Category Archives: gaining weight

Toujeo or not to jeo?


Yes folks we have a new insulin and the best best news is that it is priced affordable – R590 SEP for a long acting insulin that almost guarantees NO hypos!!!

What great great news !!!

I can barely contain my excitement as I scribble out scripts for gazillions of patients for whom this means a huge leap up in quality of life living with type 1 diabetes or diabetes that requires insulin injection.

What is it? Toujeo – or insulin glargine U300 – lots to figure out. In a nutshell it is the same as lantus/optisulin BUT squashed smaller. What does that mean?

Science is “fucking” wonderful – sorry I had to – I LOVE !!! science. When you make a molecule smaller you decrease the surface area and thus slow the absorption rate right down. So now you have a more concentrated molecule (U300 vs U100) that is “dissolving” or releasing much more slowly and predictably and yes you guessed it all you insulin boffins out there – no stacking of insulin, which means no HYPOS !!

Simple yet brilliant, don’t you think – or am I just a proper nerd.

Once daily dosing – truly once daily.

No hypos, predictable.

Need I say more

Toujeo or not to je o ??

😉

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Diabetes – the biggest killer of women under the age of 60


Shock horror indeed!

The medical people have long been warning of this tsunami and everyone has just yawned and gone – not me. and carried on munching on that way too big carb full meal.

Not me. Not today.

Only to find out 10 years down the drag that actually yes me too.

Diabetes is a tsunami and it IS happening and best we sit up and take notice. There is so!! much that can be done and also there is much to be said about early diagnosis and best management.

Which brings me to medical aids. In their best interest for good management to happen and yet so slow on the uptake. Folk, medical aids need the ground swell pressure of the people to force them to do what is actually best for them – ironically.

And yes CGMS, continuous monitoring and good insulins and newer treatments and earlier interventions actually SAVE money in the long term BIG time and death and morbidity (that’s when you suffer but don’t actually die).

So, folk, women and men folk. Really so much to do, so little time. Go out and have a blood test, if is it negative don’t just accept that as up to 30% of people will have a “normal” fasting sugar but an abnormal post meal sugar – and you guessed it – you could STILL have diabetes.

Stop reading and get a proper test.

Diabetes non-month -we can still make folk aware ;)


Hello. Today is the first of December. November (diabetes month) officially over. “Ca dover”.

Diabetes is a growing problem. Most people do NOT choose it. More so type 1 – spontaneous destruction of all beta cells of the pancreas making you insulin dependent (like alcohol dependant only a little different (this is a little joke so don’t get too upset about this statement if you are prone to getting upset).

Type 2  can be lifestyle induced but that does not mean you should judge the person. Or that anyone has given you the power to do that. Or the right.

Insulin only comes in the injectable form. Yes that means you have to inject anywhere from one to 6 x a day. Then you also have to test your sugar – another “prick” required.

So don’t be a prick to diabetics as having dealt with so many already they can’t tolerate you too. And for that matter the moms and dads of diabetic children also fall into the category of not needing any more pricks in their lives – they are hard enough. Grow some empathy. Please? Even if just for the festive season.

So, in december, the festive season. Not everyone in this life is as blessed as you : health and wealth and mental health wise. If you only do this this festive season let it be that you are kind. To all around you. Truly kind not the falsely kind of kind.

Myths around diabetes


November is diabetes month – awareness around what it is and treatment etc. There is actually quite a lot of strange information that circulates, “fake-news” so to speak regarding diabetes at large.

So let’s dispel some myths.

1.) Diabetes is caused by poor diet : firstly type 1 has nothing to do with diet and is bad luck essentially. It seems to be an auto-immune disease and essentially destroys the b cells of the pancreas creating an absolute lack of insulin.

Type 2 diabetes is a lifestyle related as well as genetic disease and even more complex in nature.

Insulin resistance is a condition more and more prevalent due to lifestyle as well as stress – a big factor. More about this another time.

2.) IF you eat properly you will get better : well firstly type 1 diabetes, without insulin – you die, children in the era before 1921 died. Only since 1921 and Banting and Best’s discovery do type 1 ‘s survive with normal life expectancies.

Concerning type 2 diet is critical and important (as it is with type 1) carbs are key and obviously healthy eating and exercising are key but eating 100% correctly will unfortunately not bring back b cells that have died.

3.) Type 1 diabetics should never eat carbs : whilst one should be mindful of the type and quantity of carb and dose the insulin accordingly it is by no means advised that type 1’s exclude all carbs. This is a tricky one and best discussed in consultation with a dietician.

 

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.

Diabetes does not have to be


To be or not to be – TYPE 2 I mean. Lifestyle induced diabetes. This is a disease that we hardly saw 100years ago. It’s a new thing really.

A question of quality of life I believe. Both to prevent it and to “cure” it. Type 2 diabetes is essentially “toxicity of life” disease. Too much sugar, too much bad stuff, mainly sugar that causes inflammation generally but is specifically bad for the pancreas and the reason being it is like flogging a horse. Every time YOU demand insulin of the pancreas (every time you eat sugar or carbs) it has to produce it. Only it only has so many b cells to do this and the harder you flog it the harder those cells work and you literally flog your pancreas. At some point – once you have lost 50 % of those cells you become diabetic.

Now here ‘s the interesting thing. At 49.9% you are not diabetic but at 50% you are – go figure. Like with a lot of things there is a spectrum. So, surely you understand that one can “pick up ” this continuum BEFORE you qualify for type 2. SO why not find out??

Once you have type2 for real it is a matter of time before you flog those last 50% and then need insulin to save eyes, heart, limbs etc. However IF you take it seriously and “recruit” dying cells that are about to become apoptotic you can actually turn it around a bit, not back to 100% but you can slow the progress and retard the disease. So why not do that?

To be or not to be ? The choice is yours and the decision in your hands for the grab or not?

 

Josef Pilates – unconventional response


I do just love the story of this man, born in Germany to a father of greek descent. He had “healthy” parents who got the flame kindled for what was to come. He was a sickly child with many obstacles to overcome and born into the world at a challenging time. He was a circus performer who toured England and somehow also got involved in training the scotland yard police in physical training.

When the war broke out he was “interned” on the isle of man due to being german (first world war). It was during this time that he helped prisoners of war who were bedridden to “exercise” by “creating” novel equipment so that they could exercise in bed.

He was a war hero and asked by the kaiser to train german troops but declined the offer and rather went across to America to start a new life (and not partake in world war 2).

In Manhatten he started a “contrology” studio in the same building as some dance studios and the rest is largely history.

I find it fascinating that someone dealt a fairly difficult hand of cards came up so trumps with this “new” form of exercise that now helps millions of people across the globe.

If you have not tried pilates do it today : mind body soul invigoration!

don’t just sit there – phone around, google and go