Diabetes and Emotions

Minimise The Lows. Minimise The Lows.

7 Comments

“Are you alright?”

“What’s wrong?”

“You seem quiet today.”

I knew why my work mates were asking. Diabetes has been affecting me so much at work lately, to the extent that my feelings could be read off my face with ease.

“I’m fine. It’s nothing.”

It wasn’t nothing. But the last thing I felt like doing was talking about it.

Going to work with the insulin pump has really tested my patience. I’m on my feet and moving around for much of the day, which makes insulin a lot more sensitive than normal. My work day is a prolonged period of physical activity, and not simply an hour of exercise. I guess what makes the insulin sensitivity more of a big deal with the pump, is that my basal insulin is being delivered to me live and continuously as I’m working, unlike Lantus. 

For a few days last week, the hypos were relentless. I recall having at least three on one day, in particular, last week. Three. Every time I crack open a fresh canister of skittles, I hear my diabetes educator’s voice ringing loud and clear in my head.

Minimise the lows. The first thing we need to do is to minimise the lows.

img_1325

Hypo unawareness is my biggest fear. With every passing hypo, all I think about is was whether I can feel it or not. I think about how much longer I will be able to feel them. At the end of it, all I really want to do is succumb to the defeating exhaustion that follows.

I had talked over my work day with my diabetes educator in the beginning. On a scale of 1 to 5, I’d rated my level of physical activity at around a 3. We’d anticipated a reduction in basal insulin requirements while I was working. I just never anticipated that the taps would take so long to turn down. I’ve now reduced my basal rates to about one seventh of my normal rate, and it finally seems to be holding me steady through the mornings.

The other factor that I am also starting to consider is the insulin I take to cover my meals at work. I’ve been plummeting quite quickly after my lunchtime insulin dose, and I’m starting to think that I might need to reduce my bolus by a certain percentage.

I’m hardly a role model for physical activity. I’d never have guessed that it would be such a significant issue for me on the pump. Not in a million years did I expect to be here, writing about physical activity and diabetes!

But I’m close. I’m really close to nailing this.

The Whole Patient

3 Comments


I’ll never forget the social worker who came to visit me in hospital, a few short days after my diagnosis. She asked me if I was feeling anything in particular after my diagnosis. Angry? Depressed? Wanting to talk? She even asked if Mum and Dad needed to leave the room. I had to convince her that I was feeling fine, as she didn’t seem to want to believe me.

It still frustrates me today that this was the way that these emotional issues were dealt with.

Having the social worker come in like that made me feel isolated. Her presence, and her questions that day were based on assumptions that I did not appreciate. I didn’t feel like a normal patient. It didn’t make these issues feel normal. Even if I was feeling something that day, I certainly didn’t feel comfortable discussing it in front of a stranger who thought she knew me.

What really frustrates me, is the fact that I had been surrounded by medical professionals for days in the hospital. Doctors, nurses, dieticians, specialists. Yet I can’t recall one of them asking me how I was. I don’t mean my blood glucose levels. Or the hospital food. Or why I didn’t eat my white bread sandwich before bed. I mean how I was feeling after a diagnosis with a condition that would affect me for the rest of my life.

The healthcare professionals I was surrounded by at the time were the ones I felt most comfortable around. While I certainly don’t expect them to fill the role of a counsellor or a friend, I don’t think it’s too much to ask them to look at the whole patient. To simply ask something like “how’s it all going.” To show some empathy, where necessary. To help me feel normal, and understood. Sometimes, that’s all we need. Other times, they can help us find greater support.

During last Tuesday’s OzDOC chat, there was a debate over whether patients felt that they were on the same level as a healthcare professional during consultations. I believe that this is a very individual issue, that comes down to both the patient and the healthcare professional.

Some patients contribute to feeling on the same level as a healthcare professional. They are very motivated, switched on, and not afraid to speak up or search for what they want. However we are all different, and not everyone is as vocal in nature.

This is where it is the responsibility of a healthcare professional to make the patient feel on the same level. Some healthcare professionals I have encountered certainly don’t seem to live in the real world where day to day management of diabetes is concerned. Some lack the ability to look beyond what’s written in the charts for an explanation. 

Yet other healthcare professionals are able to discuss diabetes management in a very supportive and constructive manner. They are able to motivate the patient and praise their self management behaviours. They are able to see the whole patient.

When emotional wellbeing is prioritised in my diabetes care, I feel motivated to improve on what is contained in my chart. My healthcare professional only needs to put down that chart for a moment, and take a look at the whole patient sitting in front of it.

First Week On The Insulin Pump

11 Comments

The last two weeks have been an absolute blur. This month has been diabetes overload. The new devices that are attached to me are a big reminder of that, although not necessarily in a bad way. My desk is an absolute mess of cable cords, information booklets, carb counting books and test strip containers. Every time I clean it up, I end up needing to pull the stuff out again.

I’ve been asked so many times about how I was feeling in the lead up to insulin pump day. Yet the reality didn’t actually set in until I was at diabetes clinic last Monday morning. Some of the other questions around it, however, have been rather amusing.

So when do you go in for your surgery?

Is it like a computer that’s strapped to your back?

It’ll be quite heavy. Will you still be right to work here?

Does the insulin go in through an IV line?

And my favourite, courtesy of one of my Aunts:

They’re going to have to cut you open! They’re going to have to cut you open!

It’s so bloody hard to explain what it actually is, so I’m really looking forward to being able to pull out my pump and show everyone.

Sidenote: My favourite diabetes hack from Friday’s Diabetes Blog Week prompt goes to Laddie at Test Guess and Go – objects photograph better on colours.

IMG_1207

The biggest misconception here, is that people thought I was taking time off for a physical recovery after the insulin pump. The truth is, it’s been more of a mental one. I’ve slept over almost every alarm that I’ve set for myself during the night to test, simply because my brain is fried from diabetes. Even harder, is the fact that most people won’t see the huge learning curve of these initial weeks.

Every night this week, I’ve been putting my overnight basal insulin rate to the test. Seeing if it will hold my BGLs steady, drop me further, or make me spike. Every morning, I’ve plugged my devices into the computer and analysed the results. Having access to such detailed data through my FreeStyle Libre (I received a reader and two sensors free of charge – further disclosures are here) has been helpful in tracking the movement of my BGLs overnight, and making changes to my basal insulin rate. It’s also a challenge not to respond to those annoying trend arrows and micromanage data. 

IMG_1204

Having both my diabetes educator, and my family to talk it through with each day has been a huge support. I’ve sorely missed my educator’s guiding hand over the weekend, and I hope that I haven’t veered too far away from the road in my decision making. Being home to navigate my way through it this past week has also been a massive relief. But I’m also a little overwhelmed at the new factors that will be thrown into the mix when I head back to work tomorrow.

This past week has taken enormous patience. I’ve hardly even made a dent in my homework. Once my overnight basal rate holds me steady, I’ll move onto testing my morning basal insulin rate, where I’ll have to deal with morning cortisol glucose dumps. Then the afternoon, and then the evening. Then fine tune Insulin to Carbohydrate ratios, and correction ratios.

It’s hard to remind myself that this will take time to get right.

Amongst all of this, it was hard to believe that it was also my birthday yesterday. 

It was such a relief to have that guidance from the pump in bolussing insulin for my birthday dinner, rather than my lazy guesstimates. It was so nice to simply pull out the pump from my pocket, and push a few buttons to bolus for the cake. 

The pump is one of the greatest birthday gifts I could have wished for this year. It’s a brand new chapter for my diabetes, and I’m confident the change will be a positive one.

img_0049

The Other Half of Diabetes

12 Comments

img_0048

Today is day 2 of Diabetes Blog Week, an annual event in the diabetes community created by Karen at BitterSweet Diabetes. Here is today’s prompt:

We think a lot about the physical component of diabetes, but the mental component is just as significant. How does diabetes affect you or your loved one mentally or emotionally? How have you learned to deal with the mental aspect of the condition? Any tips, positive phrases, mantras, or ideas to share on getting out of a diabetes funk? (If you are a caregiver to a person with diabetes, write about yourself or your loved one or both!)

Being diagnosed with diabetes as a young adult has presented it’s own unique challenges. I had already lived a significant portion of my life without it, which I am extremely grateful for. However, everyone around me knew me without diabetes. It wasn’t just automatically there, which made acknowledging my diabetes publicly a very difficult task. It essentially entailed a new conversation and fielding a whole lot of questions. It’s a risk, and sadly some people react insensitively. Even today, many people still don’t know, or remember that I live with diabetes.

I was diagnosed at an age where I wanted to manage my diabetes myself. I didn’t want to burden others around me with my diabetes. I was, and still am extremely stubborn. The more time that passed, the more I closed myself off. I didn’t talk about diabetes. I struggled to even acknowledge what was going on in my head. I distinctly recall moments where I was struggling with the frequency of my hypos. I was slamming my fists into the wall, and then getting emotional and comfort eating my way well out of hypo territory behind a closed door.

I was very self conscious around my diabetes. I wanted to be seen as normally as possible. I didn’t want to be seen as the sick, “diabetic” kid. I didn’t want people to see me managing my diabetes and pity me. There were times where I didn’t want to test my blood sugar levels in front of others. I’m still very self conscious about injecting insulin in front of others.

Beginning this blog 18 months ago was a big step out of my diabetes comfort zone. I quietly began following other people with diabetes online. I nervously stuck my head into OzDOC chats. I began sharing more about my diabetes than I ever acknowledged in my own life.

Much to my surprise, I began genuinely connecting with other people online. I became extremely interested in diabetes. I became far more motivated around my own management, and standing up for what I want from my healthcare team. I entered the pumping world yesterday, as a result of a decision that I made happen myself. I had the privilege of travelling to Sydney last week, and making some online to in real life connections.

Today, I am still fiercely independent in managing my diabetes. The specifics around my diabetes is still a very personal topic. I don’t often talk about what’s going on with my numbers, my food, and other individual elements of my day to day management. I set the agenda, and my family respects that.

I am, however, more motivated to talk about my diabetes in a broader context. About what I expect from my healthcare team. Elements of my management that I’m hoping to make changes to, or do better. Talking about how diabetes makes me feel. Commenting on the news, and the politics around diabetes. My blog posts are often the subject of dinner table conversations, too!

Today, I am not so afraid of talking about my diabetes in front of others. I comfortably bring it up when it adds value to a conversation. I feel much more confident in the way that I express myself around my diabetes, that I no longer feel so conscious or so pitied. I feel that I am so much more of a “switched on” patient, and in a much better place with both my physical and emotional health.


I would say take a step out of your comfort zone. Take an interest in diabetes. Connect with others. You don’t have to do it all at once. Set some boundaries you are comfortable with.

I feel that the progress I have made with my diabetes over these past 18 months has been so worth it.

To read other posts related to today’s prompt, click here.

Same, Stupid Mistakes

5 Comments

I wrote this last night, hence the timing may not make any sense if you’re reading this morning.

My blood sugar was a perfect 4.8 when I woke up this morning.

Yet right now, I can taste the sickly residue of skittles that are stuck on my tongue after all of the hypos I’ve treated today.

I wonder where I went wrong today. I wonder where I keep going wrong.

I’m exhausted, just writing this, but I need to get today off my chest.

It was one of the first real winter mornings of the year. I woke up after a comfortable 8 hours sleep. Feeling the early morning chill, I began to prepare one of my favourite winter morning breakfasts – a hot bowl of porridge with half a cup of milk. The sweet smell of Espresso was brewing in the kitchen, as per usual.

36 grams of carbs for my breakfast, a carb ratio of 1 unit for every 6, and I dialled up 6 units on my insulin pen. For a moment, I considered opting for 5 or 5.5 units instead, seeing as I was close to the hypo range. Add to that the fact I would be at work and on my feet shortly, meaning greater insulin sensitivity. I don’t know why I dismissed that thought, but I did. I dismissed it, and went with the full 6 units of insulin instead.

By the time 8.30am rolled around, my blood sugar was 3.9. Three point fucking nine. Fuck diabetes, I thought to myself. Fuck diabetes, I told myself as I reached for the canisters of skittles in my locker and started shoving them into my mouth.

It was the stupidest mistake. I’ve made so many stupid mistakes like these recently that it’s not funny. I should know better. I do know better. Yet I just don’t seem to be thinking clearly. I feel like shooting myself in the foot.

I was in awe of the DOC members yesterday who took part in sharing a #dayofdiabetes on Twitter. I’m in awe of expectant people like Kelley and Kerri who are so diligent with their diabetes. I’m so happy for them, but at the same time I feel like I’m failing. I feel like I can’t even give myself the diligence that I deserve.

It was one of those days where I just had the words fuck diabetes on repeat. I ripped open a bag of Malteasers (which I did share, FYI), because I really couldn’t give a fuck for today. But at the same time, I think to myself, how much longer can I afford to keep saying this?

One of the best things about today was reading this from Brianna.

And learning that she’d never heard of Malteasers. Malt coated chocolate balls, FYI.

DOC friends for the win.

Here’s hoping tomorrow’s a better day.