Diabetes - Scrambled Brain Issues

I have this nagging suspicion that having diabetes and extra large glucose molecules floating around my vascular system may in all likelihood have a potential impact on my BRAIN. Why you ask.........

Well, for one there are definite links to dementia and vascular disease. It is also becoming obvious to me that mood and diabetes are intricately linked.  I mean I not only notice this in my own actions and moods, but now in those of my two other D kids under my direct care. 

Of course the obsessive part of me, or my brain, asks questions like; how early does the small vessel damage in the brain occur? Is it inevitable? And am I turning into this monster as I go about my day-to-day activities? Or, is it simply normal responses to everyday stresses causing my temper to flare, and my words to fly, often inappropriately, and almost always too quick for me to control.

Then there are my Kids. The ones with Diabetes of course. They are notoriously more temperamental then the other siblings. My teen is, lets just say, unbearable some days, and linked to poorly controlled sugar levels, sleep patterns, and the typical hormonal fluctuations she is unfortunately afflicted with solely based on her pubescent phase of life. Undoubtedly annoying to me nonetheless.

Back to my brain. I admit I have insurmountable domestic responsibilities. We moved again, and have just recently started a new school year at differemt schools. Sounds a lot like typical life. Changes, the ebb and flow, the usual. But is my mood, behavior, and my ability to handle stress some how worse and more difficult to manage because my small brain  (not my size, he he) vessels are being ravaged over time by the occasional elevated sugar levels?  So really, has diabetes and high sugar levels "Scrambled My Brain"

Anyone else out there in the D-sphere find that concentration, temperament, memory is effected from having diabetes for many years or at the very least when your diabetes is completely messed up.

I wrote this post a few months ago, and have since found out my thyroid was really, really low, and since taking synthroid, my memory and concentration has improved, but I still pose the above question.

Turning a Woe into a Win

I know my titles kill me too!

So after I wrote the last post I was feeling the need to pay a visit to the school to touch base post traumatic letter writing warfare.

I feel it is imperative for Rowan`s sake to have a cohesive team with good morale. I went into the office and said hello, and proceeded to ask to speak to the principal.

I am fully aware of office politics and am 99% certain everyone in the school office was somewhat aware of the little quarrel from a week ago. Oh well.

I  was permitted to enter Mr P`s  (Name is changed) office. I shook his hand and asked him how things were going now with Rowan. I then said that I wanted to make peace as I now felt that Rowan`s team is strained. He denied feeling the same way, and assured me that everything was fine on their end.

I tried to convey empathy for his position and his need to take a formal stance when he feels that a students safety is paramount, but I also encouraged him to please call me next time with anything, small to prevent a cascade of letter writing warfare that invariably leaves all parties feeling segregated and awkward.

We shook hands and decided to move forward in a positive direction. On the way out I bumped in to the TA in charge of Rowan`s care. ``Awkward`` But nevertheless, I asked her if ``our team`` was still good and intact. Sometimes I think I am far to sensitive but I feel it is important to maintain good relations with those responsible for keeping my baby safe. I thanked her for learning about diabetes and taking good care of Rowan. She said ``Go Team Rowan``

I hope all is well.

Trev 

School Woes

I need to share our recent experience with our daughters new school.
But first a little back ground info.

We recently moved locations, in the same town, but far enough to consider changing schools. After deep thought we decided to change schools.

As anyone knows change is hard enough, new people, new schedules, but we thought what the heck it`ll work out just fine. Wrong.....

I went to the school to do a mini presentation on diabetes management 101 to all the school officials involved directly and indirectly in Rowan`s care. All went smooth, or so I thought.

School started, routines were becoming entrenched, and more comfortable each day. Communication was multiple times daily via text, cell phone and the occasional email.

Until the dreaded formal letter.

To my surprise we were delivered a letter from the Principal CC`d to his boss pointing out three issues that they failed to call me to discuss or text me during our daily interactions. My blood instantly boiled.

WTF. They create a paper trail as opposed to a simple phone call.

Okay, I know you are asking, what were the issues. Well they were 1. Her glucose levels were fluctuating - duh, that is because we have her on a crap insulin to accomidate school life, the dreaded NPH.....2. They need ample supplies to care for her diabetes, well we once forgot to send the right glucometer, at which time they called me and I immediately dropped another off, and 3.  We are not easy to get a hold of - that one I simply disputed by showing the principal my cell phone and all the daily texts from the teachers aide.

We felt like we were being attacked from our so called team members.  I guess the purpose of this post is a bit selfish, yes I am venting to the DOC.

We refuted the letter by writing our own to the principal, hand delivered and discussed with him, even though it went in one ear and out the other. We also CC`d the letter to his boss, following suit with his paper trailing methods.

I am still, sitting here shaking my head thinking, what the hell is wrong with picking up the phone and dealing with people face to face directly.

Trev

ED phone Home - Diabetes, Depression and Sexual Health

It's time to talk about this topic. I am by no means making fun of E.D. (Erectile Dysfunction) as we all know it is prevalent with 40% of all men over 40,  or something like that.  But like the movie E.T. we all want our E.D. to phone home or connect and work again.

What about Libido and its relationship to depression or using antidepressants? These are also topics that need to be hashed out, talked about, and openly discussed.

The odds are even worse for men with Diabetes. Glucose is a huge molecule, jamming up blood flow and damaging our penile highways, effecting erectile strength, sensation, and over all drive.

As I have mentioned in past posts, E.D. doesn't get talked about enough during clinic visits. My health care providers dodge it. Asking things like; "So.....how are things working down there?" or they don't ask about E.D. at all.

I hear that if you have diabetes then you have a 50% likelihood of developing depression.  What that means to me is that there are a lot of diabetics taking SSRI's which are an  anti depressant medication that may make you feel happier but not happy "down there" as they are notorious for decreasing sensation during intercourse and  libido. Shitty deal really for the person taking them and their partner.

What are the options?.......let's see......

Adding another med. Like Wellbutrin - an antidepressant that minimizes the sexual side effects but can increase agitation and anxiety in some individuals. Not good if frustrated over the above ED and lack of libido issue.

The blue pill, well those are good for ED in some cases,  but not so good to increase ease of ejaculation, sensation due and abating the effects caused by the SSRI. 

The stress that ensues when a man in his prime can't "climax" or in some cases"can't stay hard enough" to please his partner and or himself. Yes, you got it, major feelings flood the brain, like, "I suck in the sack" or "I am useless, whats wrong with me" thus leading to performance anxiety the next time around, and if you are the avoident type a mere lack of all around initiative and libido ensues. The partner in this case is often left feeling "unattractive" because all of the sudden the man can't "climax"   This effects the sexual intimacy in the relationship in some cases. No libido, performance anxiety, less flirting, less connecting, greater distance, and then the inevitable both parties give up. Okay not in all cases but you get my point.

Once again diabetes effects all areas, Mood, Depression, libido, decreased sensation, E.D.

What do we do about it?

 Well, I am hoping my readers can contribute. I have no clue.

Trev    

             

Life vs Diabetes

"Oldest and Youngest, Beautiful......"

We all know that "good" diabetes management takes a lot of effort and devotion to be effective. But we also know that all life's successes also require our devotion, our mental energy and basically our time. The trick lies in balancing the two areas successfully.

Life is full of change, un-imposed and imposed.  Diabetes is inevitable and also full of change. We can't turn our mind off when it comes to managing diabetes. Life is similar, we have to pay attention or life spirals out of control, we miss appointments, fall behind in the daily chores of life. The trick is balance, we know this, but my god this is not an easy task and I notice that when life gets crazy, out of control and overwhelming, my diabetes tends to loose its place in the balance of things. Basically diabetes fails to be my priority compared to life's commitments.

I see this in my self and most diabetics I meet. My 15 year old Type one would rather fit in socially at lunch then test and take insulin. I would rather just grab some take out, eat it, then take my shot of insulin after the fact. Why, because life, the social pressures, the time constraints take precedent over this thing called diabetes.

If I am happy, positive and feeling good about life, then I am highly motivated to take care of my body. This includes exercise, sleep, food, and diabetes management. If I'm in a low mood; the opposite effect occurs. For this post I guess I'm just "thinking" out loud, venting, so to speak.

I was on a flight to visit my home town a few weeks back. During the safety video, when the oxygen mask falls and the passenger places it on them selves first then the child I thought of this post. We need to make diabetes the first choice, as difficult as this is. Otherwise we get sick;  we damage our bodies, and life spirals even quicker out of control like a plane loosing altitude. If  we don't take care of our health, then we are useless to everyone else in our life.

Trev


  

Sure I Can Handle It! - NOT

"To School........"

Today I was left with the simple objective of getting my five kids off to their 3 different schools. Easy enough I thought. Some good strong coffee, a positive attitude, and easy peasy, no problemo! Bloody hell am I exhausted.

First off; I was on my own, no Mrs, just myself, she opted out to earn some dough instead, important yes, but boy did I miss the team today.

Now generally my house is chaotic, five girls, bathrooms, brush fighting, hair bret and attire comparisons, mirror gazing, and texting.  Now throw diabetes into the mix and add not having a clue who's teacher belongs to whom - You've got yourself a recipe for chaos. Oh and did I mention I forgot to register our youngest, minor oversite. Anyway moving along....

As I sit here pondering over the days events I think; I don't know quite how I pulled it off. Teen was pretty good, got up wwwwaaayyyyy to early to ensure a stellar look for her first day of high school, eagerly awaiting for her friend to show at our door as god forbid they be seen walking to high school alone, like oh my god, that would spell social disaster on day one, only the most important day of the year!  She tested her sugar, I think, well she didn't die at school as I personal witnessed her arriving home. Not sure how the diabetes went, but socially she seemed bright.

Upper two middle kids, if that order makes sense, going off to junior high. No diabetes = easy. Backpack; check, lunches; check, ride to school;  checks, slow down just enough for them to jump out the door; check. I'll let ya know how their day went later. But I didn't get any calls from the school.

Younger two, second youngest being the little Type 1.  Now this is where it gets time consuming and importantly so!  I arrive, they have reno'd the entire school so everyone meets in the Gymnasium with all the teachers semi-holding up signs like at an airport when the driver is seeking out his passenger after a flight. We ask around, all the while dragging the 4 yr old in a crowded gym full of screaming kids and finally track down her grade 2 teacher.  Who I might add was eerily calm in the midst of chaos;  I would have needed a heavy dose of some form of sedating anti-anxiety medication to remain calm in what I percieved as pretty much the scariest environment imaginable.

"Summer has ceased to exist"

We find her, I introduce myself and da kids, and we follow her back to the class room. She informs me that she is aware Rowan has Type 1 Diabetes and we will need to talk. During a quiet moment where the assistant reads the class a book, I give her the "Crash Course in Diabetes Management for Kids at School Presentation" She nods, and says would you be able to repeat that again to the assistant. I hand her my notes and state, sure thing. I leave, toddler in tote, return 1 hour later, repeat, test, leave, return and repeat, test, inject, ensured they understood.  Peering at the teacher, I could sense the apprehension, or fear, of "You are leaving this precious child with me to care for with this poerilous chronic illness called type 1 diabetes look, you know the one....if they don't have that look on their face then be concerned. 

I peered calmly at her and said, "I've had type one diabetes for 30 years; before the good insulin's, before glucometers, and back when they assessed your health and development on how much weigh you were gaining. I survived, not blind, no damage done. She'll be okay and you can always, I mean always text, email or call..........Anytime."

Wow what a day!

Cheers!
Trev

Running High Out of Fear

"Reminded me of the curves of diabetes management"

Why we do it and tips to hopefully prevent doing it. Diabetes definitely has its curves, and lows are by far the worst of them.

I have noticed a trend in my own diabetes management and those I see weekly in the clinic I work at.
That is, folks on insulin tend to run their blood sugars higher before bed to avoid being jolted out of bed in the middle of the night and will do anything to prevent that from ever happening again. Including eating a snack with too many carbs so they run high all night, cut back on insulin so they don't worry, but wake up with higher fasting blood glucose readings, which as we all know drives up our A1C percentage.

I have to disclose that I too still do this on occasion but not nearly as often. The newer insulin that lack a significant peak and the insulin pumps with continuous glucose sensing capabilities are proven scientifically to be safer in preventing nocturnal lows. But sometimes, lets say if I have a really intense endurance workout after 7 p.m., I will purposely run high, knowingly doing damage to my tiny vessels for the sake of a sane night's sleep. It is really quite frightening, kind of like the sign I seen on my recent camping trip.

Now, I notice we (my spouse and I) letting our wee one run a little high and being very reluctant in giving correction shots after 7 p.m. for fear that she will drop too low, not wake up, and suffer seizures or, the worst case scenario, death; see my earlier post about my Smallest Type 1 Kid not feeling her lows. Scary stuff; improved though. I mean, during waking hours, she sometimes comes and says "I feel low," which I am so happy about. It sounds strange to be happy when your kid feels a low, but it was really stressful for the longest time when she didn't. 

Okay, back to the theme of this post.  I still tend to let her glucose level ride higher then target, not crazy high but a little high, and I know this effects her A1C and long-term health. For now the risks of her not waking up from a nighttime low far outweigh the benefit of keeping her alive and a little high.  But what about us adults, specifically those who don't use a pump and CGS (Continuous Glucose Sensor)? What's my excuse? I wake up, so why run high?

Well, I think it helps to to know your normal physiological profiles, like; responses to stress, food, and exercise as these are key to preventing the sudden overnight lows and the associated fear.

How?  Well test like crazy, I mean before bed, every two hours. Borrow and or buy a continuous glucose monitor(CGM), or get an insulin pump that has one incorporated into the device. My experience with CGM's are good for finding out your profiles what your requirements are in a 24 hr period of time.  My trusted way is just trial and error, and using a meter to test yourself using the mindset that you are the scientist and also the Lab Rat  Yes you will have to set the alarm and test, yes you will figure out weird responses to things like high intensity training and rebound highs that later result in extreme lows, but that's my point.

With a lot of testing and record keeping, learn about how diabetes, food, activity, medication, and stress effect you body and more importantly your glucose levels. The more we figure that out the more trust we have in the shots we take and then hopefully we have more happy nights and less fearful ones.

Cheers!

Trev

Stinky Teddy Bears - Type One Bedwetting

One of the offspring

When I was a wee one I wee'd one too many times in the bed. I remember waking up wet and cold, getting up, trying to hide the blankets or simply grabbing a towel to cover the spot and go back to sleep. I felt terrible, ashamed, and I knew my mom got sick of the constant flow of laundry I was providing. It eventually stopped, I think around 10. I never gave it much thought until we created a wack of offspring. One of which wets the bed almost nightly.  Our teddy owner also has Type 1 diabetes, and I am certain there is a link. I wish I had of considered this back in the day instead I thought it was me. It would have nicer to blame it on D.

I checked the net quickly for info, and found this Link on bed wetting 

How many of you folks have issues in your house with stinky stuffies and diabetes?

We try to not push the fluids too much after 6 pm, unless she is high. We don't wake em up and carry her to the BR as this apparently trains the bladder, yes I know odd that our pee organ can be trained like a dog.  Yes I have resorted to using pullups, but am open to any good ideas, other then electric shock therapy.

Cheers!

 

The Teenage Diabetic Brain

My Teenage Brain

I have one of these living in my midst. Yes a teenage diabetic brain. She is one of, the three to treat. I must discuss recent happenings in hopes to relate or get support. 

Okay I know that most teens have limited capacity to focus, as they are concerned about social events, sports, and in our case fashion and hair.

My daughter has really taken the diabetes thing in stride, seriously since 11 she has injected, tested, gone to appointments, learned about carbs, exercise and other intricacies in relation to managing diabetes. Is her diabetes well controlled? Well not perfect but well enough. I was never harassed about my diabetes from my parents. They kept me safe, ensured I took my shots, ate my meals and snacks, and that was it. Never nagged and therefore I never had any anger towards them. I could essentially be a kid with "D" in the background.

I must say that we attempt to do the same with our D kids. But I note that lately, I have to ask her to test, like in the mornings on my way out the door, I'll pause, and ask, "Did you test?" and she will put down the backpack and hair brush, and proceed to test. I really try not to lecture but this is happening all the time, like everyday.  She will go to her friend and forget her supplies, get home from school and say "I haven't taken any insulin today because I didn't eat" or my least favorite, she injects blindly, basically having know clue what her glucose is and taking a whopping dose based on her teenage brains strange calculation.

Scary stuff! I know. I have discussed this calmly, more times then I can remember. Still no change. Yes I've called off sleepovers and events as a consequence, taken her phone away, she still doesn't have it back, but I feel guilty as I know diabetes is a supreme pain and inconvenience in our everyday life. And I know it just isn't important to her.

Question is I am honestly at a loss....what do I do next, lock her in the house? Duck tape an insulin pump to her? What?!  Sorry just frustrated. I certainly can't be there to remind her every time she chooses to eat to remind her to count the carb and take the appropriate amount of insulin. Trust me I've considered it. There is the option of NPH, but then I fear lows and rebounds.

You'd think in a house full of D, my child would be a superstar, that just ain't so. I just want her safe. Any ideas would be very much appreciated.

Trev

Diabetes explained. Search for diabetes treatments at a private hospital in nottingham.

Type 1 Diabetes and Weight Management

Over the past couple of years I've been teaching fellow diabetics how to manage their diabetes. You know, the basics like;  food, activity, medication, insulin use and adjustment, stress management, physiology, complications, blood glucose and health monitoring.

During this time I have noticed a trend, and that is;  the challenge of losing weight or better yet, just maintaining weight with type 1 diabetes.  The media as I'm sure you've noticed at most grocery stores and on talk shows (not naming any names of course) group diabetes (both type 1 and type 2) as being the same with little effort on the authors part to explain the difference between the two. They also advertise incessantly about weight loss and diabetes.
But what I'd like to explore is the topic of weight loss and maintenance when it comes to type 1 diabetes. I mean healthy weight loss, not the loss that comes from ketoacidosis and insanely high sugar levels. Why do I think this topic is important, well I also notice that Type 1 diabetics are gaining weight putting them into the insulin resistant abdominal obesity high BMI health risk category. And a lot of people I see with Type 1 have a desire to learn more about weight loss.

I feel that Type 1's  have very little guidance on losing weight and safely adjusting insulin levels to do so. When I have sought guidance on this subject in the past I get the usual verbal nonsense.  "Increase activity, eat less"  I begrudge that scripted response that seems to be ingrained in thought and promoted with out question by most world government health agencies. Fair enough, create a caloric deficit and lose weight, simple, right? NOT!

I am sure a lot of folks out their that have lived with diabetes long enough can tell you basically how to lose weight, but what about giving formal advice. I find that there are numerous studies and information for Type 2 DM with regards to weight loss.  But what about insulin dependent diabetes or more specifically type 1 diabetes?

Weight loss and type 1 is logical to me. Look up insulin in any Medical Physiology textbook and it will clearly tell you that this essential hormone is not only responsible for utilizing and storing glucose but it is also responsible for Fat and protein storage and utilization. Hmmmm.........What the heck am I getting at?

Keeping in mind that Lipolysis is fat breakdown (A good thing) and Adipose is fat tissue/cells (A bad thing)

Lower your insulin and lower your energy storage. It is common knowledge that when a person is started on insulin they usually put on weight. I know from personal experience that the more insulin I take the more weight I gain. The question is why and more importantly what to do about it.

This is not new info at all by the way. Most carb reduced diet plans rely on this to get results. Even weight watchers tend to promote products that are lower in carb, just looking at the bread products they market. Carbs increase blood sugar, blood sugar requires insulin to put it where it needs to go, into the cells for energy, and any unused energy goes to fat, liver and muscle for later use. Or something to that effect, I am by no means a biochemist. All I know is; when I reduce my insulin levels, I always lose weight.

The number one precursor to insulin needs is the amount of carb we choose to consume in our diet. Number two is how little activity we do in a day. Number three is stressors placed on our bodies.

Eating large amounts of carbs = taking large amounts of insulin = storing more energy as fat = weight gain

Inactivity = Less energy used = more insulin requirements = more stored fat and less stored energy used = weight gain

Stress = increased resistance = increased liver output of fuel (glucose) = higher glucose = more corrections or more insulin = more weight gain

Notice the trend: more insulin = more storage = more weight gain

Lower carb (not extreme) = less insulin = less fat storage = weight loss
More activity = lower insulin requirements = less fat storage = weight loss

Less stress or more sleep = less free floating glucose = less insulin (or correction doses) = weight loss

Easy,  right?  Well not always.  Here are a couple of other things to consider.

You need to have the right insulin(s) and or delivery methods. MDI or Pump. You need to be willing to test a lot,  I mean a lot. You will fluctuate at first but given time and good record keeping, things will even out. Try to eat the same amounts of carb for each meal. Eat protein for each meal, then carb free choices, then slow carb choices - More on the specifics later if any one manages to read this or expresses interest in knowing more.

Cheers!

Trev

To Snack or Not to Snack......

I have a hard time with the night time blood sugars, always have, call it fear from dropping low, or simply being unable to saw logs on an empty stomach, whatever the case this is come around once again in my life in my children's diabetes management.

I am comfortable bolusing or taking a shot of rapid for a snack, pretty much figured it out, if it is greater then 20 grams of carb, I bolus, if it's one hour before bed I take 50% of my ratio, if I've been active I likely won't bolus at all, and if I do it's 75% less then what I'd normally take, so lets just say I've figured it out.  My two dia-kids on the other hand, NOT THERE YET!

My 7 year old insulin user, sounds like I am making her out to be an addict, nothing could be farther from the truth, but she is definitely a user of insulin.  Snacking is,  lets just say, a little riskier.  But in our house full of people,  snacking is the routine. Like popcorn on movie night, ice cream when its hot, anything a non-d kid would eat, our d-kids eat too. The tricky part happens with warm weather, increased and/or unpredictable activity, late nights, and other life events that don't fit into the diabetic routine. These things usually lead to variable carb intake and a Vegas approach to calculating  an accurate carb to insulin dose. Sometimes we win and a lot of times lately, we lose, and when I say lose, it is usually sleep. We end up staying up until after the majority of the rapid insulin is done its job, and this as you are well aware takes a few hours.

This sucks, but we do it because that's what d-parents do, they watch over there lil ones thinking like a pancreas, checking levels, only able to sleep when they are certain their kiddo is safe for the remainder of the night.

It is still my biggest D-Fear for me to not test, or miss that low or high and do harm to our baby.

My heart goes out to all the parents out there who share this experience.

Trev

Tight Rope Act Getting Old ?

YUP!

I say give me a plank to walk on instead any day.

I totally think that managing Type 1 diabetes, and Type 1 diabetes in children especially is a constant tight rope balancing act. If you lean to far in either direction, or lose your concentration, then over the edge you go, sometimes landing on the safety net and unfortunately sometimes not. It really is a precarious balancing act of food, activity, stress management and insulin dosing. Not to mention the inevitable "curve balls"

I equate my house with diabetes to a tight rope walk while juggling three balls as there are three of us to manage. I must admit that the prospect of caring for my 2 kids was incredibly overwhelming at first and still is at times. Things in the house of syringes and test strips has stabilized to some degree, well at least the routine has, but the numbers could always use a little work.  The routine is ingrained, as anyone dealing with diabetes can attest to, testing, thinking, calculating, injecting or bolusing, testing to see if you guessed correctly, and so on and so forth. You adapt to the routine, but are never completely at ease, once again with children in particular. Like a tight rope walk, one screw up, miscalculation, mismeasurement, and over the edge you go. 

I try to imagine or wish that the tight rope could be more like a plank, not like on a pirate ship; where you'd eventually plummet to your death to be eaten by frenzied sharks, but wide enough to take some of the nervousness and precariousness away by allowing for a larger margin for error. I do believe the technology that exists today is widening the plank. Pumps fine tune basals to prevent lows at night and spikes in the morning. Continuous blood glucose sensors are allowing us to notice trends in our blood sugars allowing us to relax and let a machine do a bit of the brain work. Newer insulin analogues in the last 2 decades have really helped me feel more at ease resting my head on the pillow at night knowing I am far less likely to be jolted out of bed with a frightening low. Glucometers, where would we be with out them? We'd likely still be judging our control based on how much weight we've gained or urine sample showing glucose from hours long gone past. That being said; most days feel like I am tight rope walking while juggling.

Why is that? Well, because so many things mess up our sugars. A handful of those yummy skittles, a sleepless night, a rebound high after a night time low. Do you realize how hard it is to stop eating after treating a low with 15 grams of carb. It is like a dog not taking advantage of the piece of bacon dropped beneath it's nose during a breakfast frenzy. Ya, that bacon is gone with in a split second, along with your plate of eggs an toast. Alright, back to the point, which is everything can effect our glucose.

My teen Type 1 often forgets to test, and will arrive home with a glucose that would cause any Endo or Doc to drop, or prompth them to call the authorities. I don't judge my girl though, I remember the balancing act, I remember being a teen, and I can only gently yell remind her to test while at school. When I ask what could be the cause of her reading (trying to encourage critical thinking) she shrugs and says, "I had some of my friends chips" That's it, as simple as a bag of chips, not criminal just thoughtless, diabetes has obviously not entrenched itself into my daughters thoughts as it has mine, she has yet to be relentlessly governed by the big Mr D.

Now my little Type 1 who is 7 is frequently falling onto the safety net, close at times to the hard concrete floor, but has always landed safely, conscious, with her brain intact. The near misses have occurred; nights where I get up and randomly check her after having a low myself, finding her reading less then the desired range or after an activity that we neglected to feed her enough, another example of losing concentration.

It is these occurrences mentioned above that remind me that we're walking a tight rope, and the minute I lose concentration, put my guard down, relax a little, the potential to miss the net is ever so present.

Trev

Can Exercise Kill You?

Okay I must admit the title sounds a little ominous. But in my reality participating in physical activity can  in effect make diabetes harder to control and can cause serious fluctuations in blood glucose. As anyone who has been jolted out of bed at night (sweating, shaking and fumbling for a quick source of carbohydrate only to rebound the next morning into the high teens) with an extreme low due to exercise performed earlier in the day. Sorry for the run on but need to get my point across.

The Canadian Diabetes Association recently sent out a News Letter that had some stats about what type of support Canadians get from Province to Province. There was one number or stat that stood out regarding exercise and diabetes. "Ninety per cent do not have a fitness expert to consult with when they require specific advice about how exercise impacts their diabetes." Interesting.....but not surprising.

In the past 20 of my 30 years living with a dead pancreas, I know I sound melodramatic, I have found it extremely difficult to find a health or fitness professional locally to assist me in this area of my diabetes management. Sure you get basic guidelines, like feed your activity or reduce your insulin by a certain percentage prior to exercise, but I must admit that as usual, my approach and control is the result of self awareness and self experimentation using my trusty glucometer. 

As I age, and routines change; I am still learning new things about exercise and diabetes. For example; that if I perform a high intensity workout I often require extra insulin prior to the work out. Once again due to the stress response mentioned in the last post. Crazy, as I have always been instructed to feed or reduce for activity. I also understand that everybody reacts slightly differently to exercise, stress, food, etc.  So it is likely hard to narrow down specific exercise recommendations.

Back to the stat; 90 % of people - That's a high percentage who would benefit from a specialist in exercise and diabetes. I also notice that there's a  lack of detail out there on exercise and diabetes, and that any info out there is difficult to weed through and unfortunately these details and lack of accessibility can in some cases be crucial to all diabetics (Type 1 in particular) So hopefully in the future our health care team will also include an exercise expert focused on diabetes or the option to see one. I doubt it though, as my docs over the past few years tell me that active people are a rarity these days so if a person is doing anything remotely resembling exercise, that is good enough. But what about the select few of the Type 1's out there that require expert support in the area of exercise?  Trial an error is good but there are certainly tips I would have loved to know years ago that I know now regarding nutrition, glucose response to the different types of activity, etc.

What I have learned using myself and observing my kids in terms of exercise and diabetes:
-over training is not good, my limit is 2 intense work outs per week.
-If i train near my max heart rate I typically don't need to feed the activity and generally require a bit of rapid insulin
-If I train at a low intensity I either have to lower my insulin by 30 % (Thanks to my Nurse educator) and this seems to work, or feed the activity 10-15 gms of CHO for every 1/2 hour - keeping in mind we are all different and I am sharing what works for me.
-If I don't drink enough fluid or water during the time during and prior to the work-out then my sugar level tends to really spike with high intensity training.
-I get sick really frequently if I workout more the 3 times a week with high intensity training (circuit weigh training, Muay Thai Boxing, and never work out more then an hour (includes warm up)

Even with frequent testing and self observation, fine tuning etc, I still have the occasional low, and would still love a good guideline and expert advice and feedback on the specifics, like carb loading and intake on training days, specific tips to stay healthy looking through the goggles of a diabetic paradigm. Questions like; will a certain activity worsen or accelerate any diabetic complications?

Feel free to point me in the right direction. And overall I do believe that just the right amount and type of activity will keep up healthy but too much of any activity is damaging.

Cheers!

Trev

CHANGE is GOOD but can be STRESSFUL

Change is the one constant in life that is inevitable. Be it the weather, relationships, jobs, homes, and the list goes on. Change can be self induced or in some cases imposed. It can be predictable and unpredictable. Change in any of the above scenarios can also wreak havoc on our diabetes control.

Fluctuations and Change are one of the things us folks with diabetes must contend with daily. The past few months we (my family) have gone through some Change. The change was imposed and we were forced into a decision and subsequent change. Regardless of what the change was, I just want to share some observations related to blood glucose control through this period of change.

Imposed change (to me) results in more stress when compared to self motivated change. I react emotionally first then intellectually second. It is the emotional reaction that messes with my diabetes control. Emotions tend to evoke a physical reaction, and before you know it my glucose levels become more difficult to control.

Why is that? It's that damn "Stress Response" I tell you it may have been handy for our Neanderthal ancestors, but it sure sucks for modern day folks.

In summary; I get emotional, my brain responds buy telling my adrenal glands to pump out adrenaline which basically tells my liver to produce more glucose and also conserves the glucose I have floating around, which as you can well imagine sucks for us diabetics. We don't need the extra energy (glucose) to run from the tribe up the river trying to steel our food - which was likely the scenario our ancestors faced on a frequent basis. Point is stress = crappy high sugars.

Needless to say that when the change passes the glucose gets easier to control and insulin requirements go back down to pre-change levels. I guess what I continue to tell myself and my kids with Type 1 is that change will happen, so test more often, correct more often, and listen, discuss, and address your emotional response because not doing so seems to make the physical response more turbulent.

I notice this (change - emotions - physical) reaction with many things. Sleep deprivation really messes up my emotional regulatory system or more easily put make me a very moody or as my kids would say a very grumpy dad. Sleep, I've learned is crazy important not only in stress reduction, but in decreasing insulin resistant, which is not as important to type one diabetics. We just crank up the dose to accommodate.I have also learned that getting enough sleep is the only solution to getting rid of that stubborn fat that hangs over the belt buckle.

If faced with change, and feeling emotional, get it out, talk it out, it will pass like all other things, and most important of all,  test that blood sugar A LOT.

Cheers!

Trev