Work

Overflowing.

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Being diagnosed with diabetes as a young adult came with its own, unique set of challenges. I had lived a ‘normal’ life for 17 years, and then all of a sudden I had this new condition that I had to find a place for in my life.

Nobody around me knew that I had diabetes, and it was difficult to explain such a complex condition to the people around me. In some ways, it was just easier to deal with my diabetes in private rather than having to try and explain what I was doing in the middle of another frustrating high blood sugar.

Today, I think my diabetes is pretty visible. Whether I’m talking with the pump in my hand, checking my blood sugar in the inventory office at work as someone comes to interrupt me, or walking back out again crunching down glucose tabs.

It’s fair to say that I have a pretty big interest in diabetes today. I spend a lot of my spare time writing here, freelancing over at Diabetes Daily, posting about diabetes on my social media, attending community events, as well as being part of a diabetes Committee here in Perth.

“Are you going with the diabetes group?” is now a fairly standard response from colleagues when they hear that I’m taking annual leave from work.

“What are you doing?”

“What’s that?”

I spent so long imagining people’s reactions to a finger prick or an insulin injection. Today, it often feels like they simply don’t take any notice. Those explanations of the condition that I live with don’t seem to have any effect when the same questions pop up again and again. Perhaps others are just sparing my feelings by not asking me what I am doing.

However after National Diabetes Week, it finally began to feel like those messages of awareness were getting through to the people who needed to hear them the most.

The response to my diagnosis story that was shared on Diabetes WA’s Facebook page last Sunday was phenomenal. The story that appeared in The West Australian on Thursday was absolutely huge.

Despite my repeated arguments of just how terrible that photo was, two colleagues at work pulled the newspaper out of my hands on Thursday morning, took it over to the photocopier and stuck it on the staff room wall at work. “It’s a really important issue that could affect the people you work with!”

Doing media is a really big thing, even for an over sharer like myself, but I couldn’t be prouder of the outcome.

After a big week spent raising awareness of diabetes, and hearing stories shared from fellow people with diabetes, my cup is well and truly overflowing.

This is what National Diabetes Week is all about.

itsabouttime.org.au.

Kicking off Diabetes Week with some of my tribe last weekend.

Feeling Tired With Type 1 Diabetes

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The final stretch of last year was a pretty challenging time for me, physically.

I felt tired. All. The. Damn. Time.

I would often find myself crawling into bed at the end of the day, feeling utterly exhausted. I was no longer waking up to my 1am alarms, and my blood sugars definitely suffered for it. I would wake up after a solid eight hours of sleep feeling bleary eyed, wanting nothing more than to close my eyes and go back to sleep again.

I honestly could not find an explanation for the way that I was feeling. Although the management of my blood sugar levels had slipped a little since achieving a personal best hba1c in July, my ability to manage them was still far better than they had ever been in my pre-pumping era. My bloodwork from July was also really good, and I had seen my endo in August.

I probably should have made an appointment with my GP, but I honestly didn’t feel that he would have been very helpful to me.

I felt more burdened than I had felt in a long time. in fact, I’d go as far as to say I felt equally or more burdened than I did during my start on insulin pump therapy. These feelings affected my work, my attitude around others and my overall quality of life. Part of me was ready to accept that these symptoms were simply a tradeoff of living with a demanding chronic condition like diabetes.

Living with type 1 diabetes creates somewhat of a complex relationship with food. We need food to fuel our bodies, but at the same time food spikes our blood sugar levels – and we want to avoid out of range glucose levels at all costs.

What’s the best nutrition advice for a person with diabetes? From my experience, It depends on what you’re reading and who you’re talking to. While I absolutely love my diabetes community, the overwhelming messages that seep into my brain is to avoid this food group or cut back on that one that and stop the spikes from happening.

I don’t want to single out any particular way of eating, but diabetes has distorted my relationship with food without me even realising.

The average male needs to consume about 8,000 kilojoules of energy per day to fuel his body so that it can function properly and match energy expended through activity. I don’t think I was even coming close to that. Not to mention having an active job where I’m on my feet all day expending even more energy by the minute.

I honestly cannot ever recall being taught to eat to fuel my body and meet my daily energy needs – from healthcare professionals and diabetes websites alike. Or perhaps I wasn’t listening carefully enough.

The past month or so has been a bit of a learning curve for me. Let me just say that it is pretty challenging to eat 8,000 kilojoules of quality food every day, and I have slacked a little at keeping tabs on this at times.

Of course, as with anything you make a major change to in life, diabetes management also demands attention and there have been a few tweaks to basal rates. I’ll share more specifics in time. 

But I’m sitting here in the sunshine typing this today, feeling far better than I have in quite some time.

“Are You On a Diet?”

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I can’t begin to describe some of the funny looks I’ve been getting when I sit down with my bag of almonds at morning tea time. Those looks that just scream of “is that all you’re eating?” or “are you on a diet?” or “are you not feeling well?”

The young guy in the fluoro shirt who should be skulling choc milk and having a Woolies donut, eating almonds? Yep, I get it. While my diabetes is pretty transparent, people still forget or don’t realise it’s there.

Last week, one of my work Mums brought in a tray of leftover sweets to share from her weekend. As usual, I got the typical Nonna treatment. “Go on. Take it!” I politely said that I was trying to be good, and asked her to save me something for later. “Why?”

Last week, we had a bake sale in the staff room at work. I felt guilty for not buying anything. As I sat down in front of all of the tempting cake with my bag of almonds, someone remarked to me “you’re being good today, are you?”

I don’t put a lot of things off limits when it comes to diabetes and food. So long as I feel that I truly do enjoy eating something, then it is worth the effort. But I absolutely hate to perpetuate the myth that someone with diabetes can’t eat whatever they choose. I felt compelled to explain my choice not to indulge in cake at 10am on a work day to the staff room table.

After six months of experimenting and fine tuning, I am finally starting to see some consistency in the mornings while I am physically active at work. I am starting to feel that sweets are just not worth the effort while I am working. I will be guessing the carbs. I will be giving a generous dose of insulin. That insulin is more sensitive while I am physically active, and I am more likely to go low. What tends to follow is a day where I am trying to juggle highs and lows. I don’t feel very motivated to manage my diabetes well after days like this, and it’s just not fun. 

I eat a satisfying breakfast when I wake up. My treat in the morning is my Coffee Club Cappuccino with no sugar, enjoyed with my team mates. It’s 12g of slowly digested carbs, and I can handle that just fine.

But at 10am, I eat almonds. Almonds have minimal impact on my blood glucose while I am working. They don’t send me into a vicious cycle where I am correcting highs and warding off lows. Turning down cake is a small price to pay for the juggling act I so badly want to avoid while I am at work.

Plus, the cake will still be there to enjoy later, right?

giphy

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. 

Playing the Diabetes Card

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A few weeks ago, I was consulted about some potential changes to my position at work. I felt that what had been asked of me was huge, and very unexpected. It was a big step out of my comfort zone. It left me feeling stressed and with blood sugar levels that were through the roof in the hours after I first found out.

I knew that this change was not going to be great for my diabetes, either. It was going to mess majorly with the routine that I had become ever so familiar with over the past four years. I knew that it would make me unhappy and ruin my attitude towards my job.

I pulled out my pump and explained to my boss that I had diabetes. That the little pager-like device attached to my hip delivered all of my insulin, and that I had only just finished fine tuning the insulin delivery settings after three months. I went on to say that I thrived on a routine, and that I didn’t really feel too comfortable messing with it to such a huge extent so early on into my pump therapy.

I felt terrible. I felt so small, and so defined by my diabetes that day. I absolutely hated myself for having to fall back on diabetes as an excuse. I absolutely hated that first impression I had given to my relatively new boss, of both diabetes and otherwise. I couldn’t even begin to imagine what he would have thought, as he asked me if there was anything he could do to help make this change happen.

I was prepared to go back and make a compromise that I felt more comfortable with after much thought, but ended up being offered an even better option.

I felt absolutely terrible for using my diabetes as an excuse in that situation. Very rarely do I use my diabetes as an excuse for anything. Morning coffee. Christmas lunch. Taking on extra responsibilities at work. Helping others. Doing handy work myself to save hiring someone.

But two weeks into this compromise, I realise that it was well worth speaking up. I knew that I would have been unhappy with the original change, and that it would not be good for my diabetes and general wellbeing at all. I know that I am miles happier than what I would have been. And as one of my work Mums reminded me yesterday, this would not have happened had I not spoken up.

The reality is that I do have diabetes, and it can afford me some special privileges if I see fit. Taking into account the special privileges that I’ve been given in trying to operate a broken pancreas for the rest of my life, I think we can just about call it even.

https://www.instagram.com/p/BJ9fanIgD1j/