this weekend brought with it a revelation, one that had me walking into a completely different world. a world better than the one i'd been in (whether i was fully aware of it or not) since the early 90s. no love found, and no, no love lost.
the revelation was that my type 1 diabetes could be brought under a tight level of control.
the revelation that i may actually be able to reverse some of the damage my illness has inflicted upon me.
the solution is one which, by some irony, is blindingly obvious to anyone without diabetes.
tell someone you have diabetes and likely they'll think: "you poor thing, you won't be able to have any sugars now"
and that's what i thought when i was told, at the age of 11 that i had type 1 diabetes.
lead down the wrong path
however, what i was then taught was that i could, and should, eat like a normal person, just so long as i did my injections.
my type 1 as a child was relatively simple but as i grew into adulthood things got steadily more difficult, to the point where i was firing off shots of insulin that could hit any target in a very random fashion. in short, my levels were all over the shop.
where's the right path?
and then this weekend, i read in full Dr Bernstein's Diabetes Solution which said the complete opposite of what i'd been taught. he put it to the reader that all one needs to do to get their control to manageable levels is to stop so eating such a ridiculous amount of carbohydrates.
with insulin you're trying to hit a target level. the more carbs you eat the more insulin you need. it's like trying to hit a target with a rifle. for small ranges you're going to have a much better chance of hitting the target than if you're a long way back from it.
similarly with hitting your target sugar levels, you've got a far better chance of hitting the target levels if your carbs and insulin are small amounts.
busting out of vegas
so with this in mind i can get out of the losing lottery i was playing for all these years. damage has been done and i owe a large debt to my body, but i've now got a chance to halt and possibly even recoup some of those losses.
all i've got to is make sure i don't overdo the carbs. avoid eating the sugars, just like i thought i should be doing all those years ago as an 11 year old.
it feels like i've climbed a mountain for nothing but now i've at least got the chance to run back down it, to a place of safety.
Monday 16 February 2009
Thursday 12 February 2009
Analyse this
This is venturing into geeky territory but it's good stuff for knowing what's happening in me when I eat.
The idea is that when I eat and take my insulin shot the insulin tries to get the energy into the cells (or liver or somewhere) and out of the blood stream at the same rate as the sugar is entering your blood during digestion.
It works something like this
Typically with meals involving a fair amount of carbohydrate, the sugar will get to your blood at a faster rate than the insulin can get the sugar into your cells.
If the digestion rate is faster than the insulin absorption rate, like this, my blood sugar will start to rise. The further my sugar levels rise, the less ideal the balance.
Of course, different foods have different sugar absorption rates. High GI foods get absorbed quickly, low GI foods are absorbed more slowly. GI means glycaemic index which essenially means how quickly the sugar in different foods are absorbed into the blood.
So how can you measure the balance?
To measure whether your insulin is reacting fast enough to cope with the sugar absorption, you can test yourself after meals. Two hours after meals is thought to be the point at which your blood sugar levels are likely to be at their highest after eating.
So it makes sense to take a sugar reading just before eating and a reading or two 1 to 3 hours after eating.
So how did I do?
Here's my sugar level readings from the last few days
Evening meal analysis
On the 10th I had pasta for evening meal with half a glass of orange juice.
7.4 at 18:11 just before eating
4.1 at 20:10
2.4 at 21:16 (I ate sweets to get levels back up to a normal level)
6.2 at 23:37
This shows two things.
I probably took too much insulin for my evening meal (as my levels went significantly below 4.0)
The pasta at this time of day isn't causing my sugar levels to jump up - a very healthy situation
Breakfast analysis
On the 11th I had mini-shredded wheats for breakfast with skimmed milk
4.8 at 09:13 just before eating
7.9 at 10:33
4.7 at 12:45
This shows I'm taking the right insulin for breakfast.
It also shows that my breakfast is being absorbed a bit quicker than my insulin can keep up with.
Why are the levels going up between meals?
My shredded wheats are probably not too dissimilar in GI to the pasta I have at tea time. I would expect the sugar in the shredded wheats to be absorbed about as quickly as the pasta.
However, I think there is another reason that is causing the raised sugar levels. It's a phenomen which I've seen referred to as 'the dawn phenomenon' in Dr Bernstein's 'Diabetes Solution' book. The idea is that in the morning hours, just after one wakes up and for about 2 to 3 hours after, the insulin is less effective at lowering blood sugar levels. The insulin is slightly impaired.
This would offer a good explanation for why my sugar levels are raising a few points up to a couple of hours after eating breakfast.
What can you do?
As far as I can think tonight, there are two main options available
However, I may be able to lower the GI of the breakfast if I switch to using full fat milk instead of skimmed milk.
I am told that having fat with a meal can slow down the absorption of the sugar, so it's worth a go. I'll give it a go next week and see if it helps at all.
Where from here?
I'll spare the lunch analysis but it is along similar lines.
So now I've got an idea of how good these particular meals get absorbed and how well the insulin works against them.
If I were to analyse each relatively regular meal I have I would be in a very good position to control my levels really well. That's the ultimate goal.
As a bonus, the results I've been getting this week have been really good.
The idea is that when I eat and take my insulin shot the insulin tries to get the energy into the cells (or liver or somewhere) and out of the blood stream at the same rate as the sugar is entering your blood during digestion.
It works something like this
- I inject insulin
- I eat more or less straight after
- The sugar starts to be broken down and begins to be absorbed into the blood
- The insulin starts to be absorbed into the bloodstream
- The insulin works to get the sugar from my blood into my cells
Typically with meals involving a fair amount of carbohydrate, the sugar will get to your blood at a faster rate than the insulin can get the sugar into your cells.
If the digestion rate is faster than the insulin absorption rate, like this, my blood sugar will start to rise. The further my sugar levels rise, the less ideal the balance.
Of course, different foods have different sugar absorption rates. High GI foods get absorbed quickly, low GI foods are absorbed more slowly. GI means glycaemic index which essenially means how quickly the sugar in different foods are absorbed into the blood.
So how can you measure the balance?
To measure whether your insulin is reacting fast enough to cope with the sugar absorption, you can test yourself after meals. Two hours after meals is thought to be the point at which your blood sugar levels are likely to be at their highest after eating.
So it makes sense to take a sugar reading just before eating and a reading or two 1 to 3 hours after eating.
So how did I do?
Here's my sugar level readings from the last few days
| | 0 | 2 | 4 | 6 | 8 | 10 | 12 | 14 | 16 | 18 | 20 | 22 |
| 10 | 5.8 | | | | | | | | | 7.4 | 4.1 | 6.2 |
| 11 | | | | | 4.8 | 7.9 | 4.7 | 5.2 | | 7 | | 8.5 |
| 12 | | | | | 4.7 | | 8.4 | 4.3 | | 5.5 | 3.2 | |
Evening meal analysis
On the 10th I had pasta for evening meal with half a glass of orange juice.
7.4 at 18:11 just before eating
4.1 at 20:10
2.4 at 21:16 (I ate sweets to get levels back up to a normal level)
6.2 at 23:37
This shows two things.
I probably took too much insulin for my evening meal (as my levels went significantly below 4.0)
The pasta at this time of day isn't causing my sugar levels to jump up - a very healthy situation
Breakfast analysis
On the 11th I had mini-shredded wheats for breakfast with skimmed milk
4.8 at 09:13 just before eating
7.9 at 10:33
4.7 at 12:45
This shows I'm taking the right insulin for breakfast.
It also shows that my breakfast is being absorbed a bit quicker than my insulin can keep up with.
Why are the levels going up between meals?
My shredded wheats are probably not too dissimilar in GI to the pasta I have at tea time. I would expect the sugar in the shredded wheats to be absorbed about as quickly as the pasta.
However, I think there is another reason that is causing the raised sugar levels. It's a phenomen which I've seen referred to as 'the dawn phenomenon' in Dr Bernstein's 'Diabetes Solution' book. The idea is that in the morning hours, just after one wakes up and for about 2 to 3 hours after, the insulin is less effective at lowering blood sugar levels. The insulin is slightly impaired.
This would offer a good explanation for why my sugar levels are raising a few points up to a couple of hours after eating breakfast.
What can you do?
As far as I can think tonight, there are two main options available
- try to eat less carbohydrate (sugar) by choosing a lower-carb breakfast
- try to eat a lower GI breakfast
However, I may be able to lower the GI of the breakfast if I switch to using full fat milk instead of skimmed milk.
I am told that having fat with a meal can slow down the absorption of the sugar, so it's worth a go. I'll give it a go next week and see if it helps at all.
Where from here?
I'll spare the lunch analysis but it is along similar lines.
So now I've got an idea of how good these particular meals get absorbed and how well the insulin works against them.
If I were to analyse each relatively regular meal I have I would be in a very good position to control my levels really well. That's the ultimate goal.
As a bonus, the results I've been getting this week have been really good.
Monday 9 February 2009
that's what you get
So what would've happened if I stayed getting the numbers I was getting in December?
If I'd carried on how I was, I would be really risking some seriously horrible stuff happening to my health and well being. One thing that happens when you have consistently high readings over a number of years is that you start to get haemorrhaging of the blood vessels in your retina - a condition called retinopathy. As more vessels burst, you start developing black spots on your vision that you can't shift. You'd need some serious-ass surgery to sort it out which is beyond the means of most - if it exists at all?! If several of them bood vessels start to burst, you're on a one way ticket to blindness.
Ouch.
...and it gets worse
High blood sugars don't just hurt your eyes, they will really fuck around with your kidneys, your heart and, scarily, your nerves.
Keep the blood sugars too high and I'll be asking for big trouble. Your nerves are really important. They're a big factor in controlling digestion for instance. When the nerves have been degraded by consistently high sugar levels, they cause a constant alternation between constipation and diarrhoea. This condition is called neuropathy.
When you read about some of the sufferers in their 20s and 30s it's hard to accept. The stories are beyond heartbreaking, they're heart stamping. I don't mean to venture into hyperbole but if you read what some people are going through, you'll understand what I'm trying to describe.
The sad thing is that there are loads of people, often teenagers who are struggling so bad to keep themselves controlled that they're heading straight down the railroad to this real-life hell.
I was riding this very track until this January and it's only will power that'll keep me away.
If I'd carried on how I was, I would be really risking some seriously horrible stuff happening to my health and well being. One thing that happens when you have consistently high readings over a number of years is that you start to get haemorrhaging of the blood vessels in your retina - a condition called retinopathy. As more vessels burst, you start developing black spots on your vision that you can't shift. You'd need some serious-ass surgery to sort it out which is beyond the means of most - if it exists at all?! If several of them bood vessels start to burst, you're on a one way ticket to blindness.
Ouch.
...and it gets worse
High blood sugars don't just hurt your eyes, they will really fuck around with your kidneys, your heart and, scarily, your nerves.
Keep the blood sugars too high and I'll be asking for big trouble. Your nerves are really important. They're a big factor in controlling digestion for instance. When the nerves have been degraded by consistently high sugar levels, they cause a constant alternation between constipation and diarrhoea. This condition is called neuropathy.
When you read about some of the sufferers in their 20s and 30s it's hard to accept. The stories are beyond heartbreaking, they're heart stamping. I don't mean to venture into hyperbole but if you read what some people are going through, you'll understand what I'm trying to describe.
The sad thing is that there are loads of people, often teenagers who are struggling so bad to keep themselves controlled that they're heading straight down the railroad to this real-life hell.
I was riding this very track until this January and it's only will power that'll keep me away.
What a difference a month makes
The difference is clear
I replied to an email from my grandparents this evening and I gave them an update on the work I've been doing to get my sugar levels back on track. To illustrate the point I gave some statistics about how things have stepped up a gear.
Here we go:
In December 2008
41 tests taken
17 were above 10.0 (this is a high result)
9 were above 15.0 (this is a too high result)
2 were above 20.0 (this is a potentially dangerous level!)
In the month since I started this blog
79 tests were taken
9 were above 10.0
2 were above 15.0
0 were above 20.0
A huge improvement
To keep myself healthy, I should is to keep as many tests as possible below 10.0
In December, 59% were under 10.0
In the month after starting the blog, 89% were under 10.0
That's a massive difference.
I replied to an email from my grandparents this evening and I gave them an update on the work I've been doing to get my sugar levels back on track. To illustrate the point I gave some statistics about how things have stepped up a gear.
Here we go:
In December 2008
41 tests taken
17 were above 10.0 (this is a high result)
9 were above 15.0 (this is a too high result)
2 were above 20.0 (this is a potentially dangerous level!)
In the month since I started this blog
79 tests were taken
9 were above 10.0
2 were above 15.0
0 were above 20.0
A huge improvement
To keep myself healthy, I should is to keep as many tests as possible below 10.0
In December, 59% were under 10.0
In the month after starting the blog, 89% were under 10.0
That's a massive difference.
Sunday 1 February 2009
Halfway dead and enjoying the ride
On a recent journey back home I was listening to Jane's Addiction Strays and midway through I had a very peculiar experience.
I felt like I'd reached the mid point of my life and felt that after all the efforts of trying to take on more and more information, trying to figure people and things out and worrying about all sorts of things, I felt like now was the time that I knew and understood enough that things would get easier from this point on and I should sit back and enjoy the ride. Like going over the very top of a roller coaster.
My diabetes sometimes has some similarly strange effects on me, but this time I couldn't so easily put it down to a lack of glucose in the brain and it also made more sense than low blood sugar episodes usually do.
Further fuelling the ride
Whether it was low blood sugar induced or not, the message I got was very positive so I want to cling to it tight and keep it with me. My aim now is to keep on top of things, keep on the rails and see what I'm capable of as much as I can.
A line from Free's Seven Angels sums up the overall feeling
"The world is behind me, only one way to go, that's straight ahead, that's where I'm going"
I felt like I'd reached the mid point of my life and felt that after all the efforts of trying to take on more and more information, trying to figure people and things out and worrying about all sorts of things, I felt like now was the time that I knew and understood enough that things would get easier from this point on and I should sit back and enjoy the ride. Like going over the very top of a roller coaster.
My diabetes sometimes has some similarly strange effects on me, but this time I couldn't so easily put it down to a lack of glucose in the brain and it also made more sense than low blood sugar episodes usually do.
Further fuelling the ride
Whether it was low blood sugar induced or not, the message I got was very positive so I want to cling to it tight and keep it with me. My aim now is to keep on top of things, keep on the rails and see what I'm capable of as much as I can.
A line from Free's Seven Angels sums up the overall feeling
"The world is behind me, only one way to go, that's straight ahead, that's where I'm going"
A month later, has it worked?
About a month after choosing to post my results on a blog, has it actually worked?
I think so. The results have definitely better and I still feel committed to keep going.
In the past I've 'endeavoured' to record my results and get better permanently but then it's all gone to pot very early on.
When it goes wrong: the usual routine
What's different now?
This time I've recognised that things do get out of hand in the second week. I've taken that as given and kept up the work and it's helping.
Now I'm starting to see patterns in the numbers I'm getting. This is good and allows me to see if I'm making regular miscalculations.
Myt highest figure was a 16 which was down to eating a large portion of chips. I should know better for next time.
Now that I've got some basic control, it frees up my mind to concentrate on the details and iron out the creases, like occasional high readings. Previously, there'd be so much to take in I wouldn't even get started.
Regular sleep times
Certainly a big help has been the better sleeping habits I've stuck to this month.
I'm really pleased to see a huge collumn of black in the early hours of the morning. December had readings scattered between 2 and 6 in the morning, in January it became an untouched area.
This is very useful as the more regular your days are, the easier it becomes to manage the diabetes.
Easy on my mind
A useful side effect of my better sleep and diabetes control has been that I feel more awake in the day.
I also think that writing things down in this here blog has made things easier on my mind. It's like taking the problems and offloading them into the internet.
I don't feel I need to spend so much time worrying about things. If I need to think about things I can always revisit them here. It feels like I've freed up space in my mind to think about other things. My brain feels like it can take on more things now than it could just a month previously. It feels like there's less background stress.
I think so. The results have definitely better and I still feel committed to keep going.
In the past I've 'endeavoured' to record my results and get better permanently but then it's all gone to pot very early on.
When it goes wrong: the usual routine
- The first week sees a marked improvement
- The second week I start to get results which don't make sense to me
- This makes me feel dis-spirited
- My efforts to keep up the monitoring soon fall apart
- Within three weeks time I'm back to old habits of not recording and not really caring
What's different now?
This time I've recognised that things do get out of hand in the second week. I've taken that as given and kept up the work and it's helping.
Now I'm starting to see patterns in the numbers I'm getting. This is good and allows me to see if I'm making regular miscalculations.
Myt highest figure was a 16 which was down to eating a large portion of chips. I should know better for next time.
Now that I've got some basic control, it frees up my mind to concentrate on the details and iron out the creases, like occasional high readings. Previously, there'd be so much to take in I wouldn't even get started.
Regular sleep times
Certainly a big help has been the better sleeping habits I've stuck to this month.
I'm really pleased to see a huge collumn of black in the early hours of the morning. December had readings scattered between 2 and 6 in the morning, in January it became an untouched area.
This is very useful as the more regular your days are, the easier it becomes to manage the diabetes.
Easy on my mind
A useful side effect of my better sleep and diabetes control has been that I feel more awake in the day.
I also think that writing things down in this here blog has made things easier on my mind. It's like taking the problems and offloading them into the internet.
I don't feel I need to spend so much time worrying about things. If I need to think about things I can always revisit them here. It feels like I've freed up space in my mind to think about other things. My brain feels like it can take on more things now than it could just a month previously. It feels like there's less background stress.
January's sugar levels
My blood sugar's certainly got better over January. It's not perfect but it's noticeably a lot better.
Here they are:
Here they are:
| 0 | 2 | 4 | 6 | 8 | 10 | 12 | 14 | 16 | 18 | 20 | 22 | |
| 01 | 5.5 | 7.2 | ||||||||||
| 02 | ||||||||||||
| 03 | ||||||||||||
| 04 | 2.9 | |||||||||||
| 05 | 15.4 | 10.2 | 9.3 | 8.6 | ||||||||
| 06 | 5.3 | 3 | ||||||||||
| 07 | 13.1 | 12.8 | 12.9 | |||||||||
| 08 | 16 | 6.2 | ||||||||||
| 09 | 7.7 | 2.8 | 5.9 | 5.2 | ||||||||
| 10 | 4.9 | |||||||||||
| 11 | 7.8 | 3.8 | 8.9 | |||||||||
| 12 | 5.9 | |||||||||||
| 13 | 3.3 | |||||||||||
| 14 | 5.9 | 4.5 | ||||||||||
| 15 | 3.8 | 6.1 | ||||||||||
| 16 | 8.1 | 5.1 | 3.5 | 3.6 | ||||||||
| 17 | 9.7 | 4.9 | ||||||||||
| 18 | 7.7 | 6.8 | ||||||||||
| 19 | 4.4 | 12.2 | 2.9 | 4.3 | ||||||||
| 20 | 4.3 | 5.7 | 2.9 | 10.5 | ||||||||
| 21 | 2.6 | 14.6 | 6.2 | 9.1 | ||||||||
| 22 | 2.4 | 3.4 | 9.8 | |||||||||
| 23 | 8.3 | |||||||||||
| 24 | 13.3 | 5.4 | ||||||||||
| 25 | 7.6 | 4.4 | 3.3 | |||||||||
| 26 | 14.3 | 6.3 | ||||||||||
| 27 | 16 | 7.1 | ||||||||||
| 28 | 7.2 | 3.2 | 9.8 | 7.4 | ||||||||
| 29 | 9.8 | 12.4 | 4.4 | |||||||||
| 30 | 4.9 | |||||||||||
| 31 | 13.1 | 6.7 | 3.2 |
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