Category Archives: continous monitoring

Your sugars and your holidays


holidaysHow does one approach glucose control during the holidays?

Holidays are generally a time where we relax and let our hair down a bit more than at other times. Included in this are dietary relaxations like consuming more refined sugar than normal as well as alcohol in slightly greater amounts and strengths, depending on your preference and age. Also for some it may include more than normal outdoor activity and exercise.

All of these have repercussions for glucose levels.

So, obviously each person has an entirely unique set of circumstances as well as metabolism but roughly speaking here are some basic holiday guidelines.

If you are a type 1 and injecting insulins and testing :

1.) Consider testing your sugar more often if you are exercising more and possibly feeling hypo.

2.) Consider adjusting your insulin dose at meals with more carbs and simple carbs than you are used to (perhaps go through your dietician and doctor re this).

3.) Understand that if you drink a lot and sleep in the next morning this is dangerous and alcohol will at first raise your sugars and then after about 10-12 hours drop your sugars, so watch out for a “missed” hypo and make sure you tag a mate to check on you at least.

4.) If you are snacking and the carb count is more than 10-15 g of carbs you may need to bolus for this kind of snack in order to keep your sugars stable but it really depends on a number of factors other than just this.

5.) the weather plays a bigger role than you think, some people will go either high or low depending on very hot or very cold conditions so try to understand your body and rather pre-empt the rise or fall or at least be vigilant and test more often.

6.) consider wearing a type of medic alert bracelet in case of unconsciousness – it may save your life.

For type 2 diabetics on oral agents only or have additional insulin injections

1.) Most importantly holidays can mean massive weight gain, and this is very bad and hard to get rid of in the long run. Pre-empt this by seeing a dietician who could give you guidelines on how to cheat without too much weight gain. Also see it as a challenge to maintain your weight rather than a punishment and reward yourself with things other than the wrong food on the holidays. Set incentives and be kind to yourself with spoilers that blow your hair back and don’t put weight on.

2.) Make sure that you have enough medication and testing strips for the time that you are away as well as some back-up diabetes supplies.

3.) Know what carbs are and how they affect your sugars and plan accordingly.

4.) Know the carb content of the alcohol you are drinking and factor it into the daily calculation of insulin (if injecting) as well as the total effect of the alcohol and your activities (physical) or not.

5.) Try to see the holiday as an opportunity for increased movement -exercise in many different forms and find one that works for you, start the routine on holiday.

6.) Experiment with different healthy food and take mental note of how you feel and what it does to your sugars.

We all need a break, a re-set and a proper unwind. So most of all give yourself the mental  “space” and time you need to do just this. Planning for your holiday around your diabetes will aid in enjoying this time more and taking stress out of certain situations.

There are always healthcare professionals on duty, know the nearest casualty location and telephone numbers as well as ambulance and other emergency numbers before leaving home.

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Mental health, impossible tasks and other musings


Why is it that when we are ill either physically or mentally and it comes to support for the person it is hard to find. In fact a very common reaction is for people by and large is to withdraw. Leaving an already vulnerable person more vulnerable and more likely to become sicker. Why do we do this as a society?

It seems we are quite cruel.

Much like being a type 1 diabetic. Once diagnosed your life depends on testing sugars and injecting insulin. People are wary, they hide, they run they disappear from your life entirely. Schools refuse to admit children with it. Kids don’t want to have them at their party. And why ?

Yes it’s different. Yes it’s a disease that requires things that some humans are uncomfortable with. But, can you not dig a little deep and conquer that fear, reach out and be a friendly face, hand , eye?

We are actually all connected and our reactions have repercussions. We have choices to make daily.

I challenge you today to not run and hide. To be present, even when it is uncomfortable. To be present. Really there. In the flesh and the mind. Present. That’s all. To be there.

Pushing past impossible is something that is actually possible.

And you know that we all – collectively benefit from that.

And the world at large can be a better place.

 

Innate


http://innatehilton.wix.com/innate

Holistic integrative medicine

Pump for me or not for me?


Report back : We had a marvellous discussion about pumps on wednesday evening. Highly enjoyable and informative, even our pump patient learnt something.

JOIn us today : On wednesday night 530 pm in Hilton Pietermaritzburg we will be holding an informal hour discussion about pumps -insulin pump therapy. What is pump therapy ? Who “qualifies”? What is the benefit. Is it for everyone who injects insulin?

Feel free to join us for free for an hour to explore the “pump market” in south africa and get first hand feedback from “pump” patients 😉

Diabetes cure?


There are various teams around the world – dedicated scientists and enthusiastic people working on all aspects of diabetes – trying to find prevention, cure, treatments – better, onwards and upwards. The diabetic scientific community at large strive for better quality of life.

There are also many snake juice paddlers as there are fake news folk. Do not be duped or sucked into some scam.

It’s a pity that in the light of such a huge and devastating epidemic there would be folk peddling snake juice and basically lying to a vulnerable subset of people. But that is life and ours the task to engage the brain and always question.

New treatments, closed loop technology and cures are on the horizon and I salute the many people working around the clock to accomplish that. Please the internet if FULL of rubbish – surf wisely.

Success !


It’s a brand new year and great excitement after a really good rest and break.

I started using ryzodeg as it hit the shelf (I had been anxiously awaiting its arrival for months). I have reviewed most of the patients started on it now and wow!! incredible results. Even more incredible when combined with a libra pro sensor!!

This is cost-effective, accurate and well tolerated treatment for type 1. Most patients have stopped having hypos and certainly all have stopped having bad hypos. All of the patients average sugars have dropped significantly and variability come back to a much more acceptable range. Patients are happier, have better quality of life and generally walk in with a smile on their dial.!! Yay!! Yay yay!!!

I could not ask for a better way to start the year 🙂

This is a video link of how the new long-acting insulin works: on youtube: Tresiba® (insulin degludec injection 200 Units/mL) Pharmacology

Ryzodeg  (avail in SA) is part (1/3) short acting (novorapid) and part long-acting (48hour half life) degludec as in the video.

 

Carb : Insulin mismatch?


Are you matching your carb intake to your insulin intake? What is your specific and individual insulin sensitivity and carb ratio – do you know?

If you are injecting insulin either long or short acting or both these “numbers” are important to know.

What complicates things further is that sometimes they are different for different times of the day as well as different states of health.

Injecting insulin is a very tricky business if you are aiming for “perfect” control – i.e. glucose between 5-9 mmol/l (this is my personal goal post). Overshooting and under dosing happens most days.

In order to try and get it right most of the time it helps a lot to KNOW your body and your numbers. So what is carb ratio ? This is the amount of insulin you specifically need to cover 15 g of carbs – that is roughly one slice of bread. Most patients are in the region of 1-2 u units per 15 g/one slice bread. Children/babies however are more usually 1 u for 30g or more and in terms of sensitivity 1 u dropping sugars by 10 mmol/l (vs adults usually 1 unit dropping sugars by 2-3 mmol/l).

This information/calculation needs to be worked out by yourself, your doctor as well as your dietician. It is really important to understand and apply this in order to get better control.

Then bear in mind that on sick days you usually need a bit more. When exercising hard a little less (sometimes a lot less). And so it goes : hot weather, cold weather, different foods, stress, etc all influence the sugars and how they react to insulin.

Don’t be caught high or low this festive season – stay jolly and even.