The … Diabetic

The … Diabetic

I received an e-mail the other day relating to playing volleyball with an insulin pump and thought that the questions and my answers may be relevant, not only to volleyball but to a lot of other sports and activities.

I asked the nice young lady if she’d mind me using it for a blog post and she said that was okay as long as I used her pen name which is The … Diabetic, She writes her own blog (click on that link to get to it). I’ve also changed her e-mail address for the one she requested so feel free to contact her if anything on her pages floats your boat.

Date: Tue, 5 Feb 2013 14:43:08 -0800
From: the_3dots_diabetic@yahoo.com
Subject: Insulin Pumps and Volleyball
To: NottsType1@hotmail.co.uk

Hi Dan,

I came across your blog when doing some research on insulin pumps and playing volleyball. I’m quite interested in getting an insulin pump, but am only at the start of my investigations. I have an appointment with a Pump Doctor at my local clinic in a few weeks time, so I’m trying to do some homework beforehand and be prepared at the appointment!

I’m quite a keen volleyball player. I train 2 hours on 3 nights each week, I help coach juniors for 1 hour on one of these nights (before training), and play matches on a Saturday. Depending on the match schedule, I sometimes play on a fourth night in the week too.  I guess my main worry is how well infusion sets stay in place when jumping, blocking, hitting and diving, as well as how easy it is to avoid a pump getting damaged whilst throwing myself around court.  Would you be able to give me a bit of insight? Do you disconnect your pump? Have you had problems with air getting into sets or sets coming dislodged? From your blog, I gather you’re using a Roche Spirit Combo – has it been a positive experience? Where do you put it when on court? Finally, did you have to ask permission from the referees commision to play with a pump at matches?

Apologies about the million questions, there aren’t many testimonies out there of people playing volleyball with their pumps, and providing details on how they manage, so any extra insights would be much welcomed.

Kind regards,
The … Diabetic

My Response:

From: Type 1 Diabetic <nottstype1@hotmail.co.uk>
To: The … Diabetic <the_3dots_diabetic@yahoo.com>
Sent: Wednesday, 6 February 2013, 16:34
Subject: RE: Insulin Pumps and Volleyball

Alright The … Diabetic,

I’ve actually quit volleyball temporarily for a number of reason’s, none of which, I’m sure you’ll be pleased to hear, are to do with the pump!

So to answer your questions as best as I can:

1. My infusion set always stayed in fine while playing, I chose the Accu-Chek TenderLink when I started off pump therapy but have changed to the FlexLink, both of these have a flexible cannula but the TenderLink goes in at an angle which I thought would protect it better from bumps while playing, however I am on the thin side (about five foot eight (1.72m) and 10 and a half stone (65kilos)) and I found after a bit of use my stomach looked like a pincushion. The FlexLink ones are, in my opinion, if anything a little hardier and come with the added bonus of the Link Assist Insertion Device which works like a kind of staple gun to get it in to you (honestly, better than it sounds!!!). If you have a preference for which side you dive on it might be worth considering that when placing infusion sets but with the amount you play your probably better just to stick it in and see how it goes. Certainly reaching up for blocks and the force of hits seemed to have no effect on the set staying put!

2. I have a neoprene pouch with a loop to feed the velcro elastic strap that came with it through, not sexy but worked for me, however you sound like you play pretty intensely so it might be worth you looking at the hard case along with sports belts here. I wore my pump on my back turned so it ran vertically up my spine, more or less, so there was little chance of me falling on it, kept it on the whole time and didn’t have any problems with bits falling off or coming loose.

3. Keep it plugged in pretty much all the time, only time it comes off is when I shower or swim.

4. Never had problems with air getting in, they are pretty well sealed units, although when I got it I was warned that I should keep checking the tightness of where the pump connects to the cannula and I now do that pretty much as standard without even thinking about it.

5. The Accu-Chek Combo has been brilliant for me, although I suspect that there are probably better pumps out there already, I’ve had it nearly two years now after all. This site is pretty good for the latest info, but as above it’s probably worth checking what accessories you can get when trying to make a decision, it might also be influenced by your healthcare team but frankly I have a lot of friends on various pumps and no one has been disappointed!

6. Never even thought to ask the referees, although I did check with my coach as well as my Diabetes consultant, whether they thought I needed to consider taking any action other than what I had already decided (e.g. wearing it strapped on and on my back while playing) and they both said it should be fine.

If there is anything else I can help you with, Volleyball related or otherwise please drop me a line, I’m always happy to help.

By the way is it okay if I use your e-mail and my response in a blog post? I suspect this information would be useful to a lot of people!

Cheers

Dan

Web-Monkey
Nottingham Type 1 Diabetes Group
I’m Gonna Stick You!!!

Hope you all find that useful!

Let’s Have A Party!

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!

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 TenderLink Infusion Set

Wait for Me!

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

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!

Australia – A Really Badly Written Travelogue

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

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!

I Opened The Door And…

…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…

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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…

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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

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

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 😛

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:

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An article Frederick Banting read about the pancreas peaked his interest in diabetes. Research by Naunyn, Minkowski, Opie, Schafer, 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.

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

This is quoted directly from the Nobel Prize website:

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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, 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’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

The 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 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

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 4^th 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.

Unidentified Flying Illness

Unidentified Flying Bacteria

I’m Ill!

Okay that may seem like stating the bleeding obvious, however I’m not talking about my Diabetes, this is something new and frankly not super-comfortable. Let me tell you about it.

A couple of weeks ago we visited my parents in Dorset for the weekend, everything was fine until Saturday Morning when I started feeling a bit odd. Then at about ten or eleven in the morning I ran to the toilet and was ill. I continued to feel unwell for the rest of the weekend.

After getting home I forgot about it until the next weekend when I got a kind of pain under my ribs which lasted a good chunk of Saturday. We went to our neighbours’ house in the evening and frankly got a bit drunk, which was quite good fun, then on Sunday I didn’t feel great, which I put down to the alcohol I’d consumed, however I had a volleyball game on so I thought “self-inflicted, just put up with it” and played anyway (even with my ill-health and at-the-time-unrealised underlying health condition we won three sets to none – I actually played pretty well!!!).

Anyway, it got to Tuesday and as the day went on the pain under my ribs came back and I was having pains every time I took a deep breath in, coughed, sneezed or laughed…funny! I got myself to the NHS walk-in centre in town and got seen by a Nurse. Deanne had suggested it was Pleurisy but he discounted that because when he listened to my lungs they didn’t rattle, probably a good thing really.

After a bit of consultation he decided that it was possibly pancreatitis, caused by my recent-ish change in regime on to an insulin pump, he said this may have upset my pancreas due to the difference in my blood sugars and general control from being a bit random and bad to being quite well controlled.

This actually seemed to make a lot of sense to me but he said it was sensible if I went and saw my GP anyway so he booked me an appointment in the afternoon. I went and saw the GP and after a bunch of questions she decided that she wasn’t sure exactly what it was but that it may have something to do with my diaphragm and lungs or else something completely different so she gave me some pills called “lansoprazole” which seem to calm the acid in your stomach down so it doesn’t upset your other organs but sent me to the blood-letters at city hospital in the morning for a blood test just to discount the pancreatitis.

So currently I have no idea what’s wrong with me but still have pain and no idea when I’m likely to hear about my results.

Great!

Tired

Having A Nap

Okay so it’s partly my own fault, the last couple of Sunday’s I’ve been going out (at 9pm) to an open mic’ night with the guy who lives next door to me, this has meant that I’ve got home both times at something close to midnight, which is way past my bedtime! As well as that I’ve had quite a few busy days at work due to colleagues being off and the surprising number of spam e-mails that seem to be circulating at the moment.

In any case I’m feeling a bit run down, of course  that’s not unusual at this time of year, I’m sure we’ve all heard of SAD (Seasonal Affective Disorder in case you haven’t) and of course the nights are drawing in and the temperature has plummeted.

However it’s only really the past year or so that I’ve become more acutely aware of the effect that the temperature and other factors have on my diabetes, and it’s definitely the first time I’ve been connected to a pump when the seasons have changed so dramatically so I’m wondering whether there will be anything different I need to do?!

Should I re-do all my basal rate tests to see if the base rate I am having throughout the day needs changing, or if my bosul needs will go up or down when I eat. I guess like everything else it is just a case of living it and seeing what happens as I do. I guess if I seem to be having a lot of hypos or high blood sugars then I may need to adjust but until that happens I should probably just keep on keeping on!

Type1 Group Stuff

Probably the Best Diabetes Group in the World

All right Dudes,

I won’t apologise again for the lack of updates ’cause it’s starting to get boring but I thought I’d post a few things that came out of the meeting on Tuesday night along with a few things I’ve been meaning to put on for ages but kept forgetting:

1. This is the book I mentioned when I did my talk a couple of months back. It’s very good and if you do carb’ counting it can be a lifesaver!
2. For those looking in to Insulin Pumps this is what I was talking about, it’s an Insulin Pump with a Continuous Glucose Monitor which work together to control your blood sugar. Haydn mentioned there is a newer and smarter one out but I can’t remember who makes it so I’ll look in to that and see what I can do!
3. If you want to get involved in research then take a look here or here (other research projects are available!!!).
4. The Nottingham Type 1 Diabetes Kids group can be found on Facebook, if anyone is interested in getting involved message the group.
5. This article appeared in New Scientist months ago, one of my brothers passed it on to me so I thought I should post it for you all to have a look at.
6. Having problems with Twitter and Facebook on Internet Explorer 9 at the minute in case any of you were wondering why the status updates seem to have dried up a bit! Trying to fix!!!
7. Oh yes I’ve set up an account for Notts Type 1 on Google+ in case anyone is on there and wants to put us in your circles search for Notts TypeOne.

I can’t remember anything else but I’m sure something will come to mind just after I’ve posted this. If you have any thing to add feel free to post comments on this blog, Facebook, Twitter or Google+.

Thanks for listening 🙂

HbA1C

If you are Diabetic then you’ll probably know what an HbA1C test is, if not then I’ll tell you now.

Haemoglobin

HbA1C is a test which looks at the amount of Glycated Haemoglobin in your blood and returns a result which gives you an average blood sugar reading over a number of months.

As far as I have been able to figure out the way it works is that when your body creates red blood cells they contain the amount of carbohydrate that your body has in it at the moment they were formed. Because red blood cells have a lifespan of around three months it means that a sample of your red blood cells will always tell you what the average reading has been over the last three months or so!

For a Diabetic this is obviously important, the closer we can get to normal (between four and eight) the better our long term prospects will be, health wise!

Anyway I went to have a blood test a couple of weeks back in order that my results would be ready in time for my doctors appointment on Monday of this week. I went along quite excited but unsure of what to expect because it is the first blood test I’ve had since really understanding how the Insulin Pump works and how best to use it. It was my first visit to the consultant since getting the pump so that was also a bit nerve racking.

It was quite a good meeting, I asked a few questions and we discussed how it’s been going and then she let me know what my result was.

6.9mmol/l

I was amazed, this is the lowest I’ve ever had so obviously something is working 🙂

Advance Australia Fair

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

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.

Other Type 1 Bloggers

Wordpress

I’ve finally been having a bit of a poke around on WordPress to see if I can find any other interesting people talking about Diabetes, it appears that there are quite a lot of Type 1s on here some of whom mostly talk about Diabetes and some of whom just write about whatever comes in to their head at the time.

Fingerpricker

http://fingerpricker.wordpress.com

This one was only started recently and is purely about the Diabetes, check it out and leave some comments so they know there are people reading it.

The Princess of Pavement

http://princessofpavement.wordpress.com

She runs for fun and fitness and posts some really interesting information about coping with Type 1 Diabetes and exercising, she is also on an Insulin Pump.

smartDpants

http://smartdpants.wordpress.com

A blog about life with Diabetes in quite a lot of depth.

The Pretty Well Inconsequential Flux Capacitor

http://scratchtype1.wordpress.com

Don’t ask me why it’s called that! Also a runner, seems to have lots of bad dreams 😦

Picnic Time

Picnic

In case you haven’t been looking at our various social media (shame on you) you might have missed the fact that the Nottingham Type 1 Diabetes Group is having a picnic on Sunday the 31st of July at midday meeting on the steps of Wollaton Hall at 12:00 (midday).

That’s here!

All we ask is that you bring some food, drink and maybe a frisbee or some other means of entertaining ourselves for a few hours.

See you on Sunday 🙂