Royal Garden Party at Holyrood Palace 3rd July 2019

I was thrilled to be invited to the Royal Garden Party at Holyrood Palace Edinburgh on 3rd July.

The Queen, Princess Anne, Prince Andrew, Prince Edward and Scottish First Minister Nicola Sturgeon were in attendance as were 8,000 other people.

Invitations came out a month in advance. Most guests are invited due to having a role in public services, the armed forces, youth work or for humanitarian work.  I saw two dogs who were both Labradors wearing service uniform.  I was invited due to my General Practice work which I have been doing in Mauchline Scotland for the last 32 years. I am retiring from this aspect of my career in January next year.

The weather was great. Sunny, a little cloud and not too hot. Despite floods the week before and rain a couple of days later, we managed to hit a sweet spot. The grass had dried out too so was good underfoot. The ground didn’t turn into a quagmire in other words.

Organisation was very slick and the large group of guests were ushered in via three entrances well staffed by police to allow security checks.  Tea and food pavilions were well laid out with about 15 stations in each of two rectangular open marquees.

The toilet facilities were portaloos of a very good standard and most importantly there was about four times the number of cabins for women as men. This meant that the queues were always similar for each gender. Someone has done the maths!  Theatres and other public venues take note! Additionally they had guest wranglers who made sure that everyone came in and out of the cabins in the most efficient manner possible.

Music was provided by two different military  bands. One male and one female. The Queen’s bodyguard were in attendance. These old gentlemen had long arrows with them and each had a golden eagle feather in their caps. They were very helpful and interesting to talk to.

There was a good choice of snacks and drinks. Tea, cold coffee, water, and apple juice.  Cucumber sandwiches, salmon on oatcake, chocolate cake, Victoria sponge and macaroons for example. Unfortunately all were wheaty and carby so I didn’t have anything to eat. Surprisingly I only saw one seagull the whole time.

People were dressed as if they were going to a wedding. Fascinators dominated the women’s heads compared to the hats by about 7 to one. The gardeners must have been delighted to get the lawns aerated by about 8,000 high heels.  By 5 pm many women were nursing their sore feet and walking about in their stocking soles.

There were many uniforms in evidence and some top hats from the men in morning suits. It was evident that a lot of people knew each other.  This didn’t work out for myself and my husband. Although we knew of three other couples who were going, we never managed to see them.

The day started at 3pm. The Queen came down the steps from the palace at 4pm and the national anthem was played.  We left at around 5.10pm. I understand that the Queen leaves at 6pm and the national anthem is played again.

Our vantage point for the Queen’s entrance was at a higher point in the garden. Thus we had a good view of her and the group, but we were so far away that we couldn’t have identified anyone except for the colour of clothes they had on.  The Queen wore pink. Anne wore Aquamarine, Nicola wore white. Andrew and Edward wore morning suits. They all had umbrellas.  No doubt they had been  caught out before.

This was an interesting and memorable day.

 

American Diabetes Association Endorses Low-Carb for Type 2s

eggs and asparagus

eggs and asparagusA landmark decision this week—the American Diabetes Association (ADA) has decided to back low-carb diets for type 2 diabetics.

Diabetes.co.uk reported the announcement this week. The charity has produced a report, ‘Nutrition Therapy for Adults with Diabetes or Prediabetes: A Consensus Report (Consensus Report)‘, published in the journal Diabetes Care.

Last year, the ADA acknowledged the low-carb approached as beneficial for treating type 2 diabetes. The new report goes further, stating that diabetes-focused nutrition therapy is a crucial part of overall diabetes management.

Previous high-carb recommendations

Previous dietary guidelines have focused on high-carb diets for people with or without diabetes.

The report says: “Reducing overall carbohydrate intake for individuals with diabetes has demonstrated the most evidence for improving glycemia and may be applied In a variety of eating patterns that meet individual needs and requirements.

“For select adults with type 2 diabetes not meeting glycemic targets or where reducing antiglycemic mediations is a priority, reducing overall carbohydrate intake with low- or very low-carbohydrate eating plans is a viable approach.”

Non-starchy vegetables

The report also says it is important to eat non-starchy vegetables, minimise the intake of added sugars and refined grains, and choosing whole foods instead of highly-processed foods.

As one of the authors of the paper, Dr Laura Saslow from the University of Michigan was also the author of a research paper published last year which revealed that 26 percent of users of Diabetes Digital Media’s Low Carb Programme put their type 2 diabetes into remission after a year. Remission was defined as reducing HbA1c to normal levels while taking no glucose-lowering medications or just metformin.

If you’re a low-carb enthusiast (type 2 diabetes or not), you’ll find lots of recipe ideas on this website and you can also buy our book, The Diabetes Diet as a paperback or e-book on Amazon. The book has recipes, meal plans and suggestions for how to adjust insulin when starting on a low-carb eating plan.

Diabetes and the ol’ green monster

Me this week. Not attractive, I know

Ah, the green monster… It surfaced this week, startling me with its intensity. I’m talking about jealousy and the mean feelings I experience occasionally in relation to diabetes.

Every week, the mighty search engine that is Google picks out the week’s diabetes news for me. Most of the time, it includes new research, a dose of doom and gloom where scientists and doctors reinforce the lower life expectancy/increased likelihood of contracting a nasty side effect (Gee, thanks folks) and a Daily Express article telling you to eat this food to avoid diabetes*.

This week’s offerings included a video on the BBC where a teenage type 1 spoke about the pump she wears which uses artificial intelligence to monitor her blood sugars and keep them within normal range, and how it will allow her to soar through life. She’s one of the first type 1s to get this pump on the NHS.

Believe me, I know a one minute 55 second film clip tells nothing like the full story. I don’t know the extent of the teenager’s medical background. Her mother, the video showed, found it hard to sleep at nights because she was so worried about her daughter’s overnight hypos. I get it, I get it, I get it…

No awards for long service

But the horrible green monster reared up anyway. “It’s always the young ones,” I muttered, bad-temperedly. There might even have been a self-pitying tear or two. “What about me—don’t I get an award for long service? Thirty seven years with this ruddy condition! There are empty jelly baby packets in landfill sites all over Scotland to prove it**. I wouldn’t mind soaring myself.”

The nasty bout of whingeing was in part triggered by a letter I received this week relating to my progress on the flash glucose monitoring (FGM) waiting list. At my appointment at the diabetic clinic in September last year, the doctor put me on that oh so elusive list. The waiting list was only the start. After that, a mandatory half-day educational course takes place and then a letter wings its way to your GP requesting they prescribe FGM. Still there I was. ON THE LIST!!!

“Happy days, Emma!” I said to myself as I skipped out of the clinic, phoning my mum and then husband to share the good news. They whoop-whooped too.

Patience, not one of my virtues

I waited. And waited. Well, I suppose those half-day courses are over-subscribed,” I said to myself. Friends, patience isn’t among my virtues but I held off writing to the good doctor to request a situation update until the beginning of March. The letter I got in return said there is a cap on funding and until that increases, I’m on a static waiting list.

Again, I get it. Times are tight, but every other type 1 I know sports one of those FGM thingies on their arm, included blasted Theresa May. (Admittedly, I don’t know that many type 1s.)

Here’s the thing—I never envy other people their non-diabetes status. A long time ago, my brain must have told my heart jealousy over the impossibility/unlikeliness of a cure in my lifetime was too much of a wasted effort. But when I read of other diabetics and their access to the latest tools and tech, I glow so green I’m practically radioactive.

The blessings of perspective

Fortunately, perspective kicked in after twenty minutes or so of mumping and moaning to myself. In the US, two senators have launched an investigation into rising insulin prices (585 percent from 2001 to 2015 for Eli Lilly’s Humalog, for instance), and this in the world’s wealthiest country. Many people have tried swapping insulin types and brands, changing to something that might not work as well for them or worse, stopping it or rationing it.

In addition, part of my work at the moment involves communications for a health-based project in two African countries where access to any diabetic medication is seriously limited, and knowledge of how to treat the condition not as wide-spread as it is in the developed world.

I don’t have the latest up to date equipment, but I do have insulin (Brexit fears aside), plenty of test strips and all the other bits and pieces I need. The green monster surfaces from time to time, as I’m sure it does with you. Let it do its whinge-y bit and then remind Madam Monster we do live in the best of times for people with diabetes (country dependent of course). If I’d been born 100 years earlier, I wouldn’t have made my 11th birthday. So, Emma 1, Jealousy 0.5.

*Yet to click on that one as I assume it’s click bait.

**They will outlive me.

Imagine NOT having diabetes…

a picture of a blood testing machine on The Diabetes Diet
This will be my blood sugar levels from now on. All the time. Yes sirree.

When you’ve lived with diabetes as long as I have, it’s almost impossible to imagine what life is like without that constant round of tests, injections and mild anxiety around food as you eat something and hope it doesn’t result in postprandial blood sugar levels that are too high or too low.

Today, I read about people’s experiences of research or new procedures they’d taken part in. One woman wore the artificial pancreas when she was pregnant. Giving it back afterwards was, she said, “like losing a limb”. Another person received islet stem cells transplant because he couldn’t recognise hypo symptoms and was able to come off insulin altogether, although he did have to go back on small amounts four months later.

So, Emma B, I said to myself, say you woke up tomorrow without type 1 diabetes what would be the best thing about it. And is there anything you would miss?

Energy

The main point that would strike me would be the energy. Imagine living with levels of energy that remain more or less constant. To the non-diabetics out there, please make the most of it this on my behalf. You have no idea how brilliant it is. I get days here and there when the energy is constant, and blimey you could put me in charge of Brexit and I’d sort it out… But some of those other days are tedious. Tiredness makes you grumpy and makes every task far more difficult, meaning you have to invest in willpower (a finite thing) for trivial rubbish.

It’s hard to over-estimate the impact that one single thing would make. Perhaps I’d turn into an extrovert. Tiredness often makes conversation an effort. Or I’d enter a full marathon instead of a half. My freelance copywriting business might take off because I’d be able to do far more work every day AND I’d be an excellent net-worker and pitcher, thanks to the whirling fizz running through my veins.

Injection-free meals

I’d also relish sitting down to meals without having to do blood tests and injections first. Oh the bliss of pulling up a plate without eyeballing its contents and doing all the calculations in your head—right, so that’s about 15g of carbs (I think), my blood sugar is a little raised so I need to factor that in, but I’m going for a walk afterwards so include 30 minutes of exercise, maybe allow for an hour because I’m going up that big hill… etc., etc.

I might never go near a doctor’s surgery again. A silly thing, I know, but we sugar shunners spend a lot of time in hospital waiting rooms, often wondering why the magazine collection is so rubbish and why all the posters on the wall are so out of date. There’s the clinics, the retinal screening and all the other appointments associated with diabetes. Not going along to any of them ever again would be a joy.

My abdomen would say an almighty big ‘thank-you’ for not getting stabbed seven or eight times a day. Granted, the needles we have these days are tiny (I use a 4mm version), but occasionally I hit a nerve and it HURTS. Ditto my fingers. As one of our regular readers said, doctors can always tell the folks who are conscientious about blood tests as they were the ones with tiny black marks all over their finger tips.

Pizza and chips anyone?

Would I dive into plates of chips, 15-inch pizzas and cakes and sweets? Probably not. I’m used to eating in a certain way, and I believe it’s healthy for most people, not just those with diabetes. I do eat chocolate and pizza from time to time because life’s too short to eat low-carb all the time.

And now for the things I would miss… wait for it…

Nothing? Diabetes doesn’t need to be dreadful. A sensible low-carb eating plan and a bit of exercise can work wonders. And it’s not the worst chronic health condition you can have, but honestly, truly and seriously I do not think there are any type 1s out there who wouldn’t say “goodbye” to diabetes without a backward glance.

 

PS – Do you remember my post about stockpiling insulin in case of a no-deal Brexit? There’s a post on Diabetes UK with the latest information here.

High dose Vitamin D improves cardiovascular health markers

Adapted from UK Medical News 17 July 2018

Several different health measures, all which improve your cardiovascular outcomes, have been found to result from high dose vitamin D supplementation. You are likely to need to take at least 4,000 iu a day though, depending on how much extra sunshine you are exposed to regularly.

A meta-analysis of 81 randomised controlled trials looked at almost one thousand patients randomised to taking supplements or to a control group who did not. The active and control groups were both roughly 5,000 each.  The durations of the trials varied but averaged out at ten months. The doses ranged from 400 iu a day to 12,000 iu a day. The average taken was 3,000 iu a day.

The outcomes were related to the blood level of vitamin D achieved. Levels had to be over 86 nmol/L to get benefits. You need to take over 4,000 iu a day to get vitamin D concentrations of 100 nmol/L or more.  My comment:This does mean that the minimum levels advised by the Scottish Chief Medical Officer last year are way too low to see the benefits discussed here.

So what extra benefits do you see?

lower systolic and diastolic blood pressure.

lower high sensitivity C reactive protein.

lower serum parathyroid hormone.

lower triglycerides.

lower total cholesterol.

lower low density lipoprotein.

high density lipoprotein increased.

All benefits were numerically small but did reach statistical significance. Cardiovascular outcomes were not measured directly, only blood markers and blood pressure.

Mirhosseini N et al. Vitamin D Supplementation. Serum 25(OH)D Concentrations and cardiovascular disease risk factors: A systematic review and meta-analysis. Front Cardiovasc Med. 2018 July 12.