Diabetes by numbers

This blog first appeared on the Diabetes UK website on 29th November 2012

When I got diagnosed, I remember the Specialist Nurse telling me that really, my lifestyle shouldn't be different to that of any other normal, healthy individual.  Walking out of the clinic, laden with insulin pens, needles, test strips and other paraphernalia I was sceptical to say the least but of course she was right.

A low fat, low salt, low sugar, high fibre diet with plenty of fruit and veg is probably what most of us should be eating most of the time.  I suppose the difference is that the consequences of not eating sensibly are a bit more severe for diabetics.

What I didn't grasp at the time (and perhaps only subconsciously realise now) is all the diabetes maths involved in managing my condition - it really can be an overload of numbers at times..  I've recently been dieting having put on a lot of weight and lot of my waking hours are spent devoted to all the figures I need to keep on top of things.



What do you see?  2 slices of toast?  190 calories?  31g of carbs?  3 units of insulin?


On a daily basis I'm remembering and adjusting numbers for:

• Long acting insulin
• Quick acting insulin
• Carbohydrate content of food
• Blood glucose levels
• Calorie content of food
• Exercise time

I'm also doing calculations in my head to make sure I can keep my blood glucose level throughout the day.  I think diabetes gives you a new way of looking at things and a new appreciation for how your body works.

It seems quite daunting at first - and it can be even now.  One unexpected hypo or BG level in the 20s has me going back over what I've been doing to try and understand where I've gone wrong.  I've noticed this a lot more recently as my exercise regime has made my blood glucose levels a lot more sensitive to insulin.

In the 11 years I've had diabetes a number of things have made life a lot easier, and not just advancements in medication and testing.  I use a phone app to track my daily diet which helps me monitor both my calorie and carb intake (and therefore my insulin doses).  Eating out is no longer something that worries me as I can usually find nutritional information for most restaurants online.

It's easy to forget that whilst there are so many fellow diabetics, the way in which everyone manages their condition is completely different.  It took me a long time to organise myself into a daily routine that allows me to stay on top of my condition without it becoming a full time job.  There's a lot of support out there fromplaces like the Diabetes UK Careline, GP, Specialist Nurses and from other people with diabetes themselves.  Finding the right routine for you is the key to making all the numbers a lot less stressful and just another part of your day.

Finally, I was recently offered a place on a two year clinical study comparing the effect of the DAFNE course on people with multiple daily injections (MDI) and insulin pumps.  I'll find out which group I'll be in (staying with MDI or getting a pump) nearer to Christmas.  Hopefully I'll have more to share on that next time.

Birthday post - but no cake

Hi

Apologies I've not posted for a while - September seems to have flown by.

Having officially said goodbye to running for the year, I've turned my attention to trying to shift some weight.

As my exercise post-marathon has been sporadic at best, I've put on a fair bit of weight in the last 4 months.  I've spent a bit of time trying to ignore it but predictably that hasn't worked very well so now I'm actively trying to do something about it.

Obviously there are a number of benefits to this.  Being able to fit more comfortably in the clothes I own is one.  Not feeling knackered every time I have to exert any kind of energy is another.  And keeping my diabetes under control is probably the biggest benefit I'll get.  I've got my annual(ish) review at the hospital in October (I rescheduled from September because I knew I'd get a kicking) and so being in a bit better shape when I go will be good news.

My plan is fairly simple - try and lose 2lbs a week between now and Christmas.  The means I should lose about 2 stone by December 25th which would be pretty good.  I know the reality of that will be a bit different but it's worth a shot.  Weight is generally easier to lose when you're carrying a lot extra (as I am at the moment) and I know that come mid-December, I'll be into Christmas mode, but it's worth a go.

I'm using MyFitnessPal to track my calories and exercise on a daily basis.  If you're unfamiliar with it, you give it some information about yourself (height, weight, age, gender) and then tell it how much you want to lose and at what rate (between 0.5lbs and 2lbs per week) and it calculates a daily calorie allowance for you.  There's the option to add exercise into the mix as well.

Based on my current and target weights, I have a daily calorie allowance of 1440 per day (though I earn a few extra each day from exercise).  While that sounds like a fairly low number, it's essentially what I eat most days as long as I cut out the snacking that I'm incredibly prone to.

As I mentioned in my last post, I've invested in an exercise bike and I'm trying for 2 sessions per day on that to aid weight loss and boost fitness.  At the moment I'm doing 20 minutes 6 mornings a week and between 30 to 40 minutes each evening. On average that burns off about 550 calories per day.

After one full week of calorie counting I didn't lose any weight, but I'm attributing that to a general 1 week lag in diet/exercise showing in my actual weight.  Hopefully Saturday morning will show a reduction when I step on the scales.

What I have noticed is that my blood sugar levels have come under control very quickly and that my reliance on insulin has reduced significantly.  I'll talk more about that next time.

I've made my daily diary available for public viewing if you're so inclined.  As with the running, making this a bit more public gives a bit of added motivation so I hope you'll forgive the slight dullness of this post.  I've got some more interesting ideas kicking about for future blogs - don't worry.

Finally, the title refers to the fact that this blog is one year old now.  Thanks to every that's read some or all of the posts.  Hopefully you'll keep coming back.

Take care

Andy