A real life health pyschologist speaks

We hear a lot about diabetes research – mice being cured, islets being transplanted – but what about the other side of research. The bit looking at the practical side of how we deal with diabetes? Chloe Redshaw has been playing at being a pancreas for 20 years and is also studying for a Masters in Health Pyschology. We tied her to a chair and tortured her until she agreed to answer our questions about what she does.

Why did you decide to go into health pyschology with a focus on diabetes?

I’ve had type 1 diabetes for 20 years and have had times of extreme difficulty with not just coping with self-care routines and glycymic control, but the psychological aspects of having diabetes. Feelings of denial, anger and sadness have all been a part of my journey to reach acceptance of my condition. I have had times where despite my best efforts to adhere to treatment regimes proposed by my healthcare professionals, my diabetes has still appeared to me at times to have a mind of its own.

All this has led me to believe that optimal control of diabetes is not just about administering the correct insulin, eating the correct food and monitoring my blood sugars, but the way I view myself as a person and how I view my diabetes as a condition. [The other reason I was so keen to interview Chloe is that I think she is spot on about this and so few people talk about it – Alison]

Ah, so diabetes…it’s all in your head. Discuss.

It would be foolish for anyone to suggest that diabetes (of any type) can be purely controlled by one’s own mind. However, we as humans are not robotic being purely driven by biological mechanisms. Our lives and our diabetes control are a result of an interaction of the biological body, the environment and our thoughts, feelings and personalities. A key example of this is stress. We all encounter situations that cause stress in our everyday lives and we all have a biological response that can cause increase in blood sugars. However, the way we respond and deal with these situations in our mind mediates this interaction between a situation and our biological response.

You’ve done some research into gender differences in diabetes. Obviously you’ll have discovered that women are superior, but other than that what did you learn?

This was specifically in adolescence, though I would be interested to also review the work done in adult diabetics. A prominent part of adolescence is gender identity formation. The review aimed to highlight the particular issues asthmatic and diabetic adolescents face and how they differ amongst males and females. These issues were found to be; social identities, personal feelings of self and representation of illness, talking about their illness with their peers, sport/exercise, diet, diabulimia, treatment regimes, conflict and sense of control. Gender does appear to impact substantially on the experience and management in adolescents with a chronic illness. Interventions and care should have considerations for how boys and girls respond and deal differently with their illness and the impact this can have. [So the research says we should be treating patients as individuals rather than putting them all through the same sheep dip, couldn’t agree more – Alison]

You went all modern and looked at whether text messaging reminders and encouragement to teenage diabetics made any difference. Did it?

Text messaging interventions proposes a way to integrate a diabetic health intervention into current adolescent culture.  Studies vary in their methodology, varying between focusing on one particular issue and also whether the patient is a passive recipient or encouraged to interact with the text messaging system. Results show that studies focusing on attendance reminders are generally supportive but lack any evidence relating solely on adolescent diabetics. Other singular issues targeted such as blood glucose testing have been successful; however the problem of maintaining interest did arise.

A more interactive and personalised system has been introduced which enables multiple issues to be addressed; it appears to maintain interest relatively well over a 12 month period. Text messaging interventions for diabetic adolescents appears to be a viable and potentially inexpensive solution to enhancing the support that is already provided by primary care.

The above two pieces of work were focused on adolescent diabetics. However many of the issues addressed are still extremely relevant to diabetics of all ages.

What are you working on at the moment?

I’m currently working on a study exploring factors that influence HbA1C levels in diabetics. I am looking at factors such as; rumination, self-compassion, self-forgiveness, self care, self-esteem, stress and depression.

The study is centred around the self. For example; diabetes requires a high level of self-care and it can also lead to blame on the patient if their glycymic control is not good. However, I am interested to explore if high HbA1c levels can lead to a person having a lack of self compassion and forgiveness themselves. On the other hand I will look at if in fact it is a person’s trait of general lack of self-compassion and forgiveness, that in fact causes stress and increases HbA1c levels.

Is there anything we can do to help?

Finding willing respondents to research studies can be difficult, especially if there is no incentive to complete the questionnaire. In an ideal world I would offer everyone £100 to complete my survey. However, many researchers especially postgraduate do not have funding and would have to put their hand into their own pocket. Therefore, if you see advertisements for a study, please try and take the time to complete it. The saying really does go here; that every little helps!

Whilst I am on this note I would be extremely grateful if you could fill out my online study before 15 August 2011. It is a relatively short online questionnaire and I would really appreciate it!

Isn’t research like this a waste of time, surely we should all be focussed on a cure?

This is a completely understandable question that many may ask. First of all, it is important to note that psychological research  into diabetes runs in parallel to the work towards a cure. Psychological work aims to enhance the day to day live of diabetics. It aims to help those with diabetes to live the best life that they can. This can be looked at in a variety of ways; from adjustment to diabetes life when first diagnosed to learning to successfully incorporate the illness into your identity without a negative impact on your psychological well-being. Psychologists are not capable of offering their time to find a cure, but are capable of offering their time to enhance diabetic’s lives, so why not utilize this?

And now, because we’re nosy, tell us about your diabetes…

How do you treat it?

I treat my diabetes just using my mind obviously! Seriously though…I inject long-acting insulin twice a day and my fast acting about 4 times a day. I am a little obsessed with checking my blood sugar so do that about 9 times a day. My doctor once said that it is too much and that maybe I should see a psychologist!

What’s your favourite hypo treatment?

Anything! I am like a wild cat when my blood sugars is low..literally want to eat anything!

Tell us your most embarrassing hypo story…

Hmmm. I was in Spain once walking around a festival. There were big statues and banners etc being carried through the street and I started thinking they were all coming towards me and getting really paranoid. I initially thought someone had drugged my drink and proceeded to get myself into a complete panic. Then I stopped for a moment, checked my blood sugar and of course it was 1.5! After a heap full of sugar I realised that the statues were not coming to attack me and I was safe!

And so we finally untied Chloe from her chair and released her back into the wilds of diabetes research on the condition that she comes back to share the results of her work with us. If you haven’t already, please take a minute to fill out her survey – we can’t complain about a lack of decent healthcare if we’re not willing to put a bit of time into supporting the academic work looking at how to improve it.

A whole new world

I’ve decided to learn to play a musical instrument. My family will quickly tell you that this is well outside my current skillset. I’m not renowned for my sense of rhythm or pitch. However, the husband plays the tenor horn in a wind orchestra and in a pub after a recent concert I was bullied/coerced/persuaded/pressured into learning. Lots of enthusiastic cries of “the husband can teach you and then you can practice with us” and a little bit of beer lead to me agreeing to learn to play the baritone.

The instrument through which ears are being tortured

I don’t remember my diagnosis with diabetes, but learning a musical instrument has given me some sense of the complete bewilderment that happens when you are dragged into a world you didn’t really know existed. While the new diabetic grapples with basal rates, carb ratios, hypos and hypers I am being told to tighten my embouchure, control my diaphragm (which I’m yet to locate) and to believe that one day I will be able to translate the dots on the page into some form of enjoyable music.  This is like being told at diagnosis that one day you will be able to carb count a whole meal without the aid of a calculator and several reference books. It’s very hard to believe at the time.

There are lots of new things to do. Those who aren’t pancreatically challenged consider it abnormal for someone to stab themselves in the finger to illicit blood or to inject random areas of fat throughout the day. Those of us who aren’t musical are perplexed by the revelation that some people are able to beat a rhythm with their feet, whilst their fingers press down the valves and their mouth blows in the air to create the notes. Changing my first infusion set was not this confusing, I’m sure of it.

The sense of bafflement isn’t helped by the fact that people keep moving the goalposts. Like when you learn to carb count and you learn what insulin you need for 10g of carbs. You start to get confident, this isn’t so hard after all. And then they tell you that actually 10g of carbs from an apple will be absorbed at a different rate to 10g from a pizza, so really it’s a lot harder than it first appears. The same happens in music. You think you’ve got the hang of the counting thing and then they change the rhythm you’ve got to count in. It’s a cruel world.

One of the marvellous things about diabetes is that you get to start again every day. Just because you were a 15 all day yesterday doesn’t mean the same has to happen today. Music appears to be similar. Last night’s rendition of Twinkle Twinkle Little Star was quite frankly an embarrassment to nursery rhymes. Today’s however was a shining example of wonderment, assuming you like your nursery rhymes belted out from a lower brass instrument. Things change quickly in the worlds of diabetes and music.

So, as I blunder into this new musical world it does make me realise how much I take my diabetes knowledge for granted because I have no memory of having to learn all this stuff. I’m quite grateful for that. If I’m not very good at the baritone I can always hide it under the table and forget all about it, sadly the same doesn’t apply to the diabetes.

A needling problem

Generic pictorial filler - you love it really.
Generic diabetes-related pictorial filler - you love it really!

The other week I ran out of needles in the easy-reach box in our under-stairs cupboard. I have a couple of nicely painted IKEA boxes there where I keep my day-to-day diabetic supplies. Pretty thrilling stuff, I think you’ll agree.

I went upstairs to my diabetic warehouse and was horrified (well, not really horrified at all; more mildly surprised – I’m trying to build tension here) to discover that my pharmacist had given me the wrong needles. Now, in the interests of professional courtesy said pharmacist should remain nameless. But he won’t, he’s called Simon and his pharmacy is on the Dalry Road in Edinburgh. Anyway, that aside, I noted the only actual difference from my normal needles was the size.

Since diagnosis I’ve used teeny-tiny 5mm needles which are so small that even my most needle-phobic friends take no notice of them. However, these brutes were 8mm – shock, horror! But bravely shrugging aside the extra 3mm I started using them.

Lo and behold! 8mm is actually a much better needle for me. I get much less “insulin ooze” post injection – where insulin that should stay in your body leaks out, making your t-shirt smell of disinfectant all evening. Never ideal. Additionally the extra 3mm has made no difference in terms of pain or bruising which is, in turn, ideal.

I think this whole wrong sized needle-thing was caused by the fact that when I was diagnosed five years ago I was as skinny as anything – for obvious non-diagnosed-Type-One-diabetes reasons. Now that I’ve got my insulin management nicely under control I’m back to being fat. In fact I’m now much like the hideously grotesque guy who portrays “Gluttony” in psychopathic chucklefest Se7en. Well, sort of.

So there we have it, when it comes to needles its obvious that biggest is best! Bring on the 50mm horse-needles I say!

Its nearly that time again

World Diabetes DayDoesn’t time fly? In a couple of weeks its World Diabetes Day again.

There’s lots of good work going on around the world and it’s nice to see the major UK diabetes charities joining forces to work together to raise awareness of diabetes on 14th November – Diabetes UK ; JDRF;  Diabetes Research & Wellness Foundation ;  Insulin Dependent Diabetes Trust ;  INPUT; and the UK Children with Diabetes Advocacy Group .

How can you get involved?

  • Join thousands of others pledging to Get Serious about diabetes.
  • Leave a message for Gordon Brown asking the UK Government to increase research funding for type 1 diabetes.
  • Turn something blue. Last year in the UK alone we managed to light up more than 25 buildings with blue light on 14th November. This year we’re aiming for more. If you have a suitable specimen locally that you think would look rather fetching in blue, here’s some guidance on how to encourage it’s owners to support WDD.  
  • Go blue online. On a more local level, why not turn your Facebook, Twitter or Myspace profile blue on 14th November to support WDD. For the technically inept like me, here’s how to do it.
  • Go viral. Finally why not help to create the world’s longest viral highlighting the life long nature of diabetes.

I’ll be spending World Diabetes Day talking to parents of kids who’ve been recently diagnosed with diabetes. What’ll you be doing to mark our day?

Comatose and rotting toes – the lighter side of insulin dependency

Skip to toolbar