Category: health

My people all together – #type1diabetes

Emma6 Comments

blood testing equipment type 1 diabetesEver sat in a room and thought, “I am with my people”? That was my experience this week as I attended an education session the NHS had put on; my attendance a condition for prescription of the Abbot FreeStyle Libre.

I doubt I’ve ever been in a room with so many other type 1 diabetics. Sure, type 1 is a hidden condition. Perhaps others travel on trains with me or flit about the offices of the University of Glasgow dropping their test strips wherever they go?* Still, my original statement holds. I reckoned on about 200 people there, with perhaps a third of them partners or parents.

All shapes and sizes

I arrived at the Queen Elizabeth University Hospital early and watched in fascination as folks trooped in to the lecture theatre. We come in all shapes and sizes—all ages, all colours and all creeds. Who were the ones with diabetes? I put it down to those of us who carried our precious bag—the FreeStyle Libre and the doctor’s letter handed out when we registered—tightly. I’d expected lots of young people, but that wasn’t the case. The average age, I reckon, was mid to late 30s. Every time I saw someone who looked a lot older come in, I cheered silently.

Take that, reduced life span, and shove it where the sun don’t shine.

Our session took the form of a PowerPoint presentation by one of the diabetologists at the hospital, followed by some Q and As. I didn’t bother asking anything. As an introvert, I’m not going to raise my hand in a room that full of folks—even if they are my people. But there were plenty who didn’t suffer from shyness who dived in.

Can you scan your sensor through clothes? Yup. (So handy!)

Can you swim with it? Yes, but only half an hour is recommended. (Seriously, do people swim for longer than that? It’s the world’s most boring form of exercise unless you’re in open water.)

How long does it take for the prescription to come through once you hand the letter to your doctor? About 48 hours.

Can you connect it to your phone? Yes—there’s an app for it.

What happens if it keeps falling off? Some people have slippier skin than others. Thankfully, the two times I tried the sensor it stayed in place for its allotted fourteen days.

Talking to my people

I longed to talk to my people, but didn’t. See above-mentioned introvert tendencies. Who would I have chosen? The Indian girl who talked about running, exercising and wearing a sensor? The man behind me who asked if the Libre 2—the one with alarms that sound if your blood sugar levels go up or down too rapidly—would be available for us in the future? The glamorous young couple where I couldn’t work out which one would hold out the fingers covered in black dots from too much finger-pricking?

No. The one I’d have picked out was the woman I guessed to be in her late 30s who came in with an older man and woman I took to be her mum and dad. I watched her sit down near me and wiped away a wee tear. That might have been me once upon a time, attending with my lovely, supportive ma and pa. My father died nine years ago and how I’d love to have shared this new, wonderful development in diabetes care with him.

Session over, my precious bag and I got onto the bus to go home. “A new chapter, Emma B,” I said to myself. “How terribly exciting.”

*About to become a non-problem. Yay!

Vitamin D shown to improve blood sugar control in gestational diabetes

kaitiscotland1 Comment

From Ojo O et al. The effect of vitamin D supplementation in women with gestational diabetes mellitus. A systemic review and meta-analysis of randomised controlled trials. Int J Environ Res Public Health. 2019:16(10)

A meta-analysis has indicated that various factors relevant to improved blood sugar control are likely to be improved by vitamin D supplementation in  a total of 173 women with gestational diabetes.

Fasting blood glucose decreased by a mean of 0.46 mmol/L

Glycated haemoglobin decreased by a mean of 0.37%

Serum insulin reduced by a mean of 4.10 uIU/mL.

 My comment: Although the improvements are small, vitamin D supplements are inexpensive, easy to take and do not have the side effects of other medications.

 

 

Lower cholesterol may not better if you have neuropathy

kaitiscotland1 Comment

From Jende JME et al. Peripheral nerve damage in patients with type 2 diabetes. JAMA Netw Open. 2019;2(5);e194798

In type two patients who had diabetic neuropathy affecting the legs, low total cholesterol and low density lipoprotein cholesterol had more nerve lesions, impaired nerve conduction and more pain and disability than those with higher cholesterol levels.

Almost all type two diabetics will be advised to take statins to keep the cholesterol level down as this is generally accepted as improving the outlook for cardiac and circulatory conditions.

One hundred participants with type two diabetes were tested using magnetic resonance neurography. 64 had diabetic neuropathy and 36 did not.

My comment: Although this was not discussed in the abstract, I wonder whether those people with more advanced complications were being more intensively treated all round and thus had more/higher doses of statins, and so the relationship between low cholesterol and neuropathy severity was simple association, or whether there is a causative factor here. I am aware that statin neuropathy is believed to exist.

Higher blood pressure is linked to LESS cognitive decline

kaitiscotland4 Comments

From Streit S et al. Ann Fam Med 1 March 2019 and reported by Sarfaroj Khan UK Clinical Digest 13 March 2019

In my GP career treatment of blood pressure for the general population has become more intensive as time has gone on. This hasn’t always resulted in better long term outcomes overall. Indeed, the target systolic blood pressure, the upper measurement, has been moved from 130 to 140 in the last few years because of this.

A Dutch study of over a thousand patients over the age of 75 showed that those with a systolic blood pressure under 130 showed more cognitive decline than those with a blood pressure over 150 when they had mental functioning tests a year later.

Those with higher blood pressures had no loss of daily functioning or quality of life.

As aggressive blood pressure control in those with diabetes is standard treatment, it is worth knowing this. Perhaps further studies in this subgroup of patients would be worth doing. I have seen reports of impaired kidney function when blood pressure levels are “optimal” but low too.

Another study regarding blood pressure management reported in the British Journal of Sports Medicine indicates that blood pressure reduction of almost 9mm Hg in hypertensive patients when regular structured exercise is undertaken. This is of a degree similar to most anti-hypertensive medications. (Reported in BMJ 5 Jan 2019)

 

 

Approved for Flash Glucose Monitoring!

Emma8 Comments
Cheerio oh meter – you are about to become a thing of the past. Ditto that test result too.

Joyous news, friends… I’ve received approval for funding for the FreeStyle Libre flash glucose monitoring system.

Oh, what changes this will bring! Firstly, there’s the ease thing. I often sit down for dinner, realise I’ve still to do a blood test and groan. Now, it will be a matter of seconds. Take out the reader, scan and voila. I’ll also be able to do TONNES of tests, and catch those pesky sugar levels when they misbehave firing to the top or plunging to the bottom.

As a wild optimist at heart, I tell myself my day to day energy levels will also shoot through the roof – diabetes being much easier when you’re not tired all the time because of glucose level misbehaviour.

Before I receive my very own precious reader and prescription for the thingies you stick on your arm, I’ll need to attend an education session. Once that’s done, a letter wings its way to my GP and she starts prescribing the arm thingies. (Note my fine grasp of the technicalities.)

So, there we go. Happy days! I’ll report back.

Eating carbs last gives lower blood sugar spikes

kaitiscotland5 Comments

From IDDT newsletter December 2018

A report in BMJ Open Diabetes Research and Care Sept 2017 shows that in type two diabetes, eating sugar and starch later in the meal halved the blood sugar spike after the meal compared with those who ate the sugar and starch first.

This study was done on 16 people who ate test meals of protein, vegetables, bread and orange juice. Those who were instructed to eat the bread and juice last also had 40% lower post meal glucose levels compared to those who ate all of the meal components in a mixed fashion.

My comment: This is a small study but easily reproducible with yourself and your blood glucose meter. If you do wish to eat sugar and starch best have these last, unless you are treating a hypo.

 

 

More fat = more kidney failure

kaitiscotland2 Comments

From BMJ 12th January 2019

Chang AR et al The CKD Prognosis Consortium BMJ 2019;364:k5301

Between 1970 and 2017 a huge number of people were assessed for fatness using body mass index, waist circumference and waist to height ratio. The outcome was that the fatter you get, the more your kidney function declines. This was true whether you started off  with normal or impaired kidney function.

The lowest kidney disease was seen in those with a BMI of 20 and this barely changed till a BMI of 25 was reached. After this was a linear progression. By the time your BMI is 40, you have double the risk of kidney function impairment.

The results were adjusted for age, sex, race and current smoking.

My comment: This is a new risk factor for obesity as far as I know.

 

 

 

Natural and Low Carb Kitchen: Chocolate mug cake

kaitiscotland7 Comments

Ingredients
3 tbsp almond flour (you can switch for coconut flour if preferred)
3 tbsp cocoa powder
2 tbsp butter
1 medium egg
1 tsp vanilla extract
1 tbsp milk
1 square dark chocolate (over 70% cocoa)

Create It
1. Add all dry ingredients to a mug and mix.
2. Add butter, milk and vanilla extract and mix well.
3. Place mug in the microwave for 2-3 minutes. (Every microwave varies on cooking time so keep an eye on this)
To serve – whip up 2 tbsp double cream and top with berries.

Jovina cooks: Seafood chowder

kaitiscotland3 Comments

Seafood Stew
Ingredients
3 tablespoons butter, divided
1 garlic clove, minced
1 large shallot, diced
1/2 cup chopped onion
1 cup chopped celery
1 thin carrot, diced
1/2 cup diced red bell pepper
2 cups cauliflower, cut into small florets
½ cup diced rutabaga (or potato)
2 cups homemade or store-bought low-sodium chicken broth
1 teaspoon seafood (Old Bay) seasoning
1/2 teaspoon dried thyme
1/4 teaspoon freshly ground black pepper
1/2 teaspoon salt
1/2 teaspoon crushed red pepper flakes (chili)
2 tablespoons apple cider vinegar
1 large plum tomato, seeded and diced
3 lbs firm boneless fish fillets (such as halibut, cod, red snapper, sea bass, grouper), cut into small cubes
8 oz medium shrimp, shelled, deveined and tails removed
1 cup heavy cream
1/4 cup minced fresh parsley
Directions

In a large saucepan over medium heat, melt 2 tablespoon butter. Add the onion, shallot and garlic. Saute for a minute or two and them add the carrot, celery and bell pepper. Cook until the vegetables are tender, 3-4 minutes.

Add the rutabaga and cauliflower. Stir into the vegetables. Pour in the chicken broth and bring to a simmer. Cover the pan and cook the vegetables until the rutabaga and cauliflower are tender.

Remove the cover and add the: salt, pepper, chili flakes, seafood seasoning, thyme, tomato and vinegar. Sir well.
Add the cream, fish cubes and shrimp. Cook stirring the mixture gently for 4-5 minutes or until the fish and shrimp are cooked. Add the parsley and remaining tablespoon butter, heating until the butter is incorporated. Serve in large individual  bowls.

My comments: this is a particularly delicious chowder. If you don’t have all the ingredients some are optional. Morrison’s supermarket sells a packet of frozen “fish pie mix” for about £4. Using this with extra prawns,  garlic, onion and cream also produces a lovely basic fish stew. Remember my son’s tip about using frozen pre chopped onions if you are short of time or don’t like your hands getting oniony. Jovina’s recipe is more sophisticated. 

BeTravelFit: Ultimate travel workout

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From: BeTravelFit blog:
While I was traveling I saw myself faced with situations in which I didn’t have access to any sort of gym, not even a bar to do Pull-Ups with, hell, not even a damn park bench to do Tricep-Dips on because every single bench in the park was used by loved up couples and other people who don’t work out because they actually do have a social life and other things do to then lifting (what a bunch of losers).
So here’s a workout that you can perform anytime, anywhere, with absolutely no equipment needed – just as promised.
The workout consists of three different circuits with three different exercises in each circuit. The exercises in each circuit are to be performed directly one after another with no rest in between. That way the heart-rate stays elevated over an extended period of time and more calories are burned as a result.

Circuit 1: Upper Body (Chest, Shoulders and Triceps) – To be performed 5 times, 60 secs rest
Hindu Push* up x 5
Diamond Push-Up x 5
Push-Up x amrap (as many repetitions as possible)
Circuit 2: Lower Body (Quads, Glutes, Hamstrings and Calves) – To be performed 5 times, 30 secs rest
Single Leg Box Squat x 10
Single Leg Romanian Deadlift x 10
Single Leg Calf-Raise x 15
Circuit 3: Core (Abs And Lower Back) – To be performed 5 times, 30 secs rest
Oblique Crunch x 10
Crunch x 20
Plank for 60 secs
And there you go, here’s your first full body, zero equipment, bodyweight only workout!
It burns a ton of calories, engages all major muscle groups and keeps you occupied for at least an hour to an hour and a half. Feel free to add extra repetitions or sets to make the workout more challenging as you progress and don’t feel intimidated if you can’t perform as many repetitions as suggested in the routine. Just give it your best shot and you’ll be fine!

 

  • Assume the downward dog position. Move your upper body backwards,  into child’s pose, and then move your head and trunk forwards taking your weight in your arms till you then extend your head up with your trunk in the upward dog position.