Carbohydrate

What Happens to Carbohydrate with Insulin

Okay, I’ve had enough of what I’m meant to be doing at the moment and anywhere to get a drink or something to eat has shut so I thought I’d start on my A-Z of Diabetes, or at least trying to give a bit of background on what it is and what all the things I talk about mean so…

Type 1 Diabetes, also called Diabetes Mellitus is an autoimmune disease, that is it is a problem with your immune system, in my case I believe I got a virus of some sort when I was about 22 months old, my white blood cells killed off the virus but then didn’t know where to stop and decided that my beta cells in my pancreas were also BAD so they started destroying these as well!

Beta cells have a few roles but the most important of these (to a Type 1 Diabetic at least) is that they pump out insulin and (sort of) glucagon. Both of these hormones have an effect on carbohydrates, insulin turns carbohydrates in your blood stream in to energy which your body can then use to power itself, glucagon turns stored energy, e.g. fats, etc. in to energy if you don’t have enough carbohydrate in your blood stream when you need it.

Obviously you need energy to power pretty much anything you do, if you do not have enough then parts of your body can start malfuctioning! This is called “low blood sugar” or a “Hypo”. I have experienced a whole gamut of different types of hypo and personally find they tend to be different dependent on what I’m doing at the time, for instance if I am exercising, not necessarily full on cardio-vascular body pummeling, can be as low impact as walking (or more likely these days pushing a pushchair!) then I will tend to have a muscular hypo, that is some muscle group in my body, possibly all of them, won’t have enough energy and therefore I’ll get wobbly legs or arms or possibly collapse on the floor or else not be able to get out of a chair.

Worse for a number of reasons are hypos that occur when I am thinking hard, e.g. writing a document at work or doing a brain intensive DIY task, in these cases the organ in my body using the most energy is my brain and so when I run out of energy my brain ceases to function properly. The reason this is particularly bad is because my brain, being short of energy, is often unable to realise that it is short of energy and so I miss the signs I would normally pick up and just get lower and lower until (on occasion but not so much these days) I become unconscious, it can also cause bad moods, arguing (more than normal) and a general change in personality. If it is one of these ones the best thing to do is just to tell me it’s a good idea if I do a blood test, I might well argue but if I do too much you can just leave me until I collapse and then call an ambulance 🙂

So, because I am unable to produce my own insulin I need to somehow get insulin inside my body, over the years this has been by syringe and needle, plastic syringe, pen injector and most recently an insulin pump (hooray), all of these devices do pretty much the same thing but to different degrees of control, syringes were okay but you simply sucked up as much insulin as was required by eye and injected it, insulin pens were a bit better as you wound up the dose and it would give you the same dose, standardised, each time you wound it up on the pen so you knew you were getting exactly 10 units if that is what you selected. I’ll come to the pump in a minute!

Of course to control the level of insulin you are giving yourself you also need to find out how much carbohydrate is in your body, originally when I (in fact my Mum and Dad) had to do this you had to catch some urine in a test tube and add some water and a pill which would then change colour to give an indication of how “sugary” I was, e.g. whether I needed to exercise to try and bring my blood sugar down or if I needed to eat something, they were pretty much the only options available back in 1976. Then they bought out dextrostix, which were plastic sticks with a reactive piece of chemistry on the end which, again, changed colour when you wee’d on it, somewhat simpler and less prone to accidents or mistakes in the process. Nowadays I have a blood test monitor, this involves pricking my finger with a lancet to draw some blood, this blood then goes on to a strip, not a world away from the Diastix I used to use but plugged in to a machine which then gives a reading as to your blood sugar, this has a number of advantages!

The old Diastix used to have a number of colours for the different readings, I believe that “blue” meant your blood sugar was between 0 and 9 millimoles per litre (mmol/l the standard unit of measurement until fairly recently) green was between 9 and 12 (or something like that, it was a long time ago!) and then a range up to brown which was frankly much too sugary! Bearing in mind that a normal blood sugar is meant to be between 4 and 8 it obviously didn’t give a lot of fine control over your blood sugar. Also it meant whenever you wanted to test your blood sugar you needed to be able to pee…and find somewhere to pee! Finally because it takes a while for your body to process carbohydrate and eject it the tests were always about an hour or two behind where your body was currently at.

Blood tests are more or less instant, you still have to carry kit about with you but no longer need to find somewhere private to test and the results are to 0.1 mmol/l, in this way my average blood sugar results have come down from somewhere between 9 or 12 to about 7 these days which is obviously desirable and in fact makes me feel much better about myself.

So these days I need to do blood tests to check my blood sugar, guess the amount of carbohydrate in food I am eating and adjust my insulin accordingly (a bit more about insulin types another day).

The pump is a fantastic device, it is programmed with the amount of insulin I need to deal with 10 grams of carbohydrate (CHO) and the amount I need to bring my blood sugar down by 1mmol/l (0.3 units I think) and when my blood test monitor tells the pump what I am eating (which I program in to it) and what my blood sugar is it decides how much insulin to give me for the food and to adjust my blood sugar to the right level and then pumps it in to me! Technology is fantastic.

That’s it for now, gotta go. I’ll continue this another day, feel free to ask questions if you want more info about anything I’m talking about and remember these are my views and opinions and probably wrong on a number of counts!

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