Back again.

After a long hiatus I'm returning to the blogosphere. It's been quite a while since I've last posted here but I doubt if anybody was waiting in agonised anticipation.

I'm afraid I haven't a whole lot to say today but I do intend to get this blog up, running and active again, if only as a means of maintaining the motivation required to keep my own diabetes management in check.

So I'll be back soon and in the meantime I'll have another one of these....

Here comes the sun....

Well I'm back again. Apologies once again for the sporadic nature of my posting. I promise I'll endeavour to post more regularly, though I sense a touch of déjà vu as I write those words.
Anyway school's out and salad days are here again. We were promised a heat wave this week here in Ireland though it's been more of the heat and less of the wave. Basically it's been warm and muggy and getting the grass cut means a bit of a dash to get it done before the showers. Now I've always found humid weather a bit intolerable, but this is the first time I've experienced this weather as a diabetic and it has been a bit of a revelation. Last summer was my first as a person with diabetes but whole there was some nice weather there wasn't much of the humidity that we've been experiencing this past week.
It didn't dawn on me at first. I've been experiencing quite a few hypos over the past few days and had been struggling to understand why. I'd figured that maybe I need to alter by basal dosage and was all set to do so last night until I stumbled upon a post on a diabetes Facebook page. I had totally overlooked the possible impact of the change in weather until I read a post in which a chap spoke about the many hypos he'd been experiencing during the heat wave in London.
Now don't get me wrong; it hasn't exactly been tropical here in Ireland but I reckon there's been enough heat and humidity in the air to play tricks on my bg levels. It leaves me wondering how I'll get on when we visit the in laws in New York at the end of July.
So why the hypos? Well it seems that our metabolism is higher in this weather with an increased chance of low bg levels. It also seems that hypos can be a bit hard to detect in hot weather; something I've also been experiencing during the past week.
So what to do? If you're carb counting maybe you cold adjust your ratio slightly though I guess that's a bit hit and miss unless you've a good idea exactly how much your levels are affected by the heat. Otherwise I guess it's about being vigilant. Test bg levels more often, keep fast acting carbs close at hand and don't ignore any possible symptoms. Also take care when driving and keep the air conditioning on as cars can get quite hot. I'd also suggest taking a few carbs before going to bed as I've experienced hypos at 3 or 4 a.m. almost every night this week.
Other than that, enjoy the sun and don't let the beets spoil the fun.

A cup of joe...

My name is Ja and I'm an addict. Do I have any intention of signing up for a twelve step programme in the near future? Not on your life. My daily vice is the rather innocuous drug of the masses; a freshly brewed cup of strong coffee. So aside from the minor dent in my personal finances created by regular doses of over-priced brew, it hasn't had an overly adverse effect on my day to day life.
As a T1 diabetic however there are some considerations to take into account when it comes to the cup of joe. First off, as a carb counter I generally stick to straight forward Americano or espresso. The carb content in a black espresso is nil and the added carbs of a dash of milk in my espresso is negligible. Of course I do partake in the odd cappuccino or even a mocca now and again, but they're always the more considered options as they generally necessitate a bolus. A cappuccino would usually be accompanied by one unit of insulin; the chocolate in a mocca might require a bit more.
So that's as far as if goes for me in terms of coffee and bg levels. However, there seems to be a broader range of experiences amongst both diabetics and those involved in the treatment and management of diabetes and there is a degree of debate out there around the effects of coffee on blood-sugar levels.
While my first concern is the influence of coffee on bg levels among those like myself who have already been diagnosed with T1 diabetes, it would be remiss not to point out that various studies concur that regular consumption of coffee can lead to a lower risk of Type 2 diabetes developing.
When it comes to T1 results of studies around the influence of coffee are less conclusive. That consumption of my daily tipple can prevent diabetes is not the case when it comes to Type 1, an auto-immune condition that thus far has not been shown to be preventable. But went comes to the bg levels of those with T1, the effects of coffee is a subject of debate. There seems to be a small degree of evidence to support the view that coffee can cause a rise in bg levels, even in the absence of added milk/cream/sugar (http://www.diabetesselfmanagement.com/blog/the-mystery-of-coffee-and-diabetes). While my own personal experience doesn't back this view I guess it is worth occasional monitoring.
Perhaps more worthy of consideration in the long term is the degree to which regular consumption of coffee can lead to reduced sensitivity to insulin. While this is also the subject of debate, there seems to be a degree of evidence to suggest that regular consumption can, over time, lead to reduced sensitivity (http://care.diabetesjournals.org/content/25/2/399.full). My own limited knowledge of the research tells me that the studies have been somewhat inconclusive and certainly won't have me rushing to give up my daily fix just yet.
See also
http://teeccino.com/images/uploads/pages/File/diabetes.pdf

http://www.mayoclinic.org/diseases-conditions/type-2-diabetes/expert-answers/blood-sugar/faq-20057941

It's been a while...

I suppose it was a milestone of sorts; not exactly a cause for celebration but a date worth marking all the same. Last October saw the first anniversary of my T1 diagnosis. At the risk of sounding a touch self indulgent I may as well fess up to having had a sense of occasion about the whole thing. Emotionally it was a bit of a trip to the pick 'n mix counter. There was certainly a sense of achievement; a degree of pride in the fact that, broadly speaking, I'd handled it all reasonably well. I hadn't let diabetes drag me down. There can be no dressing up T1 diabetes as something good but with the right attitude it can bring positive aspects to ones life. For me it was a disciplined approach to diet and exercise and a greater awareness of my body and personal health. So while T1 diabetes brings its obvious risks and complications, good management can bring improvements to one's overall better health and well being.
There was also a sense of pride my diabetes was not the sole thing that overrode and characterised the entire year. For any newly diagnosed folk the important thing to remember is that a condition and a part of life but it's not your entire life. For me it was a sojourn in hospital followed by a couple of days off work to get into the swing of things, then back to work and I haven't looked back since. I started carb counting from day one, cut the crap out of my diet, began to get fit and started researching and blogging about the exclusive club of which I'd become a fully paid up member. Otherwise life and work went on as normal. Indeed the biggest event of that's year has possibly not been my T1 diagnosis but my appointment as Deputy Principal in a new school. Or maybe it's seeing my beautiful daughter begin her first year at school.
Of course, as the song goes, I'm no Superman and there have been plenty of downers. Despite having began carb counting from day one and completed a DAFNE course in February '14 my BG levels still need a bit of work and tend to fluctuate sometimes. Am I bovvered? Not a whole lot. I'm a pragmatic sort at heart and I certainly know that Rome wasn't built in a day. Yes it can be a little frustrating to wake up of a morning with a 12.3 reading but it takes time to refine one's control of diabetes and even then there's an array of influencing factors that can put the cat amongst the pigeons. Personally speaking I'm happy having been broadly in control over the past eighteen months in the knowledge that my knowledge and management of the condition is improving all the time.

You need to get one of these...

It first happened to me around ten days in. I was a few days home from hospital following a diagnosis of type1 diabetes and it was a case of so far so good; my bg levels had stabilised and I was getting into a routine that prompted me to wonder what all the fuss was about. Little did I know of the many pitfalls and hurdles ahead.

My first minor incident occurred on a Saturday evening while getting ready to go out and meet some friends. I call an incident but it was more a 'non-incident'. I followed my usual routine; bg test, insulin & meal. Fast forward an hour and the doubt sets in; did I take my insulin? Five minutes I'm pacing the kitchen in a vain effort to retrace my steps. Of course the more I try to recall the more I question my ability to recall. Needless to say, as this was my first such diabetes related episode, I took a rain check on my night out with the lads. My evening was spend doing hourly bg checks until I reassured myself that it was all a case of much ado about nothing. I had indeed taken my insulin and recorded a very nice 6.9 gong to bed.

'So this is the face of things to come' I thought to myself. If I was already beginning to forget whether or not I had taken my insulin what would happen in the months and years to come and, worse still, at that stage of life when 'senior moments' are part of everyday life?

Fortunately, a Google search seeking advise around what I figured must be a common issue threw out an interesting solution, particularly interesting given my penchant towards gadgets and gizmos. So it transpires that by attaching a little gizmo to your pen you can log the time lapsed since your last dose. Bingo!

There are a few different products n the market that basically do the same thing with a few subtle variations. I've mentioned the Irish product, Insulcheck in earlier posts but today I'm talking about the very nifty Timesulin. I've been using it for a few weeks now and I must say I'm quite impressed by it.

What first struck me about Timesulin is its neat design values. Unlike Insulcheck which fits on to the end of the pen, Timesulin is a perfectly fitting replacement cap. It adds no bulk to your pen and barely alters the appearance. Eight seconds after removing the cap to administer your dose the digital timer goes back to 00.00. Administer the dose, replace the cap and the timer starts counting. If you find yourself in doubt later on just a quick glance will tell you how long it's been since your last dose. Why the eight second delay? Well, that's in case you need to take the cap ff to check how much insulin is left before going out.

A further advantage of Timesulin relates to when you feel the need to check your levels between meals/doses. This is a common issue for me as I have yet to fully master DAFNE so I'm often guessing the dose, especially when eating out. I often find myself having to check levels between meals. Timesulin enables me to see exactly how long working time is left in my insulin cycle, providing obvious benefits.

A particular advantage that Timesulin has over Insulcheck is that there is no minimum dose required. A minimum dose of four units is required before the Insulcheck device reverts to 00.00. This is a problem where low doses are required and renders the Insulcheck particularly problematic for honeymooners.

What is a little disappointing about Timesulin is that the battery is the non-replaceable battery. I imagine it would be quite straightforward to allow for battery replacement in future versions. Other than that, Timesulin is a great little device that's nifty, neat, easy to use and gives peace of mind at a relatively low price of €29.99 (£25). 

Daddy DayCare

Ah, the joys of teacher holidays! Not wanting to gloat but it is nice, especially given the nice weather we've had here in Mayo over the past few days. While her nibs slaves away in the corporate corridors I've been spending some quality time with our little princess. Between playground activity, cycling, visits to coffee shops and general fun and games it's been a busy few days. Needless to say there have been one or two melt downs, but the princess doesn't take much notice of me at the best of times anyway!
We did a little baking today. To apply the term 'baking' is a little generous; nothing was actually baked but hey, there was a mixing bowl involved and the end product was presented in cupcake papers with sprinkles on the top. Best of all however was the low carb count of my confectionary efforts; just 1 cp per treat. And they were, according to the verdict of the princess, "yummy scrummy". The fact that the completion of the task neatly coincided with a borderline hypo rounded things off nicely, thank you very much.
So I guess I should tell you what was on special in our little bakery today. I may even share the recipe, though it's not exactly complicated. As you'll see from the picture, today's bake was a plate of chocolatey vanilla rice crispie treats. Not exactly a contender for the Great British Bake Off but I'm pretty sure I saw the Barefoot Contessa have a go at them once. I also reckon they'd go down well with Nigella, the thinking gourmand's crumpet!
Seen as you're such nice folk I'll share our 'recipe', though I doubt you'll need it; is there anybody out there who doesn't know who to knock out a round of rice crispie treats?

75g rice crispies
100g chocolate
A 'dash' of vanilla extract (a dash is a very exact measure in our house)
Sprinkles

Melt the chocolate in a Bain Marie. Add the vanilla. Stir in the rice crispies and scoop into a tray of 12 cupcake papers. Top with sprinkles and Bob's your uncle!
125g of yummy carbs on a tray. A very neat 10g of carbs per treat. Enjoy!

Return of the insulin zombie

I guess I should open proceedings by apologising for my somewhat protracted hiatus. Work commitments combined with writer's block and more than degree of lethargy have left my blog feeling a little lonely recently.
So what's been happening? Well, I was very fortunate to be given a place on a DAFNE course which I completed in February. This was certainly one of the best things I've done since diagnosis. I couldn't fault the course. The content was brilliant but what really made it worthwhile was the delivery. Our facilitators, Berne and Carmel were second to none. Between them they have a tremendous level of expertise and I reckon they could teach a thing or two to some of my teaching colleagues about pedagogy and the imparting of knowledge in an interesting and enjoyable manner. They were also aided in their delivery by a positive and responsive group of willing students. All nine of us were positively disposed to the concept of DAFNE and gelled in a spirit of collaboration and support. We were all active participants and shared many interesting and often humorous experiences and anecdotes.
DAFNE (Dose Adjustment For Normal Eating) is a way of managing Type 1 diabetes and provides people with the skills necessary to estimate the carbohydrate in each meal and to inject the right dose of insulin. It's a relatively straightforward concept; find your correct background dose, work out your insulin - CP (carb point) ratio and take your mealtime dosage according to the carbs on your plate. As I said, a relatively straightforward concept but the execution isn't so easy to master and requires five days of intensive training with follow-up sessions and constant monitoring and tweaking. I've certainly embraced DAFNE but I'm far from an expert yet and still working at getting my own levels consistently within range. Even as I write this entry I'm just after registering 13.2, despite having taking what I thought was a dose consistent with the carbs on my plate; counting carbs can involve an fair degree of guesswork on some occasions! Still, I persevere and I'm mostly within range.
If you haven't come across DAFNE already I'd highly recommend you to follow up on it and check out if there's an opportunity to enrol in your area. In the meantime you'll find out lots of information on www.dafne.uk.com