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Showing posts from February, 2007

mg/dl and mmol/l

Americans use mg/dl as the unit for measuring glucose levels. Most other countries use mmol/l. The relationship between the two is that 1mmol/l = 18mg/dl. I was interested to understand this relationship (as a former chemist) and also find out what it meant in practical terms. It is a bit sad, but here is my calculation (previously posted on diabetesdaily.com in response to a question):

The unit mmol/l stands for milli-moles per litre. (or liter in the US, I believe). milli means a thousandth, so what is a mole (other than a small rodent-like animal). A mole is that quantity of a substance whose mass in grams is the same as its formula weight (atomic weight). Each molecule of glucose has 6 Carbon atoms, 12 Hydrogen atoms and 6 Oxygen atoms. A carbon atom weighs 12 units, a hydrogen atom weighs 1 unit and an oxygen atom weighs 16 units. These units are called relative atomic mass units (don't need to go into why). So the atomic weight of glucose is (6x12) + (12x1) + (6x16) = 180. Th…

Flapjacks!

Emailed the company that makes my favourite flapjack to find out the nutritional information for them. They replied this morning and it doesn't make pretty reading. The values for the 145g flapjack are as follows:

NON HYDROGENATED FAT 28.7g
PROTEIN 11.6g
CARBOHYDRATE 92.4g!!
ENERGY 660kcal!!

Guess my flapjack eating days are over. I work on roughly 1 unit of insulin for 10g of carbohydrates. I usually allow myself 8 or 9 units per meal. Therefore I could have a flapjack for my meal, but nothing else.

Worked out my average BG for the past 2 weeks. It was 7.5mmol/l, so am fairly happy. It could be a little more controlled, but I will discuss this with my diabetes nurse at my appointment on Friday.

Josh is being really hungry at the moment, so we (mostly Claire) are struggling to keep him happy. It didn't help that when she went to get him weighed yesterday, he wasn't keeping up with the growth curves. We have no faith in these curves as they don't seem to allow for breast fed…

Novorapid & Levemir

Not a lot to report today, so thought I would tell you a bit about the insulins that I take. For those of you who are type I diabetics, this will be dull and you will probably know all about it, but for others, it may be good to see what is involved. Apologies if the picture below makes you feel uneasy, but it shows what an insulin pen looks like.
The needle attached is the smallest they do and is 5mm. The dial on the right is used to select the amount of insulin you want to inject. You then press the button and it clicks until the right dose is selected.This insulin is called Novorapid. As the name suggests, this is a rapid action that starts working in 10 to 15 minutes. It peaks (as far as I can tell, although opinions on the net vary) in just over an hour and can be in the blood stream for 3-5 hours. I have also read that it can be gone in 2 hours, so am not sure about this figures. Novorapid is taken before meals and means that you can vary the times of your meal and if you want a…

Count your Carbs...You Must!

Had a strange experience in a diabetes chatroom on Friday. Was happily chatting about levels and how I was coping, when one of the members suggested that my levels were bad if they went over 7 and that I must start carb counting immediately. When I said that I would consider it, but wouldn't be told I had to do it, she took umbrage and left following a rant about not listening to advice! Carb counting is quite an emotive issue, particularly I have found with Americans (although this person was British). People who carb count can almost be categorised like various stages of religious beliefs, there are atheists (not many), agnostics (me), followers and evangelists. This person and several Americans that I have spoken to fall into the latter category. I have no problem with people evangelising about anything, as long as they don't expect me to follow exactly what they say without question.

The ironic thing is that this person is constantly complaining about having hypo unawarenes…

Linear Relationship?

Starting to get a little frustrated with my diabetes and my especially my blood glucose (BG) levels. So far it seemed to be that if I ate more carbs, my levels went up in proportion, unless I increased the insulin dose. This is the principle of DAFNE (dose adjustment for normal eating). The principle of this is that you learn the amount of insulin that you need for an equivalent amount of carbohydrates. You do this empirically, testing BG before and after a known amount of carbs and insulin. I notice that my hospital is not a DAFNE centre, but there are some in Birmingham. Will ask my nurse about it. Have my first diabetes doctor check-up a week today. Quite worried about it as I don't know what they do...I am sure it will be fine, but believe it or not, I am concerned that they are going to take blood from me. OK, I have got used to pen needles, but not sure that I will ever get used to the big ones. At least Claire is going with me!

Anyway, I digressed. I am frustrated…

What does a hypo feel like?

Since being diagnosed and learning about diagnosed, I wanted to know what a hypo felt like. Last night my levels went down to 3.0mmol/l (54mg/dL). It was really obvious: I went pale, had a shaky feeling and started to sweat quite a lot. It wasn't pleasant at all! I didn't intend to go that low, but probably didn't have enough carbs at supper time. I treated the hypo with some fruit juice and some Weetabix. Very quickly these bought my levels up and I felt better. The theory, I believe is that you should take some rapid action carbs - fruit juice, glucose tablets, and then some longer lasting carbs - wheat, pasta. I also felt really hungry whilst my levels were low and therefore devoured numerous crispbreads afterwards. The problem with treating a hypo, is that actually you need very little food to raise your levels. In fact, by bedtime my levels were 11.2mmol/l, which is rather too high.

I understand that people feel hypos as different levels and that people build…

Pancakes!

The highlight of a fairly lousy day were the lovely pancakes that I cooked when I got home. Being low in carbs, I could eat loads of them without fear of affecting my blood glucose levels too much.

The day was rubbish, not because of my diabetes, but because we made some mistakes at work, one of which was totally my fault, which has resulted in us having to reprint some work. I was really annoyed, but it is done now.

Also attentions have now started to focus on our house extension. The planning application was registered yesterday and we had the full quote from our builder today. It is a bit daunting, but it will be worth it. Still got issues with the sewer that runs near our property. Need to find out exactly where it is before we start work.

Good Hope

The Good Hope Hospital is my local hospital; what a great name for a hospital! I am spending increasingly large amounts of time there. However the service recently has been exceptional. Today as I mentioned yesterday was Josh's visit to the opthalmologist. Whilst she couldn't tell us much, she did confirm that he has nystagmus. She gave us some leaflets. Whilst the condition has a broad spectrum of outcomes, it does seem that his vision will at best be restricted and could be virtually non-existant. She was positive that his nystagmus (quivering of eyes) had settled a bit, but this is a condition that cannot be cured and always causes visual difficulties. He responds to bright lights, so has some vision. His next appointment is in the summer as then he will be old enough to have the full gamut of tests including electrical tests to test the optic nerve. It is going to be a long wait.

Had a good day apart from that. As it is Shrove (Fat) Tuesday tomorrow had pancakes …

Spring has sprung!

Felt really spring-like today, managed to get out in the garden and do some tidying. We have a lovely garden, but it is going to take lots of work. Took the old bean poles out and Abby & Claire cleared up some twigs and leaves. Luckily we have our monthly garden refuse collection tomorrow.

Pumped up the tyres on our bikes too. I have resolved to cycle to work in the near future. It is only about 2 miles and this afternoon we did a recce to find the best route. It turns out there is a canal that you can get to on backroads from here that goes right past work. We had a walk with the double-buggy this afternoon along the canal and made it as far as Halfords, where we bought a new saddle and some lights. Have no idea how to fit the saddle to the bike, so may have to take it back as I am not sure it is compatible.

Cooked another curry tonight. Garam Massala seems to be a key ingredient and once formed part of a lovel curry. Will continue to experiment with recipes. Each day t…

Lichfield

Had a really nice day today. Woke up to good levels again (4.3) and levels have remained under 10 all day.

As it was a good day weatherwise, decided to go and visit a city we hadn't visited before - Lichfield. The main driver for this was because we had been looking for rice syrup and pear and apple spread that were in a recipe in a diabetes cookbook for flapjacks. We had heard that there was a good Waitrose in Lichfield. In fact it was an excellent Waitrose. We have a joke in our family that you can't get out of Waitrose without spending at least £40. We spent £39 today! The produce is just so much better than the normal supermarkets and the variety is great. We'll have to come back here for treats.

After Waitrose we went into the town. It is a compact town with lots of lovely shops and some nice independents. We went to the cathedral, which is a stunning building. It was 15 years ago that I last visited, singing Mozart's Requiem with the school music society…

Level Lottery

I am trying to make the most of my diabetes. Therefore I have found some ways to take away some of the drudgery of it. Each lunchtime before I take my glucose levels I challenge the other people in the office to guess my level. They ask me about what I have eaten and try to guess. I get to guess too. The person closest gets 10p! I have the advantage of knowing how I feel. So, you'd have thought that I would win. Not a bit of it! I haven't managed to be closest in any of the times we have played it. I hope I get better otherwise I'll have no change left.

Other things that brighten it up are my spreadsheets of stock levels and my glucose monitoring graphs.

My daughter (2 and a bit) has got right into the procedures I have to go through. She tells me to 'do my blood sugar' then 'do my leg' or my tummy. She won't let me get away with slacking! In fact she doesn't let me get away with any of my bad habits including biting my nails or putting my knife down …

Level 4.2

Woke up this morning to blood glucose of 4.2mmol/l for the 3rd day running. Pleased that it is so stable. My experimenting with a hypo didn't go as planned last night. For some reason my levels went back up again without me doing anything. I have heard that this could be because your body counteracts hypos by releasing glucogon which in turn stimulates your cells to release glucose to your bloodstream. This doesn't happen in all cases, but it was interesting to feel nevertheless.

Levels have been lower today than usual as I didn't have cereal for breakfast. Had yoghurt instead. I have found some nice low fat, low sugar yoghurts (Muller lite) that actually have bits of fruit in them. Food seems so sanitised that actually finding yoghurt that isn't totally smooth is quite difficult. Found out that peanuts are OK for diabetics as they don't have much carbohydrate in them. Have to be careful of the fat content. Anyone who has set fire to a peanut in a chemistry …

Working Hard

A really busy 24 hours, with little time to think about my diabetes. As I said yesterday, it was the church men's night at the pub last night. This went off well and I met some interesting people. It will also mean that on Sunday, I will recognise a few more people.

Unfortunately, the evening was taken over rather by work. I didn't get away from work until 19:00 and then was back in from 22:00 until 00:15. It was all because a customer had contacted me at lunchtime and asked that we print a job for him to be delivered by lunctime today and that he would like to print with us for at least 6 months. Needless to say I pulled out all the stops, the team did a great job and I think we have a happy customer.

Of course today was/is St Valentine's day. I got a nice heart card from my daughter and a box of diabetic chocolates (Thorntons) from my wife. Although the latter are not meant to be that beneficial, I am eating them in moderation and they taste pretty good.

Below is the receip…

Buffet Blues

Had an up and down day yesterday. At lunchtime, we had been delivered a sandwich buffet by mistake, so I thought I would see what affect it would have on my levels. I didn't have much to eat and my level shot up from 6 to 15! Didn't manage to get it back to normal until after supper, when it dropped to my lowest level yet - 3.7. Managed to keep it stable through the evening and night and woke up to 4.2. I'll see how I do today.

Spoke to a number of people last night on the internet; including new friends that I have made through my diabetes. I feel it important to share my experiences and listen to others so that in some way it can help to deal with this difficult condition. I also chatted to some old friends who are being supportive, but not wanting to dwell on the diabetes too much, it was good just to have a sensible adult conversation.

This evening I have a church 'male-bonding' session at the local hostelry. Evidently if you are one of the first 6 to arrive at t…

Roast Beef & Pancakes!

Went to the supermarket on Sunday for the first time since diagnosis. It was really depressing to walk down the aisles and see all the produce that I used to eat in vast quantites and was now off-limits. Even found myself being jealous of the person in front of my at the checkout who had an array of desserts in their trolley! I am really noticing how people's lives seem to revolve around food in all its wonderful forms. Took solace that I have found a couple of things that I really like, that I won't need to avoid, although of course with diabetes, moderation is the key. I made a roast beef lunch with Yorkshire puddings, roast potatoes and veg. I did my normal dose of insulin and my levels remained fairly constant. I also had some batter remaining so I had pancakes for breakfast this morning (with lemon juice and sweetener). The batter was made with Alpro soya milk, as my wife can't eat dairy. They tasted excellent and were low in carbohydrates.

Level Bouncing

My levels have been really odd in the past 24 hours. Thought I had a grip over what was causing the levels to change, but the logic has gone out of the window today. Last night I was at 4.6 mmol/l, which was a little low, so I had a Kit Kat. 2 hours later my level was 14.6 mmol/l, it had dropped to 6.4 by morning. As I was going to a birthday party at an adventure centre, I thought I would use up some glucose, however my level was 10 by lunchtime and 14.5 by teatime. Took some more insulin before supper and my level dropped to 3.8 by mid evening (borderline hypo). Spoke to some people on a chat room and they suggested I ate a banana to raise my levels a little. Feeling better now.

Anyway, snow has all but gone. Last night I had to leave the car 5 minutes from home as I couldn't get up the hill for the ice and snow. I had a great time today with my daughter at the adventure centre birthday party. I also resisted the temptation of the party food, eating one corner of a tuna sandwich …

Snow

Above is the view out my window this morning. The country seems to have ground to a halt in some areas (or so the news reports are saying). People are quoting inches of snow. I don't generally believe them. An inch of snow is an awful lot! My daughter loved the snow and played around outside with me for half an hour before bed, squealing with delight!
Levels are good again this morning - 4.6mmol/l. Also, managed to stay below 10 all day yesterday. Still using 6 units Novorapid before breakfast and lunch, and 8 before supper. 14 units of Levemir at 20:00. Hands were cold last night and it took me 4 attempts to do glucose test. Will make sure I am properly warm before I do the test in future.
Been reading the book I have just received from Amazon. Type 1 Diabetes in Children, Adolescents and Young Adults is really excellent. It is really detailed but not too complex. When I have digested some more, I will relay some of the information.
Fact of the day: Some cells in the body use insuli…

4.0!

Took my levels this morning and they were at the magic 4.0mmol/l level (72 in US units)! Had a biscuit in celebration! Latest graph above. Seems less predictable than I thought, but at least I am now generally below 10 most of the time. I believe I am however in the 'Honeymoon Period'. This is the time when the body is still producing a little insulin and therefore your levels are easier to control. I don't think that it lasts long. A thick blanket of snow has fallen during the night. I was meant to be going to London today, but I think I'll give it a miss. My daughter (2) saw the snow and got very excited. She had not been out in snow before. We had an excellent half hour out the front of the house making tracks and getting cold! In my nice warm office now drinking a big mug of tea and looking at the snow continuing to fall. Won't be late home tonight.

Stocktake, Excel and Hospital

Had a good day today. Levels seem to be alright and had a good chat with my nurse. Also had the haemoglobin test (A1C). This shows how your blood glucose levels have been in the last three months. My reading was off the scale, as expected! At least next time I have it, it should be a better reading. Had a chat with a nutritionalist too. He wasn't good and didn't seem to be able to offer us much. Maybe this was because we eat well at the moment, but was hoping for more. Most useful was a list of how many carbs are in foods. It even gave levels for things that are really off-limits (chocolate & KFC for example). At least now I can make informed decisions about what I do.

Did a stocktake of my stuff and worked out how much I had and how long it would last. I really like Excel and think I am quite skilled in it, although a little obsessive! I created a nice little spreadsheet to monitor the stock levels.
Had a great day at work, it is really helping with my confidence pos…

Food Storming

Starting to get into a routine now. Don't have a problem with either the glucose level tests or the insulin injections. Have got over the initial anxieties much quicker than I expected. Thoughts have now turned to practicalities. My wife and I spent the whole of yesterday evening talking about it. Most of our attention has turned to food. She has borrowed a couple of diabetic cookery books from the library, which I am sure will be useful. There are so many questions that we have about my diet. We are lucky as I believe we eat healthily already. We never eat ready-meals and eat fish and vegetables regularly. I just need to cut down on sweet desserts.

The big problem that I have is where are the boundaries? Can I eat a couple of biscuits before bed. What does having a sugary pudding do? If I do some exercise, can I have some moresugar? Whilst I understand that healthcare professionals are the most qualified to answer these questions, would you expect a dentist to say th…

Glucose Levels

I like spreadsheets, so am going to plot my glucose levels until I get bored of it! Means I can email it to my nurse too.

Weekend Progress

After self-administering my first injection, it did seem to get easier with every go. I have to inject four times a day, which seems a lot, but they are well spread and actually doing the blood tests are more demanding. I do these four times a day as well. It is interesting to see how my levels are changing. I have been in the 'normal' range for the last 24 hours, which is a positive sign (5.2 mmol/l today). I have cut out the majority of my glucose intake, replacing it with fruit, pasta and potatoes. I am not quite sure on the diet I should be following, however if I start to make the changes now, I will have less trouble adjusting in the future. Definitely noticeably less thirst now.

The physical side of it has been relatively easy to cope with, however mentally it has been more challenging both for myself and my immediate family. Realising that there is no cure and that you have to follow this same routine for the rest of your life is daunting. However, there are ma…

Friday Afternoon

Shortly after the previous post, I received a phonecall from the Diabetes department at the hospital. They said that I needed to be there within half an hour as they had only just seen my referral letter and were concerned for my health. When I got there, they expected me to be much worse than I was and even had admission papers ready. Luckily I appeared to be OK, although my level was still 25 mmol/l. This began what was a very traumatic afternoon, not physically but mentally. Even though (being a scientist) I understand the mechanisms of Insulin action, I knew little about the condition. The reality I was told was that I had type I diabetes, and therefore would need to inject insulin for the rest of my life. This didn't hit me immediately as my needle phobia had well and truly taken hold. However, through the excellent support of the entire team (or so it seemed) at the diabetes clinic and my wonderful wife, I was able by the end of the afternoon to self-administer the fi…

Needlephobia?

Not sure whether I have a true phobia of needles, but it does seem to be an irrational fear. Blood and other gory things don't fuss me, but even if needles are mentioned or come on the TV, I have to look away. It's really strange over the last 24 hours, my body has been playing tricks and I keep feeling fake needle pricks every time I start to dwell on my diagnosis and what may happen in the future. At least my condition will cure me of the phobia!

Not heard anything yet about my referral to the hospital, don't want it to happen too quickly, but I know the sooner I get my glucose under control, the better both for my short and long-term health. Had long chats to people about it and it has made me feel better. Have routine appointment with GP on Tuesday and will have list of questions for him....will a 10 minute appointment be long enough?

First Post

This is my first post on a blog. Not sure whether it will be the last, but we'll see. I'm not sure I'm keen on sharing too much via a blog. I think work is out of bounds and not sure I want to share too much family stuff, but maybe I'll use it to record certain events. Most probably I will use it to record my experiences with diabetes.

I was diagnosed yesterday with Type 1 (insulin dependent) diabetes. I am terrified (probably phobic, although I think it is an overused term) of needles, and know little about diabetes. Evidently my blood glucose was 37mmol/l when a normal reading is less than 10mmol/l. I guess the writing was on the wall. I have lost weight and had great thirst even though I ate lots of stuff and drank almost throughout the day. It is going to be an interesting few weeks finding out about the condition and dealing with the inevitable hardships that may follow. I even managed to eat Weetabix this morning without sugar for the first time in my life! I'…