Hi, everybody (hi, Dr Nick!). I hope you’re keeping well and enjoying the weather. Not much new with me really. Same old, same old. The year does seem to be flying past though! Can’t believe we’re over halfway through already. My little girl starts primary school in September. Mad. They really do grow up so fast. Anyway, enough about the ever-flowing sands of time, my topic today is Diabetes. Let’s crack on.
I know a lot about diabetes. It would be hyperbole to say that I’m an expert, but I certainly know more than the average person. The reason I know so much is that my wife is diabetic. And I therefore know the crucial information.
Now, straight off the bat, it’s probably worth saying that there’s two different types of diabetes: Type 1 and Type 2 (there may actually be more types, but these are the main two). Type 1 is a genetic condition that is usually diagnosed in childhood; the cause of it has absolutely nothing to do with diet, weight, or fitness. Type 2 on the other hand does tend to be caused by diet and weight; the worse your diet and the heavier you are, the more increased your risk of getting Type 2 diabetes is.
My wife is Type 1. She was diagnosed when she was 18 months old. We’ll put a pin in that, as it’s something I want to come back to. There are a lot of misconceptions about diabetes, so let me try to explain what it is. In simple terms, a diabetic’s pancreas doesn’t work; it doesn’t produce insulin.
When a non-diabetic consumes carbohydrates, their pancreas releases insulin to break the carbs down (I’m sure it’s more complex than that, but that’s the general gist). A diabetic’s pancreas doesn’t release any insulin, so after consuming carbs, their blood glucose (yes, this is the correct term, not “blood sugar”) level will rise and rise. High blood glucose levels can be very dangerous for long-term health, potentially damaging organs, nerves, tissue, and blood vessels.
To combat this, diabetics inject themselves with insulin. There are many different brands and there are various ways they might be injected. But ultimately, there are two types of insulin: long acting and quick acting.
Long acting, as the name suggests, works over a long period of time. It would usually be injected first thing in the morning and/or just before going to sleep at night. Basically, your blood glucose level always rises, even if you haven’t had anything to eat or drink. In a non-diabetic, the pancreas will release insulin throughout the day to keep the glucose levels steady. Long acting insulin essentially mimics this, trying to keep the blood glucose levels steady throughout the day.
Quick acting is the insulin that diabetics inject when consuming carbs (be that food or drink). They need to assess how many grams of carbs they’re having, and then work out how many units of quick acting insulin they need to use. For my wife, broadly speaking, it’s one unit for every 10g of carbs. Though not only does this vary from person to person, this also varies for my wife depending on the time of day; her bloods seem to be higher in the morning, so she would usually do more than the 10:1 ratio for breakfast.
It really is a delicate balancing act and it’s impossible to get it right every time. If you don’t inject enough, your bloods go high. As well as the aforementioned long-term health issues, high blood glucose also causes irritability, the need to pee frequently, and being extremely thirsty.
If you inject too much, your bloods go low. The technical term is hypoglycaemia. Having a “hypo” can be dangerous, as if your bloods go too low, you can fall into a coma. That only happens in the cases of extremely low bloods, but even mildly low bloods are problematic. If you’re having a hypo, you’ll feel weak and shaky.
Fortunately, there are many ways to cure a hypo. There are more medical type options, i.e., glucose injections. Thankfully, my wife has never had to use one of these (not since we’ve been seeing each other anyway). The more common way of curing a hypo is with food or drink.
You might think a chocolate cake or similar would be good, but that probably won’t bring bloods up quickly enough. Sweets are pretty good though. Something like Jelly Babies or fizzy cola bottles work well.
Drinks can be a good option, as you can probably drink more quickly than you can eat. Things like regular cola or Lucozade can do the trick. Although interestingly, Lucozade isn’t as good as it used to be. 5-10 years ago, the UK government introduced a “Sugar Tax”. In a bid to curb childhood obesity, companies now get taxed more for products that have over a certain amount of sugar in them. This caused a lot of companies to limit the amount of sugar they use, thus saving themselves some money. A decent initiative by the government, but no one thought about the diabetics did they?
If you don’t feel like guzzling down a fizzy drink or a lot of Lucozade, another option is glucose tablets or drinks. There’s a product called Lift that comes in both liquid and tablet form. The tablets are just tablets made mostly from glucose. The liquid comes in a little bottle, is basically pure glucose, and you can drink it like a shot. I’m sure there are other similar products out there too.
So how do diabetics know when their bloods are too high/low? Firstly there’s the above-mentioned symptoms. If they start to feel a bit funny, that can often be the first sign that something’s up. But to know for sure, a diabetic will test their blood. The most common (and accurate) way to do this is a finger prick test.
You will never meet a diabetic who doesn’t own (and probably carry on them at all times) a finger pricker. Essentially, it’s a slightly thicker pen shape that holds a hidden lancet (a long needle, basically). You prime it (I sort of think of it like cocking a gun; it won’t “fire” unless you prime it first), hold the end against your fingertip and then press the button. The lancet shoots out quickly into your finger before retracting back into the device. This leaves you with a little bit of blood on your finger, which you then sort of feed into a blood testing strip, which is inserted into a blood glucose monitor. After a few seconds, the monitor will tell you what your blood glucose levels are.
Blood glucose monitors – in one form or another – have been around for decades. I’m sure the speed, or the accuracy, or the simplicity of use has improved over the years, but the process still involves you stabbing your fingers. Thankfully, some (slightly) less painful methods have been introduced in recent times.
There are sensors that you can attach to your body (usually on your arm, back, or stomach) which can tell you what your blood glucose levels are. These readings will never be as accurate as a finger prick test, but they do give you a very good idea, and all without having to draw blood.
There are two types of sensor (that I’m aware of). One type works using Near-Field Communication (NFC), where you can scan the sensor with your phone, and your blood glucose level will show up on your phone screen. Of course, you have to have a special app installed for this to work, but this generally works quite well. My wife has used an NFC device called Libre in the past.
The other type of sensor is a Continuous Monitoring System. This connects to your phone via Bluetooth, so you don’t even need to scan the sensor; it just sends a blood reading to the app on your phone once every five minutes. My wife currently uses one called Dexcom G6.
There are a couple of great benefits to using a Continuous Monitoring System: firstly, because you don’t need to manually scan, you continue to get readings while you’re asleep (or if you’re just busy and don’t have time to scan). Secondly, because of the regular blood updates, you end up with a nice graph that shows you in detail what your bloods have been up to. With finger prick tests, the monitor just tells you what your blood glucose levels are at that moment; sensors tell you whether your bloods are falling or rising.
There are some cool safety features included with sensors too. With Continuous Monitoring Systems, you can set alarms to go off if your bloods go over/below a set level. You can also set up family accounts on your loved ones’ devices. They’re sort of like read-only apps; they allow you to monitor the blood glucose levels from afar. If an NFC sensor is being used, you can set up notifications to come through every time the sensor is scanned. With the Continuous Monitoring Systems, you can set up notifications for high or low bloods.
Remember that pin from earlier in the blog that I said I wanted to come back to? I’ve described in some detail some of the difficulties of living with diabetes. To be honest, my words probably haven’t done justice to how difficult it can be. But I can’t imagine how much harder it would be having to deal with an 18 month old baby with diabetes.
Pricking them to test their blood. Horrific. Injecting them multiple times a day… for parents reading this, think how bad you feel when you take your baby to get vaccines. Then imagine them going through that daily. Heartbreaking. Obviously, you do what you have to in order to keep your child safe. But I have to give huge credit to my wife’s parents for how well they cared for her growing up. Heroes.
I don’t want you to get the wrong idea about diabetes. I’m aware that I’ve probably made it sound very scary. But while it is serious, diabetes shouldn’t stop you living a full, long life. Off the top of my head, the following celebrities are all type 1 diabetic: comedian Ed Gamble, Spanish footballer Nacho, and former British Prime Minister Teresa May. I daresay you’ll find plenty more if you wanted to Google it.
The point is, diabetes can’t hold you back unless you let it. There are so many resources available now to help you if you need it. There are online forums and message boards. And if all else fails, you can always turn to know-it-all bloggers…
Thanks as always for reading. Unfortunately I will now be resigning from A Rob Blog. But I will be staying on as caretaker until the autumn, because apparently I don’t know the meaning of the word ‘Resignation’ 😉
A little topical joke. Until next time, take care.
Rob Recommends
The Umbrella Academy – TV – Netflix- 9/10
I love this show. It’s quirky, it’s interesting, it’s funny. There’s not much like it on TV. Based on a comic book series, a dysfunctional family battle against mysterious forces to save the world.
There are some truly bonkers set pieces and wonderfully absurd visuals at every turn. The ensemble cast are genuinely great, with some truly terrific performances (particularly watch out for the character, Five).
This is not the sort of show you watch with one eye on your phone. The story does get very complex and it would be easy to miss a plot point if you’re not giving your full attention. You needn’t worry though; after a couple of minutes, you won’t be able to take your eyes off it.
A Rob Blog 