Check up

Yesterday I went to my GP surgery to see the nurse.  I was hoping that she would have the results from my blood test last week, which included the c-peptide test to determine whether I am producing any insulin.  Unfortunately this test does take some time, so no result yet.  It is possible that the hospital will not let the GP know and that I won't get the result until I go to the hospital again in 6 months time!  Oh well, I guess it's the same treatment whether or not I am producing insulin!

I have been cutting down on carbohydrates, and avoiding rice, bread, pasta etc.  I am beginning to get used to it now, and enjoying finding different things to eat and drink.  I decided not to tell my nurse as I have read on the forum (www.diabetic.co.uk/forum) that the NHS are not too fond of the idea.  I don't want to create any conflict as I do appreciate her support.  She is a very nice person and very positive and uplifting.  But i did start to tell her that I have been testing postprandial, and finding that some foods 'spike' me quite high.  She immediately said 'You don't want to worry about that!' and crossed through the spaces in my book so that I couldn't test then any more!!!

My feelings are that non-diabetics would not get a spike after meals, so why should I as a diabetic tolerate it?  I do think that having blood sugars swinging violently from normal to high and sometimes back too low is what has made me feel under par for the past few months.  If I can do something about the spikes then it can only be good for me. The only thing that I can do to reduce the spikes is to cut out the carbohydrates that are producing the spikes.  The Hb1Ac test shows the average blood sugar for the past 3 months, and even short periods of time at high levels will affect it.

By the way, Hb1Ac is still at 9.5.  I wasn't expecting another drop so soon.  Still a way to go to get it below 7.  Just these last few days I have got BS readings consistenetly below 10.  Now to get it below 7!  May have to be brave enough to inject a bit more insulin - I am always worried about hypos!

But I forgot my insulin this morning!!!  I ate a weightwatchers choc bar before I went out to sewing class, and tested before lunch.  I was expecting a low reading, but it was 12.2!!  EEK!  Looking in my notebook, I had not written down my units, and I could not remember injecting.  So I have injected 6u just before lunch.  Much less than usual so that it doesn't clash with evening insulin.  

Why me?

Since my symptoms started, not a minute has gone past without me thinking about my disease.  Are my blood sugars too high?  or too low?  Have I eaten the wrong thing?  Have I eaten at the wrong time?  Have I remembered my insulin injection?  Have I tested my blood?  Have I tested too much?  Will the GP keep prescribing all the things I need?  Diabetes is not something I have thought about much before my diagnosis.  Yes my Dad had type 2, but we all thought that it was something to do with his myeloma, and anyway, the myeloma was a much more serious condition.

Recently, there has been much publicity about type 2 diabetes, and the 'obesity' epidemic.  But, I have not been obese!  I have been moderately overweight for the last 20 years or so, and a little bit yo-yo with my weight, but only by 1 stone (14lbs) or so.  I have been to weightwatchers a few times and regularly attended Rosemary Conley for a number of years.  Although I do not class myself  as athletic in anyway, I have done regular exercise over the years.  Most recently I attend a local gym for 4 classes per week, and up until last year walked our dog for at least 1 hour a day.  I cycle once or twice a week, especially if I want to go into town and try to always cycle to CAB.

So a question I keep having to ask is - why me?  I have to pinch myself sometimes as though I will wake myself from a horrible dream.  Here I am injecting myself with insulin twice a day!!!  Gone are the 'carefree' days now.  I have to inject the correct amount of insulin, and watch what I eat, as there are extreme dangers with too high or too low blood sugars.  It is a life long condition that will not go away.

It is something I have to learn to live with.  I need to be in control of my life, not let diabetes control me.  I am very grateful for the support from family and friends, and from the internet!

Starting on Insulin

The nurse at my GP's surgery had mentioned insulin a couple of times, as no matter which drug she prescribed, my BS were not coming down.  I had by this time discovered www.diabetes.co.uk, and had begun reading about low carbohydrate diets.  Many diabetics both type 1 and type 2 have had good results by restricting carbs.  I tried it for a week or two, and did see a reduction in the very high blood sugars.

So at my appointment with the specialist nurse, I was prescribed insulin.  Novomix30, which is a mixed insulin, consisting of 30% fast acting and 70% long acting insulin.  Anne, my surgery nurse showed me how to inject using a pen.  The needle is really tiny, and I hardly felt a thing.  I don't think I will have problems injecting.  They went through all the symptoms of hypoglycemia, and what to do on sick days.  I was given a new meter which also checks for ketones if my BS is high.  This is to check that I am not going into diabetic ketoacidosis, another life threatening condition that type 1 diabetics can get if they have no insulin on board.

Oooer!  I was a bit shell shocked!  Unfortunately, none of the chemists I went into could do my prescription that day, so I left it with the chemist near the doctors and went to pick it up the next day.  It was the bank holiday weekend, and Maurice was flying off to Phoenix on business for 1 week.  But there is a lot of support.  I can phone my nurse at the surgery, I can phone the specialist nurses at the hospital, or there is an out of hours helpline run by the drug company that make the insulin.  Knowing that the support was there was very comforting.

I picked up the prescription on the Friday, which included insulin (keep in the fridge), 2 pens, disposable needles, test strips for my meter, for BS and ketones, metformin, and lancets for the stabber!  I went home, made a cup of tea and sat down and read all the leaflets.

Here we go!  Now I have to inject insulin every day for the rest of my life!

Isn't it amazing?

Isn't it amazing at how well our bodies work?  In a non-diabetic, insulin and glycogen work to stabilise the amount of glucose in the blood.  Normal values are between 5 and 7 mmol of glucose per litre of blood.

Diagram found on http://www.biology-online.org/4/3_blood_sugar.htm

I find it amazing that crude injections of insulin will keep a diabetic alive!  Over the years the method, timing and duration of insulin has improved so it more mimics the normal human system. 

Insulin is required for the glucose in the blood to gain entry into cells to be used for energy.  In type 2 diabetes, the receptors on the cells do not work properly so glucose cannot enter the cells.  The pancreas works harder to create more insulin and eventually 'tires' and stops producing insulin all together.

In type 1 diabetes the cells in the pancreas that produce insulin (beta cells) are attacked by the immune system, and there is no insulin produced.

I am having a blood test to find out whether I am producing any of my own insulin (c-peptide test) - but this will not tell me whether I have type 1 or type 2 diabetes.  I should have the GAD antibody test which will show whether I have the antibodies which are destroying my own cells.  

Not so good today...

I am interrupting my story to record how awful today has been!  I was out for dinner last night at a thai restaurant.  I did my research before we went and decided to have a thai stirfry in oyster sauce.   I even looked up the amount of carbs in oyster sauce (11g in 100g of suace if you are interested)  I wasn't sure how much oyster sauce I would get in a portion of stirfry but decided it was the best on the menu.  I also had a small glass of dry white wine.  I avoided the prawn crackers, just having 1.  That was hard, I love prawn crackers!!  My portion of stirfry was very tasty but not enough.  I ended up eating mine far before my friends had finished theirs!  It would have been wonderful with lashings of white rice, but that looked like poison to me, as I knew it would spike my blood sugars really high.  The restaurant poured us a small glass of Baileys which I am afraid to say I did drink.

So I did feel hungry when I went to bed, but blood sugars were 11, so I just had my low fat hot choc which has a carb content of 3g per serving.  At 5.20am I awoke feeling really weird!  Of course, it was the one night I had forgotten to take my meter upstairs with me!  A trip to the loo and then downstairs for my meter, blood sugars 3.3, eeek!  I ate about 5 glucose tablets and tested again a few minutes later.  I also ate a fruit muesli bar.  After about 15 mins or so I began to feel better and went back to sleep.

I stayed in bed a bit longer as I had had the hypo in the night.  BS 12, only to be expected.  So I decided to go for a walk after breakfast of 1 poached egg on small slice of sourdough bread.  I took my usual 10u insulin after I had eaten.  I usually try and take it just before I eat, but isn't it funny, I can be reading the diabetes forum and still not remember to take my insulin!  After I got back from the walk BS were 11.2, so I drunk a bulletproof coffee (1tsp coconut oil and 1tsp butter)and decided not to have a snack with it.  I went back outside to fill the green bin.  The walk or the gardening were hardly arduous exercise!  But then when I came back in my BS had crashed down to 3.6 and I felt dreadful!  I drank some lucozade, tested again 5 mins later 10.5, which may have been a rogue reading, as I tested again 4.3, but still felt awful, so waited another 5 mins, BS back down to 3.2.  After another swig or 2 of lucozade, my BS started to rise.  Phew!  But I felt bad for quite some time, sort of shaky, anxious, and a bit nauseous.  I went upstairs to have  a shower.  I must admit to having visions of me collapsing in the shower and the kids coming home to the not-such-pretty sight!

I made my usual salad and cheese lunch but had a cup-a-soup with it.  They are about 14g carb, and of course really fast acting.  1 hour later my BS was 19.4!  I went to CAB, but really didn't feel very with it, I seem to have ended up with massive brain fog after 2 hypos in quick succession.  I'm guessing it's the fast rise of BS that makes me feel so rough.

So why the hypos?  The wine?  but it was only 1 small glass.  Not enough to eat?  Maybe.  Maybe not enough carbs in dinner.  The exercise this morning?  Obviously, that contributed to today's hypo.

It is very scary having a hypo, especially when I don't start to feel better quickly.  And I always seem to over treat, so have a massive post-hypo rise in BS which cannot be good and must make me feel worse.

Now what I do about tonight and tomorrows insulin?  Shall I take less?  I think I will drop by 2 u for both tonight and tomorrow.  Bet that means I'll have higher BS tomorrow, sigh!

In the beginning

Gosh!  This journey is a rollercoaster!  One minute I am down, down in the dumps because I have some bad news or high blood sugars, then I am soaring on a high after a day of blood sugars not going over 10!  Over the last few months I have learned so much about diabetes so I thought I would try and write a diary.

To go back to the beginning - my symptoms started last March 2014.  I was going to weight watchers to try and lose some weight, and was bumbling around losing about 1/2lb per week.  But suddenly - about the time of my birthday, I started losing 2-3lbs per week - every week despite eating more or less what I liked.   Not that I was complaining about a nice weight loss, I could do with losing a stone (14lbs) or so but I started feeling thirsty and going to the loo a lot.  I also suffered from terrible leg cramps every night, sometimes I had to get up and walk about the bedroom!  I looked up my symptoms and 'diabetes' kept coming up.  I was sure that I could not have diabetes as I had never been massively overweight and I exercised a lot.  I only knew about type 2 diabetes and knew from the media that it was a problem for people who were obese and took no exercise.  It took a few weeks to pluck up courage to go to he doctors.  I hadn't been to see a GP for quite some time so felt really nervous about it!  Luckily I saw a really nice young female doctor who was very sympathetic and she arranged for me to have a 'fasting' blood test that week.

Of course my results were dreadful!  My Hb1Ac was 13.5%!!!  I had an appointment with the practice nurse, which actually didn't happen until 2 weeks later.  She prescribed gliclazide, and scared me silly when she told me about the possibility of hypoglycaemia!  We were going on holiday 2 days later, and I wondered how on earth I was going to tell if I was having a 'hypo' on the back of the motorbike!  Well, my blood sugars were way above any possibility of a hypo, ranging from 11mmol/l to 28.8mmol/l - mostly above 14mmol/l!  After my holiday I increased the gliclazide and added in Metformin.  I was backwards and forwards to the GP surgery and the pharmacy, sorting out a medical exemption card etc.  I had hardly ever had a prescription before so it was all new to me!  I felt well and truly in the system.  My blood sugars were still not coming down by much, so another drug was added: Sitagliptin.   I was beginning to read about Low carbohydrate diets on the internet, so I tried cutting down on the carbs for a few days.  So during the last week or two in August I was getting lower sugar results -but  mostly between 9 and 12 mmol/l.  

I was still questioning as to why I should get type 2 diabetes as I was not overweight and had exercised regularly most of my life (not that I would say I was a particularly sporty, athletic type mind you!).  Eventually the nurse booked me an appointment with the specialist diabetes nurse who comes to our surgery once a month.  Well, she took one look at my blood sugar readings and said that I should be taking insulin.  So began my insulin journey...