Diabetes — the STIGMA

If there is one thing which really bothers me about Diabetes (and surprisingly this is not the disease itself) is the STIGMA surrounding the word and the reaction of many people who have found out about my condition.   I’ve never wanted to be considered in the least  disabled nor have I ever felt in the least disabled by this disease.   I don’t think DIABETES  should ever be thought of   or taken as a disability.  The second you believe you’re disabled – well then are!    The way I’ve learned to  look at  my diabetes  is  that SOMEONE  ABOVE  was telling me it’s time for me to get healthier and in better shape  than I’ ever would have dreamed (or tried to be) if I wouldn’t have gotten the disease.  The word DIABETES however might cause a lot of people  to pity you or think you really are disabled or can’t do things other people do like  compete in strenuous sports or physical activities.  Diabetics definitely need to be careful but no diabetic needs to live the STIGMA.    The expression on some peoples faces   after telling them you’re  a diabetic  is many times one of queasiness.  Then just tell them how many injections a day you take  and  that you prick your fingers (to test your blood sugar)  a dozen times  a day and  then you’ll really see the meaning of going into SHOCK.   No diabetic who has his disease under control will ever go into DIABETIC SHOCK but the type of  DIABETIC SHOCK non-diabetics get when you tell them about your diabetes is definitely real.  

One of   things I decided from the onset that  I found out I was diabetic (in my teens)  was that I wasn’t going to let the STIGMA of diabetes limit me physically. Diabetes (especially type-1) might be life sentence but it sure doesn’t have to be a death sentence – unless you let it become one.  I worked out and trained hard all of my life making fitness a top priority.  Like many athletes who have had to overcome obstacles I  let the disease motivate me into getting into better shape  than I probably ever would have been in if I hadn’t gotten the disease.  Sometimes I wonder if I didn’t get the diabetes just where  I’d  be today.  I’m  pretty sure my life wouldn’t have been nearly as fitness oriented as it has been nor would my diet have been nearly as healthy as it has been.  So despite all of it’s short comings and hardships – diabetes and it’s STIGMA’s have made me a stronger person both physically and  mentally.

Getting back to the STIGMA of diabetes –   there is no question that this disease is surrounded by a lot of FEAR.  I won’t go into a  discussion about all of these fears but  some of them are  founded and a lot  are not.  One of the things I did decide after I got the disease was that I wanted as few people as possible to know that I was a diabetic.  Throughout the years it was always a question of who I could trust with my STIGMATIC secret.   People I did trust  were SWORN to secrecy not to tell anybody that I had the disease.   Me and my parents  kept my disease   TOP SECRET except from  close relatives.   The same was true for FRIENDS – and  I would tell only  my closest friends and  people who had to know about the disease  like my doctors,  employers  and of course my wife.  As for my wife -I guess she would have found out anyway (sort of hard to hide all the injections and between thinking I’m a drug addict and knowing I was diabetic –  I think she preferred  the diabetes!! )

In conclusion to this  short post — I’m pretty sure that a lot of diabetics out there have felt  the STIGMA of this disease.   I definitely have been a LITTLE obsessed in the past to keep my  disease a secret.  The days of swearing people to secrecy or having them  take a secret OATH  (signed in BLOOD)    never to reveal my diabetes   are now “pretty much”  behind me.  That said I still don’t wear a sign around my neck “I am a Diabetic” although I DO always wear a “Medic Alert” necklace  and think that all diabetics should have one  (I wear mine under my shirt   but it’s always there just in case).    The truth is –  even though I still really want my privacy upheld  I realize that being a DIABETIC is no sin, definitely nothing to be ashamed of  and  there’s very little  reason for me to live the STIGMA.     Unlike years back – today  if I need to  or must take  some insulin I will  pull out an injection in a restaurant or public place (when I can’t get to a restroom )  and inject myself.  I am not worried anymore what people will think.

  Last but definitely not LEAST  is that I’ve found  that  there’s a whole lot of other diabetics out there  that I probably or almost CERTAINLY  would never have known about if I didn’t talk a lot more openly about the disease these days.  I’ve actually been able to help many of these STIGMATIZED diabetics which has helped me too!.    It’s also pretty interesting to see  how just KNOWING YOU”RE NOT ALONE can help someone feel better….  which I hope this BLOG will also do!!

 

Posted in Uncategorized

OMG – Insulin Injection Mistakes…. and what to do and not do!!!

We get up in the morning and it’s another beautiful day.  We don’t expect anything to go wrong  but we all have our busy schedules, we are all in rush to get to work or school,  and the pressures of life are always surrounding us when all of a sudden  out of nowhere   on one of these beautiful days SHIT will HAPPEN.  SHIT HAPPENING is an almost inevitable part  life.  To me it’s happened a number of times   and if you haven’t guessed what I’m talking about it’s an INSULIN INJECTION mistake.  The mistake can come in many  forms but it’s as scary as hell for anyone who  has ever gone into insulin shock or has experienced extreme hypoglycemia.    I think every TYPE-1  diabetic and the parents of  children with TYPE-1 diabetes will find this post interesting and possibly relate to some of the things I describe.    Nothing in this post however are supposed to replace or change the  medical help or instructions that you have gotten   from your doctor or will get in the future.    Many diabetics  have started  using CGM (Continuous  Glucose Monitoring) devices instead of glucometers which I mention a lot in this post.  Things are continuously changing  but I sincerely hope there are diabetics out there who will find this post helpful to them.

OMG (Oh My God) I just overdosed on INSULIN.  To me as a type-I diabetic probably the biggest fear I have is overdosing on insulin. I’ve gone into diabetic shock twice in my life when I was much much younger – once on the tennis court  and once after I managed to park my car while driving to work.  I’ve learned my lessons the hard way – that low blood sugar should never be ignored.   I literally have freaked out on more occasions than I’d like to even think about because of the fear of an episode of hypoglycemia.   I’ve yelled at myself (something like WTF did I do), my heart has skipped  beats   and depending on  what exactly I did or didn’t do I’ve given myself self inflicted panic attacks.  In short I fully understand any diabetic who fears hypoglycemia.    Today I know how to handle most of these hypoglycemic  situations but I also know that severe low blood sugar can kill me or  put me  in a coma.  So if I do  freak out I  freak out quickly and  get over it.  There’s no time to waste and there should be  nobody better prepared than yourself to  treat your  low blood sugar episodes as well as to prevent it from happening if you know that at attack is imminent.   Here are some (first hand) examples of things that could happen….

  1. Accidently taking  2 rapid acting insulin injections like LISPRO.  This has happened  to me  on a few occasions and it’s scary.  Sometimes I take my rapid insulin injection before my meals and other times I take it  after eating.  Taking the injection both  before the meal and then again after is a hypoglycemic event in the making.    Mistakes like this  don’t happen often to me but when you take many injections throughout the day to keep your blood sugar levels in check and then add life’s usual stress to the equation- things can go wrong.  Depending on how extra insulin I’ve taken this could be a pretty serious situation if I don’t treat it quickly.   Unfortunately when SHIT HAPPENS you can’t take it back  — you have to deal with it!!
  2. Taking a  high  dosage of  rapid acting insulin that I didn’t need to take.   This has happened to me occasionally and the reasons for taking large injections are usually not a mistake.  Since I balance my blood sugar with different dosages of rapid acting insulin throughout the day the amount of insulin I take usually depends on what sort of meal I’ve eaten and what my blood sugar is to begin with.   When I  see my  blood sugar levels  are very high and seemingly out of control the way to get it back under control is with a rapid  insulin injection.  Taking a large dosage of rapid acting insulin seems the right thing to do – correct?  Well usually… but sometimes for whatever reason SHIT HAPPENS or maybe MURPHY IS WORKING OVERTIME and  you or I can  get a false high reading on our trusty glucometer .  This doesn’t happen very often and shouldn’t happen   but  if  SHIT is meant to happen it will happen!  Glucometers are not fool proof and sometimes need calibration and even  taking a bIood test from  fingers which aren’t clean can cause faulty readings.    Generally I check twice when I see a very high blood glucose reading on my glucometer – especially  if this glucose  reading  is the reason I  am going to take another   injection (which  I normally wouldn’t take!!).  Unfortunately (for me) there have been tmes   I’ve shot first   and checked  later.   Ever wonder why  you always see your mistakes after you’ve made them — well it’s probably because if you saw them before you made them then you wouldn’t make them and they wouldn’t be mistakes!!   I am pretty convinced that  it always pays to   WASTE  another blood glucose testing strip before you shoot yourself with more insulin. I usually make sure my hands are clean the second time!  Seeing high blood sugar numbers on my glucometer have  always been upsetting to  me  which has sometimes contributed to me  making quick and sometimes bad decisions.    Whenever taking an added  or extra dose of insulin make sure you really need it!!.
  3.  This mistake  happened to me a few months ago  (and I actually hadn’t made this mistake before… guess I missed one)  – This time I took the wrong type of insulin and mistakenly injected my rapid acting lispro  insulin instead of taking my long acting LANTUS insulin.   Since my long acting LANTUS injection is at a much higher dosage than my  rapid  acting lispro injection this was an OMG mistake.  I had to act fast to get my blood sugar up to avoid getting a very dangerous case of hypoglycemia.   Despite a lot of initial fear I suffered no ill effects or hypoglycemia.

Summing the above up –  we are all human, we all make mistakes  and SHIT  does  HAPPEN  and MURPHY DOES EXIST and comes out of nowhere when you least expect him.   If you are a type-1 diabetic you need   to know how to deal with situations like this and be always be prepared.

What Now – you think you just made an OMG (insulin injection) mistake!!

I’ve said it before — try not to freak out – I know what you’re going through.   First off  once you calm down  take a minute to think about what you really did.  In times of fear/stress etc… your mind can play tricks on you.  Did you really take those 2 injections, did you really take the wrong insulin, how much addition insulin did you inject  etc..     From my experiences there’s been many times I’ve thought I might had made a bad mistake when I hadn’t.  Do not add insult to injury by making an even worse mistake!!   Bringing up your blood sugar levels by going on an eating spree when you didn’t actually take the wrong injection   is only going to cause you lots of unnecessary blood sugar problems — so take a minute to think what you actually did!   If you don’t   remember if you took an injection or not do NOT run to  take that missed  injection without thinking or trying to check what you did.   My cardinal rule which usually works for me  is when in real doubt —  I do not take another injection until I  am 100% sure that I didn’t  take the one I thought I skipped or missed.   Keep testing your blood sugar until you’re sure what happened.     If  you feel the need then talk to your doctor and definitely tell some family member or close friend what is going on!.      I personally WHEN IN DOUBT  prefer to control any  high blood sugar levels which might be caused by a missed or forgotten injection  with small dosages  of rapid acting insulin  than run the risk of accidently taking a double dose of  rapid acting  insulin.

The Unthinkable Oh My God (OMG) insulin injection mistake happens to you!!

You now know for sure that you just took that extra injection or a big overdose of insulin.   There is very little time to waste from here on.  Rapid acting insulins such as lispro starts working after a short amount of time   so  getting your blood sugar level up quickly  before the insulin reaches it’s maximum peak is essential in preventing a bad case of hypoglycemia or going into insulin shock.  First thing I do now is to test my blood sugar and know where I stand. This is one of those times where high blood sugar levels are a welcome guest to me.    In one of my previous posts I talked about insulin curves and how important it is to know how  your insulin  works. Rapid acting insulin usually has a peak between 30 minutes to 3 hours.  There are many different brands of insulin on the market and each has it’s own specific action curve – and the curve of quick acting REGULAR insulin is  different than  rapid acting insulin LISPRO.  If  for example your insulin reaches it’s peak after 30 minutes and then tapers off after 3  hours then getting your blood sugar up  quickly is essential but once the insulin starts tapering off (and your blood sugar levels are not low)  then you know you’ve probably dodged the bullet of hypoglycemia.   Don’t forget  however that  dodging the hypoglycemia bullet doesn’t always mean you are out of the woods.  High blood sugar (because of consuming excessive amounts of glucose/carbohydrates to prevent hypoglycemia)  is a real threat which must be recognized.  Bringing low bood sugar up too high and then taking injections to lower it can become a real ROLLER COASTER ride for diabetics.

HOW DO I GET MY BLOOD SUGAR UP  and still AVOID a ROLLER COASTER  RIDE AND CYCLE OF LOW & HIGH BLOOD SUGAR LEVELS?

If I didn’t  mention it   I’ll say it here  (and again and again)  that a diabetic needs to BE PREPARED -ALWAY!!.  Being prepared and ready  for an imminent hypoglycemic emergency   means having 2 things with you at all times.  The first is a working functional GLUCOMETER with many glucose test strips available.  The last thing you want in an emergency is to find you’re out of strips or your glucometer battery has ran out.  Murphy is always lurking around every corner – don’t help him!! Always have a spare battery and a spare bottle of blood testing strips for your glucometer – it could save your life or save you a trip to the ER (emergency room of your nearest hospital).   The next thing in your survival kit are glucose tablets. Keep LOTS OF THEM at hands reach just in case of an emergency!!  I never move without them – at work, in the gym or beside my bed when I go to sleep.   The glucose  tablets are also available in liquid form  if you prefer.  I think it’s probably worth keeping both of them on hand!

Unfortunately I don’t know of any magic pills or remedies   that in one BANG  will get your blood sugar back to normal after overdosing on a large amount of insulin.  Below is the  method that I  use to treat  my hypoglycemia when any medical emergency arises.

1 First I try to make sure I know what happened.   There’s a big difference between treating yourself for a major overdose of rapid acting insulin  or having a hypoglycemic reaction due to  perhaps a  missed  meal or  excessive physical activity or exertion.  Hypoglycemia that is not caused by a major insulin overdose – which is probably the usual case that unfortunately plagues diabetics most of the time  should be  treated quickly by consuming glucose tablets (or other glucose sources) immediately to bring up the blood sugar.   After I consume the glucose tablets I usually check my blood sugar again after   15 or 20 minutes  to see that my sugar level is back around the normal range and I don’t need any additional glucose.  If my blood sugar level is back to normal  (and this was not brought on by a major overdose of insulin) then this bout of hypoglycemia  is usually over and I can go back to my usual routine.  Knowing the reason for any hypoglycemic reaction  is always a big plus in treating it   but the body is a very complex piece of machinery  (as I keep learning everyday…)  and sometimes the cause of both low and high blood sugar can be pretty evasive.

2.  If I have discovered I’ve taken  an overdose of insulin  there’s not much time to waste.   Even if my blood sugar is normal or high at the time this is not the time for complacency.   As all type-1 diabetics know – rapid acting  insulins work very fast  but luckily (if you overdose)  their peak duration time  is  shorter and the peak blood lowering action will be out of your system in around 3 hours .   In this sort of emergency  I  try to increase  my blood sugar  immediately to a  pretty  high level (before the peak effects of the rapid insulin)  again   with the help of glucose tablets.  This is hopefully  before I start feeling the effects of  the rapid acting insulin and getting a hypoglycemic reaction.  Trying to prevent any hypoglycemic reaction is the main objective right now.     Once the rapid insulin starts it blood sugar lowering magic it becomes a continuous routine   of glucose testing and consuming   glucose tablets or glucose syrup  to keep my blood sugar levels  from reaching any low danger point.     I usually keep checking about every  15 or 20 minutes which is the time it takes for the glucose tablets to work.  In overdose emergencies like I am talking about   I’m not that  worried about seeing some high glucose readings since the main objective  is to dodge the bullet of extreme hypoglycemia or insulin shock.  If  my blood sugar remains around or above  the  level  (or in the high range)  from  when I tested it last then there’s usually no reason to keep consuming more glucose.  I do however keep testing for the entire duration that the rapid insulin is  working at it’s peak.    If   during the peak  period   I see my blood sugar levels   decreasing   or going below “my safe zone”   I   resume consuming   glucose tablets to raise my blood sugar.

I titled the  above paragraphs as the ROLLER COASTER RIDE and  HOW TO AVOID IT  but never really got into details. I’m pretty sure that just about every insulin dependent diabetic knows what a roller coaster blood sugar trip is – when he or she has had a case of hypoglycemia only to eventually see his blood sugar skyrocket and then to get it down he or she must take  additional injections which sometimes lead to additional cases of low blood sugar and in short – a vicious cycle which sometimes takes days to get your blood sugar back under control.    I’ve had this happen to me and it’s never fun.   One of the major reasons  for my ROLLER COASTER rides have been the uncontrolled way I’ve  used to raise my blood sugar levels which means I’ve either gone on a  feast of  eating cakes, cookies, ice-cream, sweet drinks etc… or otherwise a feast combined with glucose tablets as a sort of  topping to the desert!!   One  of the reasons for my frantic eating was of course the FEAR FACTOR of the hypoglycemia   but you always pay a price for  gluttony when you’re a diabetic and it’s seldom worth it!!.       The irony with these one man feasts that I gave myself  is that most of the foods I was consuming despite being full of  calories and sweet as sugar   didn’t raise my blood sugar nearly as fast as glucose tablets do.   Don’t forget that even sugar is part glucose and part fructose – and fructose raises the blood sugar slower than glucose.  These sort of feasts can really turn into a  diabetics LAST SUPPER….

Now For Some Simple Math about glucose (tablets and syrup)

I’ve talked about glucose tablets a lot throughout this post.  The best, simplest  and maybe the only way a diabetic can bring his blood sugar up in a CALCULATED way without running a really big risk of  a ROLLER COASTER RIDE  is by using glucose tablets in my humble opinion.  Below is an example…

If you weight  100 pounds (45 kilogram) every gram of glucose will raise your blood glucose 5 units (mg/dl), if you weigh 150 pounds (68 kilogram) it will raise your blood glucose 4 units (mg/dl)  and if you weigh 200 pounds (91 kilogram) it would raise your blood glucose level by 3 units(mg/dl).   In short the less you weigh the more the glucose tablets raise your blood sugar.  The math is simple.  Lets say you’re  a  man weighing about 91 kilo (200 pounds)   and your blood sugar is now in the hypoglycemia range of 50.   Let’s say you want to get your blood sugar up to the 90-100 range as fast as possible.  What do you do?   First thought might be to grab a chocolate bar, piece of cake and wash it all down with some cola — but that is the wrong answer….   Here goes:

A 91 kilo man would increase his blood glucose levels by 3 points for each gram of  glucose.  If you are this man and you want to bring your blood glucose up from 50 to around 90 to 100  you need to raise your blood sugar between 40 to 50 units(mg/dl).  The math here is 40/3 to 50/3 grams of glucose to get you there which comes to somewhere between 13 to 17 grams of glucose.  The glucose tablets that I take are 4 grams per tablet but there are loads of different brands out there coming in different sizes.  The man in question would  have to take around 3 to 4 glucose tablets (of  4 grams glucose/tablet) in order to get his blood sugar up in the range specified.  Even without a calculator most people can do this math in their head.    Now try to  do the same calculation but instead of the glucose tablets you  take a piece of cake, some ice-cream, a chocolate bar and maybe some cola  or possibly coffee and milk  to wash it all down….   It’s pretty easy to see that if you’re a diabetic  having glucose tablets with you at all times is a MUST.

Looking forward to user comments on this post.

 

 

 

 

Posted in diabetes control, diet and food, glucometer, injections, insulin

Diabetes and Glucometers

I’ve made some good friends in this life but being a type-1  diabetic my closest  and most trusted friend  is by far my  GLUCOMETER – the machine that gives me an accurate reading of what my current blood sugar level is.   If any of my friends are reading this please don’t get mad  at me – what I meant to say   is closest  and most trusted ELECTRONIC FRIEND!   It is always by my side (in my pouch)  and has saved my life and helped me to survive too many times to count.    I depend on this machine  so much that I even went out and bought 2 .   I test my blood sugar somewhere between 5 to 10 times a day and this little piece of machinery is probably the best thing that has come along for diabetics since insulin was invented.   Maybe  some or most diabetics can get along by testing  less than I do but that doesn’t change the fact that every diabetic MUST have at least 1 working glucometer if he wants to sleep well at night.

There are lots  of different models of glucometers on the market (I own a freestyle and accuchek glucometer) so I’m not going to tell anybody which one to go out and buy.   What’s important in a glucometer you ask  Here’s a list of things you might want to check out …

  • 1.  Accuracy of course is super important.  Getting a crappy glucometer that gives you all sorts of crazy results is not what you’re looking for.  Check the reviews or ask your diabetes specialist what he suggests…
  • 2.  Some glucometers require less blood to be put on the test strips and still gives accurate results .  This is a nice feature since you’ll land up pricking your finger less.  By the way — there are other places to take blood from aside from your fingers – like your palm, arm etc…  Taking blood has actually never been a problem for me — or maybe I’ve just gotten used to being a pin cushion…
  • 3.  I  like the glucometer to be  small and light because I’m carrying it around all the time
  • 4. It’s also important that the display is clear and easily readable.
  • 5.  A night or backlight to see the display in the dark or poor lighting  conditions is important.  I sometimes find myself testing my blood in all sorts of places and times where the lighting is poor.  It’s also nice to have a glucometer which shines some light on your test strip so you can  see where to place the blood  in poor light conditions.
  • 6.  Most glucometers have a nice memory size today which  holds a large number of test results which you can look back on.    It is a  good idea  to check exactly what your glucometer gives you and if it suits your needs.  Some glucometers have interfaces to download your results to your PC and some also supply programs that give you all sorts of statistics and charts concerning your blood sugar results. Nice stuff for the high-tech diabetics out there.

I’ve probably forgotten some stuff – but the above is at least  some of the important stuff you might look for when you’re buying  a new glucometer.

One of th questions some of you might be thinking is why in the world do I need 2 glucometers and why 2 different brands or models… Good questions!!  First off —  I just can’t take the chance of one of these machines dying on me or going into a diabetic coma before I do.  I need a working glucometer at all times and won’t take the chance of being without one for any extended period of time.  The price of a glucometer these days is pretty cheap and it’s well worth the expense to have another one handy — just in case!   Even if the glucometer doesn’t totally  croak on you there’s always the chance the batteries will need to be replaced one day  and of course Murphy will make sure the shop with the batteries  down the block  will  be  closed and of course the next one you go to  will be out of those type  batteries …  We all know that Murphy is always out there watching us…   And of course your glucometer will go on the blink just when you think you took the wrong injection and are in a panic etc,etc..  Not funny — but when things go wrong they usually  seem to go wrong BIGTIME.. 

So why 2 different brands of glucometers?   Another good question!   It doesn’t happen often but occasionally I get crazy or illogical results from one of my glucometers like lets say my blood sugar shows a reading of 40 or maybe 400 and I’m feeling fine (well at least I was feeling fine up until I tested!!).  So what I usually do is take out my other machine  and test again.  Chances are pretty good that if both machines agree with each other then they apparently know what they are talking about.   If you do have to perform the same test twice then I think  using the same finger or area where the first test was done is a good idea — to  keep the test honest…    Don’t forget however that if you didn’t clean the area where you’re taking the blood from you might get some weird results!!  Washing your hands before taking a blood test  from your fingers is always a good idea.   Even if you get the same results twice make 100% sure that the area you are performing the test from is clean.  If the area is smeared with honey or ice-cream I’m not sure you can trust those results too much!!   If the two blood sugar tests do differ greatly  just make sure you test again before doing something you might regret — like taking another injection of fast acting lispro insulin.   Fortunately this sort of situation does not happen very often!!  It always is better being safe than sorry when it comes to taking additional  injections of insulin.

One not so obvious reason for having 2 different machines is that you never can know when a certain type of test strips might run out or not be available in your pharmacy or wherever you get your supplies- and having another machine using different types of strips  can be really helpful.     In short — I’ve found that having 2 different  glucometers   has it’s advantages and  it works for me.     Main thing however is you have at least 1 working glucometer that can be trusted!!   And don’t forget to treat HER or HIM well…..

Posted in diabetes control, glucometer

Physical Activity for Diabetics is a Must Do

I am a diabetic for over 40 years. I’m lying if I say it’s all been easy   but if there’s one thing I can say (and I usually say “a lot”  of things) is that I honestly believe that in many ways diabetes has made me a healthier person. One of those ways it has made me more healthy is that it has PUSHED  me into a pretty strict routine of exercising and doing lots of sport as A WAY OF LIFE.  I say PUSHED because the alternative to not exercising has always been less control over my  blood sugar levels which is never good . The JUGGLING act to control your diabetes without physical activity be it  exercise  or sports leaves you with one less tool in the fight to remain healthy and avoid the many unnecessary complications that can be brought on by diabetes.  If you can’t run then walk and if you can’t walk then get some weights and start lifting them from your chair but  Nike was right when they said JUST DO IT.  It’s very easy to find excuses why NOT to exercise and there are millions out there but one excuse just leads to another until the excuses turn into debilitating health problems and then the  REAL excuses begin!   If you want to live longer, get healthier  and feel better about yourself  both physically and mentally then it’s time to get out of bed and off the chair or couch and start moving….  If you need any more coaching just let me know…

I have lots of philosophies and opinions about what the best exercises for diabetics can of course be debated and are open to discussion  but  the absolute  worst exercise  that any diabetic can do (and this isn’t really  open to  DISCUSSION) is NO EXERCISE….    Not convinced yet- well go out and take a walk and think about it…. end of post.

 

Posted in diabetes control, sport and physical workouts

Sport and diabetes

I honestly cannot say enough about how important physical activity  is a MUST  in controlling blood sugar levels and living a Better Life  for diabetics.  It has helped me  so much that  there is nothing I like writing about more than the benefits of physical activities, exercise and  sports  in controlling this disease and hopefully eliminating or at least  decreasing or delaying many or most of the debilitating effects it can have.    You will live a healthier life both physically and mentally if you work out — diabetic or not!!

Now that I’ve gotten my point across how good exercise is for us I have to be honest and pass to the other side of the coin…   Physical exercise , sport etc.. is more CHALLENGING for diabetics than it is for non-diabetics and precautions do need to be taken.  Here is something that happened to me a long long time ago when I was much younger.   

I’ve always loved the sport of tennis and have been an avid fan and player since in my teens.  Every Saturday I would play tennis early in the morning with a tennis friend.  We knew each other for quite some time but I never mentioned to him that I was diabetic.  My diabetes in my younger days was something almost nobody knew about and I kept it secret on the same level as  Houdini kept his greatest magic escapes  secret…

I got up that fateful morning, took my insulin injections (then NPH+REGULAR), had some coffee and whole wheat crackers  and left for the court.  Nothing special up till now.   Don’t remember what my blood sugar level was when I got up that morning  but there probably was no reason  for concern or I probably would have paid attention to eating more.  Don’t remember exactly why this happened (maybe I was in a hurry) but  I didn’t  take any  glucose tablets, sweet drinks or anything else along with me which could raise my blood sugar levels quickly if I needed it.  I lived only 5 minutes from the courts so getting home quickly was no big deal – or so I thought.   What I remember now about that day was that it was  hot and humid day and the tennis match went on forever. The regular insulin injection I took in the morning began kicking in strong after a few hours!    The longer the match went on the weaker and worse I felt. If I had any brains I would have gotten off the court at the first signs of weakness and shakiness  – but winning the match was much more important.  I soon found it really hard to run to my opponents shots and  knew something was wrong  but I continued to play.  It must have been at least 15 minutes or more  that I could have gotten off the court (while my brain was still working) but I now reached the point where I was  almost completely brain dead  and running on empty.   No idea what I was thinking at this point except maybe ‘hit the ball’ (which was pretty impossible at this point).    Just about  the last things I do remember was that double vision had set in.  If it wasn’t bad enough that I couldn’t run (or hardly stand up for that matter)  now  I  was seeing 2 tennis balls flying by me and something in my brain-dead brain knew I was going to pass out.  I don’t really remember much after that  but I did manage to start getting  off the court and mutter to  my partner that I was a diabetic and needed something sweet.  That was the last thing I remember before waking up in the hospital after being in a coma  for almost 2 days from  insulin shock.  Definitely not one of my better matches or days on the tennis court..!!!

Luckily (for my kids who weren’t born yet)  — I did survive and live to tell the tale… but there are lessons to be learned.  Here’s a list of things I MAYBE could have done  better,  smarter  etc,etc… to have prevented the above.

1. If you are going to participate in any competitive sport make sure you lower your dosage of insulin and always take into consideration the insulin curves.  If  you took an injection of regular insulin  which starts to work after 1/2 to 1 hour and has peak action  after 2 hours  then you better make sure your blood sugar levels are up high enough to compensate.  Don’t rely on chance or pure luck (it doesn’t always work in your favor) — CHECK YOUR BLOOD SUGAR LEVELS PERIODICALLY and eat accordingly.

2. Always have some quick  acting glucose tablets like GLUCOTABS available as well as a liquid glucose drink (which is something quicker/easier to take – or pore down you if you lose consciousness). Always have a supply and  keep  them available everywhere so you don’t run out. I  keep them in my pocket at all times, I keep them in my pouch, I keep them in my gym & pool bag and I keep them in the glove compartment of my car.  You can’t be too careful but you can always be too careless!

3.  Since I got this sweet disease when I was in my teens I never wanted anyone knowing about my diabetes.  It’s nobodies business and I don’t want anybody feeling sorry for me.  Most people out there just don’t understand this diseases and for the most part I never wanted to go around explaining it.  That said –   today I do not  keep this disease a national secret like I did in my younger days.   Friends,  people I work out with, play tennis or other sports with or I’m in close contact  with are let in on my secret.  I just tell them to keep it quiet.  Most of them do… and the rest  I just don’t talk to anymore….:-)  If on that day my tennis partner would have known I was diabetic maybe he would have been smart enough to see something was wrong and get me off the court and give me something to eat …  and prevent a near death experience.

 

 

 

Posted in diabetes control, sport and physical workouts

Insulin — A Learning Curve

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One of the things I keep saying is that controlling diabetes is a juggling game.  You need to juggle your physical activity with your diet and last but far from Least is your daily injections. Type-1 or juvenile diabetes as it is sometimes known almost always requires injections.  If you’re a type-2 diabetic there is also a chance you might be on injections if you haven’t managed to control the disease with pills, diet and exercise. Even with insulin injections if you think it’s easy to achieve perfect  blood sugar levels and control then apparently you’re NOT a diabetic.   Maybe if we  lived in an imaginary world where we ate, slept  and exercised  exactly the  same thing every day then maybe it would be ALMOST possible  — but unfortunately most diabetics don’t  live in the land of OZ or some other imaginary place. This brings me to the point of this post — knowing the ins and outs of the INSULINS you take or at least the basics…

We take insulin injections because for whatever reasons  our bodies  (pancreas to be exact)  just doesn’t produce enough or efficient enough insulin (which is a hormone)  to regulate the  glucose (sugar) levels  in our blood.   In order to regulate blood sugar  diabetics need to take daily injections.  It’s supposed to do what the pancreas does or at least produce something that the pancreas produces and doesn’t work well or at all in diabetics.  Simple — well yes and no…  Taking an injection is quite simple but getting it to work for you to control your blood sugar levels is not that simple as any diabetic can tell you.  The human body is an unbelievable machine when it works well —  when things don’t work well it’s very hard to achieve a replacement in the laboratory.  That said — most type-1 diabetics would not be alive today without this wonderful thing called INSULIN.

The thing with insulin injections  that separates it from the insulin produced by your body  is  that your body is an unbelievable computer that knows just when to produce the insulin and also the right amount of insulin  to control any  blood sugar spurts and hopefully keep your blood sugar levels  in the normal range (~80 to ~120).  An insulin injection however follows a pretty strict CURVE.  The insulin injection starts working after a certain amount of time, reaches a peak performance after a certain amount of time and then tapers down and  magically stops working entirely.  In short – in  order to control your diabetes you need to know your insulin injection curves.

I won’t go into all the different insulin types and their curves for the simple reason that I don’t know all the different insulin types out there (I’m not a diabetes physician or specialist ) — but I will however discuss the ones I do know a thing or two about (mainly because I’ve used them… which hopefully will help me make my points clear!!).

For many years I used to take  a combination of regular and NPH insulin because that’s what was available at the time  and that’s what my diabetic specialist prescribed.  Here’s the curves of the way  these 2 insulins work:

Regular Insulin:  Onset = 1/2 hour to 45 minutes. Peak = 2 to 3.5 hours. Total Duration = 5-7 hours.

NPH Insulin: Onset =  1 to 3 hours. Peak – 4 to  9 hours.  Total Duration = 14-20 hours.

Now let’s look at the CURVES of these insulins and the  challenges they presented me .   Let’s say I’d get up in the morning with a normal blood sugar level ….  I now start off the day by taking my NPH insulin injection and also a REGULAR insulin injection before I eat breakfast.  If  I start eating  my breakfast immediately after taking the injections the chances are that my blood sugar  levels will rise way  before the REGULAR insulin begins to work – especially if I eat too much quick acting carbohydrates (a few crackers).  Despite the fact that the onset of the regular insulin is a 1/2 hour to 45 minutes  – the peak performance is only after 2 hours which might allow  blood sugar levels to go up considerably   before the regular insulin brings it down.  Eventually the REGULAR insulin will of course  lower the morning pop in blood sugar — but only after what could be considered a seesawing effect depending on when and  what I ate.

Next possible problem — the NPH insulin would start to reach it’s peak (for me) about noon time which is around 4 hours after I would  take my morning injection.  In addition to this –  the regular insulin would still be working during the time the NPH  insulin started  it’s peak — making the NPH even more potent.  What this meant  is that if the regular insulin  had  brought down my blood sugar levels before lunch– the NPH plus the added effects of the still working regular insulin  had  a pretty high chance of  giving me hypoglycemia(low blood sugar) around lunch time  unless I  would eat on time – which is something I would always have to do.    In order to prevent the very unpleasant  and very scary complications of hypoglycemia eating on time became a necessity and urgent — and skipping meals would become very dangerous.

In the evening  it again becomes  necessary to take an injection of  regular insulin to bring down the rise in blood sugar from eating dinner. The peak effects of the morning NPH injection usually  ended by the evening   – so the regular insulin injection was mandatory to lower the rise in blood sugar levels from my dinner.  Again eating on time and not missing the meal is a major consideration.

As you can see – LEARNING THE INSULIN Curves is very important for all insulins any diabetic might be taking.  Not knowing the curves can be dangerous since missing or eating at the WRONG times could cause all sorts of fluctuations is blood sugar levels.

ON THE BRIGHT SIDE new insulin types have made life a lot less demanding and challenging for diabetics….

Advances in insulin have come a long way since I first got the disease.  Today my insulin regime has given me tremendous  freedom which I didn’t have in the past. I now take the following 2 insulins which have curves that have made life a lot simpler and given me almost entire freedom ovcr the times I need to eat or do exercise which was almost impossible with the insulins I used to take in the past.

1. Lispro or Humalog insulin —  this is similar to regular insulin only that instead of being sort of quick acting like regular insulin is the  HUMALOG INSULIN   is VERY QUICK acting which can help attain much better blood sugar levels!!

Onset = 15 minutes,  Peak = 30 to 90 minutes,  Duration= 3 to 5 hours

2. Lantus insulin —  this is the insulin I now take instead of NPH insulin.  While NPH can  be  considered a pretty long acting insulin (working almost a full day)  it’s peak effects  are gone after  about  1/2 a day (and the peak effects can be brutal if you don’t eat on time).  The Lantus insulin will also work around an entire day with 1 injection but there are MAJOR DIFFERENCES between NPH and lantus insulin.   The major point about Lantus insulin is that it doesn’t have a curve like the other insulins — it will work at the same potency throughout the day after the onset has started — which is very similar to the effects of an insulin pump.   To simplify what that means is that if you have a  normal blood sugar level at the time you inject the insulin then you should remain around that same blood sugar level for the entire day barring the effects of any meals or food you eat  which need to be taken care of by taking an injection of the Lispro insulin.   Maybe this doesn’t sound like much — but it is!!   Taking Lantus and Lispro instead of NPH and REGULAR insulin allows me to exercise and eat whenever I want  and I only have to remember to take the injection of Lispro  just before, during or  immediately after I eat.  The stats for Lantus insulin are:

Onset= 1 hour,  Peak = no peak ( just an equal effect throughout the day),  Duration= 20 to 26 hours

In a nutshell here’s my current regime.

Every night  – around about 7 or 8PM I take 1 injection of LANTUS insulin.   The amount needs to be enough to keep my blood sugar levels normal throughout the day barring the effects of any food I eat   during the day.  Each time I eat — be it a snack or a meal I take  a varying amount   of the lispro insulin which  brings down (on the spot more or less) any spike in my blood sugar level which would be  caused by the food I eat.  This means I do have to take much more injections per day than my previous REGULAR & NPH insulin routine  but my quality of life has improved tremendously.    Eating meals at a certain time each day to compensate for the insulin curves doesn’t really exist anymore except that you MUST NOT forget to take the lispro injection when you’ve eaten a meal – or your blood sugar levels will take off.   This can sometimes be tricky but  it’s  been worth it  to me considering the added freedom it has given me in just about every way.

Hope this post is more or less clear but feel free to comment if it isn’t.  I have no intention of changing anybodies insulin regime nor   am I trying to convince anyone what insulins  to take to achieve better control of their disease.  There will be CHALLENGES with any and all insulin regimes.    The purpose of this article is to explain the insulin curves  and to stress how important it  is that every diabetic take them into consideration……

 

 

 

Posted in diabetes control, injections, insulin

Diabetes should not be an obstacle to achieving better health – it can and should be used as a prerequisite!!

Almost everything in life can be taken with different perspectives.   One person sees the glass as 1/2  empty while the next sees the glass as 1/2 full.  They both are right — but the guy who sees the glass as 1/2 full is usually a lot happier than the one who sees the glass as 1/2 empty.  The same is true for diabetes.  If you give in to the disease, worry about it all the time  and don’t control it then it will undoubtedly control you and that can bring all sorts of unwanted health consequences and probably make you miserable.  If however you do decide to control the disease then this disease can and will help you live a better and healthier life.  You will eat better, exercise more and appreciate things a lot more than people who take their health for granted  and go through life  eating  wrong , never exercising and ignoring their health.

I have spent a lifetime trying to keep my diabetes under control – so I know the mistakes. It’s not easy keeping diabetes in check  and it’s still and probably always will be a  WORK IN PROGRESS  for me.   I take daily injections, still experiment and learn new things about how to  diet  to keep the disease under better control and last but not least — I am a die hard physical fitness fanatic who has spent a good part of his life doing lots  of exercise and sports.  Hopefully there are a lot of diabetics (and non-diabetics) out there who will  find this blog both interesting  and  HELPFUL!!

 

Posted in Uncategorized