Statin a New Phase of Diabetes

23 years, 10 months and 9 days! That's how long I've been an “insulin only” chick with type 1 diabetes. Last week, I started taking an additional medication in the form of a statin. Alas, now at age 44 and a cholesterol of 5.7 (the recommendation is 4.5 for people with type 1 diabetes) and a LDL of 3, I'm statin a new phase of diabetes.

I have lived with type 1 diabetes for almost 24 years. I've gone from hypodermic needles, to refillable pens, to disposable pens, to an insulin pumps and CGM. I've used a good few different types of insulins that I can’t remember the name of.

However, I was very proud of the fact that the only medication I took all this time was insulin. The mischievous side of me always got a kick out of some healthcare professionals surprise to this. Why, Yes, insulin is the only medication I take!

Now it seems those days are gone. And while I'm not ok with getting old (see here), still. I am, oddly, ok with this new phase…. now!

When my consultant first suggested a statin I was very reluctant. At that point, we didn’t have any lab results for my cholesterol but considering my age of over 40, she said it would be a sensible preventative measure. I said I would consider it.... maybe?

As the months went by, I did some research on type 1 diabetes and heart disease. I found out that heart disease in people with type 1 diabetes doesn’t present always with symptoms like it does in people who do not have diabetes. This is good to know!

Heart attacks and other cardiovascular complications cause the death of nearly 3 out of every 4 people with type 1 diabetes, compared with just 1 in 4 people in the general population, according to a Swedish study published online September 18 2015 in medical publication; Lancet Diabetes & Endocrinology. OK now I"m paying attention! I'm not trying to scare people. It's just that, for me, this information is being forewarned.

And it just so happened that we had a person who had recently had a heart attackat at one of our diabetes support group meetings. Then, George at Ninjabetic US wrote about his recent heart scare. Thank you George.

Yep! Frightened the bejaysus out of me. Lots of “signs” from the universe and I wasn’t going to ignore these ones. Sometimes a little fright is what I need - but mostly fear is not a good motivator!!!! (Note: for all those who try to use it as one).

I also thought about how it’s possible that only one heart attack can take me from this world. While losing my eyesight or a limb is more likely to leave me in it. And yes, the possibility of losing my sight would bring a sadness to me that would make living difficult to cope with, BUT I would still be alive.

So, I’m totally onboard with preventing my heart attack or a stroke. I started taking Rosuva (Rosuvastatin), the generic equivalent of Crestor, last week and I’m also finding one or two remaining areas in my diet where I can trim some fat off.

So take that cholesterol!

P.S. If there is anyone who would like more information and you live in the Co. Clare area. We are having an information evening on Type 1 Diabetes & A Healthy Heart with Dr. Ray O’Connor, GP When: Tuesday 21st February at 8pm Where: The Temple Gate Hotel Ennis, Co. Clare.

New Year New Me... meh!

Now that January is over I can stop saying “It's the new year!” I know, I know! I’m probably a couple of weeks behind everyone else. New year's resolutions are a distant memory as is a reason, as good as any, for some people to have a new beginning. And, apparently, that only ever means a diet, maybe a gym membership that never gets used and a bombardment of media ads to be healthy, get fit and go on a diet. I felt this year it was more annoying than usual. I actually have a friend who refuses to buy a women's magazine for the months of December and January for this reason!

I still try to embrace the whole new year resolutions malarkey but in the essence of trying to be nicer or work on my patience.

However, just as the year was wrapping up I stumbled across a couple of things that has made me leap, all in, with a genius idea for next year's new year resolutions. (And Yes I know that self praise = no praise, i.e. I'm not a genius :-)

Here’s what happened; In December, I read this piece from DiaTribe on New Apps in Diabetes. It was really interesting (Thank you DiaTribe). However, it was this video, by Dr. David Sobel on “how people are not unmotivated; they are overwhelmed.” that fired up my brain.

In the video, Dr. Sobel talks about how health care professionals tend to overwhelm their patients with lots, and lots of information and a long list of things they need to do to become healthier. And what often happens is that people end up being so overwhelmed with all of it and leave the office feeling so much worse than when they went in. But worse than that, they become paralyzed to do anything.

And I thought about this, especially, while at our local Type 2 Diabetes meet up in January, as I was looking through Diabetes Ireland’s Healthy Eating guide for people with type 2 diabetes with page after page of advice and no clue where to start.

I put it to our type 2 diabetes support group that if they were given a list of small defined tasks such as;

- Cut back on sugar in your beverages by even 25% - If you take an artificial sweetener reduce it by one if you take more than one - Switch from full fat milk to low fat - Switch from low fat to skim - 10 minutes of moving 3 times a week - Switch your daily Latte/Cappuccino to tea or straight coffee, etc.

And what if they only had to pick one thing from that list and stick to it for 10 weeks, would they be more likely to make it a change for life? Or how about the first thing they do is make a list of all the things they would like to change or things they would like to bring into their lives.

Some said “yes” and some were skeptical. So I suppose it’s back to “New Year, New me Meh! But for me, talking all this through with the group gave me focus on what I'm going to do about my elevated cholesterol. Watch this space;-)

I also like the idea that Dr. Sobel came up with to have our invitation to our annual diabetic eye screening come from our eyes to address the 50% of people who do not attend their eye screening appointment. Mine would go something like this;

Am I Ready for my Diabetes Appointment? Yikes!

My next diabetes clinic appointment is next week. It’s been eight months since I was last there. I’m not sure how I feel about having such a long time between appointments but maybe that’s another post? Diabetes, especially type 1 diabetes, is one of the few conditions where you actually have to prepare for your clinical review appointment. It’s how you will get the most out of your visit.

For a lot of years, I just showed up with my “diary” and walked out of there disappointed. If truth be told, I was very resentful that I had to be there and a little down in the dumps about the whole diabetes thing. During these years my primary goal was to get out of there as fast as possible and get on with my life.

I became more motivated at my diabetes clinic appointments when I was considering starting a family. And that motivation and effort has paid off.

I don’t dread my clinic appointment, like many do, because I feel this is my chance to get help if I need it, or to review where I need a little extra support from my team. But I do dread the getting ready for my appointment! It is a lot of work.

Everyone has a different way they prepare for their clinic appointment. Here's how I prepare for it;

SAVING UP QUESTIONS TO ASK In between appointments, if a, non-urgent, question pops into my head I try to write it down somewhere - preferably somewhere near my Long Term Illness book which I’m already in the habit of bringing with me. This coming visit I need to get an updated letter for travelling and I’ve already noted it.

THE LABS About two/three weeks before my appointment, I have my blood drawn in my GP’s office to be sent to the lab. The results are usually sent to my clinic automatically but sometimes that hasn’t happened on time or at all, so before my appointment I collect a copy of my results and keep a copy for my own records.

BLOOD GLUCOSE RECORD This first and last thing I do to get ready for this meeting is to upload all of my blood glucose meters (I use two) to the software programme I use for my insulin pump. I also upload all the information from my insulin pump.

LONG TERM ILLNESS BOOK I bring my Long Term Illness book with my to my appointment so that I make sure it has been updated every six months. I also print out a list of all the “stuff” I use. My LTI book is 10 years old and there is a lot of stuff on it that I no longer use. This also saves a bit of time and scores me some brownie points with my endo. Always useful.

PRE-EMPT QUESTIONS I MIGHT BE ASKED I try to preempt questions I might be asked about specific high or low blood glucose readings as best I can. I try to remember that the important readings are the ones that I can’t account for. Sometimes, I have to remind my healthcare professionals of that too.The highs and lows that are from the usual culprits are ones that I can address myself. Its those very rare highs and lows where I don’t know what the cause was that are a problem. If I don’t know what caused them then how can I prevent them from reoccurring.

So, am I ready for my diabetes clinic appointment? As ready as I’ll ever be! :-D

Here is another article I thought had some very useful tips on getting the most out of your diabetes appointment.

My Blood Tests for Diabetes Clinic

My diabetes clinic appointment is coming up next month and I scheduled my blood draw for my labs with my GP’s surgery. I usually get them done about 2-3 weeks before my appointment so that I have enough time to collect and copy them for my own records. The regular blood draw for labs is one of the "joys"  of having type 1 diabetes. And for this one,  I scheduled a fasting blood sample because my cholesterol was due to be checked. However, I have read that being fasting for this test doesn’t actually affect the accuracy of the result. But do I want to have that “discussion” with my nurse practitioner or not yet?!?

The morning came and I had written a note for myself to remind me not to have breakfast. Sometimes, I wonder “What I’m like?”

Low (pun) and behold my CGM started to alert me to the fact that my blood sugars were below 4.1 mmol/l (74 mg/dl) with a ⬊. I did a check on my meter just to be sure. And YEP!

So what to do? I decided to still forego brekkie and top up with 2 glucose tablets, which is usually enough to bring me back into the 5’s. The important thing for me to remember was that I was driving - it was only a short drive but none the less driving. Don’t drive under 5 mmol/l (90 mg/dl).

By the time we left the house for the school drop off I was at 5 mmol/l. After I dropped the kids off at school, I went home and literally didn’t breathe so that my blood glucose wouldn’t drop any further. I only had to hold out til 9.50am.

I made it! I told my nurse what I used to bring my sugars up to make it safe to drive and she didn’t even bat an eyelid. So that was great!

However, there’s another disadvantage to trying to do fasting blood tests when you have type 1 diabetes and that’s when your done with your appointment.

I was starving, famished, could have eaten a horse. I ended up at the closest cafe and ordered the lesser of all the evils … or so I thought; a plain cheese and ham croissant. Definitely not a great option, unhealthy and boy did it send my blood sugars into the clouds.

I feel like I should’ve gone all out and had the muffin. But at least this job is done for another year.

The Hill and the Hypo

Last week this happened but I was only just getting back into the swing of things and so only writing about this week. Jetlag day 4 and feeling like a functioning human being again. I must have slept really well because all my aches and pains subsided. See last week's depressing post.

It's also Day 2 of the kids being back to school and day 2 of me getting back into my walking regime. I was feeling so good and my ankle was feeling so good that I decided to try that hill. The one that I haven’t tried in about 3 months due to injured accilles tendon. And go that bit further.

When I reached the top I felt like Rocky!!! I almost did an air fist pump but that would have looked sad - it’s not a very big hill :-S

Anyway, I was well on my way home when I felt my insulin pump on my hip start to buzz to alert me to the fact that my blood sugar was 4.1 mmol with a ↓ Then I remembered that I really should have factored in how much insulin I took for breakfast the previous hour and how I didn’t know then that I was going to go that bit further. Oops!

Luckily, I always carry glucose in my meter case. And I always shove my meter case in my coat pocket. I grabbed a couple of the glucose tabs but I could already feel the river of sweat streaming down my forehead, down my back and down my front. And I knew it wasn’t the moderate workout I I had hoped for. My arms and legs felt like they belonged to Raggedy Ann or Andy. A little further on I took another couple of glucose tabs because I knew this was a serious hypo.

I was still thinking clearly, surprisingly, because I felt that I wasn’t at the point where I needed to call for backup. I felt I could still make it home, shakingly, and flopsy-mopsy style(cos that’s what it felt like) but I could make it.

And I did! I got inside my front door and sat on the stairs, laid back and just wait for the intense heat steaming from my body to stop.

The lesson I hope I have learned from this experience is that I need to factor in previous insulin dose into spontaneity.

However, the likelihood of that lesson sinking in and popping out immediately when needed is doubtful. One can only hope!

Growing Old with Type 1 Diabetes

It was my birthday last month! Sarcastic yah! I turned 44. I know that anyone older than 35 thinks that 44 is young but I am not happy at all about being in my forties, especially because the aches in my joints make me feel older that I am. And because of that achy hip and torn achilles tendon that just won’t heal, I feel that my best, physical, years are behind me. So my birthday is a bitter sweet mix of "hurray, it's a day all about ME" to "Boo, another year older".

But, I suppose, there are worse things in life. And there are some amazing things going on in my life, including but not restricted to, watching my children grow and mature and become amazing young people. I’m so proud of them. I have a lot to be happy about right now. All of this doesn’t stop me worrying about the future, about worrying about growing old with type 1 diabetes.

Every year, my birthday reminds me that one day I will wake up and actually be old! Old with type 1 diabetes. I will be old and maybe my brain won’t be as sharp as it once was. How will I work out insulin doses safely? When will my old age start?

I have been taking care of my own diabetes ever since I was diagnosed but what happens if old age prevents me from doing that? What will that mean for my husband, my daughter and my son? I don’t want them to carry this burden.

Will I end up in a nursing home hoping with staff taking care of me who don't know very much about type 1 diabetes? Should I make a plan to make sure no one has to take on this responsibility?

This is my biggest fear! Getting old and still having type 1 diabetes and the fear that I will not be able to take care of myself any longer.

I do not want to be elderly with diabetes. Full stop. I want a cure before I’m old.

This is a worry I have that is persistently at the back of my mind. I don't allow it to take up much space in my head because it has the potential to drown me. So, just for today I'm letting it out to lessen its influence it has on my outlook on life. Tomorrow I will put it back in and focus on what is good about today.