Author: Frank

T1 Talk: National Diabetes Week Edition

1 Comment

We’re back!

My friend Bec of Sweet and Sour Diabetes and I originally designed these conversations as a way to highlight the uniqueness of our experiences with type 1 diabetes, despite both being diagnosed just days apart with only a few years difference in age.

We’ve slacked off a bit with these conversations this year, but we did make up for it with some great conversation while taking in the breathtaking sights of the Parramatta river when we finally met up earlier this year. This is another amazing example of how diabetes has made my world a lot smaller. 

Today, we’re back to dissect all things National Diabetes Week.

The theme of this year’s National Diabetes Week is ‘It’s About Time,’ focussing on knowing the signs and symptoms of both types of diabetes. Would you have benefitted from a greater awareness of the signs and symptoms of type 1 diabetes when you were diagnosed?

Frank: I presented to my doctor with all of the typical symptoms of type 1 diabetes – feeling tired, thirsty, going to the toilet a lot and a looking much thinner. In hindsight, it’s hard to believe that this doctor was unable to recognise any of these symptoms. He diagnosed me with a simple virus, ordering bed rest and lots of hot fluids. Three days later I wound up in hospital vomiting, panting and an extremely rapid heart rate.

Obviously nobody wants to wind up in hospital. Physically, I definitely would have benefitted had that doctor, or the people around me, known those 4 Ts of type 1 diabetes. Mentally, I’m not too sure how I would have handled that diagnosis had I been diagnosed in my doctor’s office. Initially, having type 1 diabetes was nothing compared to having all of those physical symptoms finally relieved.

Bec: It’s so easy for doctors to miss the signs, because they do mimic that of a virus. I agree, for me it would have been a much faster diagnosis if I knew the signs. I was chronically thirsty for such a long time, but I didn’t know that could be a sign of type 1. I delayed going to my doctor for so long that when I eventually got there my blood sugar was in the 40s.

Let’s talk about type 2 diabetes. What do you think people at risk of developing type 2 diabetes need to know?

Frank: As a guy, we tend to only go to the doctors when we’re dying. Overall, people tend to just soldier on when they’re unwell, rather than stopping to look after themselves and recover sooner (our workplaces and cultures could do a lot more to support self care). Furthermore, it’s a lot harder for people with type 2 because the onset is much slower and most will feel quite normal.

Honestly, I think anyone at risk of developing type 2 could minimise that risk by simply staying in touch with their healthcare professionals, maintaining their regular checkups and bloodwork. Just as you and I already do because we live with diabetes.

Bec: I completely agree there is a lot more we could be doing to prompt people to seek medical attention and take care of themselves. People with a known risk of developing Type 2 absolutely need to know the signs, and surround themselves with a good healthcare team as early as possible. This means they have support should the need arise.

I think there also needs to be more education on what Type 2 diabetes is. It’s not all their fault, and I think that assumption and misconception is what delays people seeking medical attention.

What do you think are some of the barriers to people being diagnosed with either forms of diabetes earlier?

Frank: Too many people don’t know the signs and symptoms of type 1 diabetes. Our stories both demonstrate that. It’s scary to still hear stories online of people dying from undiagnosed diabetes today.

I think a lot of people diagnosed with prediabetes or type 2 diabetes don’t have supportive healthcare professionals. Many people are sent home by the doctor being told to lose weight and exercise more, without being referred to an expert such as a Credentialled Diabetes Educator. People will often feel guilty, confused or even in denial while the condition progresses further.

Bec: Type 1 is completely unknown unless you have a personal link to it. I guess all we can do is share our stories to try and combat that. It takes time for diagnosis because we don’t know what we’re looking for, and Type 1 isn’t the first thing that pops into your head.

Type 2 again has so many misconceptions that it puts people off seeking help. Why go in when you’re just going to be told the same thing time and time again- eat well and exercise. There needs to be more support from health professionals, more awareness of the real nature of Type 2 and more compassion from everyone. No one chooses to get a chronic illness.

The 4Ts of Type 1 Diabetes

3 Comments

Happy National Diabetes Week! This year, it’s once again all about raising awareness of the signs and symptoms of both type 1 and type 2 diabetes. I know that I’ve been critical of diabetes campaigns in the past, but hit play and let me tell you why I think this a really good one.

(If you listen carefully, you might even be able to hear the whirl of the washing machine in the background…)

Basal Rate Intuition.

1 Comment

This morning, I woke up to a relatively flat line and a number in range.

I shuffled into the kitchen, knowing full well what I should do. I stared longingly at the coffee machine, knowing full well what I should do.

Instead, I took a seat at the table and opened up my iPhone. After I had whiled away some time, I headed back into my room and gave that dreaded swipe of the FreeStyle Libre.

I was almost expecting to see an upward trend arrow, indicating that I would need to go back to the basal rate testing drawing board and start again tomorrow. I wasn’t even too sure if I would be that disappointed, because then I would be able to validate my need for coffee.

Instead, I was pleasantly surprised to see a result that had barely moved since waking up, accompanied by a steady trend arrow.

I don’t really know what my morning basal rate is. Not since my morning routine changed a year ago. I just make small tweaks here and there, going by how my blood sugars react after my breakfast. I’ve been putting off doing a proper basal test for ages, because it’s so damn hard to wake up without coffee or breakfast. Not to mention that a basal test will only work when you wake up to levels that are steady and in range (less than 6mmol).

Since starting on the YpsoPump, I’ve been forced to make some tweaks to my morning basal rates to account for its limitation of only being able to set basal rates on the hour rather than half hour. I’ve noticed my blood sugars trending upward after breakfast recently. I’m also not as active as I once was at work, which could warrant an increase in insulin as well.

As I got ready for work, drove in and began my day, I was pleasantly surprised by the result of every single scan of the Libre.

I wasn’t expecting that diabetes would let me off this easy after just one day. Or that my basal rate intuition was this good.

With a mental ‘tick’ against my morning basal rates, my only homework for tomorrow is to drink coffee and revisit the insulin to carb ratio I’m employing to cover it.

Review: Yoga For Diabetes By Rachel Zinman

1 Comment

I recently had the pleasure of reconnecting with fellow diabetes blogger, yoga instructor, friend, and now author Rachel Zinman in Sydney this May.

Rachel and I first connected back in 2015 during our first Diabetes Blog Week, and I’ve since ended up with a super fan that I can’t seem to get rid of! Despite the two of us having completely different backgrounds, Rachel is one of those people who is so easy to get along with. She is so warm, enthusiastic and really takes everything in around her.

Rachel has been a massive source of support, encouragement and inspiration in my blogging and advocacy efforts. She comes across exactly as I imagined her online, which I think is a true testament to her character.

I’ve been so inspired watching Rachel’s efforts in getting her book, Yoga for Diabetes: How to Manage Your Health With Yoga and Ayurveda, off the ground. After a successful crowdfunding campaign, Rachel eventually got the attention of a publisher and has since been putting her energy into a book tour across the US over the Summer.

Since returning to Australia earlier this year, Rachel has been touring the East Coast teaching Yoga and launching Yoga for Diabetes. After asking where the best place was for me to buy the book, Rachel produced one for me from the back seat of her car.

Rachel opens the book with her own story, talking about the long hours spent in New York learning about and teaching Yoga under a mentor. After experiencing the horror of 9/11, Rachel moved back home to Byron Bay, Australia with her young family. As a health conscious person, Rachel was in disbelief upon learning that a routine blood test showed a slightly elevated hba1c at the age of 42. With a slower onset of type 1 diabetes (LADA), Rachel spent many years trying to cure herself with natural remedies before finally accepting her diagnosis and taking insulin.

The book has definitely been written in the spirit of inspiring beginners like myself that Yoga could be for me. Rachel delves into the concept of Ayurveda, which is an ancient ‘science of life.’ She talks us through the three doshas – Vata, Pitta and Kapha – which are elements that combine in our bodies in varying amounts.

Exploring the characteristics of each of these three doshas was pivotal in connecting me to the concept of Yoga. I could really relate to qualities of a Vata Dosha such as being enthusiastic, full of ideas, unnecessarily overwhelmed and thin (I already hear that more than enough!). To a lesser degree, I could also relate to Pitta qualities such as being very focussed and hardworking, while also feeling occasional frustration and burnout.

Knowing what dosha, or combination of dosha you are, is pivotal in identifying the kind of Yoga practice best suited to you. There’s a questionnaire later in the book that will give you an answer, followed by many beautifully illustrated sequences customised to your Dosha.

The book moves onto the mind, as Rachel explains that Yoga can help us to become more aware of our thoughts and get us out of our habitual need to identify with them. Especially when it comes to the thoughts about our condition, Yoga can help us to feel content, relaxed and not thinking about diabetes for a moment.

The breathing and meditation exercises illustrated in the following two chapters gave me a good idea of what Rachel was talking about in regard to the mind. Getting on the ground and practicing some of the breathing exercises left me feeling really relaxed, focussing purely on things like feeling breath moving from my chest to my belly.

So what can Yoga offer those of us living with diabetes? In Rachel’s own words:

“A simple break from the intensity of all that the body throws at us.”

“Practices, lifestyle changes and systems of thought that enable me to face this condition each and every day with a positive outlook.”

“A great friend and companion that will hold your hand through all of the ups and downs that you are bound to experience.”

Over the course of this year, self care has become a pretty big priority for me to avoid burning out (more on that soon). Knowing absolutely nothing about Yoga, I guess I was most intrigued as to whether this book might help me to find a bit more mindfulness in my life. While I don’t think I’ll become a devoted yogi like Rachel, I have found another awesome self care tool to help put my mind at ease, particularly during these short Winter days when I don’t get outdoors as often as I’d like.

Yoga for Diabetes: How to Manage Your Health With Yoga and Ayurveda is now available on Amazon.

You can also follow Rachel’s book touring adventures on Facebook, Instagram and her blog.

One Messy Night.

1 Comment

I was ready to go to bed.

As I watched my blood sugar slowly climb into the 10s, I gave a unit of insulin to correct. Thinking about the after effects of stacking my dinnertime insulin on top of a late afternoon coffee and one of Nonna’s biscotti, I set a temporary basal rate of 150% for 2 hours to help that insulin better do its job.

I set the alarm on my iPhone for 1am and switched off the lamp on my bedside. With a nagging feeling of doubt as I turned on my side, I fumbled for my pump in the dark and gave another unit.

DURN! DURN! DURN! DURN! 

I hastily fumbled for my phone to silence the shrieking alarm, before switching on my bedside lamp again. As I swiped my Libre reader, I was half expecting see blood sugars heading into low territory.

Instead, I was actually a pleasant 13.8.

I was in disbelief. However, I thought it could be plausible after having pasta for dinner. I reached for my insulin pump, and gave a rage bolus of 3 units.

ZZZZ! ZZZZ! ZZZZ! ZZZZ!

My rage clearly wasn’t enough to fuel the delivery of this bolus, which was stopped in its tracks by a very irritating occlusion alarm that was hissing and vibrating at me for attention.

I ripped the cap off my infusion site, which revealed a perfectly clear looking site. A poke and prod around the area showed no signs of any discomfort. I primed several units of insulin out of my pump line, watching it spill over the cannula and pool around the cap to satisfy my paranoia. I held my pump line up in the air and ran it through my fingers, watching it like a hawk for signs of air bubbles.

With my paranoia satisfied, I reattached the cap to my infusion site and delivered the remainder of the bolus that my pump had cut off. I set another temporary basal rate of 150% for the next two hours, setting my alarm for 3am.

When I stirred at 2.17am, feeling rather uncomfortable, my Libre reader revealed a reading of 17.7 and rising. I hastily grabbed my pump and went to deliver another rage bolus of 5 units.

ZZZZ! ZZZZ! ZZZZ! ZZZZ!

That hissing, vibrating occlusion alarm sounded once again, stopping my rage bolus in it’s tracks.

By this point, I was furious as I flung my bed covers away from me and was forced out of bed.

Finally, I ripped the infusion site away from my stomach. There was no kink in the cannula. There were no signs of blood, bruising or bleeding on my stomach where I’d placed the site. Everything looked fine, and I was convinced I had just wasted a perfectly good site.

After inserting a fresh infusion site, setting a temporary basal rate and delivering my third rage bolus of the night, I was finally able to close my eyes.

I wasn’t surprised to learn that I’d slept over my 6.25am alarm. I gulped down my coffee, showered, and hastily threw two pieces of frozen Pane Di Casa into my bag to toast at work.

I soldiered on, reminded of just how much responsibility rests on my shoulders every day.