Brexit and Insulin Shortages

a plstic box c ontaining insulin on The Diabetes DietInsulin shortages and low-carb dishes—no obvious connection, I grant you but bear with me.

The first relates to a news item on Channel 4 last night, which warned of insulin shortages post-Brexit in the UK as the country produces little to no manufactured insulin (apart from a factory which makes the stuff derived from pigs).

Sir Michael Rawlins, the chair of the Medicines and Healthcare products Regulatory Agency, told the Pharmaceutical Journal last Friday that, “We make no insulin in the UK. We import every drop of it. You can’t transport insulin around ordinarily because it must be temperature-controlled. And there are 3.5 million people [with diabetes, some of whom] rely on insulin, not least the Prime Minister.”

412,000 people on insulin

Strictly speaking, that’s no true as the Channel 4 story pointed out. Wockhardt UK produces the animal insulin, but its products are used by some 1,500 to 2,000 patients every year. And that’s less than 0.5 percent of the estimated 421,000 people in the UK who rely on insulin.

Channel 4 News spoke to the major manufacturers, Sanofi, Novo Nordisk and Lilly. All of them make insulin in Europe.

The Healthcare Distribution Association (HDA) UK which represents medical suppliers in the UK wrote to the UK Government post the referendum in 2016 to warn of serious upsets to the supply chain should Brexit negotiations go wrong.

Buffer stocks

HDA UK said the UK medicines supply chain had “inbuilt resilience” and “flexibility”, and that they were aware of proposals by the government and manufacturers to develop plans for a buffer stock of all medicines.

A spokesperson for the Government said they were confident of reaching a deal, there were contingency plans in place to ensure no disruption to supplies.

Channel 4 News’ fact check conclusion is that as the companies and the Government don’t anticipate shortages, we should be okay.

Back to low-carb recipes and my tenuous attempt to link the two. If you follow a low-carb diet and you use insulin, in general you don’t need to take as much insulin. If shortages come, you’ll have more time to use your insulin while the powers-that-be attempt to sort out this almighty mess.

Cue plug for this blog and The Diabetes Diet! Is that distasteful of me?! Probably.

 

 

 

Aubergine and Pepper Parmigiana

The Diabetes Diet picture of an aubergine and cheese dishIf you read your way through my weeping and wailing post about meat-eating and ethics last week (congratulations, by the way), then this recipe will seem a natural follow-up.

To recap, I’m reading The Ethical Carnivore: My Year Killing to Eat by Louise Gray and hoping for easy-to-follow guidelines that assuage my conscience about eating meat, falling short of killing it myself as I’m pretty sure I can’t do that.

In the meantime, there is always low-carb vegetarianism. I know vegans argue that vegetarianism is little better than meat-eating given what goes on in the dairy industry, but it’s a start. Besides, I can’t imagine a life without cheese.

Low-carb veggie

Here’s a low-carb veggie recipe for you—a bastardised version of aubergine parmigiana. Allow roughly 10g of carbs per portion.

Aubergine and Pepper Parmigiana

  • Servings: 3
  • Difficulty: easy
  • Print

  • A large aubergine
  • One red pepper
  • One yellow pepper
  • 400g tin chopped tomatoes
  • 2 cloves garlic, crushed
  • 2tbsp rapeseed oil
  • Grated rind of one lemon
  • Salt and freshly ground black pepper
  • 75g grated parmesan cheese
  • 50g grated cheddar cheese

Pre-heat the oven to 175 degrees C.

Chop the aubergine and pepper into equal-sized pieces and toss in one tbsp of the oil. Cook on a griddle until softened—about ten minutes.

Heat the other tablespoon of oil in a saucepan and add the chopped tomatoes, garlic and lemon rind. Allow to come to a boil and turn down to a simmer, stirring from time to time. Cook for about ten minutes to, allowing the sauce to become thick and concentrated.

Season the sauce with salt and pepper and sprinkle some on the cooked aubergine and peppers.

Layer up the vegetables, sauce and cheese in a gratin or rectangular casserole dish finishing with cheese. Cook for twenty minutes.

For other low-carb vegetable recipes, see:

 

 

Thrity-One-Year-Old Claims Cure for Type 1 Diabetes

A PICTURE OF BLOOD TESTING EQUIPMENT AND NEEDLES

A PICTURE OF BLOOD TESTING EQUIPMENT AND NEEDLESGoogle alerts frequently pairs ‘diabetes’ and ‘cure’ together, but most of the time the words don’t capture my attention. Even when ‘type 1 diabetes’ and ‘cure’ make the same sub-heading, I’m not jumping up and down.

Yeah, yeah, heard it, bought the tee shirt, and no impact on my life so far…

But The Sun newspaper carried a story this week about a 31-year-old who claims to have cured his type 1 diabetes with diet and exercise alone. Again, that approach can achieve results with type 2 diabetes but it’s the first time I’ve seen it accredited to a cure for type 1.

Exercise and diet

Daniel Darkes’ regime isn’t for the faint-hearted. He eats a diet high in zinc (nuts, oily fish and veg) and runs more than sixty miles a week.

But before you dig out your trainers and start stock-piling the Brazil nuts, Daniel’s type 1 diabetes has some qualifications. He has a rare, abnormal gene, which doctors believe might have restarted his pancreas.

The 31-year-old from Daventry in Northants developed diabetes eight years ago and stopped giving himself insulin last January (2017)*. He started cutting down on insulin after experiencing hypos in 2016. He travelled to the US in March 2017 to find out more. Doctors ran further tests to find out what we happening to his body.

Brain sending messages to pancreas

He was put on a fasting diet and exercised at the same time. The medical staff noted his brain had begun sending new signals to his pancreas, and he hasn’t injected himself with insulin ever since.

Daniel told The Sun that doctors believed his abnormal gene combined with exercise is the reason he’s been able to cure himself—it’s as if the gene acts as a back-up immune system and has recharged his pancreas.

He is still being monitored at Northamptonshire General Hospital.

Abnormal genes

I’m fascinated by this story—as I suspect most type 1s will be. I’m no medical expert so my opinions are qualified, but I suspect that Daniel’s abnormal gene plays a huge part in his ‘cure’ (and this won’t be regarded as such until he reaches the two-years-without-insulin mark). It’s also interesting that the description of his diet (scant as it is) sounds like a low-carb diet.

The article said that Daniel’s case “could provide a revolutionary new approach to treating type 1 diabetes”, while Diabetes UK said it couldn’t speculate on whether Daniel had ‘cured’ his diabetes or not, and that there was “no clear cure for type 1 or type 2 diabetes”.

 

*DISCLAIMER – please, for the love of all things injectable, do not skip your insulin injections if you have type 1 diabetes…

 

Coping with T1D in the Heat

Inforgrpahic about the heat by The Diabetes Diet

A screenshot of the weather in Scotland on The Diabetes DietHeavens above—this isn’t a post I’ve needed to write before but the last few weeks of incredible sunshine and heat in Scotland (Scotland! I’ll say it again, Scotland!) necessitates it.

If you’re a type 1, what special precautions do you need to take when the mercury rises? I prepared this handy infographic to help…

Please note—if you have neuropathy (nerve damage) this can affect your ability to sweat and therefore cool down. Go out early in the morning or later in the afternoon if you can, drink water to stay hydrated and exercise in air-conditioned gyms. Cut down on drinks with caffeine and alcohol, and take care of yourself as best you can.

Inforgrpahic about the heat by The Diabetes Diet

#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.