Shock news, CGMS works!

JDRFI rave about my pump and CGMS. My personal experience is that they’ve enabled me to keep my HbA1c at a very happy level for over 2 years, reduce the range of my blood sugar swings and reduce the number of hypos I experience. And now science agrees with me!

The latest research from JDRF shows that using a continuous glucose monitor regularly (at least 6 days a week) increases diabetes control and enables patients to maintain good control long term. This is exactly my experience.

My consultant never looks convinced when I tell him that I need to wear my CGMS pretty much all the time to achieve excellent results. He seems to think that I should be able to use it occasionally to get an idea of what’s going on, and then fly blind the rest of the time. My view is that CGMS is a tool I use to manage my diabetes day in day out, not something I dip into once a month to see how I’m doing.  Now science agrees with me:

“patients averaging at least six days per week of CGM use had substantially greater improvements in HbA1c compared with those who used the devices less often”  http://www.jdrf.org/index.cfm?page_id=112539

The other interesting bit from the study is the proof that the behaviour of the patient is as important in this as the technology:

“…the study found that regular use of blood glucose testing prior to beginning CGM therapy was an excellent predictor of regular CGM use and thus of improvement in glucose control” http://www.jdrf.org/index.cfm?page_id=112539

Yes CGMS is a great tool, but it is just that, a tool not a cure. I’d argue that if you were blood testing regularly prior to starting using CGM you’re probably someone who is used to putting the effort in to take control of diabetes. Common sense says a more advanced set of tools like CGMS is going to be most effective in someone who is used to making the most of the treatments available to them. I like it when science and common sense agree, it makes me feel that all is right in the world!

Hopefully this research will really help strengthen the argument for all those who are currently lobbying the NHS or insurance companies to provide them with access to CGMS. Good luck to you all!

Whinge, whinge, whinge

A portrait of an infant wittily entitled "A Portrait of an Infant"
A portrait of an infant wittily entitled “A Portrait of an Infant”

I always said I wasn’t going to whinge my way through pregnancy, because I’d wanted it for so long and it’s such a positive thing, whinging is just ungrateful. I’m not being 100% successful at this. I catch myself whinging quite often. But a detailed analysis of my whinges show that it’s not really the pregnancy that’s causing the irritations.

Approximately 10.3% of whinging is pregnancy related – normally due to being unable to stay awake, or a little bit short tempered which I’m blaming on hormones.

Circa 27.6% of whinging is related to ridiculous conversations with Drs, or general NHS inefficiencies. An analysis of that shows that less than a third of that whinging is directly related to pregnancy appointments, the majority is driven by diabetes consultations.

And coming in with 62.1% of the whinge vote is diabetes. This is what drives the majority of my kvetching and griping. Mostly it’s down to frustration with the random blood glucose generator that my body has become. But there is also an underlying toddler-esque feeling that it just isn’t fair that I have to deal with all this.

I resent the fact that the first conversations I’ve had with my unborn child have been along the lines of “Agh, mummy hasn’t quite got the hang of this insulin resistance stuff. Why don’t you just chill for a few hours? Or at the very least don’t work on growing any vital organs. Why not have a go at developing your netball skills, mummy’s managed without them for 33 years so you’ll be fine even if the glucose syrup you’re currently swimming in does mangle them.” And “Your mother is a diabetic genius, I’ve been a 5 all morning, you better be building something important today, I’d recommend moving all vital organs to the top of your to do list. Seize the day and all that.”

But when I’m not operating at the mental level of a 2 year old, I can see that having diabetes does help in one respect. Even in the darkest days of the first trimester when brushing my teeth or the smell of toast could make me sick, it was still diabetes that was getting most of the bleating and bellyaching. Diabetes is my whinge sponge, it soaks up all my whimpers and whines and means that I can avoid ungratefully whinging about pregnancy. See, I knew it had a purpose, it just took me a while to find it.

Poll results – healthcare provision

Well, it’s that time of the month where yet again we reveal the results of the latest poll (no, we hadn’t forgotten about it, thank you). Last month we asked what you thought of your local health care provider.

In general it seems we’re all pretty content, with the vast majority of respondents noting that they thought their doctors and nurses were “On the whole not bad at all” with second place going to the utterly average health purgatory option.

However, before our health care friends become too complacent, a significant number of people chose the option of using a witch doctor in preference to a modern hospital. Good luck to ’em!

Anyway, the latest poll has just gone up and we’re asking “How involved in diabetes politics are you?” By this we mean are you the sort of person who writes angry letters to your MP and is the first to man the ramparts with a flaming torch? Or do you prefer to shrug your shoulders to diabetic issues and slump on the sofa, PS3 controller in hand? Let us know!

Those results in full:

On the whole not bad at all – 25
Neither good nor bad – health purgatory – 7
So bloody awful I may as well use a witch doctor – 7
Faultlessly brilliant. I’m in awe – 6
Needing a lot of improvement – 4

Insulin Square – Episode Two

Avid readers of your soaraway Shoot Up will recall reading the first thrilling episode of Insulin Square, a real cliff-hanger of a soap opera where every character is diabetic (or are they?) Anyway, for your entertainment, here’s the utterly brilliant second episode. Episode three will probably follow in a year or two, if you’re unlucky.

EXT. DAY – OUTSIDE INSULIN SQUARE CAFÉ. A clearly upset DEREK rushes out from café, slamming door behind him, closely followed by STEVE and SUSAN

SUSAN Derek! Derek! Come back!
STEVE Leave him Susan, he’s not worth it.
SUSAN But Steve, he’s just bolused for the 17 teaspoons of sugar that he put in his tea
STEVE Yeah, so…
SUSAN But he didn’t drink his tea with all that sugar in it
STEVE You mean…?
SUSAN Yes, he could be at risk of having a hypo! He’s out there, heaven’s knows where, with 17 units on board and no Glucostop.
STEVE Oh my God, what have I done?

CUT TO INT.DAY The Banting Arms, Insulin Square’s local pub. Three young lads, GARY, JON and RAVI walk in and up to the bar. An oil painting of J.J.R. Macleod hangs in the background, the bar itself is decorated with bust of James Collip.

BARMAID Now, what can I get you gents?
JON It’s your round Ravi isn’t it? I’ll have a pint.
GARY Yeah, me too – pint of lager, mate.
RAVI (to barmaid) Yeah, can I have two pints of lager and a diet coke please?
JON Diet coke? You what?
GARY (laughs) Diet coke? You having a laugh mate? What’s wrong with lager?
RAVI I’m staying off the lagers for the minute
JON Off the lager? Can this be Ravi ‘ten pints of Tenants’ I see before me? What have you done with him, eh?
RAVI It’s just, well, it’s just that I’ve avoiding food and drink with a high carbohydrate content and / or a high glycaemic index.
JON You what?
RAVI It’s just that, I think I might have diabetes
JON (shocked) Diabetes?
RAVI Yeah mate. I went to the doctors this morning. I’d been going to the toilet a lot and drinking loads. He said that – this is really difficult to say – that I might be type one. There, I’ve said it.
JON Well I never, mate.
RAVI I just don’t know how I’m going to deal with it.
JON Don’t worry mate. It’s okay. I’ve never told this to anyone, but I’ve had type one since I was five!
RAVI You what?
JON See this (produces pump from under t-shirt) This is my brand new Animas insulin pump. Diabetes really is dead easy once you know how and I can help you work it all out.
RAVI You would help me?
JON (grins) ‘course, what are mates for, eh? (RAVI looks relieved, Gary interrupts)
GARY There’s something I need to tell you two.
JON & RAVI What’s that mate?
GARY I’ve got diabetes too.
JON No way. What type?
GARY Gestational diabetes.
JON (gasp) Gestational? But how?
GARY You’d better sit down, there’s something I need to tell you.

CUT TO EXT. DAY rough looking back alley. DEREK lies sweaty and panting in a pile of rubbish

DEREK: If I can’t have Susan, I may as well end it all. I’m going to do myself in on insulin! After that rage-bolusing earlier my BG’s down to 2.1, so it won’t take long. Goodbye cruel world! (Poises insulin-filled pen over stomach)
SUSAN (running into alley) No Derek, stop!!
DEREK Susan! But how did you find me?
SUSAN I knew I would find you here. You used to take me up this alley when we was teenagers, don’t you remember?
DEREK Of course I remember, I didn’t think you would though.
SUSAN I always remember those times we’d come here after school and you would, well, you know. Anyway, it was always a special place for me. (glances around) Here amongst the rubbish, broken bottles and rats.
DEREK What are you trying to say Susan?
SUSAN Derek, Derek, I love you!
DEREK But what about Steve?
SUSAN Forget Steve. He tries to show off with his fancy pump, but it’s you – with your multiple daily injections – that I really love. So simple. So down to earth. So needle-y.
DEREK Oh Susan, I love… (slips into unconsciousness)
SUSAN (screams) Derek!
STEVE (runs in alley, stops and appraises situation) Looks like you’ll be needing one of these (pulls unpleasant smile and holds up glucogen injection).
SUSAN Steve! Give me the glucogen injection, it’s the only thing that’ll save Derek! He’s fallen into a hypoglycaemic coma!
STEVE Now, what’s it worth? Tell you what, if you promise to go out with me and forget about Derek, I’ll give you the glucugen injection. Now how about it?
SUSAN Steve! You couldn’t!

CUT. EXIT THEME TUNE.

Comatose and rotting toes – the lighter side of insulin dependency

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