Diabetes

FreeStyle Libre: Second Time Round!

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At lunch time on Saturday, my meter came back with a 3.8. Not satisfied with the result, I walked over to the other meter sitting on my desk, which came back with a 4.7. I decided to do a best of 3 with the second meter, which produced an identical 4.7.

As I picked up the collection of discarded test strips strewn on my desk, it occurred to me that I am using test strips like water at the moment. I mean, I do use test strips like water. But I have never relied on them as much as I have now. And it kind of scares me.

I’m still fine tuning my insulin pump. I’ve made a lot of progress in the past week or two, but I’m not quite there just yet. I’m a perfectionist, I suppose. My diabetes educator has even gone on to suggest as much, having taken a step forward with the insulin pump. I can see it myself, in the great attention to detail I apply towards my basal rates and blood glucose monitoring at the moment.

Yet it scares the hell out of me, that somehow, this might become the new normal. I am scared of relying on glucose monitoring so much, instead of having confidence in my own actions. I am scared that I am becoming too compulsive and obsessive with my diabetes. Most of all, I am scared that I might never get this right.

I’ve recently used my second FreeStyle Libre sensor that I received from Abbott at DX2 Sydney, and naturally, I’ve discovered a few things that I didn’t the first time round. You can find out more about what the FreeStyle Libre is in my first review here.

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The Libre has been a life saver for me at work. I don’t need to walk over to my desk to check my blood glucose levels. I don’t need to worry about how dusty my hands are. It takes a lot of the pressure away from basal testing, where I would ideally stop what I’m doing to check my glucose levels every half hour. It offers a level of convenience that glucose monitoring doesn’t. Not to mention some the weird looks I get!

Most of the time, the results have been extremely accurate – to the nearest 1mmol. However, there have also been times where the accuracy has been difficult to trust.

It’s been hard to rely on the Libre’s readings when my glucose levels are moving significantly, particularly in the first 2 hours after meals. At work, I’ve often felt the need to go and double check with a finger prick before making a decision on a reading of 14 after breakfast.

I’ve also found that the Libre pronounces very small movements in glucose levels. For instance, I remember having an espresso with a tiny amount of milk one morning. I watched my Libre trend upwards to 9 or 10mmol, when in reality the movement wasn’t so big. It did eventually “catch up” with my meter, but I had to remember that the drop did not actually represent my blood glucose dropping.

That being said, I really need this extra flexibility with my blood glucose monitoring at the moment. I recently purchased another two sensors, which will hopefully make things a little easier for me over the next couple of weeks.

I’m just hoping that this reliance on heavy glucose monitoring doesn’t become the new normal. I really want to go back to having more confidence in my own diabetes decisions.

Setting the Record Straight

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Diabetes campaigns here in Australia never cease to disappoint me. They always tend to focus on the negatives, such as the complications and the hard hitting statistics which instil fear. Our campaigns lack positivity, and don’t do those of us living with the condition a lot of justice.

In my humble opinion, a campaign for Diabetes Week is simple. One where we encourage people living with the condition to share their stories in order to help raise awareness. Diabetes UK always seems to do this very well, with positive, empowering campaigns that actually engage and involve people with diabetes.

Before I start getting depressed about the awful complication-themed Australian diabetes week next month, I thought I’d add my two cents worth to Diabetes UK’s fantastic campaign for Diabetes Week, Setting the Record Straight. Here goes…

1) A diagnosis does not mean that you’ll develop complications. I heard a lot about complications in the Australian media during the first year or so after my diagnosis. I remember feeling horrified about that possibility, and even writing myself off because of my diabetes in conversations. It took me a long time to realise that this was in fact, not true. 

I still remember a fantastic quote I found somewhere on the internet that went something like “you might feel like crap today, but complications can take years to develop.” It’s a great perspective and it always reminds me that it’s never too late.

2) Diabetes takes time to get right. A LOT of time. After I was first diagnosed, I remember talking to others in the context that I would eventually get it sorted. Once I had everything figured out, I wouldn’t need to test my BGLs so often and I wouldn’t be having so many hypos. Six years later, I’m still trying to get it right!

My diabetes educator reminded me recently that “even though we want to do as much as we can straight away, it takes time to get it right and you need to be patient.” Be kind to yourself.

3) You don’t have to turn your life upside down or give up everything! Magazines are full of ways to change your life and feel better overnight and blah blah blah. Doctors talk as though change can happen with a wave of the magic wand. It’s completely unrealistic. I’ve made a lot of small, gradual changes to my diet and my routine since I was diagnosed. But I haven’t compromised on the things I love. I don’t do dedicated exercise, because I don’t enjoy it. I still eat chocolate. I still drink lots of coffee. I don’t peel the skin off my takeaway chicken. I still enjoy myself at Christmas time. 

A colleague recently told me that “it’s easier said than done.” While I do agree, I reminded her that it doesn’t mean that you have to be unhappy.

4) Finally, I’m loving the Faces of Diabetes campaign that’s going round on social media. Because there are actual human beings behind the condition, and it’s important to keep that in mind when advocating. You can get your picture here.

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Happy Diabetes Week to those of you in the UK! You can find out more at diabetes.org.uk and by following #DiabetesWeek on social media.

Making DOC to Real Life Connections

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One of the best things that came from Diabetes Exchange in Sydney was the opportunity to make some real life connections with members of the Diabetes Online Community. In the past year and a half, online peer support has changed the way that I look at and manage my own diabetes.

More specifically, I’ve been drawn to a group called the Oz Diabetes Online Community, where I participate in diabetes support chats on Twitter every Tuesday night. The individuals in this particular group are the ones that I feel I can relate to the most. Theirs were among the first blogs I read. Their Tweets are the first that grab my attention in the morning. They live in the same country as I do, and we likely share a lot of similarities (and differences) about life with diabetes. The chance to meet some of these folks was a dream come true.

Mind you, I still can’t believe that this happened to me. I’m not an athlete or a celebrity, nor did I know anyone of influence in the room. I’m just an ordinary guy who happens to have diabetes. I kept waiting for the event to be cancelled, or to be scheduled on another day where I wouldn’t be able to attend. I was half expecting to be told that I didn’t have enough blog readers, or that I would be too expensive to fly over from Western Australia.

Going into this event, I definitely felt a little bit like the odd one out. I lived on the opposite side of the country, and I was probably the newest of all the bloggers there. I hadn’t met any of the others in attendance prior. I was a little nervous about whether I would fit in, and whether the other bloggers would be as nice as they seemed online.

I was so nervous on the drive to the Ovolo hotel in Woolomollo on Thursday afternoon. I wondered who would be the first person I’d meet. Would I run into Renza getting out of a taxi? Would I walk up behind Ashley at the reception desk? Would I bump into Georgie on the way to my hotel room? I wondered if I would even recognise them outside of their Twitter photo.

I was escorted up to my loft style hotel room, which was like nowhere else I had stayed in my life.


And, sadly, hardly enough time to enjoy it. I was nervously counting down the minutes until 4 o’clock. When I knew I couldn’t put it off any longer, I nervously proceeded to make my way down to the lobby for event registration. I instantly recognised Georgie, Kim and Ashley exiting the elevator on the opposite side of mine, and the nerves were instantly relieved.

It was super weird at first. Even though I knew these guys online, I didn’t know them, really. It was super weird as we sat down, and part of me wasn’t sure what I was going to say to them. Hey, great blog post last week? I’m glad the registration in the lobby lasted an hour, as it served as a nice ice breaker. By the end of that hour, I’d had a decent chat with Ashley, Melinda, and PR ladies Laura and Hannah, and I’d had a few words with Georgie and Kim as well.

It was great to chat with Drew and Matt, who I did not know of prior to this event, over breakfast on Friday. I was honestly in awe of all of Melinda’s life experience with diabetes, which absolutely shines through all of her activity online. I had a nice chat with Kim on the boat, as well as a few silly photos. Renza gave me a few words of encouragement about my upcoming pump day on the way upstairs to pack my bags on Friday morning. Georgie and I counted down together as we inserted the Libre sensors on our arms. I had fun Tweeting with Ashley during Friday’s proceedings, despite the fact that we were sitting next to each other. Although I didn’t get a chance to have a chat with Tanya, I was inspired by the story she shared about managing diabetes and achieving great things in a way that worked for her.

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I guess my biggest takeaway is that I no longer feel like such a stranger around these guys. While some of the bloggers aren’t in the same circles as myself online, I do feel closer to some of the others. I feel like I do Tweet these guys more often. I have now replaced most of their “online” voices in my head with their real ones. And some of them are now Facebook friends, as well.

I feel so privileged to have met these guys, and I’ll remember our time together fondly. Here are the list of attendees and their blogs:

Ashley of BitterSweet Diagnosis

Melinda of Twice Diabetes

Georgie of Lazy Pancreas

Kim of 1 Type 1

Renza of Diabetogenic

Tanya of The Leveled Life

Drew of Drew’s Daily Dose

Matt of Afrezza Down Under

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Disclosure: Abbott Diabetes Care paid for my travel and accommodation expenses to Sydney. I received a FreeStyle Libre reader and two sensors free of charge. There was no expectation that I would subsequently blog, and all opinions expressed are my own.

Goodbye, Gwen

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A diagnosis with type 1 diabetes back in May 2010 changed my life.

I remember how awkward I felt around my new condition at the time. Carefully finding a spot on my stomach and willing up the courage to insert the needle and administer an insulin injection. Standing in the kitchen eating a white bread sandwich at bedtime, feeling uncomfortable as soon as someone walked in and saw me. The way I tried to carefully follow the very vague instructions I had been given upon my discharge from hospital – 20 units of Lantus at dinnertime, 5-10 units of Novorapid at meal times, and a white bread sandwich at bedtime to stop me from going low.

I remember how “different” I felt at the time. The reality that this condition would be around for the rest of my life was still sinking in. Nervously walking into diabetes clinic for the first time, and seeing other patients there reminded me that I was now a “diabetic” – something I felt very labelled by at the time.

It was there that I first met my diabetes educator, Gwen, a straight talking woman with plenty of diabetes knowledge and experience. My Mum was there with me at my appointments, and Gwen made her feel very much included as well. I’ll never forget her famous diagram of the mouth, the liver and the pancreas, as she demonstrated the role of a functioning pancreas when food entered the body. A diagram that she still uses to this very day.


In the months that followed, Gwen went on with helping me to fine tune my insulin doses, so that I wouldn’t need that white bread sandwich at bedtime. When she saw how complex and spontaneous my meals were, she taught me how to carb count. She always made herself available to me outside of appointments by phone and e-mail, despite how busy she was. When my first endocrinologist told me that I had very poor control, Gwen was the first to see the look of disappointment in my face. She was prepared to go and have a word with him, and she made sure that I didn’t see him again in future.

Gwen often reminded me that the first year was biggest hurdle to get through, in terms of education and clinic appointments. Her job was to make her role as my diabetes educator redundant. After the first year or so, I went on managing my diabetes without regular education sessions.

As I began to consider insulin pumping last year, I felt that it was time to touch base with Gwen again. Nerves after such a long space of time were immediately relieved, as Gwen proceeded as though our last appointment was only yesterday. She approached the matter with the seriousness it deserved. She never sought to influence or sway my decision either way, and respected the decision that I eventually made.

It’s hard to imagine starting out on an insulin pump with anyone other than Gwen. Nerves were eased going into it with someone I was so familiar and comfortable with. It was fantastic to be able to chat with Gwen over the phone every day during that first week. I was very comfortable uploading all of my data to Diasend for her to see.

Last week, I had my final education session with Gwen before she retires at the end of the month. Even though there has been considerable distance between our sessions over the years, I still find it hard to say goodbye to someone who’s been there since the very beginning.

Gwen has been a huge part of my diabetes journey. She is the professional who has the time for me. Who sits down with me, and has my undivided attention for a whole hour. Who knows me, and the very hands on approach I take towards managing my diabetes. My GP, although excellent, doesn’t often have the time for me and is quick to dismiss my concerns. I don’t always see the same endocrinologist on clinic days. Too often, they are quick to sign off on my six monthly checkup and move on to a higher priority patient.

There have been a lot of changes over the past six years.

Back in the beginning, I managed my diabetes with a meter, insulin pens and a paper logbook. Today marks four weeks since I first started using an insulin pump. I also have access to a logbook meter, Diasend software to analyse my data electronically, and a FreeStyle Libre.

Back in the beginning, I was a nervous newly diagnosed teenager who used to shy away from his diabetes. Today I am a confident, passionate and knowledgable person who is empowered to make his own diabetes decisions.

In some ways, I feel as though I am reaching the end of a chapter in my diabetes journey. And it feels nice to have been able to close that chapter with Gwen.

Goodbye, Gwen. Wishing you a very happy and fulfilling retirement that you deserve.

Minimise The Lows. Minimise The Lows.

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“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.

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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.