The hidden danger of diabetes at Christmas

Satsumas - a dangerous force
Satsumas – a dangerous force

Satsumas are one of my favourite things about Christmas. I know it’s a shocker to hear that I prefer satsumas to traipsing round overcrowded shops and avoiding hysterical toddlers who’ve just had a traumatic encounter with a Type 2-in-waiting in a red coat with a bushy white beard but obviously I’m just strange.

Many moons ago when I was a child we didn’t have chocolate at Christmas, for obvious reasons. Instead we had satsumas and nuts that you crack. Any other time of the year I can happily let Tesco shell my almonds and brazils, but at Christmas I must do it myself.

This is where having diabetes at Christmas gets dangerous. If I simply bought a box of Quality Street and ate my bodyweight in sugar over Christmas life would be simple. Instead, I indulge in the perilous pleasure of satsumas and nuts.

Last night I nearly broke my poor husband’s nose whilst passing him a satsuma via the medium of a poorly aimed cricket throw. It appears that when a satsuma hits you in the face at speed it isn’t as soft as it looks. This wouldn’t happen if we just bought chocolate.

Then there are the nuts. There’s nothing nicer than a freshly cracked nut. Sadly when I do it we either end up with a hazelnut shattered into a million pieces all over the living room, or I do myself some form of mischief with the nutcrackers.

My inevitable conclusion to this deeply scientific study is that having diabetes at Christmas is a hazardous occupation for me and my family. Christmas pudding, chocolate and eggnog are inherently safer than the diabetic friendly satsumas and nuts. For the sake of my family I fear I must indulge.

Carb counting for posh people

La fée verte
La fée verte

I was idly rummaging through my old notes, leaflets and booklets that I was given by the DSN when I was first diagnosed. I did because I wanted a) clear some space in my drawers; and b) remind myself how many bad habits I’ve picked up in the last five years.

One booklet in particular did leap out at me. And that was a useful guide produced by the Royal Infirmary which gave the carbohydrate contents of various meals one might encounter out on the high street. After flicking through it again, I was reminded that there are 83g of carbs in a McBigMac, 45g in a McMuffin and 99g in a KFC Family Bucket (whatever that might be).

However, this led me onto thinking that while somewhat useful, it doesn’t really help the posh diabetic. Those within the pancreatically-challenged masses who dine on fine food and eat in exclusive restaurants. So, dear reader, I’ve done some research and calculated the carb contents of some fabulous meals for poshos:

Pheasant & port

Like most right-minded Englishmen, I like to start each morning with a good, sturdy breakfast and like nothing better than a roasted pheasant, a large glass of port and a copy of the poems of Blake propped up against the tea pot. Sets you up for a day on the rugger pitch (in winter) or an afternoon in flannels listening to great, English sound of willow against leather (in summer). Ruddy marvelous!

Carb content: 15g (depending on amount of port)

Narwhal & absinthe

Of course, some of our readers will tend towards the more bohemian echelons of upper society; so I have included this classic dish of narwhal steak, washed down with a soupçon of la fée verte. Best enjoyed with close friends at a left-bank bacchanalian feast, you won’t even be able to even feel your legs after the first course, so taste is fairly academic.

Carb content: 22g

Ortolan

Finally, a particular favourite of mine – Ortolan. Illegal in most countries (even France, for heaven’s sake), an ortolan is a small bird which is drowned in brandy and then roasted whole. Pausing only to cover your head in a large, linen napkin (to hide your shame and gluttony from God) you consume the bird whole, biting through bones, beak and sinew. An added bonus is when said bones pierce your cheeks, mingling your own blood with the bird’s flavours. The best bit is, of course, when you bite through to the lungs and stomach, which burst and release the delicious brandy within. Best enjoyed with one of the better clarets. Yummy!

Carb content: 97g

So there you have it; please feel free to add your upper class eating favourites in the comments below. Bon appétit!

A real life diabetes researcher speaks

Theresa Ikegwuonu is a PhD Research Student at the NMAHP Research Unit of the University of Stirling (The Sunday Times Scottish University of the Year, don’t you know!) who is currently running a study into people’s experiences of having hypos and the impact hypos have on their everyday life. Theresa contacted your soaraway Shoot Up to appeal for volunteers for her study but we forced her to do an interview instead.

So Theresa, give us your Dragon’s Den-style pitch for your current research? What’s it all about?

It is really about finding out people’s views of living with diabetes and their experiences of having hypos (rather than the views of health professionals, so to say, you are in charge).

I’m trying to find out about those aspects of people’s lives hypos can impact upon. From work and employment to things like social life, participating in leisure activities and/or even driving.

If you think about the everyday life of people living with diabetes, what ‘strategies’ do they use to deal with hypos, manage their diabetes, and so on.

The really interesting bit is that I am looking at this over a few months to (hopefully) gain some insights into people’s coping strategies and their views of diabetes.

That all sounds very interesting, but what does it all mean to the diabetic in the street?

Well, at this stage, it is just a chance for people to get involved and to tell me about their personal experiences with diabetes and hypos. In the longer term, my research will hopefully contribute to improvements in health care. Also give new insights and a better understanding of what it really means to live with diabetes.

So what attracted you to diabetes research?

My academic background is actually in social work/public health, so this very much focuses around ‘normal’ people, how they go about their everyday life, how I can support them. With diabetes research in particular, it is about long term conditions and how people manage to live with it every day. I don’t have diabetes myself, but I have close family members who do. It is always important to me, that I can personally relate to the area of research I work in.

What do you think are the most important areas of diabetic research today?

Any research that is relevant to people who actually live with diabetes, research that can lead to improvements in health care, research that ‘makes sense’.

Which is more important – a cure or improving everyday quality of life?

As much as it would be fantastic to find a cure, I believe that improving everyday quality of life should be priority. Things like positive coping strategies that help people enjoy their lives can make a big difference. If you live with a chronic condition, you know it can be anything but fun. So supporting people to meet challenges that they face in their everyday life would be key.

Do you think diabetes research can be a little rarefied, having little effect on diabetic’s everyday lives?

If you look at how much diabetes treatment has improved in the last 20 years, e.g. availability of insulin pumps, flexible insulin therapy, precise measurement of blood sugar with modern medical devices; the fact that there are many options to suit different lifestyles, and the amount of information available about diabetes all highlight the important role research plays in advancing diabetes management, and thereby improving people’s everyday quality of life.

Have you carried out any research on yourself? Such as inducing hypos, etc. If so, did you enjoy it?

No, I haven’t. Generally the researcher cannot be participant at the same time; there would be some conflict of interest. I have not tried inducing a hypo on myself, but I’m sure I would be terrible at managing it!

How can we help with your research?

I am looking for volunteers who would be happy to chat to me about their experiences of living with diabetes and having hypos. Participation would involve one interview, keeping a brief hypo diary for a couple of months, and staying in touch with me during the diary time (via phone and email). I especially need male volunteers, as so far the girls have been quicker to respond! Your help would be greatly appreciated – please do contact me at ti1@stir.ac.uk

Life after birth

Someone's family, somewhere, yesterday
Someone’s family, somewhere, yesterday

It’s three weeks now since we started playing at being parents, and we’re having lots of fun. My caesarean scar has healed beautifully, which is of course amazing as most clinicians seem to expect that it should be oozing green pus and festering nicely by now, me being diabetic and all. I still can’t lift anything heavier than the baby, but I am able to walk much better now. The first time I stood up after the surgery I honestly thought all of my internal organs were about to fall out through my scar. I’m now starting to believe that this won’t actually happen.

I think my diabetes is best described as “interesting” at the moment. It’s a generally well behaved toddler who is prone to more tantrums than usual. A bit like an older sibling who’s had their nose put out of joint by the arrival of a new baby in the house. I think a third of the problem is down to the massive changes in hormones, a third is down to breastfeeding, a third is down to me struggling to believe that I no longer need a bucket of insulin for every meal and the fourth third is down to the fact that as you can probably tell, I’m a bit tired and have other, much more enjoyable things to focus on.

Breastfeeding has surprised me. I innocently expected the impact on diabetes to be relatively predictable. I know, I know, I’m a naïve fool. Generally my blood sugar drops an hour or so after I feed, but not all the time. Some of the time it has no impact whatsoever. And sometimes the drop comes later than 1 hour post feed. So I’m running at a reduced basal rate of 80% and eating 10-15g of carbs with each feed. And then I cross my fingers and more often than not it works out ok.

Continuing with the “I didn’t expect it to be like this” theme, my brain is struggling to come to terms with post birth diabetes. It’s spent 9 months running diabetes with military precision and attacking carbs with ever increasing amounts of ammunition. Now I don’t have the time, inclination or mental ability to do the military precision side of things, but my brain hasn’t quite caught up. So I’m over-correcting highs and over-bolusing for meals, because I simply don’t believe 5 units is enough to cover that sandwich when a month ago I needed 20 units for the same meal.

Generally though, the diabetes is as well controlled as it needs to be for now. The CGM helps a lot because it squawks at me when I go too high or low, meaning that I don’t forget completely about the pancreas business. Because to be honest, when you’ve got sick down your back, wee up your arm and a crying baby, blood tests aren’t really top of the agenda.

Comatose and rotting toes – the lighter side of insulin dependency