I D D M

Good day to you. My name is Jason I have been an Insulin Dependent Diabetic for the past 40+ years. This by itself gives me enough first hand experience to pass on information to all who are either interested in this subject or need to know because of contracting this illness yourself or of a loved one. I am not a Dr. Never have been and in all honesty doubt I ever shall be really. This hub will detail what I go through on a day to day basis including blood tests, hypo's (low blood sugar) and hyper's (high blood sugars). Food count and the correct dosage to bring back sugars to within range. As a UK based diabetic our range is used mmol/l in the USA I believe they use mg/dl. Here is a link to an online converter Click here Sorry but for the rest of the world I just dont know. To be fair as well I only know about the USA because I visited there.

Day and night and night and day... This aspect of diabetes management is by far in my opinion the most important to do. All of the long term complications that come with diabetes is to do with blood sugar. Imagine that your clean arteries become filled with a sticky substance which grows bigger as more and more of your bodies essential fluids get trapped in the stickiness. This stickiness (glucose) is the result of having too high blood sugars over a period of years. The most prone areas of the body that this happens to are your feet and eyes. Both of which are essential for normal day to day living.

The normal range is between 3.5 and 7.0. Ideally your sugar level should be at the lower end before eating and of course at the higher end after meal times.

Upon bedtime it is advised to have blood sugar in the higher range 8.00 - 9.00mmol/l. This is to allow for the 24 hour insulin to start work without a hypo occurring. Night time hypos are quite common and are best to avoid. The most effective way to deal with a night time hypo is to awaken and treat the hypo as normal. (Hypo advice later in this hub) One other way that night time hypos are dealt with is the body's own self recovery. This happens when you fail to awaken from the hypo and your body releases it's own stored glucose. This explains why you may awaken with high blood sugars. Best advice if you see this happening is to set the alarm clock for the middle of the night and give yourself a blood test. Not the best nights sleep but a couple of nights interrupted sleep is better than long term complications.

Injection's of course go hand in hand with Type One Diabetes. It is important to rotate the sites as much as possible. I myself use my thighs and stomach area. Below I have listed common sites to use:-

• Thighs
• Stomach
• Arms
• Buttocks

If you do not rotate the injection sites as often as possible you will find yourself producing lumpy areas of skin which are called Hyperlipotrophy (Insulin Lumps). These are not just unpleasant on the eye but also can turn into quite a serious medical complaint. In extreme cases an abscess can form and an operation needed to remove not only the insulin that has built up but also the poison that has developed. Not so serious but still enough to cause unwanted side effects is the fact that these lumps stop the insulin being released as normal. This can result in one testing ones blood sugar and seeing a high result. This is because the insulin lump has built up to such a degree that your insulin is being stored in the lump rather than being released into the body. Solution stop using that particular area until the lump has diminished.

As you will note from the video above every time you do an injection a new needle should be used. This is ensure the needle is sterile and there is no accumulation inside the needle inclusive of air. Also note that when you have depressed the plunger it is good practice to keep the needle inside to ensure that the insulin is delivered and does not "spurt" back out when needle is withdrawn.

This is a symptom of diabetes and one of which can have quite disabling consequences if not dealt with effectively. It is a common misconception that this is a result of having diabetes but in reality hypo's occur with diabetics not because of the diabetes itself but because of an overdose of insulin. There are many signs of a hypo beginning to occur and I have listed the more common ones below:-

• Intense Hunger: This is due to the body beginning to register the need for energy as the insulin overdose begins to take effect. To a non-diabetic to help you understand this it is similar to needing to eat after drinking alcohol. Alcohol lowers blood sugar.
• Difficulty in simple tasks inclusive of walking talking etc. As the body lowers blood sugar one of the first organs to be relieved of sugar is the brain which of course needs to operate at full capacity. It has been noted that when blood sugar falls below 2mmol/l it has the same effect on the brain as concussion.
• Perspiration. Increased pulse rate, pressure and sweating as the body overcompensates for the lack of energy.
• Tiredness. As sure as the brain is starved of glucose so it goes hand in hand with oxygen levels as well. The person will feel tired very quickly and from my own experience will often fall asleep once the hypo is dealt with.
• Mood Changes. The lack of glucose and oxygen to the brain does effect our personalities and we can swing from being happy one moment to being aggressive within seconds. Also strangely enough it has been noted that we will refuse to eat. If this happens stay with the patient and ensure glucose is administered. If this does not work call the medical emergencies.
• SEVERE HYPO Convulsions and Amnesia. If this occurs it is essential to call the medical emergencies as soon as possible. Upon arrival they will administer to the patient glucose. This is normally done through a glucose injection straight into the blood stream. Please note that the prelude to this is often viewed by others as ourselves being intoxicated.

The above picture is of "Dextrogel" a gel form of glucose. Not nice to taste but remarkably effective at dealing with hypoglycaemia. Other forms or dealing effectively with hypo's are:- dextro tablets 2-4, lucozade (original) 180ml, jelly babies 2-4. Once this has been administered it is then best to eat some long acting carbohydrates if your next meal is longer than an hour away. I have provided here a quick list detailing what to eat:-

• Within 1 hour of meal: Quick acting carbohydrate only.
• 1-2 Hours of meal: Quick acting carbohydrate plus digestive biscuit or apple or equivalent carbohydrate value.
• 2 Hours +: Quick acting carbohydrate and times two of the above. So 2 biscuits or equivalent.

This is the true disabling effect of Diabetes. I of course can only speak for myself but for me when I develop this it is far more disabling for me than suffering a hypo. To help you understand what happens when we suffer this in case you are not a diabetic. Imagine that your blood is of the same substance as coca-cola that has been left in the sun so it is thick and sticky and that your stomach is being pinched in a vice like grip. That is how it feels. I have listed the common symptoms of this reaction to diabetes below:-

• Thirst: This is a thirst that consumes all that one may drink akin I think to having ones mouth stuffed with cotton wool. This is due to the body having high glucose levels thus reducing body levels.
• Urination: Frequent visits to the toilet as the body identifies the extra glucose it attempts to clean the body of it. This is done by emptying the kidney of extra glucose through urination. Plus all the excess fluid that is being input due to the thirst. As a child I suffered from so much extra sugar that the toilet rim was found to have a coating of a substance that was akin to icing sugar the next day.
• Blurred Vision: This goes hand in hand once again with the body identifying the extra glucose and attempts to expel it through the eyes.
• Tiredness: As with all times when the body is not well it needs rest.

In order to treat this symptom a remedial correction injection is needed. I cannot here advise you specifically as to what the amount of short acting insulin is needed to remedy the situation. The best piece of generic advice I have been told in my life is based upon this example:-

• Ideal blood sugar I am aiming for is 6 mmol/l. At the moment my blood sugar is 20 mmol/l. I therefore take 6 off 20 giving myself 14. I then half 14 to provide 7. The amount of insulin I inject therefore is 7 units of quick acting insulin.

Of course if you take this action it is essential to check bloods every half hour to prevent hypo occurring.

It is impossible to list all the food carbohydrates here so I have elected to make a list of snacks which contain little to no sugar what so ever, so can be enjoyed without the fear of hyperglycaemia occurring. CP=Carbohydrate Portion.

Enjoy:-

Fruit:-

• 1 Kiwi Fruit 1/2 CP
• 1 Slice Mango (40g)1/2 CP
• 1 Slice Pineapple1/2 CP
• 5 Strawberries1/2 CP
• 1 Apple1 CP
• 3 Raw Apricots 1 CP
• 1 Large Melon Slice (200g)1 CP
• 1 Nectarine/Peach1 CP
• 1 Pear1 CP
• 2 Plums1 CP
• Small Glass Fruit Juice (100 ml)1 CP

Dairy

• Yoghurt1 CP (Check Label)
• Milk (200 ml)1 CP
• Cheese & Biscuits (x2)1 CP
• 5 Cheddar Biscuits1 CP

Savoury Snacks

• 2 Handfuls of plain popcorn 1 CP
• Crisps Pringles etc1 CP
• 1 Large Rice Cake1 CP
• 1 Oatcake1 CP
• 1 TUC Biscuit1 CP

Biscuits

• Hobnob1 CP
• Custard Cream1 CP
• Digestive1 CP
• Rich Tea (x2)1 CP
• Fig Roll1 CP
• Jaffa Cake1 CP
• Finger of Kit Kat1 CP
• Malted Milk (x2)1 CP

Chocolate/Sweets

• 2 Marshmallows1 CP
• 3 Chocolate Fingers1 CP
• Handful Malteasers1 CP