Diabetey McDiabeteyface

Hello!  Long time no blog but I’m back on the scene now as exams are finished. Yay!!!

Now that I’m not revising and taking A levels I’ve started reading more.  I came across an article recently that commented on a recent Diabetes New Zealand campaign that was disappointing Type 1 diabetics. (https://www.stuff.co.nz/national/health/123359777/type-1-diabetics-disappointed-with-diabetes-nz-campaign )

The controversy centred on the grouping together of Type 1 and Type 2 diabetics.  The phrase that caught the ire of some was the new “love don’t judge” slogan.  The suggestion being that Type 1 was somehow reflective of a lifestyle choice and could be reversed with support (which it can’t). 

It was interesting to me to see that even in a country like New Zealand where those who were tasked with spreading awareness were ambiguous in their clarity!

Reading it prompted me to clear up some common misconceptions between the two. Seeing as I am a self-proclaimed Type 1 diabetes black belt (or maybe a more like a purple belt) I feel that it is my duty to attempt to explain and outline these differences. 

Type 1 diabetes:

An autoimmune disease in which your body mistakenly attacks the cells in your pancreas which means it cannot make any insulin. It seems to have a genetic basis and its usual onset is during childhood.

Type 1 diabetics are dependent on insulin which can either be injected or pumped into the body.

At present there is no cure for Type 1

Type 2 diabetes:

People with Type 2 do not make enough insulin or insulin that the body can use properly. The cells in the body become resistant to insulin so more insulin is necessary to maintain a normal blood sugar.

Type 2 can be reversed through a maintaining a healthy diet and exercise regime.

It feels to me that the names of the disease are so close that they are used interchangeably whereas, as you have just read, they are very different.  In NZ there are 250,000 diabetics of which 90% are Type 2s.  So I guess it is up to us Type 1’s to come up with a catchy new name to differentiate. 

Any better ideas than my father’s suggestion of “Diabetey McDiabeteyface” are welcome. I subsequently learnt the inspiration of my father’s natty name for my disease was inspired by the internet competition to name a UK research vessel. See the attached article.

https://en.wikipedia.org/wiki/Boaty_McBoatface

Glucose upon publishing: 5.5 mmol/L

Diagknowsis

With my A level exams closing in fast I have found it hard to get creative on all manner of things and unfortunately I have experienced, for the first time since diagnosis, writers-block.  Even my usually reliable (https://insulearning.com/2020/03/29/nightmare-on-sugar-street/) vivid sugar driven dreaming seems to have settled into a pre-exam funk.  This has spurred me on to say something important that I have been meaning to for some time and post a long overdue, ever so simple yet transformational snippet of knowledge that you can all use. 

If my parents, family or friends knew what I’m going to tell you about spotting diabetes then my diagnosis would have occurred much earlier.  I am so lucky that I found out sooner rather than later; many are not so lucky.  Please read this post carefully.  This is a serious one folks.

Fortunately for me I discovered my condition during an unrelated doctor’s check-up. This is not always the case. Often many parents and healthcare professionals only find out when a child collapses and a life with diabetes begins with an emergency visit to the hospital.

Worryingly, even before a frightening collapse, the child’s ketones levels (aha another blog methinks – take that writer’s block) may have been dangerously high for some time which could have consequently already caused long lasting damage to the organs.

I am really happy to report that I am currently the healthiest version of myself ever and my diabetes management has allowed me to concentrate on my exams (yikes, must get back to revising). In between revising I have grown a little baby bicep that I am working hard to maintain now that I am able to build some muscle. Soon it’ll be biceps! (plural form).

I would like to share my top, relatively unambiguous, less subjective type one diabetes symptoms with you:

If you hear of a child or of someone displaying any two of the above symptoms, then please suggest that they get checked for diabetes. It involves a straight-forward blood test. That’s it.  Simple. 

Please pass this on.

Glucose upon publishing: 5.9mmol/L

PS I must confess that I’ve used some writer’s licence as I don’t have a sister but Diag-know-bro doesn’t work so well.

I need SOAP

“Remember, candidates sitting for the examination are to conform with the outlined Standard Operating Procedures.  In particular, candidates are not permitted to bring in any items that are not required for answering the question paper.”

I have an issue with these SOPs. No matter how much I’d like to be a conforming candidate I simply cannot be. This is not because I am forgetful. This is not because I am not switched on. This is because I have Type One Diabetes.  I must have my very own Standard Operating Amended Procedures!

To be exam prepped and ready I come equipped with my diabetic expedition survival kit. This is literally what I would need if ever I happened to be ship wrecked on a desert (or dessert) island.

With this kit I reckon I could last an extra 2 days, at least from a diabetic standpoint not taking into consideration the threat of a lack of drinking water and dangerous animals.

It also means that I can sit in a 3 hour Cambridge A-Level Accounting exam and survive from a diabetic standpoint not taking into consideration the threat of not having done enough revision.

In the kit, I have my blood glucose meter, lancets, testing strips, sweets, alcohol swabs, sweets, constant glucose monitor reader, sweets, insulin, sweets, phone and a good luck mascot.

In addition to abiding by my Standard Operating Amended Procedures, I must also prepare for a number of situations should they arise.

The feeling of stress is inevitable come exam season no matter who you are. Stress is not a carbohydrate but can affect a Type One Diabetic’s blood in the same way as a carb would.  The experience itself can cause your blood to rise similarly to how eating a carbohydrate would.  How sad is that, my glucose spikes and I haven’t even tasted a thing.

The following table gives you an insight to my stress level, what it does to my blood sugar and what I would have to eat (provided no insulin) to cause the same effect:

A way to reduce your stress and reduce blood sugar spikes is to revise using high quality notes. Big thanks to the team at ZNotes for helping me to reduce my blood sugar during my Cambridge AS-Level exams. You guys helped me smash my Psychology papers.

On a final note, did I mention that I need to bring sweets into the exam hall? It’s not all bad being a Type 1 Diabetic.

Glucose upon publishing: 5.4 mmol/L

Karbohidrat Mengira

Any Type One Diabetic is automatically inducted into the carbohydrate (carb) counting club. A wizarding world of numbers and mental arithmetic that involves a good gut feel for ratios.  A good set of measuring scales really helps too.

We carb count because the digestive system, with the assistance of insulin, breaks carbs down into glucose to be used as energy by the body. With T1D, we need to balance the amount of carbs we eat with the right dose of insulin as our pancreas isn’t producing any.

We therefore need to be able to tell how many carbs are in what we are going to eat. This can be found on a food’s packet and entails reading many, many nutrition labels that bear teenie teenie tiny tiny stats and information. 

You can imagine that this is a little trickier for me in Malaysia where the food labels are often in Bahasa Malaysia (the local lingo). I admit that I need to brush up on my Bahasa Malaysia but I am pleased to report that I’ve gotten better. Pre T1D diagnosis, I could confidently say the word prawn (udang) and hair dresser (kedai guntung rambut). Post T1D diagnosis, I have added the word for carbohydrate to my vocabulary (karbohidrat) and counting (mengira). Yeah! 

Karbohidrat mengira sounds easy but there are extra challenges I face living here. Street food is a big part of Malaysian culture which must be embraced by all, even a Type One Diabetic which is why I wanted to blog on this subject.  Freshly made street food does not come with any labels and clues as to their karb content.

Luckily enough, I was gifted a chart by a Malaysian dietitian outlining Karb estimates for some staple favourites that I’d like to share with you:

The man tou – a Chinese steamed bun said to contain 25 grams of carbs. These buns do not tend to vary in size but do in taste, some sweeter than others. This is where you must be careful because the carb content will differ if one bun is sweeter than another.

Fried chempadak – Said to contain 30 grams of carbs, these are deep fried pieces of jack fruit. Has a very distinct smell. A favourite of my friends’.

Char Kuey Teow – In Hokkien (a Chinese dialect) char means “stir-fried” and kuey teow are “flat rice noodles”. A portion is said to contain 76 grams of carbs.

Nasi Lemak – From Malay cuisine, consisting of coconut rice, crispy anchovies, sambal (chili), toasted peanuts and a boiled egg. 58 grams of carbs in a portion.

Roti Bom – A personal favourite of mine. Resembles a pancake that swims in a puddle of condensed milk. From personal experience with trying to manage the carbs in this one with insulin, it is best to stay away from the roti bom. One roti bom is supposed to have 35 grams of carbs. Roti Bom more like carb bomb.

Gluscoe upon publishing: 6.0mmol/L

Argy-Bargy Onion Bhaji

At the weekend we sat down for a dinner at our favourite Indian restaurant called Sri Ananda Bahwan, an institution in our area.

As a diabetic, it is quite difficult to navigate such an exotic menu. I have to be conscious of the carbohydrates I am eating. Picking dishes that have fewer carbs will make my blood sugar level easier to control with insulin.  

Choosing the right dishes to eat requires will-power.  I have to steer away from that delicious looking naan that seems to somehow call my name…” Antonia, Antonia eat me!” Not today Mr Naan.   

Having been to this restaurant a few times since being diagnosed, I have established a few don’ts for me:

  1. Don’t order a Milo Ice – this is an iced milo, or chocolate drink, that is divine on account of the condensed milk that that the milo drink swims in. Condensed milk is bound to make my blood sugar level go haywire.
  2. Stay clear of Mango Lassi –  a mango and yoghurt drink. Again extremely sweet. Mango has many carbs making it an unsuitable choice. They may even sneak some condensed milk into this one too. Everything tastes better with a bit of condensed milk.
  3. No to the Naan bread – Naan, nah.
  4. Avoid super saucy curries – e.g. Korma killer.
  5. No argy-bargy if you avoid that onion bhaji!

On this occasion, the waiter came over and brought us some complimentary jalebi for dessert, yum. For those of you who don’t know what jalebi is, it is a fluorescent orange Indian sweet that has been deep fried and then soaked in sugar syrup. It took a while for my father to convince my brother that jalebi is not made of carrots (nor is as healthy) and therefore really quite edible.   

The waiter stabbed the last jalebi with a fork and extended his arm towards me. I declined. Never in his years of serving customers had someone declined a complimentary jalebi. I tried to explained that the sugary delicacy was a no go. There was no knowing what such as sweet could do to my blood sugar levels.

He looked at me with the saddest eyes. My Dad thought he saw the waiter’s eyes almost water.  He clearly couldn’t imagine a life without jalebi, however, I don’t think he really understood the issue because a few minutes later he returned with complimentary gulab jamun.  Gulab jamun makes jalebi look like a cake walk for a diabetic.

Glucose upon publishing: 5.4mmol/L

PS I am delighted to report that my tactic of taking my curry beating insulin shot 2 hours after my last mouthful of curry worked a treat and my glucose didn’t go above 10mmol/L.  The timing of insulin shots after meals is one of my new developing skills which I will write about on another occasion.  I think it could be my secret sauce…..

Quiz – which one is which?

Snail versus Schwarznegger

“I’ve sent you an email,” said my younger brother. He smiled. I wrongly assumed that it would be a video of him firing a tennis ball past me from our latest on court battle (which I always win) or details of some trending dance fad. 

To my surprise I found an article attached titled “Snails are helping us unlock faster insulins”.  It was a interesting article about a species of snail called Conus Geographus aka the cone snail.

Let’s imagine a fish. This fish isn’t ordinary. This one is the Arnold Schwarznegger of the fish kingdom.  This fella might be small but he’s got shredded fins and ripped scales. No one messes with him. 

Now imagine a hungry cone snail cruising along in search of a meal.  It identifies the aforementioned “Mr Atlas” of the fish world and goes in for the kill, swallowing Arnie up whole. Hold on!  A cone snail going in for the kill sounds a bit bizarre……

I take a fast-acting insulin at meals times to prevent my blood glucose from soaring upwards causing hyperglycaemia. Although “fast-acting”, the insulin does take time to start working and because of this time lag, my blood sugar may rise and become high. It is quite tricky to get it right. Note that hyperglycaemia is very bad as it can lead to permanent damage to my eyes and other vital organs.

An even faster acting insulin could be more effective but I would need to be careful as it could potentially send my blood sugar way too low causing hypoglycaemia. If I was to go into a hypoglycaemic state I might not be blogging for a long time.

This is where our snail comes in… Amazingly the cone snail secretes a fast-acting insulin that sends Arnie the fish into a state of severe hypoglycaemic shock. In other words, it makes his blood glucose plummet and he becomes temporarily paralysed leaving him unable to avoid being swallowed whole by our snail.  It effectively makes the fish a type 1 diabetic who injected too much insulin! Wow. What an assasin.

The cone snail’s insulin lowers blood sugar much more quickly than my insulin. Its speediness means that it could well be a replacement for the insulin that I currently use. Imagine that, snail insulin in my body ewwww!

Rather unhelpfully my brother suggested I get a snail and lick it whenever I’m about to eat. No thank you.

Glucose upon publishing: 7.3mmol/L

Thaipusam

In February 2020, I was diagnosed with Type 1 diabetes and about a week later I went on my first post diagnosis outing to witness the spectacle of Thaipusam.  To those of you not familiar with the festival the irony might become apparent by the end of this post.

Like most T1Ds (Type 1 Diabetics) I use an insulin pen to inject insulin into either my arms, legs or stomach (injection sites). These “pens” are about the size of a large fountain pen and have a ratchet at the top to set the dosage and a button to push down to administer the required amount of insulin.

The nib of the pen, so to speak, is the disposable needle.  Needle sizes can range from 4mm to 12mm in length. The length you use depends on your body shape and preference. Combined with the right needle and the proper technique, I can enjoy years of pain-free injecting.  Yippee!  It is key to rotate your insulin injection sites to avoid any of this potential pain.

Thaipusam is a festival celebrated by Hindus of Tamil descent to say thank you to Lord Subramanian, son of Lord Shiva. It usually takes place in late January or early February, depending on the alignment of the sun, moon and planets. This year it was the first week of February.  

During Thaipusam devotees go to different lengths to express their devotion.  Some pierce themselves with needle-like skewers known as vals through their tongues and cheeks.  Others pierce themselves with needles and hooks on their backs and pull large, wheeled carts attached to them.  Their devotion and creativity is truly an amazing and the emotional experience is accompanied by some very very loud Indian boom box music. Many dance their way in the procession on the way to the temple.

Now I have perfected my technique using the correct needle, I don’t feel much pain… though I don’t ever really feel much like dancing afterwards. 

The devotees pierce themselves with needles to seek atonement and be closer to god. I pierce myself with insulin pen needles so that I can delay my meeting with god. 

When I attended the festival, I had to find a discrete area to inject myself because of the crowd but I’m certain no one would have noticed the 4mm needle in my tummy.  

I hope you’re understanding the point of my blog.

Don’t want to needle you but please consider passing my blog on to more people 🙂

Glucose upon publishing: 4.4 mmol/L

Sugar Doggy

COVID 19 – I hope that you and your families are staying safe during the coronavirus. Please take care.

Let’s get into some technical stuff. Our bodies need a certain level of glucose to function properly, and dropping lower than that level can be dangerous.  Hypoglycaemia, or hypo, is the medical term for low blood glucose.

A quick sugary snack can fix a hypo when symptoms are experienced.  Sometimes I get a wee bit shaky and anxious feeling, sometimes I don’t. So I have sporadic, inconsistent, irregular, mysterious, “what on earth is going on” hypoglycaemia unawareness!  Basically, I probably wouldn’t know if I was having a hypo.

There is the possibility that if I don’t eat a snack my glucose level could drop lower and lower causing………. let’s just say I will not be able to blog for a while.  For this reason, glucose monitors can come in handy.

I wear a constant glucose monitor aka CGM. It’s a clever device, about the size of my thumb, that is stuck to my stomach all the time. It feeds info to my phone letting me know what my blood sugar level is and the direction it is heading. 

My CGM is a G6 made by a company called Dexcom (DXCM (NASDAQ)). As my Dad says “if Gucci made a CGM the G6 is what it would look like”.  I am not sure if he was referring to style or the cost.

I did tell my Dad about another option being the glucose dog.  Service dogs for diabetics are specially trained to recognise a unique scent produced when a person is experiencing a hypo. They can touch the owner with their nose and jump onto their lap as a signal to alert the person of their hypo. They may also alert another family member or use a special device to dial the emergency services. 

We already have 2 dogs in the family so unfortunately the application for a 3rd, even if it is a super smart glucose dog, was denied by management (Mum and Dad).

I have yet to look into training our mini schnauzers to be diabetic service dogs but as they sit here grooming themselves whilst I type, I think I better stick to my preferred GCGM (Gucci Constant Glucose Monitor)

Glucose upon publishing: 4.2mmol/L

Not so clear!

Hi everyone, just to clarify my last post referred to my original and initial hospital visit back in February. My new and redundant sunglasses had been staring back at me for weeks and prompted me to write about my eyesight experience. Just a quick clarification as it may have sounded like I have been back to hospital for another stay – which I haven’t. Take care. Antonia GG 7.2mmol/L

I Can See Clearly Now

COVID 19 – I hope that you and your families are staying safe during the coronavirus. Please take care.

Four months ago…

Seeing clearly is wonderful.  Something incredible happened the morning I rose from my hospital bed and gently yet forcefully pushed my drip and I towards the bathroom (the drip’s hanger had surprisingly stiff wheels and as a first time drip user I was very cautious about lugging the thing around).

Arriving at my window, I could see the mountain in the distance. I could see the houses. I could see the cars in the parking lot. I rubbed my eyes.  My glasses were not there. They were not on my face and yet I could see clearly!

Now that my high blood sugar was tamed and I was re-hydrated, I could see clearly. It was unbelievable. Who knew that type one diabetes had up sides?  I sure didn’t.

A week later at college, I sat at the very back of my lecture hall. It felt amazing. So amazing in fact that I went out and purchased myself a rocking pair of sunglasses that I would now wear both indoors and outdoors. 20/20 vision was something to be celebrated. Until, one day, it all stopped…

My short-sightedness had returned as quickly as it had gone.   My days of no glasses and wearing sunglasses indoors were over.  Billboard signs that I had the joy of reading tiny tiny phone numbers off of could now only be made out with glasses on.

High glucose causes increased pressure in your eyes drawing more liquid into your eyes and changing the shape of the lens.  When I started treating my type one with insulin the lens changed shape and momentarily gave me 20/20 vision.

I am not complaining as perfect eye sight was great whilst it lasted. However, I have these perfectly good premium sunglasses that need a new owner. Would anybody like a pair?

Glucose upon publishing: 4.3mmol/L