Diabetes

Spare a Rose, Give Life to a Child With Diabetes

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My blood glucose meter often leaves me in doubt after bedtime tests. Thoughts will begin to race through my head. Did the test strip pick up more sweat than actual blood? Are my hands dry enough? Did any water get in there? How much has it dropped since the last time I tested? No, there’s no way that my BGL can be THAT high!

My head tells me that I’m being silly. But at the same time, my sub conscious tells me I need that second test, just to be sure. I don’t think about those less fortunate people with diabetes often enough. However during these moments of doubt, as I’m turfing a test strip for a fresh one, I often do.

I think about how lucky I am to live in a country where access to test strips is reasonable and affordable. I think about how lucky I am to be able to use test strips like water, if I need to. I think about the comfort and ease of mind I feel because of this life saving tool that I could not possibly live without. I think about how silly some of my rants on this blog must seem in comparison to more serious issues out there in the world.

Lack of access to insulin is the most common cause of death for children with diabetes in many countries around the world. In fact, in some parts of the world, the estimated life expectancy of a child who has just developed diabetes could be less than a year.

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That’s why this February, we in the Diabetes Community are encouraged to Spare a Rose. The premise is simple: buy one less rose this Valentine’s Day, and donate the value of that rose (approximately $6 Australian dollars) to the International Diabetes Federation’s Life For a Child program. The cost of that one rose provides life-saving diabetes supplies, medication, and education that children in developing countries need to stay alive. One rose, one month of life to a child with diabetes. A dozen roses, a year of life for a child with diabetes.

I have donated the gift of life to a child with diabetes. You can make a donation to Life For a Child too. Click here.

I will be taking Spare A Rose printouts into Diabetes Clinic on Monday.

I’ll also be supporting #SpareARose on social media. Grab the Facebook and Twitter covers here!

Spare a Rose, and give Life to a Child with diabetes in need this February. A far more meaningful gift than those corny flowers and pink stuff. Just saying.

Reviewing The Numbers

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I’m due to see my endo next week, and have a long overdue hba1c test.

I don’t feel that my diabetes management has been too great over these last six months. It’s just so much hard work to stick with a consistent regime that seems to produce those good results on Multiple Daily Injections. I’ve been waking myself up almost every night over these past few months to make sure that I won’t wake up out of range in the morning. There’s also been times where I’ve felt like a complete failure because my hard work doesn’t produce the results that I expect.

I’ve purposely avoided opportunities to get my a1c tested over the past six months, because I knew the result would be disappointing. “I know that my a1c has gone up. It’s gotta be half a point higher, at least,” I’ve told myself over and over. 

I’ve been working extra hard at my diabetes since the turn of the new year. Partly because this upcoming appointment has been on my mind, and partly because I am genuinely aiming for long term stability in 2016.

One handy tool I’ve been using is my FreeStyle Insulinx Meter. Gwen gave me this meter in November when I talked to her about insulin pumping. Apparently all newbies in clinics get one these days. It replaces a logbook, meaning that frantically filling in empty pages before an appointment is no more. There’s also no way to forge the numbers, either… If you know how to carb count, it can calculate your insulin dose,mtaking into account any active insulin still on board and corrections. I also love that the test strips are capped, rather than individually wrapped, allowing for quicker access and less mess. The blood sample is heaps smaller, too.

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By far, my favourite thing about this meter is it’s reporting function. Every week I’ve been plugging it into my computer and reviewing the numbers, and the trends. There’s about 6 or 7 different reports you can create, taking into account a week, a month or any other custom range of data. And week by week, I do feel as though I am seeing improvements.

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This is my last 7 days of data. The blue bar is my target threshold, set to 4.0-7.9 mmol/L, and the black line is my average glucose levels throughout the day from morning (left) to evening (right).

I’ve never really been one to sit and review my numbers. I’ve never owned a piece of diabetes technology, and I could never be bothered to write my levels down before that. But numbers are in my head all the time. I deal with them 24/7. They consume me, sometimes. But taking a good, hard look at these numbers lately, I realise that they aren’t as bad as I work them up to be in my head.

I’m waking up in range, which is what I’ve been striving for. Hypos are happening 2-4 times a week which I’m pretty happy with, considering they were quite consuming a year ago. There’s a rise in the afternoon and a surge in the evening, but that’s mostly because I’m home and have more time to pedantically test after meals! And my average is 8.4 mmol/L, without having too many hypos.

Sure, I still have a long way to go in my goal of keeping this effort up in the long run and further improving. But looking at these numbers, I realise that I’m off to a decent start for 2016. I’m ready for whatever hba1c result faces me on Wednesday.

The Barriers to Insulin Pumping in Australia

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Decision day for the pump is fast looming. To Pump, Or Not To Pump? One resource that I finally got around to reading was a PDF created by Diabetes Australia titled Insulin Pump Therapy in Australia: The Case for Action. It’s well worth a read, check it out here.

Since I was diagnosed five years ago, I’ve attended a Diabetes Clinic in a Public Hospital. I’ve had free access to all of my diabetes specialists there, and I really have nothing to complain about. I’ve managed my diabetes on Multiple Daily Injections ever since, and I never really knew any differently.

I’d heard of insulin pumping. I knew it was expensive. I can’t say I completely understood the concept. In my world back then, it seemed fairly uncommon. I thought that it was something for people who were struggling with their diabetes management. My diabetes care team never really suggested, or encouraged insulin pumping as an option for me.

It wasn’t until finding the Diabetes Online Community last year that I really began to consider insulin pumping as an option for my diabetes management. I began connecting with many others who were using insulin pumps. I read their stories about them. I saw how significant a part pumping played in their diabetes management. I read the all of the news reported on diabetes technology, and I realised what a big deal insulin pumping was in the diabetes world. I even found myself compelled to write about and advocate for technology that I wasn’t even using.

Reading that PDF today, I’m not surprised to see that only 12% of Australians with type 1 diabetes have access to insulin pump therapy. I need only look at my own situation to see how many barriers there are towards switching from Multiple Daily Injections to an insulin pump.

My healthcare professionals have never suggested, or encouraged me to consider insulin pumping in the five years that I’ve lived with diabetes. Sure, I was diagnosed as a young adult. Sure, on paper my chart is probably among the cream of the crop. My endo told me “this is the best I could hope for” as her patient. But that doesn’t mean I wouldn’t see benefits from insulin pumping. I’d like to bring my hba1c down further, because my diabetes isn’t getting any younger. I’d like better stability overnight without having to pour my blood, sweat and tears into doing so. I would love to be able to eat more spontaneously when the occasion calls for it, and be less stressed about doing so. However, it was me who had to spark this ignition towards considering an insulin pump.

I could qualify for a pump through the Australian Government’s Insulin Pump Program. This program would subsidise up to 80% of the total cost of an insulin pump. However, funds from this program are being allocated towards the cost of pump consumables, despite their availability at a subsidised cost through the National Diabetes Services Scheme. The end result is that my chances of being allocated funds for a pump would be significantly lower. And because I am over the age of 18, I wouldn’t qualify for a pump as my need for one is considered secondary to those younger than me.

So, thank goodness for my Private Health Insurance, right? They will cover the cost of an insulin pump of my choice. However, in order to get my private health insurance to pay for the pump, their policy dictates that I stay in hospital. Which means that I have to find a hospital bed which so many others are in genuine need of, when the pump could easily be administered in a clinic setting.

Then, if my pump malfunctions outside of it’s warranty and within the next four years, I will have to bear the cost of a replacement. Why? Because my private health insurance will only provide a benefit once every four years.

Finally, if I do choose to switch to the pump, there will be at least a three month wait. I’m in a public hospital diabetes clinic where there are more patients than there are resources and time. As a patient, I was quickly weaned off of diabetes education as soon as I was able to manage things on my own. Where pumping is concerned, a block of four consecutive education sessions won’t be available for three months. Which sucks when I’m at a stage where I’m absolutely sick of Multiple Daily Injections and ready for a fresh start.

Seriously, I love our health system here in Australia. But surely it’s time that we cut some of the red tape.

 

Tennis, With a Serve of Diabetes

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By far, my favourite thing about January is the tennis.

Two weeks ago I went to the Hopman Cup in Perth, one of the tennis tournaments traditionally held in the lead up to the Australian Open this week.

Having seen Andy Murray last year, there wasn’t a doubt in my mind as to who I wanted to see this year – Serena Williams. I was so damn excited to see her play. She is just such an entertaining player to watch. I love her expression and her attitude, which she doesn’t try to hide. I love seeing her come onto the court with a bandage on her leg, seemingly injured, and yet still thrash her opponent. And I love watching her talk down her performance after a killer win.

Needless to say, I was so damn excited to see her play that night.

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When I arrived home after work that day, my blood sugar was 10.4. Which was okay, considering I’d only had my lunch 2 hours ago.

I wasn’t particularly hungry, but I knew I’d be hungry later. Wanting to avoid junk food after all of my festive eating, I packed myself a Burgen Bread sandwich of leftover cutlets from the night before. Even though the Arena had a strict no food policy, I was pretty confident I’d be able to sneak it in. But hey, I could always milk my diabetes for all it was worth, if I had to.

I was still 10.4 as we were getting ready to leave, and I gave myself a generous correction of 2 units.

When we parked the car at the Arena, I dialled up my Lantus dose. It was a little earlier than normal, and I knew that I’d have an hour or so of overlapping insulin. But it would save me the hassle of doing it while I was in there. I knew that the game would be a long one, and I’d likely be eating less than I would at home. I dialled up 10 units, rather than the 11 or 12 that I gave the night prior, and left my pen in the glovebox.

Going past security was a piece of cake. I managed to sneak my sandwich and water bottle through, hidden safely underneath the pile of jackets. Apparently water must be uncapped, in case we decide to launch the cap (rather than the empty bottle) at the court.

Serena came onto court, and it was so damn exciting to see her. She had pulled out of her match the previous day as a precaution, and I was so worried that I wouldn’t get to see her play.

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Unfortunately after the first set, she had to forfeit the match as a precaution for her inflamed knee. It was disappointing, but an hour was still better than no Serena at all.

I was ready to eat that sandwich, and tested my blood sugar. 5.7. I finished it, and quickly went off to the bathroom to bolus 5 units before Lleyton Hewitt came out to play in the Men’s match.

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That night, I was trying so hard to be good. I turned down lollies. I turned down hot chips. I turned down more lollies. Until 8.32pm, when I went hypo.

Not exactly my ideal, carb counted hypo treatment, I really had to give it my best guess. I measured out a handful of lollies into my palm, and began to chew them down. Still feeling shaky and in doubt a few minutes later, I grabbed another handful.

When I headed back to the car at the end of a great night, I was a lovely 19.0. Insert your swear word of choice here.

I had tried so hard to be good that night, and yet one small error with the bolus for my sandwich mucked it up. Yeah, I was bloody annoyed with myself. But it happens. It’s always going to happen, because I’m only human.

But at the end of the day, it’s not the hypo that I’m going to remember about that night.

I’m going to remember one awesome night of tennis that I got to watch.

Diabetes Game Plan: 2016 Edition

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New year, new me.

Kidding! Don’t even get me started on those Facebook statuses…

Ever since I’ve had diabetes, my New Year’s resolution has obviously centred around (wait for it) diabetes. Eat well, get my blood sugar levels down, maintain a good hba1c result without too many hypos and exercise. Scrap that last one, who the hell am I kidding here!

If I’m being honest here, I feel that for the better part of the last five years, my diabetes management has sort of stayed the same. I’ve chalked up good hba1c results, but they’re extremely difficult to sustain inbetween endo visits. Making a dedicated effort that delivers those sustained results is also hard, especially when there are a million other things going on in life.

But I want to do better than okay with my diabetes. I’ve already been at it for five, going on six years. That fraction of my life with diabetes is slowly, but surely growing. I want to look after myself. I want to minimise my risk of future complications. I want to remain hypo aware. I want to remain independent, and in control of my diabetes. I want to live a long, and healthy life.

So instead of that overall improvement this year, I’m going to strive for stable overnight glucose levels.

Night times over the past few months have never been such hard work. I can’t remember the last night where I didn’t have to wake up at 1am, test and give a correction shot. My last full night’s sleep seems like a lifetime ago. And mornings where I have woken up in range without minimal effort overnight have been rare occurrences.

I also know that it’s been a long time since I’ve had a full, uninterrupted night’s sleep. It’s been a long time since I’ve woken up feeling refreshed. It’s been a long time since I’ve woken up feeling pleased with my morning number, and have that sentiment echo positively throughout my day.

So, perhaps this is an argument in favour of switching to the pump. However, until that decision is made next month, I still need to manage with Multiple Daily Injections.

So, in 2016, I’m making a resolution to focus on the back end of the day. Say, from 4pm to 10pm – the 6 hour window before I go to sleep for the night. In these 6 hours, I will focus on doing as much as I can to not spoil my overnight glucose levels. Staying away from high fat foods. Satisfying my desire to graze on junk food with something healthy. Being patient when testing and correcting after dinner.

I know that I can do this.

I hope that I will eventually return to a point where I have some confidence that my overnight glucose levels will remain stable.

I hope that I will be able to return to a point of getting a full, uninterrupted night’s sleep more often.

I hope that if I can get those overnight levels within range, I will have one third of a stellar a1c result up my sleeve and a lot more enthusiasm in my mornings.