Basal Rates

To all of those of you who know that sometimes its easy to slip into bad habits, I understand. I do too.

I had a huge wave of bad sugar levels this last month, with no particular obvious change in lifestyle; except that I've been on holiday 3 times...but my whole life is fairly unstructured and unroutined, I thought this wouldn't make much difference.

Anyways, its totally easy to start accepting bad sugar levels, and it can become a bit of a routine. Thats bad. Thats why its important to have someone close to you who can ask you important questions...someone who understand the ins and outs of Type 1 Diabetes. Most people don't have a clue, so its important to train someone up. Someone who can keep an eye on you.

For me, this is my mum. She helped me a lot when I was younger, and she is always the one to make sure that my sugar levels are on track. This has changed a bit as I've gotten older.

During university when I wasn't living at home, I kept a sign on my wall, door or wherever that said, "What's your sugar level?" That seemed to work, though I had to keep moving the sign around, otherwise I got too used to it, and stopped reading it. I tried making new signs as well, and these were a helpful prompt.

I am terrible with writing down my sugar levels and keeping an accurate record of them. I always have been. I have never found a system that works for me. If you have found one, please let me know! I think I need to ask my specialist for a tester kit that does reports. I used to have one, but it died.

Anyways, so this last month I was going down this slippery slope. And the more bad sugar levels I had, the less aware I was of everything, it becomes harder and harder to look after yourself when sugar levels spiral out of control, awareness is practically nil.

And so, it was two days ago, on holiday in Greece that mum asked me when the last time I changed my basal rates was. It was such a wake up call. I looked at the rates, and they were so low. So, I thought it wouldn't be a bad idea to try out some higher ones, and see how it went.

As it turns out, that was a brilliant idea, because my levels have been perfect since then!

I'm still waiting for my skin to return to normal, and my energy levels to increase, but I am pretty sure they will soon! Woo hoo! And I must start running twice a week again, and swimming...and pilates. Oh, and walking the dog helps too.

So, for those of you suffering with bad sugar levels on an insulin pump, have a look at your basals, that might just be the solution!

For those of you that don't know what a basal rate is, its the constant flow of insulin into the body through the infusion set. Mine vary from 0.4 to 0.75 throughout the day. And changing it by the tiniest fraction can completely change your balance. (I really should have thought of it sooner!)

Diabetic Retinopathy

Scary thing arrived in the post today. It was a letter from my NHS doctor stating that I MIGHT have background retinopathy.

Which is weird because when the guy looked at the screen to check if there was any damage, he didn't seem too concerned, and I thought it looked exactly as it usually does.

Anyways, I think this has given me a little kickstart into exercise again. And more regular sugar level testing.

I have just come back from a holiday in Italy, where my sugar levels were all over the place. Not good. Probably because I was eating too late, and eating way too much fat as well.

So, now I am heading out for a walk with the dog. To clear my head, work out what practical steps I can take to reverse the retinopathy (as much as is possible) and then I am going to make sure I book myself an appointment with the screening clinic for next year.

Oh, and check up with my optician so he can see what the overall condition of my eyes are. Because, everything is linked and I just want to be sure.

The letter says that there's nothing I need to worry about, there is no treatment at this stage, just simply to keep a good control of my sugar levels. Which could be interesting given I am heading off on holiday again in a week.

I know that laser treatment is the best cure at more advanced stages, but lets hope I don't get that far. Come on Patrick, help me out here! Exercise and low GI foods are going to be more important than ever...

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Like a rollercoaster...

For the last few weeks, since Easter, my sugar levels have gone crazy.

Those of you who are diabetic will know that once they get out of control, its hard to pull them back in again.

But I have been trying!

Its exceedingly difficult when you have a desk job, that requires you to be sat down for a large proportion of the day, as this means more insulin and less exercise. And the more insulin, the worse the absorption rate is for Patrick (my Minimed Insulin pump). So, the more insulin you use, the more insulin you will need to use to compensate.

Anyway, things can quite easily go spiralling out of control.

Unfortunately, I didn't quite pick up on this one early enough. It was only a few days ago that I questioned why I wasn't getting much done, why I was snacking more and why I was constantly tired. Hmmm. It was obviously worse than I thought.

So, now I am back on track, trying to stabilise the levels. My fridge is full of veg, and there are tons of tasty snacks around the house and a gigantic fruit bowl too. But, as brilliant as this is, it isn't the answer to my problems.

I have changed my infusion set area, so hopefully the absorption rate will improve soon. And I am trying, trying, trying to stop working at my desk, but the credit crunch has meant that I need to work as much as I can.

So, where do I find the balance? How can I acheive it if I don't have time or money? Tricky, tricky, tricky. Well, I am heading off on holiday in a week, to somewhere that I hope will restore and rejuvenate. A good relaxation, lots of walking and swimming, sunshine and good food and company should help to balance out those levels again! Or, so I hope.

Patient Care

I recently went for an outpatient appointment at my specialist centre in the South of the UK.

It really has been worth every effort to get down to this specialist as they really understand and appreciate how much you try to do for your health, and understand human limitations.

In my experience, regular GP's and nurses do not seem to have nearly enough knowledge about what its like to live with Type 1 Diabetes on a day to day basis. Sometimes I even feel like I am filling them in on whats right and whats normal.

After having been made to feel desperately bad at a non-specialist centre, I feel incredibly blessed to be able to go to a place where they understand the realistic difficulties of living with diabetes.

By the way, this specialist unit is part of the NHS, thank goodness, so I don't even have to pay for this amazing level of care.

Diabetes and Driving

Recently I started learning to drive, and although it is tremendous fun, there are some concerns for drivers with diabetes.

- Firstly, when I sent off to get my provisional licence from the DVLA I made sure to tell them I was diabetic, which meant that I got a 3-year licence instead of the usual 10 years. They had to write to my doctor enquiring about my level of health and the number of times I had been submitted into hospital. Unless your diabetes has become quite so bad as to be submitted into hospital fairly frequently, then you should have no problems getting your licence.

- Getting insurance is now a fairly simple process, as insurers no longer ask if you have diabetes. This is because it is proved that drivers who have diabetes are no more of a risk than drivers without. Although, some insurers still do ask, so do give them the correct answer.

- One of the most vital things about driving is to ALWAYS keep food, blood sugar tester and glucose in the car. This is so vital and important, because you need to be prepared to sort yourself out at the very FIRST signs of hypo/hyperglycaemia. You ought not wait 10 minutes to find a petrol station for a chocolate bar, because your low will get worse and you will have to wait longer to recover before continuing your drive. Pull over at the first signs.

- Test your sugar level before and every hour during a long journey. This is especially important for those with poor control, as your sugar levels can fluctuate quite rapidly. Also, if you can see your sugar level is going up or down you can treat it before it becomes a real problem.

- Do not drive if you feel ill or wobbly. I have (accidentally so) driven whilst going low and going high. I can safely say that it is NOT a good feeling. In both instances - high and low - ones perceptions and control over the vehicle are very limited. Plus, because going low is very similar to feelings experienced when drunk, it is in fact illegal to drive whilst you are in this condition.

Overall, check your level and make sure the DVLA and your insurers know you are diabetic. This way you and other road users are SAFE. Enjoy driving!!

Diabetes and Driving

A Cure for Diabetes?

At a recent visit to my nearby hospital doctor I enquired about the new, upcoming diabetes "cures". I asked about stem cell research and other things, and wondered if these would be available to me in the future.

Stem cells are blank cells that can grow into any kind of cell; this means they can grow into the all-important insulin producing islets. These could then be transplanted into the body and potentially cure the disease. As a young woman with type 1 diabetes I felt that this research was something I would be able to benefit from in the next 10 years, at least this is what I was told by another doctor 4 years ago. However, my doctor said that the best possible way for me to maintain good control and keep a great amount of freedom would be to stay with my Minimed insulin pump. I didn't realise how risky the procedure might be or the amount of anti-rejection drugs I would have to take after such an operation. It seems to me that I need to make the best use of my insulin pump in order to keep my body at a good level of health and my sugar levels stable. And although there are great improvements constantly being made to stem cell research, it seems best to make the most of what we currently have and just hope for the future.

A Cure for Diabetes? - Stem Cell Research through the eyes of a Type 1 Diabetic

How to handle Airport Security with an Insulin Pump

Well, even after having been through many European airport security checks I can tell you with some authority that I still get really nervous until I am through. Not that there is any chance that one could be stopped, it is a medical device after all and they have to let you through.

Before you even set off from your home, make sure that you have a signed doctors note with you. This will get you out of any problems you may get stuck in.

At the security desk the thing to remember is to make sure you do the following two things:
- 1. State which bags have got needles in to the person putting your bags through the scanner, this should then no longer be a problem.
- 2. Make sure that same person knows that the thing on your hip is in fact not a mobile phone, it is an Insulin Pump, be really really clear about that. I was at an airport in the south of France recently and I said "Its an insulin pump" several times and still wasn't heard.

It may be a good idea to have with you a small piece of paper with the translations of important words you might need, especially if you don't speak the language at all, that way you can get past the confusion. Although most airports will have come across insulin pumps or diabetics before, that certainly does not mean that every person/security guard has, so be prepared.

Another thing to always remember is never to panic. This will only increase the amount of security guards around you. Along with this, remember that every airport has a different way of checking security, so don't be worried if they do something different. Here are how some different airports sort out security:
- In an airport in Austria I had to be escorted to the gate by a senior guard, who then had to notify the pilot that I had an insulin pump and needles in my bag, and ask if it was ok that I come on board (thank goodness it was!). At the same airport I had all my bags checked, opened and searched. I had to identify everything in the bag that looked suspicious.
- At an airport in northern Italy, they didn't ask me anything at all or question the needles or insulin pump.
- At an airport in London, they swabbed my insulin pump, which I found out afterwards was checking for traces of dynamite.
- At an airport in the south of France I had to go into a 'booth' with a security guard whilst she checked every single part of me for something suspicious. This was because they did not want to send me through the gate as it may have damaged the insulin pump. Most places won't do this, but this is also why it is important to make sure that someone knows before you walk through in case it is potentially damaging to your insulin pump.

Any questions you want to ask about this article, feel free to ask.

How to Handle Airport Security with an Insulin Pump by Alissa Carter