“Are You On a Diet?”

I can’t begin to describe some of the funny looks I’ve been getting when I sit down with my bag of almonds at morning tea time. Those looks that just scream of “is that all you’re eating?” or “are you on a diet?” or “are you not feeling well?”

The young guy in the fluoro shirt who should be skulling choc milk and having a Woolies donut, eating almonds? Yep, I get it. While my diabetes is pretty transparent, people still forget or don’t realise it’s there.

Last week, one of my work Mums brought in a tray of leftover sweets to share from her weekend. As usual, I got the typical Nonna treatment. “Go on. Take it!” I politely said that I was trying to be good, and asked her to save me something for later. “Why?”

Last week, we had a bake sale in the staff room at work. I felt guilty for not buying anything. As I sat down in front of all of the tempting cake with my bag of almonds, someone remarked to me “you’re being good today, are you?”

I don’t put a lot of things off limits when it comes to diabetes and food. So long as I feel that I truly do enjoy eating something, then it is worth the effort. But I absolutely hate to perpetuate the myth that someone with diabetes can’t eat whatever they choose. I felt compelled to explain my choice not to indulge in cake at 10am on a work day to the staff room table.

After six months of experimenting and fine tuning, I am finally starting to see some consistency in the mornings while I am physically active at work. I am starting to feel that sweets are just not worth the effort while I am working. I will be guessing the carbs. I will be giving a generous dose of insulin. That insulin is more sensitive while I am physically active, and I am more likely to go low. What tends to follow is a day where I am trying to juggle highs and lows. I don’t feel very motivated to manage my diabetes well after days like this, and it’s just not fun. 

I eat a satisfying breakfast when I wake up. My treat in the morning is my Coffee Club Cappuccino with no sugar, enjoyed with my team mates. It’s 12g of slowly digested carbs, and I can handle that just fine.

But at 10am, I eat almonds. Almonds have minimal impact on my blood glucose while I am working. They don’t send me into a vicious cycle where I am correcting highs and warding off lows. Turning down cake is a small price to pay for the juggling act I so badly want to avoid while I am at work.

Plus, the cake will still be there to enjoy later, right?

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A New Addition to Team Frank

“What else has happened in your life since diabetes came along?”

“How comfortable are you when you pull out your insulin pump or prick your finger?”

“What concerns you the most about living with diabetes?”

These were just some of the ice breakers as I sat down with Linda, who I hoped I would be able to call my new diabetes educator, in a private clinic last week.

After six years of diabetes care in a public hospital, this was a completely different experience. My diabetes clinic-that-wasn’t-technically-a-clinic was situated behind the corner pharmacy store on a quiet inner city street, rather than a bustling hospital campus. My session was in a room on the ground floor, with an open window looking out into the yard behind the building. There was no sense of urgency, nor did I feel that my appointment was being rushed. There were no interruptions throughout the whole hour. I was being spoken to like a person who had diabetes, rather than the diabetes patient. The place certainly didn’t feel super clinic-y, either. Everything just added up to a nice, casual vibe. 

We looked over my diasend uploads, and straight away Linda picked up on trends of red numbers on weekends. Something my diabetes brain probably should have picked up on sooner. I admitted to cruizy days of weekend eating that were often triggered after a 10am hypo, and she helped me nut out a strategy to continue to cruise through and see a little more green.

I wasn’t really swayed one way or another as I talked through my diabetes management, either, and I wasn’t sure if this was a good or a bad thing. I suppose, like this decision, it was mine. It was diabetes on my terms. No judgement.

As we approached the end of the hour, Linda asked me how I wanted to proceed after today. I knew how I wanted to proceed. Yet I still hesitated for a moment.

I had spent the whole hour talking over my diabetes management so confidently. The numbers on my diasend report were pretty good, overall. I had reached the hba1c goal I had set myself at the beginning of the year. This session reassured to me how proactive I am in being able to manage my diabetes. Did I need to be here?

After being pushed towards self management for so long at the hospital, it felt strange to have the option there. After all the time constraints of the busy diabetes clinic, it felt super weird to have the choice of when my next appointment would be. I was paying for it, of course. But it still felt strange.

I’ve decided I want a three month catch up with my diabetes educator. As good as I may be, I still need that reassurance. I need that fresh set of eyes that can pick up things that my diabetes brain cannot. I’ll continue to see the endocrinologist at the hospital, and get referrals for all of my important check ups there. Most importantly, I’ve got someone to touch base with inbetween. If the need arises, I’ll be able to call or e-mail Linda, and make appointments inbetween. I already rest a lot easier at night knowing that I have someone reliable at the ready.

Two years ago, I doubt I would’ve had the confidence to be able to identify my needs, to speak up for what I wanted, or to go through with such a big decision.

Today, I’m confident that this is one of the best decisions I’ve made for my diabetes care. With a new addition, Team Frank feels stronger than ever.

BTW: If you’re in Perth and seeking out private diabetes care, I can’t recommend Perth Diabetes Care enough.

Pins and Needles

When I began experiencing pins and needles in my feet less than a year after being diagnosed with diabetes, I was freaking out.

The minute I was diagnosed, I had been told to look after my feet. To check them every day. To look out for cuts and abraisions. I had been made well aware of the increased risks to the feet for people with diabetes. I cringed at the thought of people needing to have limbs amputated.

I was convinced that I had done something wrong. I cursed myself for how many hypos I had been having at the time. I felt ridden with guilt for not being able to better manage my blood sugar levels. It was my first year, for crying out loud!

Foot complications were all I could think about. Mum was in disbelief when I told her I was thinking of calling in sick to work, in favour of trying to find a podiatrist that would see me on a Saturday. (I was known to be a bit of a workaholic in my first job…)

I remember standing behind a register the following day, unable to think of anything other than the sensation in my feet. I arrived home to an empty house that evening, having self diagnosed myself with circulatory problems. I pulled the cover off of the dusty treadmill that Mum and Dad bought us kids for Christmas, but never used. I put on my sneakers and began running, frantically, in an attempt to boost the circulation in my feet. And I never run!

Of course, I had worried myself over absolutely nothing. With less than one year of diabetes under my belt, it was highly unlikely that I had anything to be seriously worried about. My diabetes educator even told me so much, when she squeezed me in during her lunch break to chat about it the following week. I had automatically associated the pins and needles in my feet with my blood sugars, which did not pose any foreseeable risk.

My podiatrist couldn’t find any circulation problems with my feet either, but commended me for coming in to check. And no sooner than my mind was put at ease, the pins and needles had passed.

My diabetes is getting older. With every passing day, diabetes becomes a larger fraction of my life. I constantly doubt myself. Whether I am doing enough to stay healthy, and on top of this damn condition.

There was a quote I found on Twitter about diabetes complications, that has stuck with me for some time. It went something along the lines of this.

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Every time I’m having a bad day, and every time I’m doubting my self management efforts, I repeat these words to myself.

And again. And again. Until they sink in.

Skyrocketing Levels

A couple of weeks ago, I hit a bit of a speedbump with my blood sugar levels. I began skyrocketing after almost everything that I ate. It took several correction doses and hours of temp basal rates to get me out of my mess each time.

This is what I would often witness on my Libre after a meal. My levels would simply climb and climb and climb until they reached the high teens.


My first instinct was that my body was responding to changes in my diet. I have been eating less carbs, and more protein, consistently. If I needed proof, the total daily dose of insulin in my pump history was at its lowest, and most consistent amount day to day. I was still suprised, though. To me, the changes weren’t anything radical. I had been bolusing for my protein. I hadn’t cut out carbohydrates completely, nor was I restricting my food intake.

But it seemed that my insulin was a lot less sensitive than it once was.

My first thought was to revisit my basal rates. I was convinced they might need revising upward. Moreso after reading this article, which told me that the “status quo” for people not on high carbohydrate diets was 50% basal and 50% bolus (mine are skewed in favour of bolus insulin). I was convinced that if I fixed that, my mealtime insulin would do its job properly once again. However after going low during two separate basal tests, I conceded that my basal rates were fine.

My levels were still spiking after meals, so my next thought was my insulin to carb ratios. The spikes were absolutely ridiculous, even with lower carbohydrate meals. I adjusted my insulin:carb ratio from 1:10 to 1:6, and lowered my insulin sensitivity factor by the same proportion.

1:6 was quite a scary ratio to use, because I had such big amounts of insulin on board after eating a meal with only 30g of carbohydrates. The potential to go low from after meal activity was amplified, and pump sites would ultimately need more frequent rotation. Thankfully, it became clear that the 1:6 was sending me too low after meals, and I eventually settled on 1:8.

The 1:8 has been working great, and I have learned a few things about food and my blood sugar spikes since. For instance, on the weekend I ate porridge, which I thought was relatively low GI. Apparently the instant, microwaveable kind, is not. Not even close. And despite accurate carb counting, pre bolusing by half an hour, and a waking BG of 7.9, my levels just climbed. 9.2 an hour later, 14.7 after that, and 15.7 after 2 units of correction. Instantly, bells rang in my head as I recalled occurrences of skyrocketing blood sugar levels after Weet-Bix, potatoes and an overripe Banana.

So, yes, it does seem that less carbohydrates has reduced my insulin sensitivity, or increased my sensitivity to glucose. But it also seems that my insulin to carb ratio is less effective when I eat higher GI foods. And perhaps there were also some stress hormones in play a few weeks back, that were contributing to some of those skyrocketing blood sugar levels.

I absolutely hate that diabetes is forever changing. There’s no guarantee that what’s working today, will work again tomorrow. Or in a month. 

But nonetheless, it does feel good to be somewhat in control once again…and a little wiser…

Libre-less

It’s no secret that I have continued to use the FreeStyle Libre with much enthusiasm in recent months, albeit intermittently. I frequently talk about it on Twitter, I often refer to trend arrows in my blog posts and it’s a popular subject of messages that arrive in my e-mail inbox. Not to mention how instagrammable that graph is, especially when the line is flat.


Yeah, paying $95 to monitor my blood glucose like this every two weeks absolutely sucks. But overall, it has improved the quality of my life, and I am starting to come around to justifying those costs.

For my needs, it is perfect. I check my blood sugar frequently through the day, so this fits the bill nicely in adding some convenience to that. I like that the hardware is minimal, and that it doesn’t use a lot of real estate on my body. The only upkeep is the round sensor every two weeks, which makes it a cheaper alternative to Continuous Glucose Monitoring.

I guess where I have struggled the most is setting boundaries around the data. I find it easy to become obsessed with the numbers after wearing it for too long.

My behaviour hasn’t been too healthy during the life of my last sensor. I’ve been compulsively checking my levels before I’ve even finished my dinner, and again on the couch in the evenings while I’m watching television. The trend arrows have been really frustrating to see at times, and I find it hard to remind myself that they are only temporary. Against better judgement, I do tend to micro manage data, which sends me low far more often than I should be.

So why haven’t I taken a break from it sooner? Firstly, I wanted to give myself every advantage in getting the best hba1c that I could. Turns out that I was being much too hard on myself, because it exceeded my expectations by a country mile. Then earlier this month, I hit a speedbump where I was literally spiking after everything that I ate. I was too scared to be without it until I had figured the problem out. But I am slowly moving past that issue (more on that, soon).

I’ve been Libre-less for almost a week now, and all that anxiety is gone. I stop to check my blood sugar prior to meals, and one and two hours after meals. I’m forced to think about whether I actually need to check my blood sugar, or whether I’m simply doing it because I can. My head isn’t consumed by numbers so much, and my mood isn’t dependent on trend arrows. In fact, the numbers have been better than they were during the life of my last sensor, and I’m not hypoing so often from micro managing.

The morale of this story is that time away from the tech is equally as valuable as the tech itself. It gives me a chance to actually appreciate the tools I am using, and what I’ve been able to achieve with them.

My life is more than just numbers, and time away from the tech is definitely helping me to realise this once again.