World Diabetes Day 2016

As part of World Diabetes Day on November 14th 2016, I posted regular Facebook updates about what it's like to have Type 1 diabetes. Those posts are presented here

Libre-ating?

No, you haven’t clicked on an old link, or got here in a TARDIS, this is really a FreeStyle Libre review written in 2016.

I’ve finished my first 14 day stint with a sensor and I’m thinking about what I’ve got from having it.  This is old hat to a lot of people so you can skip the TL;DR stuff if you want – I won’t be offended.

The general reaction from anyone in the Diabetes Online Community regarding the Libre is “Oh how are you finding it?” – a fair question to ask, but not necessarily an easy one to answer.  Before I plugged myself in for the first time, I wrote about why I’d waited so long and what I was really hoping to get out of using the almost-CGM system.

So how did I find it?

Well putting the sensor on in the first place took a while.  I don’t think I’ve ever seen a more intimidating set of packaging in my life so it took a fair amount of courage/encouragement/mocking before I pushed the thing in.  Yes OK it didn’t hurt, but it look like it would so I stand by my reticence.    I’d plugged it in a little before bed so I’d have an overnight set of info to look at in the morning.

I’d set the boundaries on the reader to be between 4.8 and 7.8mmol.  I’ve no idea what other people do, but it seemed like a sensible enough range to me as that’s where I’d like most of my readings to be.

I think my overall experiences of the Libre in the first and second weeks were quite contrasting.   The first week felt positive – I had more information that I could understand and act on.  I don’t think the benefit of the directional information can be understated but it is equally important to fully understand what that information means, and how accurate it is (compared to a finger-prick test).  I was wary of effectively chucking all my old testing kit in a cupboard and solely relying on something new.  I tested almost as much as normal for the first 3 or 4 days before I got comfortable with it.

About as close as you're likely to get

The second week wasn’t as encouraging.  I got to a point where no matter what I did, the Libre was showing me as “Lo”, or under 3mmol when my finger-prick tests showed something entirely different.   The thing with diabetes is that more often than not, you can feel if your BG is too high or too low and often you test to see how high or low it is so you can treat accordingly.  Suddenly seeing “Lo” on a reader (BG < 2.2mmol) when you feel fine is quite disconcerting.  One of the biggest discrepancies I saw was the Libre reading 3.5mmol and my BG meter showing 8.9mmol.  I know there’s an inherent lag of around 10-15 minutes, but even that didn’t explain the constant low readings.

The arrow is deceiving, as you can see from the constant flat red line...

After about 10 days, I’d pretty much given up on relying on the Libre readings in any way (though I carried on scanning it to see how it was behaving).  A day or so before the sensor died, it had got itself back in order to a degree – constantly reading about 1.5mmol lower than a finger-prick test at any given time.  (It’s worth noting that this point that when I phoned Abbott, they agreed to ship me a replacement sensor as obviously those sorts of deviations aren’t good).

So what did I learn from this first foray into 24/7 data?

Well firstly, considering the three things I wanted to understand more about, I definitely noticed a dip mid-morning and having observed it for a few days, I tweaked my basal settings slightly and noticed the effect of that lessen somewhat.

Mid morning dip at about 10am

Regarding exercise, the Libre confirmed pretty much what I suspected, in that the approach I have at the moment (temp basal, few jelly babies etc) seems to work really well for me, with no noticeable spikes or dips.  Being able to keep that stable BG over distances up to around 10 miles is encouraging.  

Short spike before running, in range (and rising) at the end

Finally the occasional evening/overnight spike… it’s definitely there!  Work to reduce its frequency is ongoing.

Blerg

Secondly, I was amazed at how much having the sensor can influence your behaviour – whether you want it to or not.  I’ve read blogs over the last 12 months likening having a Libre to being like a game (think Flappy Bird) where up and downs within the blue band are OK, but do what you can to keep it within those boundaries.  Even after about 24 hours use, I can see how it gets that addictive and I was modifying my approach to self-management to try and keep a flatter line.  I’m more likely to bolus 5-10 minutes before eating now as a result of the Libre.  I’m also more likely to try and ‘nudge’ my BG in the right direction if I see it falling or rising quickly.

Cured.  Sort of.

The flip side of that is that diabetes with a Libre is a full time job.  More information seems to breed more action, which in turn breeds even more information.  If moving from pens to a pump is more of a constant reminder of living with diabetes, then throwing a Libre into the mix is basically signing your entire existence over to it.  I also think that the abundance of information is meaningless if you aren’t understanding and reacting to it properly.  Stories of people treating high BG with temp basals, or constantly fiddling with those basal settings every few hours of every day to try maintain a flat line isn’t (in my humble opinion) helping.  I think if you’ve got access to the information you need to be able to look at it objectively and make longer term changes.  I think information overload can easily be a contributing factor to diabetes burnout.

Obviously, the readings from the Libre are great when you can trust it.  Once you can’t, it becomes meaningless.  I don’t know how often other people finger prick test alongside scanning, but I felt like I needed that reassurance that the daily graph was worth looking at.  Towards the end of the sensor, I felt very demoralised by the whole process if I’m honest.  I felt like I was suddenly second guessing my every move, faced with a lot of information and decisions that I couldn’t make sense of.  I’ve had type 1 diabetes for 13 years and I haven’t been in a position where mentally, I felt like I did last week in about 10 years.

Finger-prick results never read below 4mmol...

Finally (you’ll be relieved to read), I was surprised by the little differences the Libre made.  I was really conscious of not laying on the sensor while I was sleeping.  I was very conscious of knocking it while I was walking or showering, and even getting dressed became quite a cautious activity.  I’ve no doubt that’s my own personal risk aversion, and not the experience of the majority, but it was definitely a noticeable behaviour change.

So where do I go from here?  Well I’ve got one more sensor at home, and a replacement on the way, so the experiment will continue.  I’m going to wait a week or so before going again (so it coincides with being away for a week, where I think the convenience will be most beneficial).  I definitely think an accurate sensor could play a very positive role in my life with diabetes, and probably lead to improved HbA1c results.  

From the first week, where it worked properly

I suspect that more frequent use would mean those behavioural changes become more normal (or at least less noticeable).   I don’t want my life to be 50 scans a day, along with constant small insulin doses or 5g carb snacks.  That’s not living to me, that’s just existing.  I want the ability to test at convenient times, get information I can trust, and learn how I can make simple adjustments, to remove the variability in my BG as much as is reasonably possible.

So is the Libre for you?  I can’t tell you (and neither can anyone else).  Like a pump, it’s a personal decision that you have to investigate for yourself.  I think it’s worth investing £130 (if you can spare it), to get a reader and two sensors so you’ve got enough time to make an informed decision.  If you’ve made it this far through the post, hopefully you’ve got some things to consider for yourself, but what works for me might not work for you (and vice versa).  However you choose to manage your diabetes is an entirely personal thing, and don’t let that change.

Diabetes and Resilience - a child's explanation

As part of the fundraising and awareness work I do for the Sheffield Group of Diabetes UK I asked my daughter's primary school whether they'd be interested in getting all the kids to wear blue and make a donation for World Diabetes Day last month.

Each term the school has a "mindset" which they use to promote positive behaviour to children through a variety of different ways.  This term's mindset is resilience.   So whilst they'd already got Children in Need plans on that Friday, they asked me if I'd like to come in to an assembly and talk about how resilience is important when you have diabetes.

Now over the years, I've become pretty handy at talking about diabetes within my peer group, and especially when talking to other people with diabetes.  But talking to 200 odd children is a different proposition.  Most of the time, I'm using words and phrases like 'bolus', 'carb counting', 'peer support', 'care outcomes', 'HbA1c' and many others.  These are things you say when you've become used to the diabetes lingo that is common place for many of us.  

So how do you talk about diabetes to a large group with no prior understanding, and an age range of 4 to 11...  The answer is probably "I don't know", but that makes for a short blog.  So here's (roughly) what I said - you'll note some scientific license has been applied to a few parts.  That's not ignorance on my part, but a necessary modification for my audience.

Hopefully they found it useful in some way...

I'm going to talk about three things this morning.  Firstly I'm going to tell you a bit about what diabetes is.  Then I'll tell you what I think of when I hear the word 'resilience' and lastly, I'll talk about why resilience is important to diabetes.

So what is diabetes?  Well it's a special kind of illness that you have all the time, but you can't see.  And once you've got it, you have it forever, because there isn't a cure for it.  But it's not something you can catch off another person, so there's no need to worry about that.

When you all have something to eat, your bodies produce something called insulin inside.  That helps all the energy from your food get out of your blood and into your muscles so you can play at lunch time, and do your school work.

If you have Type 1 diabetes like me, then your body doesn't produce any insulin at all and so you have to inject it yourself.  And that's what I have to do.  Normally, you'd give yourself an injection every time you eat something, plus an extra one in the morning, and an extra one before bed.  So you could have to give yourself 5 or 6 injections each day.

You also have to give yourself little blood tests each day.  You get a little drop of blood from your finger and test it with a special machine that tells you if you've had the right amount of insulin.

There's also a different kind of diabetes called Type 2 diabetes.  People with Type 2 diabetes don't have to inject themselves, but usually do have to take a different kind of medicine every day in some little tablets.

When you have diabetes, it's really important to eat healthily.  It's OK to have treats like cake or chocolate sometimes, but it's important to make sure you have lots of fruit and vegetables every day.

Now I'd like to tell you what I think of when I hear the word 'resilience'.  I often think it's about how you cope with change.  Being resilient means that you have to learn to do things differently, keep going and not give up.  It can also mean having to do things when you don't think you can.  And that's why when you have diabetes, being resilient is really important.

When you get diabetes, you have to learn to do things differently.  Before, you might have gone out and have something to eat with your friends.  But when you have diabetes you have to remember to take your insulin with you, and your special machine  you use for your blood tests.  You also have to think more carefully about what you eat and how much insulin you have to inject.

You have to keep going and not give up.  Even if you're finding it difficult to keep injecting yourself, you have to be resilient and keep going.  If you don't inject yourself, you could get very poorly very quickly, and so that mindset of resilience in important.

And you have to do things even when you think you can't.  Sometimes, you don't want to get a drop of blood from your finger because you know it's going to hurt.  But you do it anyway because it's important you do the test to know how much insulin to have.

It isn't always easy having diabetes, but being resilient helps a lot.

6489

So this is my final blog post anywhere before Sunday's Yorkshire Marathon attempt.

I say attempt because that's exactly what it is.  Despite all the training and hard work that's lead me up to this point, there's absolutely no guarantees of anything and I need to carry this determination over the start line and around York to get me to the end.

That's not to say I don't feel prepared because I think I am.  Definitely more so than I was two and a half years ago in London.  I've paid a lot more attention to my diet and training and I've focused on more than simply just logging miles.

I said recently that almost every day this year has been a lead up to this race.  Whilst I know I don't have anything to prove to anyone, I still feel like I owe myself something - that the first time I did a marathon wasn't really a true reflection of what I might be capable of.

I boldly said at the start of the year that I could knock an hour off my last time (5:30:41) and I still think that with some good conditions and a little bit of luck, that might be possible on Sunday. I think 4:45 is a more achievable time but I'm not going to put any pressure on myself to do anything until 18 or 19 miles in.

Experience tells me that the last 7-8 miles are the hardest and I'm hoping I can put myself in contention with something I can personally be proud of at that point.   If not, then maybe it just wasn't my day and whatever happens, I'll be glad to get round.

I read somewhere recently that running a marathon has become "normalised" to some degree.  Back in 1981 when the first London Marathon was staged, running 26.2 miles was a rare thing that few people outside of elite athletes even attempted.  My dad doing the 1989 marathon was what hooked me in from an early age.

Nowadays there are so many opportunities open to people that want to go that full distance (which I think is fantastic), but what I think it means is the effort that goes into preparing for a marathon gets lost.  Basically it's incredibly hard work for your average Joe like me. 

To give you some idea of what it takes to get to the start line, I've run 507.33 miles so far this year - roughly the distance from Sheffield to John and I've spent 86 hours, 16 minutes and 25 seconds training.  It's a huge commitment and it's very tiring.   But compare that to 2012 when I'd logged just under 195 miles (and just 36 hours running) it's a huge step forward.

Whilst running is mostly fun (and running in a big race with a big crowd is almost certainly the closest I'll ever get to being a rock star), it also has it's downsides.  It can be very painful, at distances over about 18 miles it can make you want to be horribly sick and you can ache in places you never knew existed.

Of course I have to manage diabetes alongside all that too which makes it a little more complicated.  I'm hoping I've had enough practice this year to have a clear strategy set out, and I'm hoping the jelly babies I'll be scoffing every few miles won't make me throw up (though you never can tell.

In short, I'm not taking anything for granted, but I'm hoping I can get round in a reasonable time and do so without injuring myself!

In 2012 I spent the day before the race watching The Hunger Games at the Odeon in Leicester Square.  This year I'll be at a networking day for Diabetes UK (conveniently held in York) meeting volunteers and other local group members, before having dinner and an early night.  It's good to have something to take my mind off it all and I'm hoping there'll be a lot to think about which will distract me whilst I'm running the next day.

Going to York is very much like going home, as I lived there for 10 years, and the start/finish will be at York University where I studied for four years.  I'm hoping it'll be a great weekend all round.

Finally, I just want to thank everyone who's supported me in one way or another.  I've received a lot of encouragement from friends and family and it's been great to see so many people generously donate to Diabetes UK.  I've raised £635 so far and I'm really hoping I can make it to £1000 before the end of the year.  I won't tell you all again, how much good that money will do (check any of my last blogs to see what I mean) but trust me, it really will make such a huge difference.  If you want to donate, then please visit http://www.justgiving.com/broomhead or text BROO81 10 to 7007 to donate £10.

I'll see you all on the other side with the verdict on how it went.

Thanks for reading.

Andy

Reasons to be cheerful

The Yorkshire Marathon is 20 days away now and I’m now fully focused on the last nine (NINE!) training runs before the big day.

 

I did my longest run yesterday – 22.2 miles – which is the furthest I’ve ever done in training and the second furthest I’ve ever done in my life.  The time of 4 hours 10 was a little outside what I’d hoped, but nothing too demoralising so I felt pretty pleased with it all things considered.  I didn’t push hard at all to be honest – didn’t tackle any of the major inclines on my route as I was trying to leave a bit of energy for the later, more gruelling miles.

 

I got to about 19 miles before I really felt like I was struggling but, that said, a lot of the last 3 miles was uphill which I took at a walking pace.  I’m also having to do these longer runs with a backpack carrying spare water as I can’t convince people to set up impromptu water stations for me around Sheffield.  Losing that bit of weight might make a difference.

 

I’ve decided that while a sub 4:30 marathon might still be a remote possibility for me, a lot of that will come down to conditions on the day.  You can train, plan and prepare as much as possible but sometimes things just won’t quite click and you’ll not get the performance you wanted.  Conversely, you can feel under-prepared and go out and have a great run.  I’m prepared to accept that unknown factor so I’ll just take it as it comes.  I feel confident I’ll beat my last time (5:30:41) and I’m quietly confident I can do sub-5.  Anything after that is a bonus.

 

This coming weekend will be interesting as I’m doing 20 miles on Saturday followed by another 6 on Sunday morning as part of the Great Yorkshire Run.  After that it’s some swift tapering before Race Day.

 

I’m also feeling pretty pleased about my weight for once as I’ve finally managed to get below 180lbs for the first time in about 5 years.  It’s fair to say that marathon training whilst dieting has played a major part in that, but I’m now looking to  just try and maintain this new weight.  It feels strange actively trying to find extra calories to eat (rather than avoid!) but I’m hoping it’ll build up my energy stores over the next few weeks and maybe make those last few miles a bit more bearable.

 

My diabetes seems to be behaving itself as well with all my post run blood glucose levels being in a ‘normal’ range.  I’m having to scoff most of a bag of jelly babies throughout the course of a long run but it seems to be paying off.  Hopefully that’s going to continue without incident.  It’s an added variable I have to take into account on each run and the longer I can keep it well controlled the better.

 

Finally it’s been a pleasing week from a fundraising perspective with people generously donating another £30 to take the total raised to £215 so far.  There’s still a long way to go to the £1000 target but it’s great to see the notifications come through about new donations – it really is an added incentive to get out and run.

 

I read something recently discussing how running a marathon had become ‘normalised’ because of the number of events and the number of people signing up for each one.  I think that is true to a large degree because it is a lot easier to find an event that it was 15-20 years ago.  But what that doesn’t do is normalise the amount of work that goes into preparing for running 26.2 miles.  It’s still an incredibly hard slog and the support that comes in from friends, colleagues and family makes a real difference.

 

As you probably know by now, I’m raising money for Diabetes UK so they can help to support the millions of people living with diabetes on a daily basis.  Diabetes is a chronic condition that directly affects more than 4 million people in the UK (and over 30,000 in my home city alone).   There’s also an estimated 700,000 people who may have undiagnosed diabetes at present, and seven million adults are currently at risk of developing type 2 diabetes.

 

The money I’m hoping to raise will pay for 20 qualified assessors to help people at risk understand what changes they can make to reduce their risk and be able to live a long and healthy life.

 

If you feel like you can spare a few pounds to help this incredibly worthwhile cause, please visit http://www.justgiving.com/broomhead or text BROO81 + your donation to 70070 (e.g. BROO81 5 to donate £5).

 

As always, thanks for reading.

 

Andy

 

Five weeks to go

I’m conscious I’ve not done an update for a while and with just under five weeks to go until the Yorkshire Marathon, I thought I let you know how I’ve been getting on.

 

I’ve logged just over 380 miles this year now and I’m on track to go over the 600 I’d planned for 2014 in total.  That’s quite encouraging in a sense because while I started the year pretty well, I had a huge dip around March/April after I’d done the Retford Half Marathon and it took quite a lot of motivation to get back out running at all, never mind training for a marathon.

 

I’m now very much at the business end of the training – three weeks of long runs and lots of miles, followed by two weeks of tapering (when I basically try not to undo all the hard work a fortnight before the big day!).  I logged 101 miles for August and I think September will be close to 120.

 

It was great to see the coverage of the Great North Run this weekend as I find it incredibly motivational to see all those people pushing themselves to their personal limits to get round the course.  Hopefully that’ll be what I can manage in a few weeks’ time.

 

Whilst running is obviously very much about overcoming physical barriers, it’s also crucial to be able to overcome the mental barriers too.  I’ve had my training plan set out for a few months now, but when it came to entering the last few long runs into my diary, I started thinking a lot more about what it means to run 18/20/22 miles just for training purposes, never mind the 26.2 miles for the actual race.  My wife has pointed out how physically and emotionally exhausted I was last time I tried this and she’s right – I was a complete wreck by the time I’d finished.  But at the same time, I’d like to think that no-one goes into a marathon thinking it’ll be anything but exhausting in every way. 

 

As a way of trying to promote a positive mind-set, I’ve been contrasting my first and second marathons:

 2012 London Marathon

Started training with one mile runs, having not run at all for over a year

Completely unknown territory – previous best distance was 13 miles about 15 year previously

Average mile times were about 11-12 minutes in training

Diet was mixed with no real information around the relationship between nutrition and running

Unsure how to deal with illness and injury – missed 5 or 6 training runs in the build up

Ran twice a week as pain meant any more wasn’t possible

Managing my diabetes whilst doing distance running was completely alien – lot of trial and error involved

2014 Yorkshire Marathon

Had logged over 700 miles in the run up to training

Know exactly what I’m getting into in terms of distance and the required mind-set

Average mile times are between 9.5-10.5 minutes and less than 11 minutes on hilly routes

More structured diet, eating the right foods at the right time

Able to handle niggles/aches/pain more effectively and better at preventing them

Run three times a week plus including non-impact training as well

Ready-made strategy to manage blood glucose levels whilst running and start/finish readings often almost identical

 

As you might gather from that, I feel like I’m in a lot better place physically which is very reassuring with my eye on Saturday morning’s 18 mile run.  I also think that mentally I’m a lot more clued up.  I know it’s going to hurt, I know I’m going to feel sick, that I’m going to have impossibly sore legs, and probably lose a toe nail or two along the way.  But ultimately I’m OK with that because it’s all temporary and I’ll live to tell the tale.  What I need to concentrate on is running my own race and not getting caught up in what other people are doing.  I’m not built to run a marathon in 3 or even 4 hours so putting myself down while reading about other people’s training isn’t going to help, and neither is trying to keep up with them on the day.  I’ve got to just zone out and do my best to ignore what everyone else does.

 

My training is currently focused on the end of September when I’ll do my 22 mile run on Saturday afternoon, and get up to do the Great Yorkshire Run (GYR) on the Sunday.  Thankfully I’m not looking to run any sort of fast time in the GYR and I’m just using it as a cool down run.  After that, my distances will drop to no more than 10 miles and I’ll be concentrating on keeping my legs fresh and injury free.

 

I feel like my diabetes has been incredibly stable over the last few weeks too which is good.  It often takes a while for me to get into a cycle where I can almost manage it without thinking and I feel like my current diet and exercise regime is really helping me at the moment.  I’m eating fresh, healthy food for every meal and I’m exercising regularly and that definitely shows in my blood glucose readings every day.  I’ve got an annual review coming up at the hospital in a couple of weeks so I’m hoping my consultant is going to be as pleased as I am.

 

As always, for those of you that made it this far, I’m going to finish with a little bit about the charity I’m running for this year – Diabetes UK.  There’s been a lot of press about charity recently and chances are unless you’ve been in outer space, you’ll be familiar with the Ice Bucket Challenge and the incredible amounts of money it’s raised for charities all around the world.  What you might not be so familiar with is how much charities like Diabetes UK rely on fundraising and donations to help the millions of people in the UK who either have diabetes, or are at risk of developing it.  As I may have mentioned before, almost 4 million people in the UK currently have diagnosed diabetes, with almost another 750,000 people who may have it but be undiagnosed.  Another 7 million adults are at risk of developing the condition in the future.

 

As I wrote last time, diabetes currently accounts for almost 10% of the prescribing costs of the NHS and this will only increase as more people get diagnosed.   Helping to educate those at risk to reduce the number of people with diabetes is critical, as is the ongoing support and education of those already diagnosed to reduce the chances of them developing serious long term complications such as blindness.  As if helping and educating all these people isn’t a big enough task in itself, Diabetes UK is a charity with a relatively limited budget.

 

To use another UK charity for comparison, Macmillan spent more than one-and-a-half times  the entire Diabetes UK’s 2013 annual income on their fundraising activities alone (£58.1m on fundraising vs £38m annual income).

 

Fundraising and donations are crucial to helping those with diabetes be able to live their lives and you can make a huge difference to millions of people by donating.   By running a full marathon, a half marathon and three 10km races, I’m hoping to raise £1,000 this year to make a difference to people with diabetes.  If you have anything you can spare, please visit http://www.justgiving.com/broomhead or text BROO81 + your donation to 70070 (e.g. BROO81 10 to donate £10).

 

Thank you.

Progress

Another week down and the miles are stacking up now.  I’ve now covered over 300 miles this year which is quite satisfying.  You may remember from a previous post that I covered 450 miles throughout all of 2013 and I was hoping to make 600 miles for 2014.  Whilst I might only have just gone over halfway to that target (with almost two thirds of the year gone), I think I’ll make 600 comfortably by New Year’s Eve.

 

It’d been a slightly mixed week with my first “long” run of the training now behind me.  It probably went about as well as I’d expected – a quick first 6 miles followed by a slower return home giving me an average pace of10:22 per mile.  It’s easy to pick out the negatives (the return was a lot slower than I would have liked) and the positives (that overall pace would get me a 4:30 marathon time) but I think I’m just content to have managed 12 miles without injury.   I’ve got some longer distances ahead of me over the next 8 weeks, including 16, 18, 20 and 22 miles before the race so drawing on the positives is going to be key over the next couple of months.

 

This week’s training began yesterday with (a little over) 4 miles.  It felt quite slow and broken as I couldn’t seemed to find a rhythm or any power in my legs (despite 3 days off from running) but actually it was actually better than I thought.  Perhaps I’ve been setting some higher (and slightly unrealistic) expectations of myself recently and I need to look at setting a reasonable pace and trying to stick to it for longer distances.  Saturday will be a 14 mile run – my longest of 2014 so that will be a good opportunity to get some proper race practice.

 

In more exciting news, my weekly dual with the bathroom scales showed I’d dropped to my lowest weight of 2014 which is really encouraging.  Again, 188lbs is possibly not something you’d want to shout from the rooftops (just an internet blog…) it’s good to see that there’s another payoff to dieting and running.  A quick check of a BMI calculator says I’m still overweight which I knew and that really to have a “healthy” BMI score, I’d need to lose over another stone.  I’m fairly sure that’s ambitious and really unsustainable in the long term but I’m quite happy to see where my reduced calorie diet and exercise program will take me.

 

A word on food and nutrition before I finish.  Having Type 1 diabetes means I fixate on food a lot more than a lot of other people I know.  My daily life is a series of maths problems regarding carbohydrate content, insulin doses and blood glucose levels.  I suppose in some ways, that makes dieting easier as I’m always looking at food labels before I eat anyway – now I’m just checking calorie content as well as carbs.  I’m currently on a diet of 1200 net calories a day which is about as fun and restrictive as it sounds.  But it does mean I’m losing some weight and I’m making more healthy decisions around what I eat.

 

Work days are all fairly similar – salad for lunch with some oatcakes for low GI carbs to keep me going.  My evening meal is usually grilled  fish or white meat with some green vegetables and either wholemeal bread on rest days (to keep a slow release of energy) or some pasta after running (to quickly replenish the energy I’ve used from exercising).  I know as I start really picking up the distance that 1200 calories a day just isn’t going to be practical, but by then I’m hoping I’ll be at a lower weight that I can sustain with more food on a daily basis.  But for the time being, this diet focuses me on making sensible, healthy choices with what I eat and it seems to be working well for my overall health and wellbeing.

 

As usual, a final mention of my fundraising page.  I’ve raised £160 so far against a target of £1,000 for the year.  I’m incredibly grateful to all those who have generously parted with their hard earned money to donate to Diabetes UK.  Raising £1,000 would mean that Diabetes UK could train 20 risk-assessment volunteers who work at Lifestyle roadshows, connecting with some of the 7 million people at risk of Type 2 diabetes and helping them to make sensible diet and lifestyle choices to reduce their risk of getting diabetes in the future.      Prescribing is the second highest area of spend in the NHS (after staffing costs) and in 2013-4, diabetes prescribing accounted for almost 10% of that cost (up from 6.6% in 2005-6).  Helping to educate people at risk will not only make their lives better in the long run, but will go some way to reducing the huge strain that diabetes places on the NHS.

 

If you can spare anything at all, please click on the link to the fundraising page and donate, or test BROO81 £5 to 70070 to donate via text.

 

Thanks.

Peer Support

There should be little doubt that living with diabetes can sometimes be difficult to the point of making you feel overwhelmed.

Having a good support network is key to helping you manage the times where you feel like you're not sure where to turn or what to do for the best.  Many of us are fortunate enough to have a group of close friends or a supportive family to help us when we need it; to listen to our problems and offer a sympathetic ear.

Some people are a little less fortunate or may even feel worried or embarrassed about revealing a particular problem or concern to someone they have a close relationship with.  In these cases, Peer Support can be an effective tool for people with diabetes.

Peer Support is an incredibly valuable service that's run on a purely volunteer basis aimed at providing anyone affected by diabetes, whether it's you with the condition or you're a parent or carer for someone with diabetes.  All volunteers go through training provided by Diabetes UK to ensure they're able to listen to whatever you have to say and provided support, advice or guidance wherever possible.  Anyone can get in contact via phone or e-mail and you can read more about it on the Peer Support page

Recently I've become involved, along with another volunteer Louise, in a new strand of localised Peer Support that is being piloted by Diabetes UK.  The overall aim is to be able to offer the same Peer Support service described above, but also offer informal support in a more social environment on a group or face to face basis within our own local areas.

Louise and I are offering Peer Support through a number of different mediums (Twitter, Facebook, and via a shared blog) as well as looking to utilise the Diabetes UK forums if at all possible.  That support will be open to anyone who feels like they need to get something off their chest, just needs someone to listen or simply needs pointing in the right direction for some support or advice.

On a local level, we're hoping we can promote the service by getting local doctors and healthcare professionals on board and by asking our diabetes specialist teams to make sure everyone in hospital clinics knows what we have to offer.  As interest hopefully grows, we'll be looking to arrange informal meetings for people to get to know each other.

Our new Peer Support work hasn't been going very long but it's starting to gather momentum and the more we can spread the word, the more we'll be able to help people affected by diabetes with anything they might need.

Louise and I aren't experts with years of medical training, but we do have a wealth of experience in living with diabetes and know that sometimes, having someone who's able to listen will do you the world of good.

If you want to find out more about what we're hoping to achieve, please visit our Peer Support Blog which also details how to get in touch with us by e-mail.

You can also connect with us in the following ways:

Andy (Sheffield area)

Twitter:  @AndyPeerSupport
Facebook: https://www.facebook.com/pages/Diabetes-Peer-Support-Sheffield/534756433284902


Louise (South East)

Twitter:  @LouPeerSupport
Facebook: https://www.facebook.com/diabetespeersupport

If you've got something that's been troubling you then please consider using Peer Support as a means of unburdening yourself.  We use the hashtag #talktosomeone on Twitter so if you need help, support or advice then do Talk To Someone.


Important: All Peer Support volunteers have been through training and checks to ensure you're always discussing any issues in a safe environment.  Your details will be kept confidential at all times.

Divided and United

This blog was first published on the Diabetes UK Blog site in November 2013

Despite being a member of a "club" along with about 4 million other people in the UK, having diabetes is a very individual thing.  The intricacies of the treatment varies from person to person (think insulin to carb ratios) and some will have symptoms that others don't (e.g. hypo awareness).

How we each manage our own conditions, and everything else that comes with it, is a very personal thing to us.  The people we interact with and discuss our daily highs and lows (pun not intended) is also an individual thing.  Some choose to talk openly to the #doc (diabetic online community), others attend local meetings and some may only share with their nearest and dearest.

Despite the myriad individual things that set us all apart from other diabetics, I recently realised that there are a lot of things that do unite us.  I think it probably helps to remember when we're having a bad day that there's someone else who's been through the same things we have, and that should make us feel a little less alone in the universe.  What follows is a list of things that I think we've all done or experienced at some point in our diabetic journey (the list is a little Type 1 specific as I'm speaking from experience, but I've tried to include the Type 2 ones I've discussed with others)

• Being told "you can't eat that" or "should you be having that?!"  
• Testing your BG only to get a reading in the 20s that you can't possibly explain
• ...and conversely, getting a low BG reading when you have no hypo symptoms
• Writing down your insulin dose in a diary but forgetting to actually administer the dose (really hoping that's not just me!)
• Waking up in the middle of the night and losing an hour of precious sleep to deal with a hypo
• Hearing that you have the "naughty" type of diabetes (something I've heard said to Type 2s a few times!)
• Concocting an elaborate excuse ahead of annual review time to explain a wayward HbA1c
• Having a particularly bad day where you end up saying "sod it, I'm having chocolate"
• Stacking insulin doses so you end up with low blood sugar
• Having a BG reading that's either so high or so low that you do a double take on your meter
• Wasting a test strip because you don't get quite enough blood on the end
• Being slightly irritable and having someone tell you to test your BG because they think your sugars are too high/low
• Getting blood on your clothes after a bolus injection or a cannula change

It's obviously not a comprehensive list but hopefully it does illustrate that whilst we have our own individual plans for dealing with our diabetes, there are some moments we all share.

It can be hard to feel like you're always in control of every aspect of your diabetic life and it can be quite easy to feel like you're the only person in the world who is struggling with something.  Hopefully you might recognise a few of the things from the list above and realise that while we're all individual, we're also all united by the same things that diabetes forces upon us every day.

Can you think of any I've missed?

World Diabetes Day

Tomorrow (Thursday 14th November 2013) is World Diabetes Day (WDD for the sake of my typing).  It's going to be the first time I've "celebrated" it and I've been thinking about what it really means to me.

The short answer is "I don't know".  I've been diabetic for 12 years now and truth be told, I've only known about WDD for a couple of years despite it having been running since 1991.  Those with curious minds can visit the International Diabetes Federation website to find out a bit more about it and the significance the date holds.

Obviously I'm all for anything that helps promote awareness of diabetes and the various difficulties it brings.  There's without doubt a certain stigma that comes with it as many people are unaware of the different "types" of diabetes and the different causes/effects of each.  Again, I'm not going to shove the information down your throat, but Diabetes UK have a pretty quick and effective guide to Type 1 and Type 2 diabetes if you're interested.

I've done a fair amount of work over the last 12-18 months to help fundraise and awareness on behalf of Diabetes UK (thanks to everyone who's supported me in those ventures) but I'm still unsure of the best way to "mark" the day, or whether I need to mark it at all.

I've got some great friends within the Diabetic Online Community (#doc) as well as some great relationships I've formed with people I've met via hospital courses or through my local Voluntary Group.  I'm sure tomorrow will be like many others in a lot of respects in that I'll experience a few highs and lows (physically, metaphorically and blood glucosely) and that I'll chat some of the same nonsense I always do.

After a little contemplation, I decided that I'll rock up to work in a blue shirt and tie (repping the IDF colours) and that I'll try and "live tweet" my day as a Type 1 diabetic.  I'll post my blood glucose readings, my meals, my carb calculations and some of the emotional responses that a "typical" day with diabetes can elicit.  (There's a lot of talk around the associated mental health problems people with diabetes can face that you may not be aware of).

If you want a snapshot into the world of a diabetic, or might know someone else who'd be interested, you can follow me on Twitter at @BroomOwl I'll do my best to tag my posts with #WDD and #DILOD (Day In the Life of a Diabetic) depending on character limits and all that.

I suppose tomorrow will be a chance to reflect and be thankful that whilst having diabetes can suck some of the time, I'm lucky to be alive in a time where modern medicine means I've got a pretty decent shot of living with it for years to come.

Thanks