#TalkAboutDiabetes – Diabetes Awarness Week June 2018

What do you struggle with when you’re talking about diabetes? It’s Diabetes Week 2018 (June 11-18) and the theme of this year’s awareness-raising seven days is the stuff we find awkward, embarrassing, difficult or even funny to mention.

Here are mine:

  • I don’t like telling people in general. I’m not ashamed or embarrassed; I just don’t like drawing attention to myself.
  • Jelly baby etiquette. When you eat sweeties in front of someone, politeness dictates you offer them around. But they’re the medicine that corrects low blood sugars*, so stinginess is understandable.
  • Explaining a hypo when you’re in the middle of one. Most of my low blood sugar episodes are manageable. But I can be in the middle of a conversation and my mind goes blank. “Bear with me! My mind’s distracted. It’s screaming ‘SUGAR, SUGAR, SUGAR’ at me. My word power will return in a few minutes,” is what I should say.
  • Or don’t talk to me. When I’m high, conversation is too much effort. Please don’t take it personally.
  • I don’t talk much either when I’m high because I’m conscious of the nasty taste in my mouth and am reluctant to impose halitosis on anyone.
  • And don’t take the grumpiness low blood sugars produce personally either. First aiders once told me about diabetics who punched people when they were low, so grumpiness seems moderate in comparison.
  • Please know that managing diabetes is like having a part-time job that you do on top of everything else.
  • If you manage to work out I’m hypo long before I do, be aware I’ll deny it in an exasperated fashion. “Flip’s sakes, no I’m not. Look I’ll even do the blood test to show you and here it…oh. Alright then.”
  • Sometimes when I say I can’t do something because of the diabetes, I might be using it as a fab, ready-made excuse. It’s not me, it’s you. OH NO! I’ve just given away diabetes’ best-kept secret!

*I told a little girl my jelly babies were medicine once. She gave me one of those, ‘why do adults lie to me?’ looks.

Half Marathon – Diabetic Training Progress

Diabetes Diet Emma with her 10k medalMutters to self—so why did you enter a half-marathon you eejit? Because it was January, and the said run was in nine months’ time. Distance from something is the equivalent of wearing beer goggles. Everything looks do-able when it’s months away.

Anyway, the experts recommend you try a few other races to keep motivation levels up so I entered the Vale of Leven 10k, which took place this morning (Saturday 2 June).

Many runners think of 10k as nothing. Easy-peasy to train for and do. Not me. Mama Nature didn’t make me a natural runner. I plod. Sometimes a 4k feels like a Herculean struggle. I can walk long distances without finding it onerous or unpleasant. I should stick to that, right?

Mornings or Evenings?

Races mostly take place in the mornings too. I’m not a fan of morning runs. My blood sugars do weird zig-zaggy things at that time of day (see pic). I’d rather run at lunchtime or early evening when they’ve had time to settle down. Plus, there’s the whole ‘what to do I do about breakfast and insulin’ question.

Still, the day came round and I got up early. Are you familiar with west coast of Scotland summers? For the most part, they promise much and deliver little. This year, however, May has been unbelievably warm and sunny. Weather forecasters promised cooler weather and even rain, but it dawned bright and sunny once more.

Eeks. My ideal run takes place at about 8 degrees with drizzle and a strong wind behind me.

The run started at Moss O’Balloch next to Loch Lomond Shores and spectacular as far as scenery goes. Parts of the route were recycled so runners like me faced the depressing sight of the fast yins heading home as we puffed and panted our way past kilometres seven and eight.

Hanging out with the Back Pack

Ah well! Lisa Jackson who writes for Women’s Running and who has a fair few marathons and ultra-marathons under her belt talks about the joys of hanging out at the back of the pack. Crowds tend to cheer you on a lot more. The marshals, volunteers and people at the race were most encouraging.

Pain when it’s passed leaves an imprecise memory—thank god—so I remember struggling for the first two kilometres as they were uphill and then at the last bit where I speeded up to keep up with the one hour pacer. But the detail’s no longer there, just the relief and pride of finishing.

tee shirt and medal for a 10k runI’m a sucker for a goodie bag and this one included a tee shirt (too big, but they always are as they’re sized for men), a medal, a bottle of water and a Mars bar. Chivas sponsored the event, but sadly a wee nip wasn’t included.

First Finisher

It’s years since I’ve run in a race. You rely on the atmosphere to chivvy you on; the crowds shouting encouragement, so you keep running when you want to walk. Or crawl, in my case. This wasn’t a busy run—I’d guess 550 people—and the ability mixed. I channelled Lisa. Yes! It’s BRILLIANT to hang out at the back, or the second half of the group at least. According to the ticket I collected at the end, I finished 257th and the 22nd woman for my age group (senior vet, whit whit whit??).

For other diabetic geeks, my blood sugar when I got up this morning was 13.6 (oops). I took half a unit of fast-acting insulin to correct this and I took my basal insulin at 7.30am and knocked two units off the usual dose. To avoid working out food and insulin requirements, I didn’t bother with breakfast* and ate a Hike bar—Aldi’s own-brand protein bars, 25g carbs and 9g fibre—twenty minutes before starting. My blood sugar at that point was 10.6, so I took another half unit of fast-acting insulin. I didn’t test my levels immediately after finishing, but an hour later they were 9.6.

So, another three months and I run more than twice that amount. Ooh, ‘eck! I ran the 10k in 60 minutes and 53 seconds (I told you I was slow), which puts me on course for running the half in two hours-ish. Wish me luck!

 

*Don’t do this at home, kids. I have no nutritional or sports expertise related to type 1 diabetes or in general.

 

More Thrush Ladies?!

a picture of canesten cream on The Diabetes DietCould I live with more thrush? Ladies who live with diabetes, you’ll join me at wincing at this one. No thanks, eh? Who wants to spend their days wishing they were sitting in a bath of calamine lotion?

I ask because I filled in a survey last week which asked me if I’d take a tablet to help with my blood sugar control despite initial findings where the control group suffered thrush as a side effect. That wasn’t the only reported side effect—weight loss is another one—but the benefits reported are exciting.

The drug is sotagliflozin (marketed as Zynquista), made by Sanofi and Lexicon, and it’s a dual SGLT1 and SGLT2 inhibitor. At present, it’s about to be reviewed by the US Food and Drug Administration, as diabetes.co.uk reported.

The SGLT1 bit works to delay glucose absorption in the intestines which helps with blood sugar spikes after eating. The SGLT2 inhibitor makes the kidneys better at getting rid of excess sugar in the blood.

Zynquista had undergone clinical trials. People who took the drug achieved better HbA1c levels without increasing the risk of severe hypos. But one group of trial participants taking sotagliflozin developed diabetic ketoacidosis, compared to just 0.6 percent taking a placebo.

Participants on the trial lost 2.98kg compared to those not taking the drug.

Would I take it? Heck, yes, even if it means stockpiling the clotrimazole creams beforehand. All addition help in the blood sugar battle is always welcome.

 

 

Office Etiquette with Diabetes

person holding jelly babies at The Diabetes Diet
Mine, all mine!!

I waved goodbye gaily to office life in 2013, glad to embark on new adventures in freelance world.

There’s a lot to be said for freelancing, not least the ‘free’ bit. I love being in charge of my own scheduling. But the pay… ah, the moolah just isn’t to be found, folks. You’re undercut all the time by global competitors who can afford to write for tiny sums or people in your own country who do it for free as a hobby. Argh.

Anyway, I started a new part-time job in April, working in a communications role on a project at Glasgow University—a worthwhile project and the chance to add a regular income. The equal opportunities form asked if I had a disability. I ticked the ‘no’ box. It also asked if I had a chronic health condition. Er…no?

Okay, I get that I do, but until my thirties, I thought all I had was diabetes. When someone pointed out it is a chronic health condition, I was stunned. No, really. I know that sounds like a “duh” moment, but diabetes hadn’t caused me much hassle. Calling it a chronic life condition felt a bit like I was straying into hypochondriac territory.

Back to my new office job. I decided to be a grown-up and tell my colleagues about my condition, instead of sneakily eating jelly babies at my desk and hoping they didn’t notice. It’s not that I don’t want to tell folks; I just I hate drawing attention to it.

I introduced the subject at a team meeting in a round-about way. Did my new colleagues know of anywhere on the campus where I could offload spare medical gear , I asked. (And benefit others at the same time by recycling my stuff. See what I did there?)

They suggested places. I’d told them I was a diabetic by default.

Job done.

Next up—the hypo talk, where I explain what a hypo looks like and why I’m a stingy jelly baby hogger, instead of offering them around.

Low Carb Diet Study

diabetes diet
You don’t want to know what’s going in here…

So, you get to take all sorts of measurements and I need to answer lots of questions about what I eat? Sign me up!

Reader, I adore a study and even more so when it relates to lifestyle. I started work at Glasgow University in April and spotted a poster looking for participants in a low-carb study.

“Aha!” I said to myself. “I’m your woman! A low-carber for years, diabetic to boot and a person well-versed in the filling in of a form.”

While certain aspects of the low-carbohydrate diet have been well researched, such as weight loss, there has been little focus on testing how this way of eating affects micronutrient levels in the body. The Glasgow Uni study, Nutritional and Cardiovascular Risk Factors associated with Long-Term Adherence to Low-Carbohydrate/Gluten-Avoidance Diets, funded by the Faculty of Medicine, Prince of Songkla University, Thailand, concentrates on this.

What is the purpose of the study? Low carbohydrate diets (LCD) such as the Atkins Diet have become common dietary approaches for weight management, and aiming to avoid starchy foods such as bread, cereals, pasta, rice and potatoes which are major dietary sources of B-vitamins, magnesium, and fibre.

The researcher is investigating the contribution of starchy / sweet foods in body composition, micronutrient status and cardiovascular risk factors. To do this, they seek people who either exclude or include these foods in their diet.

I’m not one hundred percent low-carb compliant. Who is? But when I filled in the forms for the study, I realised that I follow a low-carb diet much more closely than I thought. How often do I eat potatoes, rice and pasta, the survey wanted to know—the answer, never or less than once a month for rice and pasta and about twice a month for potatoes.

I eat bread more often (LOVE bread), and ditto chocolate, but I don’t bother with most of the other high-carb foods listed in the questionnaire.

The outline of the survey had said they’d do urine testing. I assumed that meant a sample in one of those little tubes. Not so! The doctor sent me off with two large flasks (pictured) and asked me to collect all my pee over a 24-hour period.

TBH, I wasn’t sure the two flasks would be enough. We diabetics tend to wee more than ordinary folks, anyway. When you add in my daily diet coke, water and peppermint tea intake, a lot of fluid swishes around inside me.

And what goes in must come out!

The survey will be followed up in six months’ time, then another six months after that and so on until two years are up.

At the time of writing, the researchers hadn’t found that many people to take part—nine out of a necessary eighty. If you live in the Glasgow area and follow a low-carb diet (you don’t need to be diabetic and you don’t have to follow it all the time), then they’d love to hear from you—lowcarbstudy@gmail.com

The Fitbit!

I’ve joined the Fitbit world. Having dipped my toe in the water via the Jawbone Up Activity tracker, I’m now the proud owner of a Fitbit.

My Up activity tracker vanished in January when the device fell out of the wristband. It must be somewhere in the house. Maybe the system thinks I’m dead thanks to my lack of movement. Hey ho! Anyway, by that point I reckoned I knew what you needed to do to cover 10,000 steps a day, and I was quite happy to live tracker-free.

I didn’t stare at my phone so much. My health didn’t take a nosedive, and the world didn’t end.

On Valentine’s Day, however, my husband gave me a Fitbit Charge 2, the reward for staying alcohol-free so far this year. To be honest, when he hinted the other week that he’d got me a pressie for my teetotal efforts, I thought he was talking about champagne. It always makes sense to reward your giving up something with the very substance you’ve been avoiding, hmm?!

And I was grateful and touched that he’d bothered. He’d done the research, he told me happily. This tracker is the all-singing, all-dancing one! It counts your steps, how often you climb up stairs (you should climb ten flights a day for good health, apparently), checks your heart beat, auto-recognises different exercises and monitors your sleep. You can add in a food tracker and monitor your calorie intake if you want to lose weight.

For someone who tends to obsessiveness, this is good and bad news. To prevent myself repeatedly checking my phone, I downloaded the app for Fitbit onto my tablet instead.

Exercise is very good for we folks with diabetes if you are able to be active. If you have type 2, you might be able to control the condition through diet and exercise alone. If you have type 1, exercise will mean you can reduce how much insulin you need to take overall, and it can be used with diet and insulin to keep your blood sugar levels in range.

At some point, perhaps activity trackers will be prescribed for people with diabetes? In the future, the Fitbit could include blood glucose monitoring, as a story earlier this year reported that Fitbit has just invested in a company that’s developing a minimally invasive glucose tracker. Imagine having all that information available in one place.

I, for one, would love that capability, so fingers crossed.

Having Hypos in Public

There was a story in the news this week* about a BBC presenter who had to apologise to listeners after having a hypo while on air.

World Service presenter Alex Ritson has type 1 diabetes, and apparently, his introduction to an early morning news programme left him stumbling over words. He later explained what had happened, and said it was appropriate, as the programme would also be running a story on new research into diabetes published in The Lancet.

I’ve often wondered how public figures who have type 1 diabetes cope with hypos. Those of us who aren’t famous only need to worry about treating them—and sometimes that isn’t always easy—but what about if you’re in the middle of presenting a news programme, or fighting with other politicians a la Theresa May?

[Perhaps she can blame low blood sugars for the immense confusion that currently surrounds Brexit. Some people get violent when they are hypo too so she could use that as an excuse to punch Boris.]

When you have experienced hypos over the years, your body adjusts to them, and the symptoms you get are nowhere near as severe as they were the first few times. Nevertheless, confusion and brain fog still occur.

I remember sitting at meetings or trying to explain myself at work and scrabbling around for words that suddenly seemed to vanish. You get a split second where you panic—where are the words, where are the words—before realising what is going on. I reckon that’s what happened to Alex Ritson, and the panic was probably vile because he was on-air and knew millions of people were listening to him.

Alex later said on Twitter that having a hypo on air had been a recurring nightmare for years, but the Twitter community responded really well with people sympathising, and the JDRF tweeted a handy infographic that showed the signs of hypos, a useful guide for family, friends and colleagues of we type 1s.

*While researching this article, I found out that actor James Norton is a type 1, which made me happy. Nothing at all to do with the fact that he’s exceptionally good looking, #T1DLooksLikeMe…