Sunday, 24 September 2017

A diabetes reconciliation: 1 year of insulin pump therapy


*DISCLAIMER - Please note in this article I am purely referring to Type One Diabetes and my personal views in relation to the Animas Vibe as well as my own personal experiences of NovoRapid and Fiasp. Remember Your Doses May Vary and all information found in this blog post is my opinion and is what works for me ONLY. It is not intended as medical advice. Please consult the relevant health care professionals before you make a change to your treatment plan in any way*

So I can hardly believe it, but it is well over a year since I first loaded a cartridge of insulin into the pump and pressed 'GO'.



And what a year it has been...

I would love to say that it was plain sailing from the start, but then that wouldn't be diabetes now would it?!? 
However, despite a couple of quite literal, highs and lows...the last 14 months of insulin pump therapy (IPT) have honestly transformed my life for the better. In fact, I'd go as far as to say that I've got my life back!



Prior to the pump start in July 2016, I had battled with my blood glucose levels for the previous 2 years, with the final 6 months seeing me having nighttime hypos so extreme that I didn't wake up on a couple of occasions until my parents let themselves into my house and physically shook me. I don't think I will ever fully appreciate how much they worried about me during this time, other than remembering the look of fear in their eyes one day when they woke me from a hypo... 

To say that I became scared of sleeping would be an understatement. Nonetheless, I would reach a point in the day where my eyes were so heavy that I couldn't fight the tiredness anymore and I would drift off to sleep, but this would be with a sense of worry and concern about whether I would hypo in the night or not wake up for my alarm the next morning. It was literally a guessing game...some weeks I would not hypo during the night and other week's I would hypo 3 or 4 times. To say that I was physically, emotionally and psychologically exhausted would not quite cover it. I was running on empty...

The day I finally got the 'yes' to pump therapy was life-changing for me. I knew that there were no guarantees or quick-fixes attached to insulin pump therapy, however it meant that I had an opportunity to approach things differently and to be able to inject the minuscule amounts of insulin that I actually needed after suddenly becoming hypersensitive to insulin. This substitute to multiple daily injections (MDI) for me became a life-line that I had dared not hope for.

After a few weeks of waiting and some training sessions, finally it was the day to start on using my insulin pump. To say that there were high expectations would not quite cover it. For me, my whole future as a functioning, working and independent adult hinged on the pump therapy being effective or at least improving my diabetes control somewhat. This probably wasn't the best way to start insulin therapy, but then again, diabetes doesn't always make things easy for you, and quite frankly, I didn't have many other options open to me and at 33 years old I wasn't ready to give up.

I felt like it was my first day in school again...that I didn't know what I was doing or what the rules were. But like an eager student keen to get top grades, I wanted to get the very best out of pump therapy and had researched and spoken to many people about it before I started. This is something I would highly recommend, as pamphlets and websites don't give you the reality of life with an insulin pump. I needed to know the benefits and the pitfalls before I experienced them, I needed to be prepared! For me, speaking to people who used an insulin pump on a daily basis both before I started pump therapy and in my early days, transformed my approach and gave me a huge confidence boost about the things that could be achieved. This is where the online diabetes community really come into its own. No question was ever to basic or viewed as silly. People who I had never spoken to before all took the time to answer my questions, point me towards sources of advice and to offer their support which I had never experienced before. From these people, I found the information given to me about adjusting basal doses, the use of temporary basal rates and where to wear your pump (a really question when wearing a dress!) were all hugely helpful and comforting in the early days. On the occasions when questions pop-up now, the online community are always there to help out.

As I got more confident in the functions of the pump I found that my control continued to improve. Nonetheless, as I eluded to earlier, that didn't mean that everything was perfect the moment I switched from multiple daily injections to pump therapy, but I would say that my life literally changed within days. No more night hypos, no more yo-yoing blood sugars from one extreme to the other and no more headaches, nausea and exhaustion. More importantly, as time passed from the start date of pump therapy, the fear and concern began to fade from the eyes of my parents and close family and friends. 

The most recently change for me has been the switch from NovoRapid to Fiasp in the last few months. This eliminated the need to pre-bolus before a meal. This may not sound like a huge deal when you're at home and you know your food will be ready to eat in 10-15 minutes, but this became a huge issue for me when eating out at restaurants or other people's houses. Mistiming an insulin dose could wither result in overly-elevated blood sugars where insulin was given too late or hypos occurring prior to the meal if the insulin was given too early or the food is delayed. Despite Fiasp not working for every person with diabetes, I am grateful that for me it has given me the freedom to inject just as I start to eat, and to avoid the pre-meal insulin dilemma. One more little step towards being able to take actions towards managing my blood sugars safely. After a few initial dose tweaks and a bit of trial and error when it came to exercising, I finally figured out the quantities I needed on a typical 'Ros' day!

Finally, I started to feel like I had some control in my day-to-day blood glucose levels, even if diabetes does like to throw curve-balls in there every now and again. In fact, the last two days have been a diabetes 'mystery' that I am still playing detective over as you can see from the Libre graphs below. Yet despite these little or big conundrums that type 1 diabetes likes to throw our way, thankfully these days they are few and far between.


Thankfully, looking at the journey overall since beginning insulin pump therapy, my blood sugar levels have really stabilised (despite the odd obscure number every now and again), with my last HbA1c result coming in at 6.0% or 42 mmol/mol.



Therefore, after lots of reading and research, speaking to many people including healthcare professionals and fellow people with diabetes, making many dose adjustment decisions and trying new approaches and a new insulin, I would say that this year on insulin pump therapy has been momentous in my diabetes adventures. For the few road bumps that I've had to overcome or work around, I have been able to enjoy my life a lot more and to feel far more confident in taking the reins when it comes to my diabetes management.

Thank you once again for taking the time to read my blog post.
Until next time, keep injecting 💉 or pumping 📟 insulin!
Ros x


For further information about the Animas Vibe, please visit https://www.animascorp.co.uk 



Wednesday, 31 May 2017

Myths, Misconceptions and Fallacies of Diabetes #GBDoc #doc #diabetes

 
Sadly, even in a time of easily accessible social media, online resources and innumerable TV programmes to choose from, there still appears to be numerous myths or misconceptions that surround both Type 1 and Type 2 Diabetes. That is if the distinction between the two is even made!



Misgivings can include, but are not exclusive to the following:

  • Diabetes is contagious - sadly I have been asked "Am I going to catch it?" on more than one occasion...
  • All people have diabetes because of what they eat and they must have been obese at some point. Again, I have been asked how obese I was as a child...
  • That there is only one type of diabetes, or the viewpoint that the distinction between the types are that there's one where you have 'too much sugar' and another where you have 'not enough sugar'.
  • Diabetes means we are allergic to sugar and therefore just simply need to avoid it...and all is fixed! If only that one was true eh?!?
Dispelling these myths can be a huge challenge, even if just in our own social circles or through our online presence. Confronting these errors on a national or global scale however is far more difficult, and a continuing and ongoing mission. A task that many people with diabetes are taking-on every day in our own small parts of the world.



So where do these fallacies come from? Well as a person trying to tackle them, the answer is sadly, a whole host of sources. A major one though is the media. By the term media, I mean tv programmes where insulin is given to treat a hypo (this could in fact actually kill someone with diabetes), news reports where the type is unclear or completely inaccurate, social media where posts are published about miraculous treatments or diets that 'cure all diabetes' and newspaper articles that report on 'facts on diabetes' that essentially, are completely fictional. 



I would love to say that this is the only cause of the problem. However, the lack of awareness of diabetes in general, let alone the types, is a HUGE failing. The absence of any appreciation for the causes, symptoms and treatments of diabetes is the norm in most societies, as well as the recognition of the ever-growing prevalence of diabetes among populations in countries throughout the entire world.



So, what can we do about this? I would say that all of us can take different actions to try and tackle this issue and eradicate the distorted and propagandised views of diabetes. 



News reporters – please do your research thoroughly and make sure you state the type of diabetes that you're referring to in your writing. By using the facts, you will avoid causing offence in the masses, as well as those without diabetes to understand our daily lives a bit better. Equally, you may really help those who are at risk of Type 2 diabetes or those with symptoms of diabetes to seek the support of health care professionals if they see themselves in the facts given in news reports.


People without diabetes – please be aware that what you are currently hearing, seeing and reading may not be factually correct about diabetes. Therefore, please don’t assume that people have brought diabetes on themselves or that taking insulin or not eating cakes somehow ‘fixes’ everything. For those of you who believe you may be at risk of diabetes or are symptomatic…please seek support from your GP or hospital as soon as possible. I’m not trying to scaremonger, but hesitating really could put your life at risk!!!


Health care professionals – help to raise awareness without the stigma attached to it. We all appreciate the great and wonderful work that health care professionals do every day, however we (both people with and without diabetes) need support and understanding when it comes to diabetes diagnosis and treatments. All I would ask is that you recognise that the vast majority of us are doing our very best in terms of our health care, despite whether our health is deteriorating or we are struggling with certain aspects.


People with diabetes – spread the word! Despite the rise the in number of people with diabetes, the awareness of the condition and all it entails has not increased. Therefore, we need to be the mouthpiece that spreads the word about the reality of life with diabetes and to help those who have been ill-informed about diabetes to understand the facts. By sharing posts on social media, kindly correcting misconceptions amongst our friends and family and staying up to date on diabetes developments, we are doing our bit to help. Equally, I would say that the peer support is a huge part of diabetes. So, whether you are looking for advice from those living with diabetes, want to help others with a struggle you’ve already been through or simply want to chat and offload to people who understand, then get involved in your local and online diabetes groups.


I hope that with continued collaborative work between patients and health care professionals, local and national diabetes campaigns and news/ media engagement, the general public can become factually informed about diabetes in all its forms.

Thank you once again for taking the time to read my blog post.
Until next time, keep injecting 💉 or pumping 📟 insulin!
Ros x