Author: Frank

Missed Diagnoses

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Dad had been laying on the couch for several days earlier this month. He had been unwell since a family function where he had eaten what we suspected to be an off piece of fish.

A trip to Bunnings at the beginning of the week took its toll on him, quickly wearing him out. As the week progressed, he spent more and more time on the couch. His voice was so croaky, and I could tell that even the simple act of talking used up a great deal of his energy. Towards the end of the week, he could barely remain at the table for the duration of dinner. He was still eating very little, despite my Mum constantly reminding him that “you have to eat or you won’t get your strength back.” He could barely even get up off the couch without puffing.

He went to see his doctor at the beginning of the week, who told him it was nothing more than a simple virus. When he returned again later in the week, his doctor told him that this “virus” was simply taking time to pass, and that he needed to drink fluids, eat soft foods and rest.

We approached the one week mark, and Dad wasn’t improving. Mum broached the idea of testing his blood sugar levels when I woke up on the Sunday morning, and it took me by complete surprise. Diabetes didn’t even occur to me once throughout that whole week. Maybe it was the initial symptoms of food poisoning that had thrown me off. In fact, it’s only now that I am writing this, that I am realising how much these symptoms did mirror that of type 1 diabetes.

When Dad mentioned that his mouth was extremely dry and that he might need to be given a saline drip, the reality that he might have diabetes hit me. I could feel the knots in my stomach tightening, and I knew that I needed to check his blood sugar level. I grabbed my meter, placed a fresh Lancet into my Lancing device, and tested. His blood sugar level was 8.5 mmol. Slightly elevated. He told me he had eaten a biscuit when he woke up, and I breathed a sigh of relief.

We took Dad to the emergency room that day, well aware that a week had passed and he wasn’t getting any better. He ended up staying in hospital for a week and received treatment for something much more serious than a passing virus. Two weeks on, and he’s back home and on the road to recovery.


So I guess the morale of my story is that missed diagnosises aren’t exclusive to the diabetes world. They are very much a reality in the non-diabetes world, as well.

Dad visited his doctor twice in that week prior to going to hospital. While I don’t expect a General Practitioner to be an expert in every illness or ailment out there, I do expect that he would take a patient’s concerns more seriously. Offer referrals, or suggest medications. And I fully expect that he is not the only GP in the world today who is missing diagnosises.

So, that’s where I’ve been these past couple of weeks. I haven’t really had the time or the energy to blog lately. I haven’t really been able to find the right words, and diabetes hasn’t really felt very significant compared to what’s been going on.

But it is good to be back behind the wheel of my blog once again. Stay tuned. 

I Don’t Have the Answers

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I’m not burned out. But I’d be lying if I said I haven’t been frustrated when I haven’t been able get things right.

For years, I’ve dreamed of the day where I’d finally get things in check. Where I would run decent blood sugars and feel somewhat in control of this condition. It would always be tomorrow. Tomorrow would turn into next week. Next week would become the first of the month. Then, New Years would be just round the corner…

I started using an insulin pump, and suddenly those dreams actually felt a little more attainable to me than they were on injections. Things were improving. I definitely felt more confidence, and control in my actions around my diabetes. My levels weren’t peaking so high, so often. I wasn’t making wild guesses. I was motivated to take more measured approaches. I was motivated to experiment. I was finally getting things right.

However the more I got things right, the more I kept expecting of myself.

When I couldn’t get things right, I got frustrated. I blamed myself. I rebounded with junk food. I felt increasingly guilty and found myself thinking more and more about the long term consequences of my blood sugar control.

After four weeks of FreeStyle Libre monitoring recently, I felt confidence in going back to fingersticks after fine tuning my morning routine. After near perfect graphs on the Libre, suddenly I was getting high readings after breakfast. Suddenly I had no idea, or confidence in where my blood sugar levels were sitting anymore.

Was it just a bad week? Stress? Lack of sleep? Food? Change in activity levels?

Who the hell knows. Thankfully, things eventually returned to normal.

I look back at some of the posts I’ve written recently, and I can see how hungry I am for answers. For some sort of solution. Expecting that there’s some magic way to get diabetes down pat, once and for all.

Let me clue you in on something. There isn’t. Everything affects diabetes. Anything and everything. It’s impossible to achieve perfection all the time.

Sure, I will continue to work at my diabetes. I will continue to share what works, and what doesn’t work for me and my diabetes.

But I don’t have all of the answers to managing diabetes. And I’m learning to be okay with that.

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Food, Glorious Food

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Last night’s OzDOC chat on food was engrossing enough to draw my attention away from the first ten minutes of Australian Survivor, so I’m elaborating on it today.

The dietary advice I first received after my diabetes diagnosis was to eat low fat, high fibre foods that were digested slowly. I was taught to count carbohydrates by my diabetes educator, which eventually faded into regular guesstimates while I was on insulin injections.


I think the most bizarre thing is this idea that we have to eat to avoid going low, rather than adjust insulin! I also hear it from healthcare professionals, and it’s often referenced in diabetes books and magazines. I sometimes wonder if they’re just trying to cover their backs! 

I relied on this advice heavily in the beginning. I religiously sought out foods that were low in fat and had a low glycemic index ranking, regardless of their nutritional value or carbohydrate load. I continued to eat a lot of processed foods that were seemingly healthy – cereals, juices, yoghurts, canned fruit, brown bread, muesli bars – and ridden with hidden sugar! I often remember testing my blood sugar at uni after breakfast, unable to make the connection between a level of 17 and the foods I was eating.

Since I began connecting with other people with diabetes, I’ve read a wide variety of stories and perspectives on food choices. I’ve certainly drawn inspiration here and there, but I don’t really feel that I’ve taken dietary advice from any one source in particular. Ultimately it’s about finding an approach that will make me happy, while achieving the BGLs that I aim for regularly.

In the beginning, I definitely used to shy away from foods that weren’t blood sugar friendly. And when I did eventually cave in and eat them, I would feel super guilty for the numbers that followed. One of my biggest shifts in the past year or so has been having more confidence in working my way around the foods that I want to eat. Carb counting and pre bolusing insulin have been my best assets in these past couple of months. I learn from experience. Over time, I’ve gained a pretty good idea of what effect certain foods will have on my blood sugar levels and how I can work my way around them.

Another big shift has been changing some of my old habits around food. Cutting the sugar out of my coffee and tea was one of the hardest, but most worthwhile ones. Ditto for sugary drinks. I don’t feel so guilty for my three coffees a day anymore! Afternoon snacking still remains my weakness, but I am trying to be a little more prepared these days rather than going back and forth from the cupboard and fridge. I still do eat carbohydrates, but in a lot more moderation and balance than I once did. I don’t shy away from higher fat foods either, especially for nutritional value such as iron or protein.

I still do eat chocolate. And cannoli. And donuts. When I go out for meals, I usually give it my best guess, regularly test and try to enjoy myself.

There’s no right or wrong approach when it comes to diabetes and food. But I know that this food approach is the right one for me at the moment, because it makes me happy and I can achieve the BGLs that I aim for regularly.

Dawn Phenomenon, Breakfast, Physical Activity and Diabetes

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A couple of months ago, I wrote about the relentless hypos I was having at work. There have been days where my blood sugars have been bouncing up and down like a yoyo. The smallest insulin correction would be enough to send me plummeting within half an hour. My Libre would then show me rebounding after a hypo (and I now know that the Libre tends to pronounce movements in my BGLs). I would have the urge to correct it again, only to end up low once again. This seemingly vicious cycle made it impossible to obtain a steady line while I was at work and left me feeling exhausted at the end of the day.

The one thing I genuinely do miss about injections is that insulin sensitivity during physical activity was hardly an issue. I don’t remember having to pay half as much attention to my diabetes at work while I was on injections. I’ve felt very conscious of the number of times I’ve had to tend to diabetes in a day. Unlike a Lantus injection, my pump delivers basal insulin in tiny amounts throughout the day as I’m working. In addition to physical activity, dawn phenomenon and breakfast boluses are also thrown into my morning diabetes equation.

After a lot of trial, error, and notes in my diary, I finally feel as though I’ve got my mornings down pat in recent weeks.

The obvious one has been making sure that my basal rate is right. I cannot stress how difficult morning blood sugar levels are to manage if I do not wake up in range. No amount of correction seems to be able to fix them, and I end up really grumpy at 8am as I see my levels soaring after breakfast.

A couple of weeks ago, I noticed that my levels were climbing at around 3am each morning, warranting a change in overnight basal rates. Until that was fixed, I wasn’t able to properly focus on the mornings. Another thing I’ve learned is that my waking basal rate (when my liver begins dumping extra glucose) needs to run for at least a full hour before I wake up. Even a gap of 15 minutes is enough to screw up my morning basal test. Going on intuition seems to have done the trick in fine tuning the remainder of my morning basal rates.


Breakfast really has been a case of trial and error. I’ve learned that I do not need to subtract any carbohydrates from my breakfast insulin dose. Subtracting 5g from my breakfast dose is the difference between a post prandial result of 9mmol or a post prandial result of 15mmol. My pump will also add a correction dose to my breakfast bolus if my blood sugar level is over 7mmol. 


I’ve learned that I need to ignore it unless my blood sugar level is above 8mmol, and that I need to subtract insulin accordingly if my blood sugar is lower than 6mmol.

Morning coffee at work normally happens anywhere between 8.30 and 9am. My medium cappuccino with no sugar probably has around 15g of carbs, 10g of which I do not need to bolus for. It’s been so hard to wrap my head around these tiny insulin doses, but they are indeed enough! Pre bolusing is also not necessary, as I slowly sip my hot coffee when it first arrives.

Morning tea comes anywhere between 10 and 11am, and is usually a banana which is weighed before I leave home. Again, bolusing for 10g less carbs seems to do the trick, as do the rules for correcting.

Not foregoing what I love in the mornings has been really important to me. It would have been easy to simply forego breakfast or the morning coffee, but I know that would have made me unhappy (and hungry!). I work diabetes around my life and my activity, and not the other way around.

It’s been a lot of hard work, but I do genuinely feel that I have my mornings down pat. Instead of going up and down multiple times in a day, it might happen 2 or 3 times in a week. Levels are also looking great, thanks to continued pre bolusing and my moderate carb approach. I plan on taking a break from my Libre after today, and I’m quite confident that I will be able to manage just fine on finger sticks for a while.

I’ve been nominated for a Wego Health Activist Award. If you enjoy reading my blog, I’d really appreciate your endorsement which you can do by clicking here. 

Guest Post: Surviving Insulin

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Rachel Zinman was diagnosed with diabetes in 2008 at age 42, which she now knows to be type 1 Latent Autoimmine Diabetes in Adults (LADA). Rachel lives and breathes yoga, and passionately shares with others how yoga can help with managing diabetes. I absolutely love Rachel’s unique perspective on a delayed onset of type 1 and having to slowly coming to terms with insulin. Today I’m sharing an excerpt from her new e-book, Surviving Insulin, and you can grab your free copy here.


People still think I’m the same as I was pre diagnosis. It’s hard for them to wrap their head around the fact that I’m not in control anymore. There was the life I had before diabetes, the one where I ate pretzel croissants, pizza bread and chocolate and the one I have now; low carb meals, afternoon walks and 15 finger pricks a day.

The only person with diabetes I ever knew was when I was in high school. I can still remember her ID bracelet circling her wrist and the diabetic friendly sweets she ate on the bus. She never complained and never explained. I knew it was something awful but how can anyone understand what it’s like to live with a disease that requires your attention all day, every day. I have never felt so guilty about food in my life. Always asking myself; did I eat too much? too little? did I walk enough? inject enough?

And by the way…. I am sick of people telling me how strong and brave I am. F-k that! If I could jump off the dia-boat I would. Who wouldn’t? Bravery and strength have nothing to do with it. How would you feel if you got lumped with something you didn’t ask for and didn’t do anything to get?

That’s why I get so frustrated when everyone keeps asking why it took me so long to go on Insulin. If you’d been in my shoes? Wouldn’t you have tried everything too?

I don’t regret one minute of trying something alternative. Each practitioner gave me hope. I think that’s what someone who doesn’t have diabetes doesn’t quite grasp. It’s hard not to equate the words “no cure” with “no hope”. I’m still hopeful, but I’ve learnt to be realistic.

I’m a realistic optimist.

I take my time with just about everything now and it’s not because I’m into “self care.” If I rush out the door and don’t have everything I need its a disaster. People say they admire my discipline. But the truth is… if I could drink martinis and pig out on ice cream I would.

So do I believe in fate? Not really…. It’s like you get what you get. And Yes I’m angry enough about the unfairness of it all to punch a wall. But I also feel grateful.

Before diagnosis there was no off switch. I was used to doing, eating and behaving as I saw fit. I made up my own rules and lived my idea of what it meant to be healthy. I ignored the medical establishment and put my faith in things that eventually wore thin. That’s not to say that I don’t use alternative health and healing methods to accompany my allopathic regime. It just means I’m no longer hiding in the cupboard at the thought of taking a Panadol.

And gratitude has been a big plus in my life. Everyday I literally imagine humbling myself at the unknown machinations of creation. There are some things that can’t be answered. Understanding that I’m not alone in having unanswerable questions makes things easier to bear. But that doesn’t mean that some days aren’t crappy. So… If like me, you don’t feel like being grateful or couldn’t be bothered with self care and wind up telling your friend to go jump in a pond because they’re just not getting it?

You’ll survive…

Rachel also blogs at yogafordiabetesblog.com, and you can follow her on Facebook, Twitter and Instagram.