Category Archives: insulin sensitivity

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.

 

Advertisements

Diabetes still on the rise


Whilst the world (rightly so) is horrified at the current state of zuma/zupta/corruption in south africa to the absolutely insane attacks in the UK but ALSO the ongoing terrible and unacceptable carnage in syria, iraq, afghanistan (this list is way longer and way worse than most of what the “west” has seen).

I would like to bring all of your attention to something that is “silently” killing way more people. Diabetes. Don’t believe me – look at the horrendous stats. They do speak for themselves. In both the west as well as the east as well as the poorest of the poor.

Diabetes is a scurge that is on the surge. And with no even small little sign of stopping.

What is type 2 ? A disease of wealth but also of abnormal eating. There is no reason to get type 2 diabetes unless you have actually “abused” your body OR if you have had cancer or a tumour of your pancreas.

It is a disease of too much sugar into the body. Too many simple carbs stuffed into a single body and the pancreas says ok well enough is enough and all of a sudden once you have lost 50% of them pancreas cells you find yourself diabetic.

Type 1 however is a different story. This is a case of severely unfair dishing out of disease. Mostly children and young adults who out of the blue have total pancreas failure. And become dependant (i.e. you die without it) on insulin.

Type 1 is NOT avoidable by anything you do or do not do.

Type 1’s rely on insulin, without it they die.

Diabetes is killing and causing loss of quality of life for many many people.

Educate yourself and be aware of what you say. Prevent yourself from getting type 2 and help others understand the difference.

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 😉

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.

 

 

 

 

Dubai Diabetes


I was extremely privileged to attend the META (middle-east Turkey Africa) collaborative diabetes conference in Dubai at the weekend. Wow!

I was treated like an absolute princess, divine food! International speakers were out of this world and I thank Boeringher-Ingelheim for a superbly organised time in this wonderful place. I am a big fan of Dubai! (now).

I met 2 new friends and such a rare sparkling gem to have spent this time together. Thank you!

The talks focused on a new class of diabetes drug not yet available in south africa (maybe next year) for type 2 diabetes – SGLT sodium glucose transport inhibitor drug which causes you to pee out the glucose (sugar). This new drug not only has great sugar control BUT prevents heart attacks as well as has a positive effect on kidney disease.

There has been so! much research in the last few years and it is really so exciting to be a part of being able to treat diabetes more efficiently effectively and with fewer

side-effects.

Rizodeg about to “arise”


Yes yes yes ! I am hoping (praying ) that Rizodeg will be scriptable by monday – you heard me this coming monday!

The insulin we have been waiting for : no stacking (NO stacking) nil to no hypos, steady release, long half life, a short acting component for meals -breakfast and supper – you can either eat NO carbs for lunch or do an extra short acting dose.

Essentially a BD – twice daily dose with far far better CONTROL – i.e. staying in the happy zone of 5-9 constantly – what joy!!!!

WE have been waiting and waiting for a product like this and it is about to arrive and arise!

Diabetics on insulin up to now have swung from high to low and low to high and had very little control over this, so many factors and “not at all predicable” absorption.

This new insulin solves many of our issues and we can not wait!!

Sadly probably not re-imbursed by med aids – but which diabetic would not gladly rather have quality of life?

Rather save on some other things and make sure the diabetic in your life has quality and quantity of life 🙂ryzodegabsorption