Type 1'stars R Us

Morning!

We crawled, as predicted, to the end of the academic year and dispatched them for the summer last week. I wasn't allowed to write in my annual appraisal I was most proud of sending everyone home with the correct diabetes kit as we were clearing out the drawers where we hide the stuff. Honestly, who makes up these questions on appraisals?! I'm one of these weird people who think if I'm doing my job to my standards, and to the best of my ability, that's fine by me and why have I got to identify what I'm proud of. Apparently, it's motivating for most of my younger colleagues... and my current line manager is most proud of surviving my ultra-honed skills at juggling seemingly incompatible demands of conflicting rotas and remembering why what looks possible on paper is not in practice. And my over-the-top micro-managing of my rare planned absences - especially after the "Remember you agreed to cover my early morning duty" but forgot to say to collect a vital piece of equipment on the way, and if it's a Tuesday a bag of personal care kit. I gather the students concerned sorted the errant line manager out thoroughly.

We melted our way through the heatwave training days. At least all of mine was online mandatory and I could position myself in a cool spot in the room. I was incredibly grateful a colleague offered me a lift home those days as it was way too hot for me to even consider walking home.

And now, I'm slowly decompressing and getting my life back. This coming Sunday will be the last Sunday on the organ bench until late August and today's rainy day activity will be the sort out of what needs to be done before I put that out of office on.

Diabetes? Ah, there are lovely stories to tell here - insulin much reduced since Sunday night and not needed to go back up again yet. Good job, really, in the NovoRapid pen cartridges supply issue recently. I finally got my hands on some yesterday after waiting three weeks!

I've come out of my sulk about it all and regained some energy for the fight again. As well as waving goodbye to DAFNE principles that didn't work for me, going back to what did work, both diet and walking, and feeling significantly better for the next task of tackling the Libre debacle on my last phone consultation with my consultant.

Hi all, hope you all survived the heat - and @Marie 2 those storms! Amazing photos, and I'm always astonished at how stupid some people are when the weather's extreme - why do they feel they must go out and then get into trouble and endanger rescue services?

@becca59 hope the curren battle's been fought and won - sometimes the frustration's immense....

Good to see you posting @karen8967. My own experience was yep, ups and downs, sending lots of hugs. My sister-in-law gave me some good advice when she told me to make sure I did enough of things that were just to please me; they may have included other people, but always things that I enjoyed/wanted to do/were looking after myself. Hope you're managing plenty of those xx

@Japes as I don't use NovoRapid I'd no idea there was a supply problem; are others encountering it too?

I've been rained off being outside for the first time in weeks today; we've had no rain at all. It's so needed and whilst there's enough today to make everything too wet to garden, and it's pretty constant, it's not what I'd call real rain. More like heavy drizzle if there is such a thing.

Have a good weekend all

It's really not so easy to leave this disease at the door without thinking things through and I know better. The other day I stepped out of the car to take pictures and then decided to walk farther to get better pictures and then walk farther and farther. I got some nice photos and then started to feel it and then I heard my alert go off. I look and I'm dropping fast and kicking myself because if I leave my purse I try to put ***** bears in my pocket. But I was only going across the street to take pictures right? So I never thought about it and then I kept walking farther. And that's exercise that I obviously didn't plan for at all and not only do I have to get back to the car, I have to make sure I find my husband first as he has the keys to the car. That spontaneous decision. I got back fine and luckily my husband was found near the car right by the path on the way back and I gobbled a bunch of glucose gel. I love this emoji by the way, it fits so much!!!!!

Marie 2 said:

It's really not so easy to leave this disease at the door without thinking things through and I know better.

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Glad it ended well @Marie 2 !

I made the same mistake swimming a couple years back. Nice weather, lovely little lake, spontaneous swim with a friend so we decided to swim out to a buoy on the lake.
It was only when we were close to the buoy that I remembered I had diabetes and pretty much panicked. If I would get a hypo, swimming back would likely be too far, swimming drops me rather quick. And having a hypo in the water kills you a lot quicker than on land. Very scary thought.
Anyway, we went back quickly and all was well, no hypo, but that sure was one of the very few moments I absolutely hated my diabetes.

Marie 2 said:

It's really not so easy to leave this disease at the door without thinking things through and I know better. The other day I stepped out of the car to take pictures and then decided to walk farther to get better pictures and then walk farther and farther. I got some nice photos and then started to feel it and then I heard my alert go off. I look and I'm dropping fast and kicking myself because if I leave my purse I try to put ***** bears in my pocket. But I was only going across the street to take pictures right? So I never thought about it and then I kept walking farther. And that's exercise that I obviously didn't plan for at all and not only do I have to get back to the car, I have to make sure I find my husband first as he has the keys to the car. That spontaneous decision. I got back fine and luckily my husband was found near the car right by the path on the way back and I gobbled a bunch of glucose gel. I love this emoji by the way, it fits so much!!!!!

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Hi,

I hear ya.. Got caught out a couple of times as a kid? First time at the age of 10? Out on a bike hypo hit me as I was just up the road coming home.
The second time, again as a kid I actually had treatment with me. But it must have jumped out my open pocket whilst cantering about on horse back. My mum wouldn’t let me go anywhere without “emergencies.”. (yep, I can ride a horse.) It’s an odd experience being hypo on horseback. The nag looses focus too?
Anyhow, I was out in the middle of nowhere & I came across a farm house, knocked on the door & this woman answered.
After jibbering like a fool & asking to “borrow sugar.” She bailed me out…

Yes @Marie 2
The things i do not like with diabetes
That i can do things without planning.
For example, we u walking down the street and a friend call me to go with him somewhere

I ve to go home to take me things insulin, meater and make sure i have some coca cola for emergency and the rest things u know.

From worrying after meals about bg
Correct it and fail in doing that ha ha ha.

Having a nice quiet evening before my first houseguest in two years arrives tomorrow. Houseguest will have great fun going to various Commonwealth Games events. I will have fun continuing to avoid it all apart from the first trip to take Houseguest to the venue for the first event as I do want to go and see the bull that was part of the opening ceremony which is conveniently close to that venue!

I did enjoy watching the Marathon on TV, though, as it took in sections of my regular long walking days routes! I was sympathising madly with those struggling on some of the hillier bits - my city can look fairly flat, but there are some nastily hilly bits.

And breathe...

The broken NHS systems really do mean a lot of unnecessary extra work both for me and them. I was expecting Diabetes Review Part 2 phone call from a nurse. I got Medication Review from a random (I think locum) doctor who wasn't keen to renew my medication for more than one more time until part 2 was done.

I did manage to convince said poor GP, who seemed out of his depth, with the phrase "But, none of this lot will be changing, will it ?" to extend it all for another 6 months. I did also keep apologising for being so frustrated, but there was sympathy for my valid points of view!

Diabetes review Part 2 appointment has been already made for 19th August. No-one has had the courtesy to tell me, so that would be yet another missed call and another scolding for not being able to answer my phone when I don't know I'm getting the call.

I think if I shift out of education, I need to go and do some systems sorting.

I will also say this all stems back to the infamous episode of the receptionist insisting to me I didn't need a review when I rang to arrange one, and I so clearly did as I was then unable to order anything next time I tried. Ever since then, I've been on 6 monthly meds reviews rather than annual and seem to waste more and more time sorting things out which should be simple routine

You and me both @Japes. What was relatively straightforward to do a few years ago, is now pure hard work, stressful and time consuming, oh and expensive, as I've given up ringing the surgery, so have to go each time I need anything except a repeat prescription.

It is exasperating. Here we have to see the doctor for a check up once a year to get meds. Twice a year if we get CGM’s and every 3 months if we have an insulin pump.

Okay, I understand the once a year check up. But no matter what we die without our insulin, so why is it a bargaining chip? At least a person if they have too can get the old fashioned insulin without any red tape. But what is the point of seeing you more often with a CGM? I guess I understand a pump more because the powers that make the rules don’t know who adjusts their own or the people that have the doctor do so, but I wish there was some way to exempt us that do well ourselves and have been for years?

It just feels like a lot of red tape sometimes.

And time to get it sorted.

It would make a lot more sense to do that @Marie 2.

Endo hospital appointments here are great, as they always ask when you'd like your next appointment and within a week or two it's sent to you, even if it's 6 months ahead, which mine usually are. Emails or phone calls in between are always answered promptly as well. I count myself very fortunate to have such a fantastic service, and tell them that.

Just wish my experience with other hospital departments was as good all the time, but am thankful when it goes smoothly.

Spent the day waiting for a phone appointment from the gp surgery which had been promised, but it didn't materialise. Ah well, tomorrow is another day!!

My medical reviews seem quite random to me - I think it's whenever there's a GP available to do them as soon after they're due as possible. And for years now they've been by phone; I never see my GP for diabetes stuff, it's alway the brilliant nurse, thankfully.
My surgery has recently asked everyone only to contact them by phone in particular circumstances, otherwise do so online. I phoned today as I've inexplicably, for the first time in 36 years, screwed up and not ordered needles to the point that I have two left. I'm on MDI, minimum 5 injections a day, and I already have hyperlipotrophy; apparently 46% of people who have this reuse needles, which I used to do big time but not any more. I didn't notice I was running out as I thought there was another box behind the one I was using - except there wasn't. Discovered this yesterday evening, so ordered a script online and phoned today to explain it was urgent. Brilliant response, it'll be at the pharmacy tomorrow. Just hope I'm not back tomorrow saying it didn't work out....but the pharmacy is always very good and will help if they can.

Good Morning everyone! Hot for here and more muggy than usual.

So now our first bananas have grown. And really lol, one of those bunches (called a rack) has a lot of bananas that want to ripen pretty much at the same time. So my neighbors now have some and my husband took some with him for the people that do the beach clean up Saturdays mornings and I froze some. I got some oranges from the neighbor on one side earlier this week and today the neighbor on the other side brought me some lettuce. I am trying to sprout a couple of seeds from his orange tree but it's seedless so we have found only a couple of seeds. I do want what they call here a mountain orange, it's very sweet and has a tons of juice. My papayas died, but they grow fast so we have a few already started. One got a fungus and the other the gardeners forgot to cap when they shortened it and it filled with water and died.

Does ANYONE get the recommended NICE results for Type 1 before/after meals as suggested here ?? I only ask as if I'm NOT above 9-10 before bed then I'll drop to below 3 before dawn, sometime my levels rise after; to about 4, but I always get up around 6.30-7am never later, so if I'm about 5-9 around 9-10pm I have to have about 20-30 carbs. The 90 mins after generally ranges from 10-12 , been Type 1 since '72 so got it fairly sorted, but just why NICE publish something that for me is unachievable . Biggest boon to me is the mySugr app in conjunction with the Libre 2, really does help those 2 together

@ShandyT in a word no. And certainly not in this heat. All gone Pete Tong this week. Perhaps if I was a robot. We inject insulin, unfortunately it is not an exact science.

ShandyT said:

if I'm NOT above 9-10 before bed then I'll drop to below 3 before dawn,

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Have you looked into adjusting your basal to keep you more steady throughout the night? In a perfect world, the basal should keep us level when we don't eat. The world is definitely not going to be perfect, but you might be able to get it a little more stable.

ShandyT said:

Does ANYONE get the recommended NICE results for Type 1 before/after meals as suggested here ??

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I regularly do, but only if I keep the carbs down.

@ShandyT If you have to eat every night to boost your BG level, your basal is probably too high. As @Antje77 has said............if you don't eat all day or night your basal should stay sort of even keel, give or take 1-2 mmol throughout the day. Basal is only supposed to take care of what your liver makes without eating. There is also the chance if you are taking insulin in the evening, it was too strong of a dose, so you are dropping after you go to sleep. While most of your insulin works within 3 hours, it can still be working up to 6 hours after you have taken it.

We can all vary day to day of course, between weather, stress, exercise, what we eat. Way too many things can affect our BG levels daily. But having to definitely eat every night is a trend, not a variable.

I don't eat unless I am between 4.4 to 5.9. I am retired so I can vary when I eat and I generally do not go above 9 after eating. But being retired when I am home if I see my numbers go much above 7.2 I am usually getting on my exercise bike for at least a few minutes to stall or reverse the rise until my insulin starts to kick in. I aim to be between 5.3 to 6.5 for bedtime, although on the nights I turn off my alerts I have a tendency to aim for between 5.9 to 6.7 at bedtime. Those variables though, I say that as last night I ate some cupcake to boost my levels somewhere above the 3.9 that I seem to have wanted to stay at. My control is unusual though, considered extremely well controlled.

The NICE guidelines are pretty strict. In the US, the guidelines they want you to stay is in between 3.9 to 10, 70% of the time. But I gather most type 1's in the US don't manage to do so and are more likely to be TIR between 40-50% of the time.

Basal Testing
https://www.mysugr.com/en/blog/basal-rate-testing/

@ShandyT Hello!

What I've noticed is I can be in the NICE suggested guidelines 90 minutes post-prandial, but not at 120 minutes, or 180 minutes... then I start coming down again!!

Definitely all over the place in this heat. Just taken my basal down for daytime.

Just off for a walk before it gets too hot again... it's been lovely welcoming the Commonwealth Games to my city but I'm looking forwards to some things getting back to normal again - my buses have been badly disrupted and there are a number of my walking areas I've not been able to walk through. But that's also due to the massive amount of roadworks going on!

I'm really pleased we're keeping the raging bull from the opening ceremony on display for a while longer. When the heat has subsided and life has settled down again in the areas where the Games have been causing the most chaos I'm planning a trip to see if I can get some better photos than the ones I got when escorting my houseguest to the venues!