Diabetes, teaching and winter. 

As Games of Thrones fans regularly state: winter is coming. In fact I would like to take sole responsibility for the unusually warm weather we have experience on the Yorkshire coast this last week after following the worst winter ever stories in the news and putting my winter tyres on early. It has not quite reached winter coat weather yet. (A winter coat is a thick water proof coat, usually with a fleece zipped inside, which will keep you warm when standing outside on a playground for 30minutes considering whether Siberia is warmer than the school playground.) 

As a primary school teacher Autumn brings one of the harder terms of the school year, not only do I need to train a new class, but I also need to remember how to get up for work after six weeks of holidays. I need to ensure that my basal rate matches my now active lifestyle and my carbohydrate to insulin ratio is correct for carbohydrate heavy school dinners. Small things such as ensuring my work clothes still fit (after six weeks of eating when I want instead of shoving biscuits in my mouth in my cupboard when I have time) to the bigger demands of ensuring that I don’t loose any children during the day. From 8:30am until 3:30pm I don’t have time to think about myself. My focus is ensuring the welfare of 30 plus children. I don’t have time to go to the toilet, get myself a drink or even test my blood sugar. Suddenly life becomes crazy. Once life becomes hectic I find diabetes enjoys saying hello and reminding me of it’s presence. 

  

  
If you have never experienced a day in a primary classroom, then I beg you to volunteer for a day. It is relentless. At any time I can be trying to complete at least three different activities and that is before we have started to have one table making coil thumb pots, another table adding six digit numbers and another investigating the best biscuit for dunking. All while making sure none of the stick insects escape. Yes, a primary classroom is full on. Yes, it is stressful and… Yes, you need to bring your A game every single day. There is no rest for the wicked,  or for teachers. While doing this I also have my diabetes to contend with. I know when I can test – play time, lunch time and after school. So, how do I manage in between? The freestyle libre has been a game changer. I can quickly flash myself in the cupboard (scan my sensor, nothing rude), view my trend arrow and take action. My classroom is a shrine to lucozade. I have half empty lucozade bottles on most surfaces to allow me to quickly treat a hypo. I can’t stop my job because I’m low. I can’t get rid of 30 children. I have to make sure that I can continue. I’ve found that for outdoor PE and trips then Torq gels are the best things to carry and use. They act fast and provide 28.8g of carbohydrate. When we are on our “hills near where I live” walking tour then I am responsible for those children and I’m not sure a parent would enjoy the excuse of “I was hypo and then I lost your child”. 

Winter PE is one of my least favourite things. I’m blaming diabetes for this, but it could just be me. My circulation is terrible. My hands and feet are constant blocks of ice during the winter (and during the summer). In bed I’ll wear socks and gloves to keep warm. Standing outside for an hour and fifteen minutes battling mild hypothermia is not how I enjoy spending one day each week. It has become a running joke between myself and the other teacher about how many layers I will have on each week. He will be dressed like a normal person; I will have ski trousers, base layers, fleeces, hoodies, snow boots, gloves and hat on. I will still be cold. Perhaps this is not diabetes related, but I’ve begun to realise that keeping warm is important. As soon as I become cold I cannot warm up, it makes me feel ill and wipes me out. If someone can explain why to me I would love to know. Therefore preparation is key. Other people may be happy to forget their layers. I will return home at lunch instead of facing the cold unprepared. 

Finally, once I have returned inside the warm classroom, I am faced with a hot bed of germs.  

 Snot, coughing, sneezing, nose picking, licking pencils and rulers (this happens). There is no escape. I keep hand gel on my desk and my class find it hilarious that even after marking a book I will hand gel, but it is like making your way through a lazer quest maze. The germs are every where and I seem to pick them all up. Most other teachers have a sore throat, I will get tonsillitis. The cough that a child has, I will get a chest infection. As much as I try my body loves to take an illness and make it worse. Once again diabetes is reminding me that it is here. 

Diabetes doesn’t stop me from being effective at my job. It does however ensure I am prepared and organised. Thanks to diabetes I love to be organised, know what I’m doing and when I’m doing it. As a result my Teaching Assistant is in awe of my organised boxes of resources, Monday’s lesson laid out ready to go and the back up resources hidden in the cupboard. I suppose always packing double sets of everything for a holiday, keeping snacks on me at all times and organising pre-bolus or multi-wave bolus’ has made me very organised. For that even though diabetes makes the winter hard, at least I’m organised. 

Advertisements

One of “those” days…

During September I have completed two sprint triathlons managing to keep my blood sugars in range and under control which has resulted in far better times than last year even though I know I’m not as fit ( I shaved 20 minutes off the same course this year!). I am 100% putting this down to my improved blood sugar control and knowledge of how / when to fuel along with using CGM. Instead of being one of the blind mice in terms of diabetes management, I now feel I am in control as the farmer’s wife. However for every success there is still another struggle with the sugar demons: introducing night time mountain bikes. 

I am now able to reduce my basal and drizzle in carbohydrates accurately for a road bike ride to stay in range most of the time. Recently, I completed a 55 mile bike ride without packing rice puddings, bananas and other snacks like I did the previous year. However this week when mountain biking everything I tried seemed to have the opposite action! 

Some how from starting the ride in range with a temporary basal reduction as usual for biking I managed to reach the point of “HIGH” on my blood glucose machine. I had taken action at 14mmol, 16mmol and 21mmol. Turning home was not an option as I didn’t have a clue where I was and needed the guidance of the group… 

My dexcom helpfully used ??? to express the disappointing high blood sugar. Therefore with no trend arrows I increased my basal again and bolused again: no change. Usually exercise results in insulin having a “WD40” like quality and working super effectively. This time it did not. More unfortunately I had only taken drinks with glucose mixed in which physically I needed for mountain biking, yet my diabetes didn’t need. 

Why the high? I am beginning to realise that mountain biking causes adrenalin spikes which mean I need less carbohydrate on a ride. This week it was night ride – riding across the moors / woods / fields in pitch black and pouring rain with no phone signal and through bogs (yes I did look super stylish with a headtorch on). I am putting down my ultimate high to cycling in the dark with added adrenalin as after 20 miles and insulin on board I should not have been “HIGH”.  

Was it the end of the world? Of course not, I had an awesome ride. Returned home soaked, fearing that my phone may never work again and covered in mud albeit still “HIGH”. Yes I felt rubbish and went straight to bed, but I knew my blood sugar would come down and had a bowl of cereal post ride to help prevent cramps. I’ve realised that exercise with a higher blood sugar causes cramps in the night for me. However ensuring my muscles have fuel post exercise, especially when experiencing higher blood sugars, is working well for me. I bolused for the cereal and stayed hydrated. Sometimes it really is just one of “those” days. I can’t win all the time, but neither will I let things stop me from having fun…! 

  

Muddy bike, sweaty insulin pump = mountain biking. 

Recently I’ve moved over to the dark side, the dark side of biking… Mountain biking. It all began with an email about a bike to work voucher and quickly escalated to a new bike with some very nice features which I still don’t know how to use (gears, a mysterious white button). Soon I had my bike on the roof rack and was heading off into the forest for a “social” ride. I think I initially thought mountain biking would be the same as road biking. How wrong I was! Within minutes I had come off on gravel, gone over the handle bars going down hill, ripped my trousers, cut my face and jammed the gears… A good first effort with some impressive bruises as souvenirs. Don’t worry fellow road bikers I haven’t lost all sense. My road bike is still enjoying trips out on smooth, Tarmac roads! 

I’ve learnt a few things about mountain biking. Firstly, the distance may be much lower but the technical side is much harder – especially staying on the bike. Secondly, mud gets everywhere even in summer. My water bottles have become disgusting and I’ve had to power through the mud to get to much needed glucose and water! Thirdly, adrenalin messes with your blood sugar levels! 

I have pretty much managed to get my blood sugars under good control when road biking by following the same routine each week from pre-ride smoothie (20g carbs) to High-5 drink through out (60g carbs) plus additional torq gels if required (20g carbs as needed) along with a Temporary Basal Rate reduction of 70% for up to the last 30 minutes of riding where I return to 100%. Yet, mountain biking does not want to follow the same rules. It seems to be dirtier, sweatier and harder to grab a drink! It does not make my blood sugar drop where I expect (hill climbs) due to the sudden surge of adrenalin when going down the other side. Worse still is the adrenalin feels like being hypo and my fingers are way too dirty to test. Thank goodness for CGM and freestyle libre. 

This week I completed my first (very friendly) mountain bike race. An hour of cycling a 1.1mile course to see how many laps you can do in an hour. This sounded simple. I filled my camelback with High-5 energy drink (60g or carbs for the 1hr) – see I’ve learnt about the water bottles and not being able to get them – and had my usual pre-ride smoothie with a reduced TBR. What I hadn’t accounted for was that within the hour I would be working so hard and feeling so exhausted my blood sugars would drop then rise quite a bit. That there wasn’t much time to grab a drink and stopping to take on a torq gel when I was 4.0mmol meant I lost time, even if I was glad for the rest! I was very glad I had my freestyle libre with me so that I could flash and see my trend patterns. I had to unplug my insulin pump at one point as I didn’t have time to stop and alter the TBR for 15minutes. Trying to plug myself back in must have been a sight for the other racers…! When I’m riding I keep my insulin pump in my sports bra so I can quickly see CGM / TBR / IOB data. I am now very glad I have a waterproof insulin pump. Turns out mountain biking may not cover the same distance as road biking and strava will say you’ve only burnt 200kcal, yet it is unbelievably hard work and going over rough terrain makes your heart race! By the time I had finished my hour I was out of drink and starving hungry. Of course I’d only brought lucozade for an emergency and no real food! 

In two weeks time the club will be re-racing the same route. Next time I’m going to lower my TBR more and have more high-5 powder in my drink for a higher carb ratio. I will also be packing a small meal for afterwards along with lots of water! Fingers crossed the strategy works. 

  

Tackling the triathlon 🏊🏻🚴🏻🏃

So, what’s your race day tactic? For some people the answer might be go hard with the swim, save energy for the run or even take a gel at each transition. My race day tactic sounded simple, yet was far from that…. Keep my blood sugars under control! In my previous blogs I’ve described how adrenalin affects my levels and how water temperature and wind resistance affect my need for glucose in the swim. However on race day combining considering external factors and simply remembering where I left my things in transition (rack 4 it turned out) meant a lot of mental calculations. I feel my brain was doing something like the image below…  

 
Last year when I did a triathlon I struggled in transition due to being unable to open my test strips pot as my hands were too cold, being unable to reattach my pump as I had put the site on too low on my stomach to easily get to it and then being so high I felt I couldn’t take on any extra energy. This year after attending the Animas Sport Weekend my race day tactics had changed. 

The first difference was using a Freestyle Libre which I kept with me in an overboard waterproof bag through out the event. For the swim I placed it in my wetsuit and the rest of the time in my trisuit. Pre-swim this provided me much needed peace of mind as I entered the water to know where my blood sugar was. It also (supposedly – more to come on that!) saved me from having to fumble with test strips in transition. My second change was to have two infusion sites for my pump – in case one came off – one on each arm. This meant I could very quickly plug my pump back on without fuss and reach the site. Moreover it meant that during the bike / run I could alter my temporary basal rate as needed. Third change was my nutrition. I have now learnt to “drizzle in” my glucose and alter the temporary basal rate as required to keep my blood sugars more stable. By taking lucozade pre-swim, another swig of lucozade post swim and High-5 energy drink (44g of carbs) every 2km on the bike ride it seemed to work. Although my blood sugars didn’t need a Torq energy gel pre-run, I felt that I did therefore I was able to increase my temporary basal rate and bolus for the gel at the end of the triathlon. My blood sugar stayed at 10mmol almost consistently (ranging from 8mmol to 10.5mmol) throughout the event. I finished on 12mmol due to the energy gel setting in. Previously I finished my triathlon in the high twenties! 

Problems – the Libre is amazing, when it works! Coming out of the swim my Libre told me it was unable to read the glucose. From using it regularly I know it says this when I’m rapidly dropping therefore I assumed it was due to that and took on lucozade in transition 1. Out on the bike I tried to scan again – this time the Libre told me the sensor – not the machine – was too cold (probably why the Dexcom shows the dreaded ??? after a swim). It was cold, windy and rainy on the bike so I then spent the next 3km with my hand over the sensor site. This did warm it up and the sensor was back in the game. However the stress of not knowing if the sensor would be warm enough to work and knowing I hadn’t got any testing equipment out with me as I had perhaps naively relied on the Libre to work was a little stressful. Problem 2 – I took my Torq gel as I left Transition 2 and set off for the run with my now working Libre. I got to the 1km marker and realised that I had no emergency glucose with me. Now I knew my blood sugars were fine, yet the feeling of knowing I should have taken an energy gel or a pack of haribo with me was not fun. I knew I could turn down my pump, and that I had just taken on 20g of carbs so in theory would be fine (and was fine) , but the panic of being without had already set in. In hindsight I’m sure any of the other athletes would have given me one of their gels which they all had with them and I will stock up my trisuit pockets pre swim next time. 

It was a tough, hilly, wet and windy triathlon yet I finished 17th in my category which for someone who has done minimal run / swim training isn’t too bad!  I even finished with a smile! 

 
If you’ve read my open water swimming blog you’ll know why I’m drinking coke! 

It’s about completing and showing what I can do. 

July is a busy month for me due to the fact that I entered the Great Manchester Swim and a triathlon. Each event poses quite the challenge physically, yet the main challenge is managing my diabetes during the event. Ensuring that my blood sugars stay in range and I have enough energy to complete the event. One event down and one to go, but the diabetes management training sessions are the hardest bit. 

Event 1 – Great Manchester Swim.  

 
I completed the mile swim in Salford Quays coming in the top 5% whilst my friend came in the top 1%. She does swim three times a week and compete, so that makes me feel a bit better that she was out of the water four minutes before me! I had been open water swimming with my local swimming club and knew to some level how to manage my blood sugar, but on the day I ended up finishing with a blood sugar of 20mmol – it was 11mmol when I entered the water and should have dropped. This then meant that I felt pretty awful round the end of the swim, horrendously thirsty for the afternoon and suffered from cramp. It was worth it though. I did it. I completed it and all I needed to do was bolus to correct my blood sugar and set a Temporary Basal Rate. 

My main concern during the swim was going low, so I had an energy gel up my wetsuit sleeve and had my freestylelibre in an overboard style bag down the front of my wetsuit. Having my freestyle libre on me meant I could test just before entering the water and feel reassured that I was in range. My pump and snacks had been left in the bag drop , which meant I was disconnected from my pump for an hour. I usually disconnect when I swim so apart from the worry of loosing the insulin pump I wasn’t worried about being away from that. I had reduced my basal rate before and had an energy gel as I entered the water. I would 100% recommend the Great Manchester Swim and am currently contemplating the Great Scottish Swim. I’m not sure if I want to swim a mile again though! 

 
Event 2 – Sprint Triathlon

I have to admit that my triathlon training could be better. I am relying on the fact that I ran 5km with @LwSweetpea88 in May as the basis for my running training. I am using the fact that I cycle most weeks as my road training and have to admit I have done no pool swimming sessions, but I have swum a mile…! Taking each segment of the training I know how to manage my blood sugar. I’ve found that biking is the easiest as I am able to drizzle in glucose and use my freestyle libre to keep an eye on the trend arrows. My control during runs is improving using reduced temporary basal rates and knowing how a faster speed causes my blood sugar to rise and a long steady run will cause it to drop. 

Lately, I have started my bike to run blocks. Both parts separately I can control my blood sugars and keep them in range. However in my bike to run blocks (15 mile bike then 5km run) my blood sugar seems to finish rapidly rising and reaching towards the 20s. Although I’ve finished the bike in range the run seems to be pushing me up rapidly even with a temporary basal rate of 120% which for a run seems excessive to me! I obviously need to do some more trial and error in preparation for my triathlon and then factor in the affect of adrenalin on the day. Along with the early start, (8:45am triathlon start) knowing that morning exercise pushes me up, it is going to be a day of mathematical equations instead of tactical racing I feel! 

  

Type 1 in the Primary School

Yesterday at a Teacher Meet, where we were lured there with the promise of a meal, massage and spa, one teacher asked the union representative what her responsibilities were in regards to treating a diabetic child. Today, on opening Balance magazine there seems to be a lot of information regarding improving outcomes for type 1 diabetic children for parents and the responsibilities of the school. Questions were raised by many teachers, from different schools, about what they should be doing. What level of care is expected to be provided? Should they have to stop a lesson every day at 9:30 to test and bolus for a child? However at the Teach Meet no-one (apart from me) knew about Diabetes UK Care in Schools Helpline! I suggested that should be the school’s first contact point. 

The union representative’s answer was that as teachers we do not have to administer drugs as it is not in our terms and conditions – this wasn’t out of meanness he said this. Moreover the teacher in question was having to test, carb count, inject and use the child’s insulin pump to bolus for this child. The child did have a care plan, yet with no teaching assistant in the classroom the class teacher was having to provide all the care – including on her lunch times (if you’re a teacher you will know a lunch consists of shoving something as fast as you can into your mouth) – all while heavily pregnant. As a result the teacher in question was feeling quite stressed by the situation. She didn’t refuse to provide the care, but she didn’t know what other options were available to her. This begs the question… What should diabetes care in the primary school look like? Who should be responsible? 

A class teacher has 27657 million things to keep an eye on at once, things to attempt to remember, do and plates to spin. I know I struggle to remember to let my class out for play at the right time or turn up for assembly, yet alone anything which would impact upon a child’s health. When I was at primary school my mum had to come to school at break time to test my blood sugars and I had an alarm for a 2:30pm test and biscuit. I am not suggesting in any way, shape or form that is the correct way. However what is the best way to provide support for a diabetic child at school? How can teachers be supported and should teachers – who are not medical professionals – be expected to inject children? What about supply teachers? What are their responsibilities? I know Diabetes UK are providing Good Practice Sharing Events for schools in the Autumn term. I hope that Diabetes UK are considering teachers’ workload in this. I know as a primary teacher I do everything possible for my class, yet the demands and pressure of primary classroom life are huge. Knowing that a third of parents are less that satisfied with the care and support their diabetic child receives in schools makes me question how can teachers do everything and constantly come out on top? I am not in any way, shape or form saying support and care shouldn’t be provided, but please think about the class teacher caring for / educating / inspiring / enthusing / promoting independence for a class of 36 individuals (yes there are that many in my class) day in and day out. I hope that sharing of best practise does help us teachers to understand our responsibilities and what other adult support can be provided. 

 

What did you do? 

Walking the dog along the beach with a friend on a summer evening and seeing 18 year olds enjoying BBQ’s, football and alcohol prompted a question. Where did the last 10 years go? Would we be 18 again? Both myself and my friend have had chronic health conditions and complications in the last ten years (if one of us is in hospital the other is bound to visit!). Having both worked the same summer job ten years ago and sharing the same friendship groups we both agreed we could be 18 again and have a summer of life guarding, training sessions at the open water swimming pool causing the rapids to flood and riding down slides on float boards all with horrendous hangovers. Yes we would do it all again. Although have the last ten years been as good for my diabetes? What affect has it made in the last ten years on my life? 

  
I have used a pump throughout the last ten years, however I have only used a CGM for the last 9 months in which time I think my control has been the best ever. I think it would be fair to say there have been some rough patches along the road…! Rewind ten years and I have my first experience of having my eye lazered due to retinopathy. If you have never had your eyes lazered it is a completely painless procedure… Until the eye numbing drops wear off. I have never been pepper sprayed, however I think I have experienced what it could be like. I can still remember travelling home from Leeds post lazer surgery and the feeling of “pepper spray” in my eyes. The spot where my retina was lazered also caused a dot in my vision for a while, however that did wear off. My eyes have (touch wood) been fine ever since. 

In my previous blogs I have mentioned my ski season, which was not a problem for my diabetes. Yes, changing rooms and cleaning rooms made me hypo. Yes, I ate far too many snickers bars as a result and drank far too much alcohol (€1 bottles of wine 😷), but my diabetes was not a problem. Upon my return home however things started to change. After exercising and having a basal rate for exercise returning to a routine of lifeguard shift work meant that my blood sugars were all over the place. I then started university. Lifeguarding shifts, partying and university resulted in night time hypos which at the time, due to no CGM, I didn’t realise were quite so bad. As a result my night time hypos caused seizures (3 ambulance trips none of which I can remember. One seizure when my parents were in America and another when I refused to get out of bed for the ambulance men and couldn’t recognise anyone around me) which meant that I had a complete loss of memory and ached all over due to every muscle spasming during a seizure. More annoyingly to my 19 year old self, living in an area of hourly buses and no buses on a Sunday or after 6pm,  I lost my driving licence for two years. Riding my bike to university, to work and any where I needed to go, or catching a bus, or asking my mum for a lift became the only option. Luckily, I still lived at home. 

In my final year of university my driving licence returned after some wonderful work by my consultant and education about alcohol ( if I’m high after drinking I do not correct, if I’m in range then I eat before going to sleep). I had been banned from drinking as it can be quite the helping hand in causing seizures for my body, therefore a returned driving licence and the all clear on drinking really was good news. Studying for a teaching degree while not being able to drink was hardly the party university lifestyle. More annoyingly paying for a taxi home while sober was just insult to injury! 

I then began my first teaching job, an hours drive away from my house each way, waving goodbye to life guarding and working leisure centres, and juggled diabetes with teaching after having moved out of home into the big, bad, adult world…! This went surprisingly well apart from a bout of appendicitis fixed by the removal of the offending appendix. I don’t think I can blame that on my diabetes! Teaching and diabetes isn’t a problem. With my pump I can put a temporary basal rate on for PE however my work are strict about the location of testing equipment due to the ‘needle risk’. Using a CGM has definitely helped with that. 

Finally the last two years in the last ten have seen me fly to Austrailia and enjoy Bondi Beach, climb Sydney Harbour Bridge and party hard in Surfer’s Paradise. This year has introduced me to two kidney infections. Kidney infections are horrible, I should not have tried to soldier on to work through the first one. However due to the consequences of spilling a hot drink on my lap while suffering from a kidney infection I have had a considerable amount of time off work, so I can’t complain too much. This year has taught me the most about my diabetes using CGM and #gbdoc. It has brought me closer to ‘diabetic friends’ (said in an Inbetweeners style) and taught me how to find the right education (Animas sport weekend). Also I am looking forward to finally moving onto a new pump and moving to team Animas. 

  
Would I do the last ten years again? Yes, but perhaps only if I could take my Dexcom and Libre back in time with me and join the #gbdoc sooner. 

  

Open Water Swimming and Diabetes

During the summer months I seem to lose all sense of logic and decide to “enjoy” open water swimming. Not only do I face hypothermia, risk of contracting unknown water bourne diseases and grumpy geese on a weekly basis I have to ensure that my blood sugars behave. Open water swimming is requiring quite an intense level of diabetes organisation. 

 

Markers and safety cover

 
There are certain rules to adhere to when open water swimming. We are tagged in and out of the water. If you leave the water, then you cannot re-enter the water. You must follow the course round and swim continuously: once the course has been started you can’t touch the bottom, or turn back, and it is usually a 500m to 600m lap. Already this raises a few problems… Furthermore the water has been anywhere from 12 degrees to a toasty 15 degrees. Getting into the cold water causes an adrenalin spike! 

Suddenly open water swimming has started to become a university level mathematical algorithm. How much active insulin do I have? What is my current blood sugar? Which way is it trending? Do I need to take on carbohydrate? If so how much? Will my blood sugar drop in the water? How cold is the water and by how much will this affect me? How much wind resistance is there and how hard will it be to swim? How much energy will I need for the conditions today? How many laps will I be able to manage before I need to get out to test or eat? What time did I start a temporary basal rate? 

 

spot the swimmers

 
So far I have found that if I aim to start around 12mmol, having reduced my basal by 90% 45 minutes before, and take on 10g of carbs as I enter the water (as long as it isn’t too cold), I should be ok to swim a mile (three laps round) and finish at around 6mmol.  However, if the water is really cold this seems to reduce the drop in blood sugar due to the adrenalin boost. I ensure I leave my insulin pump safely in my car and keep my testing kit on the water edge, in a zip-lock bag, with a bottle of lucozade. As I’ve swum with the swimming club since being a child they are all aware that I have diabetes and can consume massive amounts of lucozade! No one bats an eye at my infusion sets, apart from to ask me where it is if it is under my swimsuit! 

Next on to my inability to keep my feet and hands warm. Currently, I am the only person who is allowed in with neoprene booties and gloves – apparently it hinders your swimming. Even when it is swimsuit temperate (17 degrees) I still wear my booties. I know that in a swimming pool I struggle to keep my feet warm, so I won’t risk freezing my toes or damaging my feet. I’m not sure swimsuit and booties is the best look though…! 

Finally, my post swim routine. Once I leave the water I am able to test and re-connect my pump. I enjoy a nice warm towel and warm clothes thanks to my hot water bottle keeping them warm. Once I’m home, I ensure I change my infusion set in case anything unsavoury has some how made its way inside and because if I leave it then it becomes very itchy! My friend who is an iron-man triathlete swears by diet coke post open water, or sea swimming, to keep the tummy bugs at bay. I always have a can in the car ready for on my way home. 

I am now preparing to complete the Great North Swim in Salford Quays. Fingers crossed I can manage a bag drop 30 minutes before the swim time, warm up swim and the 1 mile swim all without my testing equipment or pump. Then manage to collect my bag from bag drop. I’ve a feeling I will be very happy to see my testing equipment at that point! 

Post swim selfie!

#DiabetesAndMe #DiabetesWeek

I am one of 6% of the UK population who has some form of diabetes and within that 6%,  I am one of the 10% who has Type 1 diabetes. Or to put in another way I am one of the 1 in every 17 people who will have some form of diabetes (source NHS, OpenHouse Prouducts, Diabetes.org) . 

  
However I do not suffer from diabetes as the infographic where my figures came from states. I have diabetes, yet I don’t feel like I suffer from it. I work with it and I live with it. 

Diabetes UK’s Diabetes Awareness week runs from 14th – 20th June with the theme #DiabetesAndMe. My diabetes makes me who I am. My diabetes fits to my lifestyle and further more my diabetes helps me to make choices. 

Firstly, I eat what I want and I eat it when I want. I simply bolus using my insulin pump for the food which I have carbohydrate counted like a pro using my degree in mathematics. Yet if I didn’t have diabetes would I know that all foods have carbohydrate? Would I be aware of the carbohydrates piling up in my meal? I am not saying I go to the extremes of an Atkins diet – my clothes tell quite the opposite story. Yet I know what is going into my body. I am always shocked when friends don’t realise how much sugar there is in fruit juice or fizzy drinks. Without diabetes would I be living in the same oblivious state? 

  
Next – exercise. I love to exercise. I do not let my diabetes stop me from biking, skiing, surfing, swimming. I do what I want. Although I do have to plan how my exercise will effect my diabetes. What will be the intensity? What will be my burn rate of carbohydrates? How much will I need to drop my basal rate by? When will my liver dump occur and how will I refuel? I know that weight training pushes my blood sugars up. Repeated aerobic will push my blood sugars up and a slow, gentle ride may actually bring my blood sugars down. I am constantly testing my blood sugar during exercise. This doesn’t stop me from performing, but it helps me see why the last hill was so hard: my blood sugar was dropping. Without diabetes I would once again be oblivious to this. I am often caught explaining to the personal trainer at the gym exactly what will happen to your blood sugar for different exercises. 

Most of all my diabetes makes me organised. At work I am seen as a pinacle of organisation. My organisational skills are reknown, yet without my diabetes would I be so organised? I need to know what to take out with me, I always carry snacks with me and a glucose machine. I can pack like a ninja for a holiday and my hand luggage will mostly be pump accessories. When I travelled to Australia my friend relied on me for first aid and any medical supplies. However without my diabetes would I have learnt these skills from a young age? 

Diabetes may sometimes be a pain, but each time it is a pain I remember the skills it has taught me. Moreover the friends that I have made using the instant bond of diabetes. I have diabetes and that makes me who I am.  

 

Cramp…. Perfect excuse for a G&T? 

My suffering from cramps is a constant joke with my friends. During my ski season bets were placed on an evening as to whether I would get cramp that night. When I say cramp I don’t mean a tight feeling in my calves, I mean the feeling like my muscles are trying to escape from my body. It feels like my calf is about to explode and I am suddenly woken up in the night with this pain. It is horrid. I wake up screaming and have often considered phoning an ambulance the pain is that intense.

 I’ve often wondered why my friends don’t suffer from cramps like me and instead place bets on whether I will have cramp after a night out. Why after exercise am I the one with cramp, yet someone who has done the same exercise doesn’t get cramp? 

I’ve sought help from doctors for my cramps… Potassium (bananas) and quinine (tonic water) are always recommended. Yet I still suffered after exercise. I have even taken to sleeping with an electric blanket wrapped around my legs after cycling – not how to attract a man! That was until the Animas Sport Weekend 2015…

Without a doubt the Animas Sport Weekend has helped me with my cramps. As soon as I heard the term “diabetic cramp” used I paid attention. Finally someone who realised I wasn’t exaggerating about my cramps! The hope of a solution to cramps. 

Apparently exercising with high blood sugars and lack of insulin (as I had been told to do, often pushing my blood sugar above 15mmol for a training session) can result in cramps. Revelation! (I’m sure there is a bit more science to this bit.) Finally, a reason for my cramps. I was doing everything to cause the cramps. 

Now, in my hopefully cramp free world, I am keeping my blood sugars much lower when exercising and following the advice given by Dr Gallen and Dr Lumb on the Animas Sport Weekend. Keeping my pump attached, reducing my basal rate 30mins before exercise and drizzling in the glucose throughout. It might seem simple, but I’ve always been told to do the opposite. High before, disconnect and only drink water unless you hypo. Small changes seem to have made the difference. Now if only I could stop open water swimming hand  / foot cramps from being cold…