Hypos are great

Sweets! Nom nom nom!
Sweets! Nom nom nom!

As we all know, one of the major features of type one diabetes is the occasional (or, indeed, frequent) hypo. No matter how well controlled your diabetes we all get the usual sweaty symptoms of joyful hypoglycaemia.

Fortunately, unless you’ve really screwed up, hypos aren’t really all that bad. With a hypo it’s pretty unlikely you will end up frothing at the mouth, fitting wildly or waking up in an unknown, anonymous motel room clutching an axe covered in your victims’ blood.

I’m not defending hypos, mind. They’re certainly not very nice, when I meet up with other diabetics we don’t all enthuse about the radical or gnarly hypos we’ve recently experienced. I’m just saying that things could be worse. After all, the simple cure for your basic hypo is to shove a load of sweeties down your gapping maw, after which you’ll feel fine again after ten or so minutes. Hellish nightmare come true, it ain’t.

Perhaps because of this someone commented on another diabetes web resource (I know, they do exist – crazy, eh?) that they actually quite liked hypos as it gave them the opportunity to feast on the sweeties so usually denied to them.

I thought this was a bit mad. I don’t know about you, but I tend to have a favourite hypo cure and stick to it – in my case it’s fruit pastilles at the minute. However, as a result of sticking an average of three tonnes of fruit pastilles down my neck each year (I wish I had bought Nestle shares) I now have an almost pathological hatred of the damned things. It’s the same with all favourite hypo cures – I used to drink Lucozade but now can’t stand the stuff. I used to guzzle Hypostops but now can’t even bear to look at even the packaging (not that they were really nice in the first place). Now all these are denied to me.

So, in my view, hypos don’t give you a green card to gluttony, they only ruin your appetite for your favourite sweeties. Another in the long list of tragic diabetes casualties.

The Pancreas Promotion Society

There must be a reason why I got diabetes. My money is on something technical involving a lucky combination of genes, viruses, a grumpy immune system and a certain lack of luck. But, there is another alternative. Perhaps I was selected because of my amazing ability to transform into a pancreas?

I have a theory. I think that in my case, circa 1983, pancreases around the world united and decided to try and increase the size of their empire. Not content with having a single presence in every being in the world, they wanted to boost their powerbase with more recruits. I have a vision of the inaugural meeting of the Pancreas Promotion Society (PPS) taking place in a darkened room complete with full fat coke and chocolate biscuits. The agenda was simple – pancreases felt overworked and undervalued. They wanted more resources to help them do their jobs, and more time off. Therefore, they were going to launch a recruitment drive.

By recruiting people to play at being their own pancreases, real pancreases could enjoy more leisure time and a better quality of life. The Kidney Protection League were vociferous in their complaints at the potential damage this would cause to their members, but sadly never got their act together to mount a decent defence. And the Eye Evaluation Executive were tragically blind to the whole thing.

The first step in attempting to outsource the pancreatic workload to the body owner was to identify the qualities they were looking for in a trainee pancreas. These included:

Mathematical genius – or at least a vague familiarity with numbers is desirable. Carb counting, insulin dose calculating and blood glucose results analysis is a critical skill.
Excellent eyesight and dexterity for deciphering nutritional labels written in size 5 font on the bottom of an open yoghurt pot without getting wet.
A certain lack of standards. The ideal trainee pancreas needs to quickly lower their standards. Blood spotted sheets should be accepted as normal. Ingesting decade old fruit pastilles coated in several layers of pocket fluff should not be considered strange or repulsive.
A positive outlook on life, without which playing at being a pancreas gets quite dull quite quickly.

When I think back to my four year old self I don’t recognise many of those skills. I was showing promise with my times tables, had mastered an impressive number of Janet & John books and could swim without drowning. I like to think the PPS must have spotted some glimmer of potential in me and that’s why I was chosen by them to become one of their number.

Or perhaps it was nothing to do with my talents at all. Perhaps, like any respectable organisation, the Pancreas Promotion Society is an equal opportunities employer. So ultimately, they’ll recruit you whether you meet the criteria or not. Sadly they don’t seem to have a particularly effective performance management system – I’ve messed up so many times in this job and they still won’t sack me. It seems I have what is a very rare thing nowadays – a job for life.

That’s how I think I ended up with diabetes, what about you?

Review: Glooko logbook and meter sync cable

The year is 2012. This is the year that I use my iPhone to monitor my sleep, bike rides and even where the nearest earthquake is. Yet, I have never really got to grips with using it to monitor my diabetes. This is most likely due to the fact that seeing all my blood glucose results (highs, lows and all) on one neat little graph incites a deep seated terror in me! However, I shunned my fears and valiantly tested the kit…

How it works
The Glooko logbook allows you to download all your results from your blood glucose meter into a free app on your iPhone. This is done via a rather pricey cable (£32.50) which connects the two devices. If you have an Accu-Chek meter, you are extra lucky as you have to pay out another £12.25 for the infra-red adaptor. Then you just connect the two devices and sync.

Diabetic maths

Inside the app, you can view your results much like you would do in a paper chart but you can also record details such as the amount and type of insulin you administered, what you ate, exercise, feelings, favourite ABBA song etc. You can also directly email these to your doctor or yourself. In theory, it is simple enough for a diabetic chimp to do. However, I had to try quite a few times to get the devices to recognise one another.

I also made rather a fundamental error in assuming that all Accu-Chek Aviva testing kits are equal. Glooko would not recognise my Aviva combo, nor does it recognise certain meters that are not black in colour. Odd but true! So if you’re already sold by my review, please check carefully that your meter is compatible.

What it’s like to use
So, once I had dug out a black coloured Aviva Nano, I was in business! I uploaded my horrific results and examined them in the log book. If anything, chimps have been taken into account too much throughout the design process; I found the log-book overly simple and lacking functionality. You can look at your blood sugars, click on them to see what you ate/bloused at that time but that’s about it. It would be great to have a few simple graphs or colour code blood glucose results to aid in visualisations of patterns.

What blood sugars look like within the app. Astute readers will notice these blood sugars are really terrible by British standards!

The best feature…
The star feature of the app is the carb counting functionality. If you want to know the amount of carbs in your mid-morning scotch egg, just search their database and specify how much you ate. You can also search by restaurant although this has been developed for an American audience so common British restaurants e.g., Pizza Express, Wagamama etc. aren’t listed. Unfortunately for Glooko (but lucky for you!) this is free to use.

Room for improvement…
As a pump user, I am continually astounded that no one has developed an app that allows you to enter your basal insulin rate. It seems such a simple thing to add in but is still missing from this app!

I believe some of the oddities like not being able to graph your results or manually enter readings are related to some strict (and fairly mental) regulations by the American FDA who act on the basic assumption that diabetics are deviants who given the chance, will manipulate their blood glucose data to take over the world. The good thing is that the Glooko folks sound pretty passionate and dedicated to continually developing the app for the European market so in time things will probably improve.

My diagnosis…
Although I generally adhere to the principle of “Keep It Simple, Stupid!”, at present the app is actually basic rather than simple. As owner of an AccuChek Combo pump that allows me to record my carbs, download data to a pc and Bluetooth to my pump (yet ironically cannot Bluetooth to Glooko), there just aren’t enough benefits of using this app to motivate me to get my iPhone out every time I test to enter the insulin and carbs. I would gladly pay a few pounds for the app if I could directly Bluetooth my results to my phone. However, paying out £45 for what is essentially an electronic table (plus good carb counting app) seems a bit steep. However, Glooko will probably amend these issues way faster than every kit being equipped with Bluetooth.

If anyone else would like to road test the system, please send me a private message via ShootUp, or leave a comment below.

The Diabetes Disaster

William Topaz McGonagall, some years ago
William Topaz McGonagall, some years ago

If ever you have a spare minute I would highly recommend writing a poem about your diagnosis of diabetes in the style of William Topaz McGonagall. While some think he’s Scotland’s worst ever published poet, McGonagall’s work is still in print 109 years after his death. Take that proper poets! Anyway, if you fancy more McGonagall then a good starting point is the world famous Tay Bridge Disaster and a personal favourite is Edinburgh.

Anyway, as you know your soaraway Shoot Up is a very cultured place to may I present my own personal tribute to the great man, my poem The Diabetes Disaster:

‘Twas the dreadful year of two thousand and five
When once bonnie Timothy found his health did dive
He lost plenty of weight and his face was aglow
And he was drinking so much water that he was filled with woe

“This really can’t be right!” poor wretched Timothy cried
“Some medical advice must surely be applied”
So off he went with a dark and worried brow
To the doctor as fast as his legs would allow

The doctor’s surgery was lovely to see
With green potted plants and delightful shrubbery
But poor Tim waited and was seen by the doc
And out he walked with something like shell shock
For poor Timothy had with diabetes been diagnosed
And white went his face, just like a ghost.

So up to the Royal Infirmary poor Timothy did stride
But he was feeling so disheartened he nearly cried
Yet “do not worry” said the nice DSN
“We’ll fix you up satisfactorily with some insulin”

So without pause for thoughts or circumspections
Timothy did the next day start on injections
“Hurrah!” he cried, for better he did feel
And before long his dry skin did start to heal
His appetite returned and he ate plenty of veal
Which, despite the cruelty, he did with some zeal.

Years have passed since Tim’s diagnosis
And he now treats his diabetes without much neurosis
He tries his very best to maintain a wholesome A1C
To ensure that in future he won’t be an amputee
And his bonnie DSN with this does not disagree.

Yet despite his good management of this disease
Timothy prefers to stay away from foods such as cheese
He prefers foods with a low glycaemic load
This to avoid his blood glucose being caused to implode

So the dreadful year of two thousand and five
Shall be remembered for as long as Tim is alive
But hopefully bonnie young Tim will continue to thrive
Remember that God helps those that help themselves
And those that don’t try to do so are silly elves.

(Note: the last two lines are lifted directly from The Collision in the English Channel – sorry William)

Comatose and rotting toes – the lighter side of insulin dependency

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