Happy (belated) D-day

I’m sorry. I’m a really bad diabetic. I should be punished. I forgot my own diabetes anniversary. I know, I can’t believe it either. Surely this would be the first thing I think about every morning ;-) Happy Anniversary to me

I don’t feel I should miss out on a celebration due to a little amnesia (possible complication? Must google that) so I can officially announce that today is D-day. I have had diabetes for 26 years and 3 weeks today.

To be honest this isn’t something I normally pay much attention to. I certainly don’t have a party every year with presents, low carb food and a healthy game of tennis afterwards to ward off those post meal highs.

However, last year was my silver diabetes anniversary – 25 years – so I felt it deserved a bit of a celebration. I worked quite hard on the husband and the parents to convince them that 25 years of diabetes deserves a diamond, or a nice holiday, but I had my expectations lowered to a nice meal instead.

The strangest thing was watching my parents. Firstly them coming to terms with their daughter wanting to celebrate the anniversary of her nearly dying and being diagnosed with a potentially life-shortening chronic condition. And secondly trying to think of something to buy me to mark the occasion (somehow they didn’t think diamonds or holidays quite fit the bill). So my mum went for a helium balloon (I’ve loved these since I was a kid). Inexplicably the chronic disease section of the balloon shop was pretty bare. No “Congratulations you still have all your limbs” or “25 years and not blind yet” balloons to be seen. (Tim – please note this down as a new business opportunity).

For my very special 26 year and 3 week anniversary I think I’ll settle for a nice steady day with no hypos. And perhaps I should start planning now for my 30th anniversary to ensure suitable merchandise is available.

Fun causes cancer

Concentrated cancer in a tube?
Concentrated cancer in a tube?

The major story that’s doing the diabetes news circuit at the minute is the cheerful report that suggests that everyone’s favourite long-acting insulin lantus can cause cancer. Thrill seekers can check out Google news if you want the very latest.

Being an avid lantus user (40 units a day at 7.30pm fact fans!) I had a look into these claims – after all I don’t have an overwhelming urge to be sent to an early grave by cancer. I’d much rather diabetes complications did that instead.

So I had a look through the various news reports available online. Interestingly enough – and just as an aside – most of the reports referred to two other studies which compared and I quote “similar databases in Scotland and the UK”. Since 1707 Scotland has been part of the UK, so this sentence is complete nonsense. But why do I bring this up? Friends and family do tell me I delight in being an annoying pedant and while this is certainly true this is not the reason. This rather obvious slip-up appeared in virtually all the published reports – demonstrating that lazy hacks had done a cut-and-paste from one article to the next.

While this is hardly unusual, it does demonstrate the complete lack of objective research or indeed any sort of considered thought that has gone into these news stories before publication.

Anyway, that aside, it appears from our somewhat shaky reporting that of four recent studies into long-term lantus use, one has shown a slight increase in risk of certain cancers among users. The other three haven’t. This, however, was enough to get the American Food and Drug Administration (FDA) interested; they concluded that:

The duration of patient follow-up in all four studies was shorter than what is generally considered necessary to evaluate for cancer risk from drug exposure… Further, inconsistencies in findings within and across individual studies raise concerns as to whether an association between the use of insulin glargine [i.e. lantus] and cancer truly exists. Additionally, differences in patient characteristics across the treatment groups may have contributed to a finding of increased cancer risk.

In other words, the tests were too small and too short to show anything of any meaningful significance. Despite the FDA saying this, not one of the newspaper reports considered how the studies were carried out, on whom, by whom, with how many people, whether the final reports were peer reviewed and whether there had been a significant meta-review of the topic. When you stop and think it’s astonishingly easy to pick holes in the entire thing.

So if it was so insignificant, why was this such a big splash? As we all know, the press love cancer scares and love reporting them badly and lazily. A non-specialist reporter with a looming deadline and column inches to fill is never going to give medical reports the time and in-depth consideration they need to be accurate.

So as a result we get ill-considered headlines “X causes cancer” (replace X with something you like or enjoy – red wine, chocolate, cycling, whatever). In fact we could just replace all these headlines with a generic title “Fun causes cancer”. In fact they already have.

I’m a diabetic spotter

Alison in full diabetic spotting mode

I admit it, I am a secret diabetic spotter. I’m not quite at the anorak wearing, binocular carrying stage yet (despite photographic evidence to the contrary), and I haven’t ever kept a log of my sightings, but I am always on the lookout for others who are playing at being a pancreas.

I’ve known about this habit for years, but it really came home to me quite how bad I’ve got it when I realised I was watching Sir Steve Redgrave carrying the Olympic torch, and my main interest was trying to spot where he’d hidden his pump.

It’s not just on TV though, I’m like this in real life too. A glimpse of another pump out there in the wild is enough to make me smile. Spotting someone doing a blood test in the same row as me in the cinema? I feel all warm inside.

Sightings of other diabetics at diabetes events are always enjoyable, but not as satisfying. It’s a bit like a naturalist seeing an animal in a zoo – it’s a fascinating encounter, but not the same as seeing one in the wild.

I’m never quite sure what to do when I spot another diabetic. My instinct is to rush over to them, shouting “me too, me too!” but apparently this is a little frightening for people and could ultimately lead to them calling the police. So mostly I just observe, like a creepy diabetic stalker. I have been spotted numerous times by other diabetic spotters. In points terms, I would be quite a low score for a spotter because I’ve always tested and injected in public and my pump is usually hanging off my waist with tubing flailing around everywhere so I’m hardly an undercover diabetic. Normally I notice them staring at me mid blood test, injection or bolus and when I smile at them, they confess all and we have a nice chat.

Diabetic spotting is of course a great family sport. We’ll be sitting in a restaurant and the husband will whisper “blood test, man in blue shirt, table to the left”. My parents return from holidays with tales of insulin pumps they spotted. Diabetes may be an invisible disease, but the signs are there if you know what to look for.

Do you spot diabetics in the wild? Please tell me I’m not the only diabetic spotter out there.

Comatose and rotting toes – the lighter side of insulin dependency