Blood Sugar Trampoline

Operation Transformation – A National Movement


The tv show Operations Transformation is more than just a fluffy piece of entertainment. It's a national movement. And, for me, it's the most uplifting programme on telly today.

 

No, I swear I'm not crazy… or easily entertained!!!

I only began watching the programme a number of years ago, when the creators partnered with Diabetes Ireland to create more awareness about type 2 diabetes. It was only then that I realised this show is about so much more than getting five people to lose weight.

And I got hooked! Unlike any reality TV show that I have seen, it's not about putting people down or pitting them against each other.


Operations Transformation is advertised as a health and fitness programme. It airs on RTÉ One in Ireland. The show is a cross-media event broadcast via radio, web and television and it's been running (ha, ha, pun) for nine years.

 

The show motivates and inspires people and communities to come together to become healthier. They are partnered with Sports Ireland who help organise nationwide walks in over fifty locations all around Ireland.

It encourages everyone to take back control of their lives, no matter what your demons are.

How does it work?

Five leaders are selected and are supported and guided by a panel of experts in the fields of fitness, nutrition and psychology in order to reach their individual goals. The show broadcasts over a period of seven weeks but most leaders continue on their journey sucessfully.

The leaders are chosen on the basis that there is someone for everyone to relate to. The meal and exercise plans which have been created for each leader are published online so that viewers can follow the plans also.

 
The first two programmes of the series introduces all the leaders, who they are, what they do and why they want to do Operation Transformation. Let me warn you, it's a cry-fest. Well, no it isn't I'm just a big SAP!
 
You find out that these people are not just battling their weight; they have darker demons buried inside that are holding them back. Being overweight is just a symptom of what ails them.
 
This programme also gives you an insight into just how difficult it is to decide to lose weight and that you're crazy if you think there is a quick fix and that support is key. Why do it by yourself.


Why am I writing about this programme?

I think this programme is an Irish phenomenon and could be replicated elsewhere.

 

And this programme is educational; I was happy with my weight but the truth is that when I go clothes shopping I am definately not. 

 
As a person with type 1 diabetes I feel that the food I eat is healthy most of the time! I did pare it down a number of years back to drop some baby weight and it worked. And I get my 30 minute walk into my day 4 times a week so I couldn't be bothered trying to add more exercise. 
 
But when the show introduced me to leader, Noeleen who is 5" 3" in height and 75 kgs and officially obese – I woke up! I'm 5" 4" and 72 kgs!!! Yikes! Too close for comfort.
 
So while I really don't want to change the way I eat – I starting to think I need to move more to officially be healthy. Let's face it who doesn't!
 
All the leaders are inspirational this year and along with Noeleen, I'm especially interested in cheering for Chef John Conmy who has type 2 diabetes. During his fitness test during the programme he was discovered to have heart disease. He wasn't aware he had it and this programme may have saved his life. 

 
And then there's Clare Scanlan, who's has not been able to move past her grief after losing her 15 year old son to sudden adult death syndrome two years ago. 
 

The show has teams up with Sport Ireland, who organise nationwide walks in over fifty locations all around Ireland. The highest number to date who took part is over 19,000 people. Every year this numbers climbs and climbs.

 
People are doing it! Taking back control of their lives!




Diabetes Complications are Not a Sign of Failure

The complications of diabetes are real and people are living with them. People are also living in fear of them. Myself included. I am actively trying to overcome this fear because if I do end up with complications I don't want to feel like it is the end of my life. Or that I failed to manage my diabetes well enough. And I certainly don't want to be made to feel that it's my fault.

I don't believe just because I am doing everything in my power to manage my diabetes that I will be spared. I believe that if I have type 1 diabetes I still have the risk of developing complications. I strive to keep that percentage of risk low but it will never be zero.

I will not stop trying!

Image from http://www.coolnsmart.com/failure_quotes/

So, when a friend of mine, who has lived more than 50 years with type 1 diabetes and who lives with a number of the complications of diabetes, comes to our T1D meet ups and people imply she didn't take of herself, I get a little "upset"!

My friend has survived taking care of her diabetes when there was no such thing as a glucose meter! Imagine never know what your blood sugar was?!?

She has survived during a time when the phrase "carb counting" might as well have been a foreign language in Ireland. It didn't exist!

We also did not have Rapid Acting Insulins until the late 1990's. So, even if we did practice carb counting, it wouldn't have been much good to us. Sure, we could do a certain amount of carb counting on the insulins we took only twice a day but we couldn't fine tune it like we can today.

We also did not know that the tighter your diabetes control, the less likely you were to be at risk of getting diabetes complications. This research was only published in 1993 as the DCCT Trials.

93 years ago we died! Today, we have so many tools, technology and instant access to research that people with type 1 diabetes, who have been told for decades what they can't do are breaking all of those barriers.

So I ask you? Is surviving 50 years with type 1 diabetes and living with complications really not taking care of yourself?

My friends who live with diabetes complications may even say themselves, that they didn't do as much as they should have to take care of their diabetes. And I say you did the very best that you, and everybody else, knew how.

I am so lucky and proud to have friends like Deniabetic, who are helping me overcome my fears.

Post Christmas Blood Sugar Hangovers

The Christmas holiday lasts one whole week if not two in Ireland. Most businesses close their offices from Christmas Eve to the day after New Year’s day to give their employees a well earned break.

The schools close for two weeks. This is where my diabetes can become troublesome. I’m a stay at home mother and when my children are in school I have a routine and I get out most days for a good head-clearing walk! It does my head good and it does my diabetes good.
During school holidays, getting out for that little but very important 30 minute walk is…. mmmm challenging. I could do it. If I really, really, really tried but there’s always something else I could do too.
A two week holiday is more than long enough for my body, and my diabetes to figure out that my exercise has been all but forgotten and give me a bit of a telling off.
The grey-ness and the wetness of the Irish weather for the last month did not help either! Let’s just say we would not have been surprised to see a giant ark after having SO much rain for SO long.
This holiday, my BG’s started rise just before New Year’s, at a time when I thought I’m almost there and I got away with it. My insulin to carb ratios need to be reduced radically and using trial and error the kids will be back in school before I have it figured out.

I’m also feeling a little of the January blues. The lack of exercise and my elevated blood glucose levels are leaving me deflated and unmotivated to do absolutely anything…. except declutter my house (figure that one out?).

So, I’m anxious to get back to school, I mean for my children to get back to school. 🙂

I’m itching to get out for that first regular walk of 2016, to have a routine again and reclaim familiar BG patterns so I can make adjustments.

I also need to come up with a feasible plan for the extended Easter break we will have this year (it’s 2 and a half weeks long starting on St. Patrick’s Day).

I think I just found my new years resolution! And I think I’m finding my way back.

Midnight and Lows

I wrote about this hypo experience before I got my CGM (Continuous Glucose Monitor) and so these days crashing blood sugars are not coming at me like oncoming trains and I am able to get off the tracks in time.

A few nights ago, I experienced the feeling of watching a “train wreck” coming towards me and not being able to avoid it. The problem, I think, the fact that I had too many options available to me in trying to prevent my imminent hypo that I didn’t know which one was best to choose.

Normally, when I check my blood glucose level two hours after my dinner and they are above my post-meal target, I know that some more insulin is required. On this occasion it was 3 hours after dinner and I was even more sure that I needed more insulin. See the 11.5 mmol (207 mg/dl)

HOWEVER! Approximately 60 minutes after I had given myself more insulin, the big red dot and the sharp dip in my mysugr app told me that my diabetes was not playing by the rules!  My blood sugar level had dropped sharply to  6.1 mmol (110 mg/dl). An otherwise respectable BG number but at this moment in time, especially with the remainder of my insulin dose to activate, I knew I was in trouble and that a hypo was coming for me.

I was already tucked up in bed with my teeth brushed. So, I reduced my background insulin by 50% for an hour and a half to counter the over correction of insulin. (Note to self; that wasn’t the right choice – always go for the fastest acting glucose available).

At 12:13am, perspiration steamed off me. Thankfully, I had the wherewithal to check my blood sugars again revealing a 3.1 mmol (56 mg/dl). I took 3 dextrose tabs and lay back waiting for them to kick in. But, the heat coming off my body made me grab 2 more a couple of seconds later.

I tried to lay there waiting again but I became more agitated at having to wait…. and wait, and wait, for the heat and sweat and “jitters” to subside. The seconds felt like hours!

I decided to wait the 15 minutes out downstairs and suck on some boiled sweets to, maybe, trick my brain into thinking I was shoveling glucose into me hand over fist and avoid over-treating the hypo. I pulled out the laptop and tried to document this hypo 😉 Another effort to avoid over-treating-keep my hands busy.

12:37am, 5.8mmols (104mg/dl), still feeling shaky and mildly damp but can safely go back to sleep. After brushing teeth…. again.

And yes, I had the over-correction high blood sugar reading the next morning. Sometimes, you just can’t win. But you try, and try to learn:-)

Happy New Year from Gráinne

I have nothing to fear but fear itself

Image from http://james-the-nose.deviantart.com/art/
A-deer-in-the-headlights-122552318

I attended a diabetes meeting once where one of the other attendees said they wanted to see photos of all the horrible things that can happen to a person with diabetes if they don’t take care of themselves. That this would motivate this person into doing more to take care of their diabetes. I understood this person’s point of view, they were much older than me and may have seen the “dangers” of diabetes as being more imminent than I did.

For me though “the fear tactic” doesn’t work. I’ve heard all the horror stories. I’ve heard all of the threats in relation to what I should and what I should not be doing to take care of my type 1 diabetes. And I have been paralysed into doing nothing by them.

I think it’s a well known piece of advice that fear is not a good motivator to get somebody to do something. Do you like it when someone threatens you? Even if it’s for your own good? Does it make you want do what they say?

For me, it, absolutely, does NOT! But you might ask me what does get me moving and doing? My answer is “Information and inspiration” ;-D

I don’t test my blood glucose more because someone told me I should. I do it because it was explained to me why I should consider it and how to use the additional information (EDUCATION, can’t. say. it. enough.). And I could see almost straight away how this improved my management of my type 1 diabetes.

I do remember, all those years ago, when I was told that I had to eat a strict “diabetic” diet and I absolutely HAD to take my insulin at exactly the same time every single day. If I didn’t I would end up with all sorts of ugly diabetes complications.

But guess what? Some people do all the right things and still get complications. And some people don’t take care of themselves and don’t get any complications.

Those were the days when we had very little in the way of diabetes research or education to revert to. But by God we had fear! And it got me nowhere!!

What did motivated me to do all the things that I do to take care of my diabetes? Education, education, education and some more education. Can’t say it enough times!!! And of course, a good support network:-)

DKA Kills and the Type 1 Diabetes Awareness Project

We don’t know how many children or adults die in Ireland because of undiagnosed Type 1 Diabetes but we can be sure that it does happen here, just like it happens all over the world. 
As the news is travelling through the diabetes community of yet another life cut short, I’m awakened, with a jolt, as to why the Type 1 Diabetes Awareness initiative from Diabetes Ireland is so important… And needs to happen soon!
Diabetes Ireland are planning on launching this Type 1 Diabetes Awareness project early in the new year. 
Image graciously stolen from Diabetes Mine
Up to 23 Irish children are diagnosed each month with Type 1 diabetes. The majority of these present to their GP feeling generally unwell but 1 in 8 will not be correctly diagnosed at that time. 
This delay in diagnosis usually means repeated visits to the GP and can result in diabetes ketoacidosis (DKA) which is potentially fatal.
The aim of this project is to encourage GPs to consider Type 1 diabetes first, as a potential diagnosis when a child presents feeling generally unwell and secondly to raise awareness among the general population of Type 1 diabetes signs and symptoms (The 4T’s; Toilet, Thirsty, Tired & Thinner).
However, Diabetes Ireland still need to find one quarter of the funding for this project. They are determined to commit to the February 2016 launch date but if they don’t find the rest of the money they will have to amend the initiative, which would make it less effective.
Does anyone have a wealthy relative??? 
Image from http://res.public
domainfiles.com/pdf_view/
52/13526046019596.png
Maybe if we start sharing this with our friends and talking about it, the people who hold the purse strings will take notice that this is important to us?

Just in case you’re wondering; what is DKA?


” Diabetic ketoacidosis is a life-threatening problem that affects people with diabetes. It occurs when the body cannot use sugar (glucose) as a fuel source because there is no insulin or not enough insulin. Fat is used for fuel instead.
When fat breaks down, waste products called ketones build up in the body.” Find out more here

I’m back on CGM (Continous Glucose Monitoring) Yayyy!

Back in June, I did a trial with a CGM (Continuous Glucose Monitor) and I wrote a little about my experience here. Wearing the CGM was so valuable that I was very much determined to get it permanently.

I’m thrilled to say that happened on the 25th November. So I’ve been using it for two weeks. I had a little hiccup with my pump, which decided to die on the 30th, which made me appreciate the CGM more as it’s so helpful the not only know what my blood sugars are but also know where they are going. It was such a relief to see that down arrow.

This time around I feel like I know what I’m doing this time around with this new gadget. The workshop I attended in July presented by author of “Think like a Pancreas“, Gary Scheiner entitled “Making Sense of the CGM Data” also helped.

The technology was so new to me in June that I was preoccupied by “how does this thing work?”. I was only just getting a handle on having all that extra information by the end of the two weeks. I had been able to upload the information to the software programme and identify trends where I could make some adjustments in my insulin regimen.

But then the trial ended and it was like being blind again.

The major benefit of having a CGM is having this;

This is the graph from my CGM data.
 as opposed to this;

and knowing what to do with all those extra data points.

After two weeks, I have been able to prevent a number of lows by my CGM alerting me to the fact that my BG was 4.4mmol/L and dropping. And I’ve been able to reduce the impact of how high my blood sugar climbs. It’s my hope that this will increase how much time I spend within my target blood sugar range of 4 mmol/L to 10 mmol.L (72 mg/dL to 180 mg/dL) overall.

People who have lived with type 1 diabetes since before the 1970’s often talk about how access to blood glucose monitors changed diabetes management in a revolutionary way.

I think that the CGM is a game changer for my generation of type 1 diabetes.

Insulin Pump Wizardry

I have been using an insulin pump for just over 5 years and I’m still finding new benefits in pump therapy. I should explain that I know I am very much a slooooowwww adapter of all things new – I go at my own pace.

Earlier this year, I started using the EzCarb and the EzBG features on my pump a bit more. Previously, I really only used them for correction insulin doses. I use an Animas Vibe pump and I’m told that on the Medtronic pump this feature is called the Wizard.

Since I’ve started using this feature I have noticed a reduction in the number of hypos that I have been having.

Before, I had a tendency not to factor in my Insulin on board, I didn’t really have a way to calculate it. Insulin on board is the term used to describe how much insulin is left working in your body from the last bolus and how active it is.

Also, I would only factor in a correction amount of insulin if I was over 10 mmols/L (180 mg/dL).

I have to say that since using these features I feel like I have reduced the number of hypos that I have. However, I have nothing to back up my theory, it’s just a hunch! But it feels nice.

I also like it because it separates out my insulin dose so that I know how much of my insulin is related to the carbohydrate, how much is a blood glucose correction and how much I have to reduce for my Insulin on Board.

Here’s to continually making improvements and to tiny triumphs!

Disclaimer: I have not been paid by anybody in relation to this post. 

Walk Your Diabetic Feet To The Pathway of Good Foot Care

Our guest speaker at our November diabetes get-together in Co. Clare is a podiatrist from the local health centre (Thank you, Doireann). And I know that most people with diabetes know the basics of taking care of your feet, especially if you have been around diabetes for a couple of decades.

The reason I decided to post about our meeting is that the pathway to podiatry has changed a little in recent years and that is worth sharing this information (IMO).

But I have included an article which, coincidently, was published online this week, and contains some of the basics to lead up to the local information.

So, why do healthcare professionals stress the importance of good foot care?

“In almost all high-income countries, diabetes is a leading cause of cardiovascular disease, blindness, kidney failure, and lower limb amputation.” (from International Diabetes Federation). But a simple annual foot check can prevent or reduce your risk of developing serious problems with your feet.

“People with diabetes have special reason to take good care of their feet. High blood glucose levels may make feet susceptible to injury and infection. This is because the protective sensation in the toes or feet – your “pain alarm system” ­may slowly disappear with long term high blood glucose levels.” (from Diabetes Ireland)

The Foot “Issues”.

The two feet problems that podiatrists (and people with diabetes) are on the lookout for are;

Nerve Damage

Nerve damage can cause you to lose feeling in your feet. You may not feel pain, heat, or cold in your legs and feet. You may not feel a pebble inside your sock that is causing a sore. You may not feel a blister caused by poorly fitting shoes.

Sores on your feet can become infected. If your blood glucose is high, the extra glucose feeds the infection in those sores and the infection gets worse. Nerve damage can also cause pain and lead to foot deformities, or changes in the muscles, bones, and shape of your feet.

Poor Blood Flow

Poor blood flow means not enough blood flows to your legs and feet through your blood vessels. Poor blood flow makes it hard for a sore or an infection to heal. This problem is called peripheral artery disease, also called PAD.

Sometimes, a bad infection never heals. The infection might cause gangrene. If you have gangrene, the skin and tissue around the sore die. The area becomes black and smelly.

Too much glucose in your blood from diabetes can cause nerve damage and poor blood flow, which can lead to serious foot problems.” (from the American National Institute of Diabetes and Digestive and Kidney Diseases)

Everybody with diabetes in Ireland should have a foot check by a podiatrist, children included, every year.

I know that some doctors and consultants might perform a brief foot check at your clinic appointment but our podiatrist (and lots of other reputable websites) state that if your foot check does not include a test using a tuning fork and a Monofilament tool.

Monofilament Tool

At your annual foot exam your healthcare professional will;

  • Look at your feet for signs of problems, especially if you have nerve damage
  • Test the sense of feeling in your feet using a Monofilament tool.
  • Test how well blood is flowing to your legs and feet
  • Show you how to care for your feet

How do access Diabetic Foot Care?

Referrals to your local podiatry service for people with diabetes are available from your GP, Public Health Nurse, Community Nurse, or Diabetes Clinic.

In Co. Clare, you can avail of a self referral form which is available at the Health Centre on Bindon Street in Ennis. It’s not available online. And we believe that this option is only available in Co. Clare.

Your very first foot screening with your podiatrist will assess you and place your feet in one of three categories; Low, Moderate or High risk.

If you are low risk, you may be referred back to your GP’s surgery for your annual foot exam. If this is the case then it will be your responsibility to schedule this. If you are referred to your GP, it’s really important that you keep a record of when your last foot check was and when to schedule your next one.

If you are Moderate or high risk of diabetes foot disease then you will probably continue to be seen in the Diabetic Foot Clinic, where they will send out your appointment to you in the post.

However, there are instances where the clinics fall behind in their appointments and it would be wise if you kept a record of when your last foot exam was and when your next one should be.

You can find more information from the HSE’s Model of Care for the Diabetic Foot document, which was revised in October 2014.

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