meditation Archives - Diabetes Counselling Online

Why So High?

February 24, 2015 by Imagine_David 1 Comment

So often I hear ‘why so high’ from my clients, people living with diabetes.

So often I hear no diabetes specialised health care professionals asking ‘why so high’ when a person living with diabetes is in a bed in pain following an infection requiring a surgical procedure.

So often I hear ‘Its all too hard, Im not going to bother with this diabetes stuff, its all so confusing’ – diabetes burnout! arrrghhhh!

“Diabetes is not a death sentence, but it can feel like a life one. It can really shake up your world. After diagnosis, day-to-day activities that were once simple and straightforward such as eating, exercising, even enjoying a late night out with a few glasses of red, suddenly require greater attention, forward planning and consideration.

After a while it can feel like there is never time out from diabetes management, which like an octopus, sends its tentacles into every area of your life. Sometimes you will feel totally in control of this juggle and marvel at how well you manage. At other times, monitoring your blood glucose levels (BGLs), medication and insulin on top of the hurdles of everyday life, will become a time-sucking intrusion in your day. In particular, when you are overloaded with lots of other responsibilities and tasks, or when diabetes is not ‘playing fair’, your daily ‘must do’ diabetes management list can become an exhausting marathon. In your lowest moments, this can weigh heavily and feel an enormous burden, even a curse.” from our eBook Put the Brakes on Diabetes Burnout

Up and down we go!

So, the next tome you have a question like ‘why so high’ consider some of the things here in this chart:

Causes	Ask These Questions	Take Action
		If your answers to the questions are yes, follow these suggestions.
Food	Have you increased your portion sizes? Have you changed your eating habits or food choices? Have you eaten too many high-fat foods?	You may need to measure food more accurately to check portion control. If you think your eating pattern is changing, your medication or exercise plan may need to change.
Activity	Have you decreased or eliminated your usual activity? Are you doing too little physical activity?	Physical activity is a key to blood glucose control. Ask your healthcare team about starting a program.
Medication	Have you been taking the prescribed doses? Have you been taking the medication at the right time?Do you have “spoiled” insulin? Does your insulin look different? Was your insulin exposed to very hot or cold temperatures? Has your insulin expired?	Take the right dose at the right time. If you have any questions ask a diabetes educator. Throw away the bottle and open a new bottle. Check the expiration date on bottle.
Monitoring	Is the drop of blood too small? Are you using the correct technique? Could your meter be dirty? Have your strips expired? Have your strips been exposed to very hot or cold temperatures or not been kept in an airtight, dry, container? Is your meter calibrated to the current bottle of strips?	See a nurse educator to be sure your technique is correct and your meter is functioning the right way. Learn how to clean the meter.Throw away the strips and get a new bottle. Check the code on the strip bottle.
Illness, infection, injury and surgery	Are you feeling well? Do you have any infections?	Follow sick day rules. Contact your healthcare team for questions or help.

Some of my clients have found it helpful when visiting their health care professionals to share their knowledge about diabetes. You might find it helpful to download and complete this DIABETES KNOWLEDGE QUESTIONNAIRE (old rtf format) and take it with you to your next doctor and/or diabetes educator and/or dietitian appointment.

One of the problems for people living with diabetes of course is not FEELING the high blood glucose level. A blood glucose level of 10-15mmols is likely NOT to cause the symptoms of:

Being excessively thirsty
Need to wee more often than normal
Feeling tired and lethargic
Always feeling hungry
Having cuts that heal slowly
Itching, skin infections
Blurred vision
Gradually putting on weight
Mood swings
Headaches
Feeling dizzy
Leg cramps

However, just because you feel ok doesn’t mean that things are healthy.

Treatment of High BLOOD GLUCOSE LEVEL

For Type 1 diabetes

Plan ahead. Work with your doctor or Diabetes Educator for advice about increasing your dose of short acting insulin in this situation – before you need to.

You may need extra doses on top of your usual dose, and also you may need insulin (e.g. 2-4 units every 2 hours).

Test your blood glucose levels frequently. Measure your ketone level if the blood glucose level is over 15 mmols.

Drink extra water or low calorie fluids to keep up with fluid lost by passing more urine.

Contact your doctor or go to hospital if:

Vomiting stops you from drinking and makes eating difficult
Blood glucose levels remain high
Moderate to large ketones are present in the urine.

In type 1 diabetes, high blood glucose levels can progress to a serious condition called Ketoacidosis.

For Type 2 diabetes

Even for people NOT living with diabetes it is normal for blood glucose levels to go up and down throughout the day.

And an occasional high blood glucose level is not a problem.

However, if your blood glucose level remains high for a few days or if you are sick, enable your sick day plan and seek medical advice if unsure of what to do.

Further sick day plans can be found here:

MedlinePLus (USA)

Australian Diabetes Educators Association

Royal Australian College of General Practitioners

******* If in doubt always consult your health care professional *********

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Guest Blog: There’s never enough hours in a day, days in a week.

February 10, 2015 by Helen-Edwards Leave a Comment

Guest post from Georgia

Working full time and running a Partnered Small Business, things get a bit hectic – trying to squeeze life in in between

I’ve been trying to do the early morning thing – getting to work earlier & leaving a little earlier, and so far it has done wonders, that extra hour gives me so much time to smash out all what I need to do. However I want to try and wake up earlier so I have morning time too, which leaves my weekends free for fun!

What I have noticed is with working and being so tired by the end of the week, I rarely get any time to just chill – by myself. I think it’s important to have some time to think and for me I love being creative, so what I have done is put some time in my diary every now and then to do what I want, whether it’s shopping, writing, exploring and taking photos- just a little time every now and then to re-centre myself.

Life can be so rushed, I am at fault of this too – I always rush through things so I can see results, but recently I’ve learnt to live in the moment (which has caught my attention a lot lately). I recently went to Melbourne to see one of my favourite bands, ‘The 1975’, who were flawless and exceeded all my expectations. Not only was their music and stage presence captivating – the lead singer told the audience (which consisted of mostly under 18s) to put their phones away and live in the moment, instead of longing for the time when they can post their photos and videos and hashtag until their hearts’ content.

Unfortunately, some people disrespected his request and kept snapping away – to which he had to address the audience again and told them to ‘please’ put their phones away.

This made me think of how much we depend on broadcasting our moments rather than enjoying them. To convince people we’re having fun instead of actually letting go and having fun. Don’t get me wrong I am all for social media, it’s one of the fundamentals in my business, but when it comes to my personal life, although I love sharing great moments, the share can wait but the moment can’t so enjoy it and post about it later.

Life goes too fast as it is, but I believe if we walk slower and look up from our phones to take in what is around us, you’ll get to experience the real quality of life.

Adjö,

Georgia

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While we’re busy making other plans..

August 7, 2014 by helwild 2 Comments

A diagnosis of diabetes brings the ‘C’ word into everyday life: Control. We get bombarded with information, instructions, advice. We’re told to ‘test’, given pieces of paper to go to a clinic or hospital for a variety of even more ‘tests’. We’re monitored, measured, & judged. For some people, this becomes more important than anything else. They become hyper vigilant, testing, checking, measuring, exercising, dieting. Almost everyone diagnosed with diabetes begins their journey like this; driven by fear, anxiety, guilt, the notion of ‘control’ becomes all consuming. For some, this is relatively short lived, and things become all too hard. Those who ‘drop the ball’ early give up, bury their head in the sand, ignore advice, feel hopeless, helpless. Their diabetes remains ‘uncontrolled’. For others, the steady mantra of ‘control’ rules their lives. No matter what they achieve, no matter how ‘good’ their diabetic ‘control’ is, they strive to be ‘better’, to be ‘perfect’. To all intents and purposes, and according to most measures, their diabetes is ‘controlled’. Yet they still feel unsuccessful.

How do we find balance?

Ive been thinking a lot about this lately. Those who have a child diagnosed with diabetes come to this with a rather different perspective. For us, the worry, anxiety, need to achieve control are driven by the primal urge to protect our child. It can be harder for us to let go of the notion of ‘control’ than for the child themselves. After all, our main role in life is to care for our child, to make life the easiest, the best, it can be. We will access the best technology and resources available to us, whether thats a new insulin, a new way of measuring, a new test, an app, a new alarm or monitor, a hypo dog. It can be hard to relinquish that ‘control’ to our child. At what age do we ‘allow’ them to make their own decisions about management? For many of us, the decision is taken out of our hands. Our child will refuse to allow us to administer insulin, conduct tests, record results. They may lie to us, and we have the moral dilemma of respecting their autonomy, their right to privacy, and reconciling that with our parental role to manage their health. In some families, difficult topics are discussed. In others, they are not spoken of, they are ignored. Either way, the hard subjects, sex, death, religion, war, family secrets, unfairness, prejudice, injustice, and overnight hypos, all exist. Our children will learn about them. We do have the right to choose whether or not to speak of them.

We tend to judge ourselves very harshly around these changes in our ‘control’. Yet in the end, the vast majority of children with diabetes grow up to manage their diabetes well, to live good, productive lives, to participate fully in other aspects of life, work, socially, and also often with a strong social conscience, a sense of advocacy and participation in supporting others with diabetes. Through struggle & difficulty many are very compassionate human beings, people to be proud of. In managing our own diabetes, although some Health Care professionals may seem, or indeed be, somewhat judgemental, in the end we are all doing the best we can at the time. There may be ‘scope for improvement’, but judging and blaming have no part in our Mental Health, nor in our Physical Health. We need to find our motivation in self love and in our sense of our own worth. We deserve kindness, and the best we can do.

I think one of the key notions that helps to make this journey survivable is to accept that it is just that- a journey. We travel our road in life, and sure, for everyone, some more than others, there are rough patches, difficulties. The destination is known, we don’t know when, but we do know that ‘all things must pass’. Looking around us while were on that journey is what makes the difference. Taking that holiday in Japan, even though we can’t get an Insurance company to fully insure our insulin pump; walking to the shops in the sunshine, or the rain; playing with our child because it’s fun, not because the exercise will be good for his blood glucose control; taking time out from achieving, controlling, managing, to just simply be. This week I went back to my Yoga class. It’s been 5 years since I saw my teacher, Balbir. In that 5 years she has grown old, but she still has the mesmerising power to transport me during relaxation time to a place of calm and serenity; and the ability to lead me through physical practice which stretches and awakens my body to Life. Taking time to focus on the breath, on Balance, Serenity, and the practice of Mindfulness. Most of all, on Resilience. Building resilience in ourselves, and importantly in our children, helps us and them to live life fully: to achieve a level of mental health that will see our journey through life as a balanced one, a life to feel gratitude for, not a life of self doubt. Yesterday I saw an almond tree in full blossom. It was growing alongside a busy highway. Clearly it had stood there for decades before the road came along, before the construction that rose around it. Yet there it was, in full blossom, old, huge, bursting with optimism and life.

Life is what happens to you while you’re busy making other plans- remember to Notice your Life.

Its a Long Way to go, A Hard Row to Hoe

Helen Wilde

Helen has been the parent of someone with Type 1 diabetes since 1979. She has lived with the diagnosis of Type 2 diabetes herself since 2001. She is a Senior Counsellor with Diabetes Counselling Online. If you are struggling with Control or any aspect of your diabetes you may like to contact our team at

http://www.diabetescounselling.com.au/counselling-request/

carpe diem

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Discussion on low carb diets

July 28, 2014 by Sally 8 Comments

Australian Guide to healthy eating poster

By popular demand through a thread in our Facebook group Diabetes and Food – let’s celebrate it!, this topic deserves a blog to help explain some of the ‘stuff we hear’ around carbohydrates and type 2 diabetes. I’d also encourage people with type 1 diabetes to read this though, because some of the points made are also relevant for us! Up front I will remind you that everyone has individual requirements and should see an Accredited Practising Dietitian for a personalised consultation, so this is a ‘general guide’ only.

Firstly we need to understand what ‘low’ means in such a context as in my experience as an Accredited Practising Dietitian, people tend to associate ‘low’ with ‘virtually no’ carbohydrate. We’ll also look at some of the evidence that shows that ‘low’ carb diets can help with glucose control in type 2s, and why when drugs (other than metformin or SGLT2-inhibitors) are introduced it’s important to ensure more (quality) carb intakes as advised by your health professionals. And lastly (but certainly not leastly) we’ll review how, based on the Australian Dietary Guidelines, it’s possible to have a nutritionally balanced diet while watching your carb intake.

What does ‘low’ carbohydrate mean?

If you ask some people what they think ‘low carb’ means, you may hear that it’s about cutting carbohydrates out as much as possible. Straight up as a dietitian my alarm bells ring as carbs feature in all five of the food groups that we need for nutrients to ensure our wellbeing: vegetables (starchy vegetables like potato, sweet potato and corn), fruit, dairy, protein (when the likes of legumes are included, and especially in vegetarian diets) and of course, the important grain/cereal foods.

The American Diabetes Association defines a low-carb diet as 130g of carb per day. Does that surprise you?? The ‘trick’ with low carb diets is therefore to know how to choose your carbs wisely so that you’re still meeting your nutrient requirements, and also to know what to replace that carb energy with (remembering that carbs, proteins and fats make up our daily energy intake) so you don’t get too hungry and be encouraged to ‘cheat’.

Remembering that there’s 15g of carbohydrate in an ‘exchange’ or ‘serve’ that gives us close to 9 carb serves across the day.

If you’re on medication that helps your body to produce more insulin, or you’re providing insulin yourself on a fixed dose then this idea is dangerous to your health so please speak to your health professionals before making any changes to your diet.

Some benefits of lower carbohydrate diets

Of course we know that all carbohydrates break down to glucose which is the fuel needed by our bodies, but in modern diets often too much (and poor quality) of this ‘fuel’ is provided which can cause stress to our organs and worsen our diabetes control. So understanding the benefits of a lower carbohydrate diet can help us to stick with it for longer and balance the rest of our diets more easily.

Some of those benefits may include:

Lower incidence of high blood glucose levels (hyperglycemia)
Lower amounts of medications need to control hyperglycemia
130g/day is a sustainable amount, meaning it’s easier to stick to in the longer term
Putting your pancreas under less stress to produce insulin, thereby helping it to keep working for longer
By ensuring your 130g/day is nutritious and low-GI carb you may also improve your blood fat levels (cholesterol/triglycerides) which will lower your risk of cardiovascular disease
It doesn’t necessarily lead to weight loss – that depends on your total energy intake.

How do you manage it best?

Again I will mention how important having a personalised consultation with your Accredited Practising Dietitian is because everyone is different in many ways. Here I will make suggestions that I hope will help to get your head around combining the idea of low carb into your daily routine while still meeting the nutritional requirements as outlined in the Australian Dietary Guidelines foundation diet (see page 2).

In a nutshell, it’s about only choosing your carb sources from the 5 food groups and balancing that out with quality proteins and healthy fats. I encourage you to re-read the previous blogs I’ve written on those topics as highlighted.

Remembering that 130g/day equates to close to 9 carb exchanges/serves, your day might start to look a bit like this:

Breakfast: ¼ cup of raw rolled oats (1 serve carb) served with 125ml light milk (half a serve), a small banana (85g – 1 carb serve) and a tablespoon of LSA mix (for extra fibre/protein) = 2.5 serves total

Morning Tea: A 100g tub of low-fat yogurt = 1 serve total

Lunch: A sandwich made on wholegrain bread (the grainer the better – 2 serves) made with a protein serve and as much non-starchy veg as you can handle, either on the sandwich or as a side, using half an avocado as the spread (for your good fats), and a piece of fruit such as an apple or pear (both good low-GI fruits – 1 serve) = 3 serves total

Afternoon Tea: A 30g handful of mixed unsalted nuts = not worth counting carb-wise

Dinner: Remembering the balanced plate being one quarter carb, one quarter protein and half non-starchy vegetables, this works with so many meals. Aim for your carb serve to = 2 serves total

Supper: You’ve still got half a carb serve up your sleeve. I would encourage something like half a slice of grainy toast with peanut butter on it to give you the energy to get you through the night, but half a serve of low-fat dairy would also work well, or even a couple of squares of dark chocolate if you fancied it = 0.5 serves total

In this example you can see that we’ve incorporated 9 carb serves/exchanges and yet have included quality carbs at every meal.

Some final tips

Remember to include protein and some non-starchy veg with every meal.
Rice and pasta can be problematic a serve size is so small. Something I recommend that works for many people is to include the carb serves in the form of legumes (lentils, chickpeas, kidney beans, etc) in the pasta sauce and use low-carb alternatives such as those made from konjac root, or make pasta/rice out of vegetables such as grated zucchini or carrot or cauliflower. I sometimes serve my pasta sauces on mashed cannellini beans and frozen spinach (warmed of course!) and find it’s very satisfying.
Don’t forget to exercise! If the point of minimising your carbs is to control your BGLs, then even as little as ten minutes exercise after meals can make a fantastic difference to your readings. Do some self-experimenting about how much your BGLs drop after say 10, 20 or 30 minutes walking after meals, and then if you want to include more quality carbohydrates in some meals, you’ll know how to manage better.

I hope this has proved useful for you, and that you have a better understanding of how a low-carb (130g/day) might help with your diabetes control. Of course please ask any questions below and I’ll be happy to address them for you.

Sally is the Social Media Dietitian with Diabetes Counselling Online, owner of her private practice (Marchini Nutrition), and has had type 1 diabetes for close to 40 years and coeliac disease for many years too. You can access a list of all Sally’s Diabetes Counselling Online blogs here.

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Time is a Bitch & why Christina Perri made me cry

May 21, 2014 by Helen-Edwards Leave a Comment

Time is a bitch isn’t she? So sneaky and underhanded, making you think there is so much of her and then changing tack half way and deciding that there isn’t enough of her to go around. When I was out jogging the other day I had one of those feeling memories, you know the ones? The ones that suddenly hit you and take you back to another time and place, another you. I was jogging through what we call “the track” which runs from just near our house across about 6 blocks until I reach a main road again, so basically, other than crossing the back streets as I come out from each section, I am running on a dirt track full of trees. It was a grey drizzle day, but warm. And suddenly I was 6 years old, sitting in the big concrete tunnels we had piled on top of each other in the school playground in Port Augusta, where I lived from 3 – 9 years of age. I remember it was one of those warm, stormy days we used to get all the time and I must have had canteen money as I was eating twisties or something like that, which was a real treat for me. Our family did not really do junk food, even before I got type 1 diabetes and in those days, there was far less of it in any case. In that moment, for whatever reasons, maybe the grey weather which I have always loved, maybe the treat, my best friends, or something that had just happened or I was anticipating, I was deliriously happy. This feeling memory often pops up for me on these grey, warm, drizzly days and it offers me a peek into the continuity of my timeline, of my life.

As I continued on my run this faded, and I became very mindful, focused and engaged on the act of running, staying with the pace and breathing rhythm (one of the reasons I love to run), or enjoying the beautiful Adelaide foothills surrounds, taking it all in. Time in this part of the run was very much about being in the moment, the very current part of my timeline. Then, I reached the Morialta Park where I stop and carry out an exercise circuit, knocked it out of the park, and went on my way for the final part of the run.

As I climbed the steep hill out of the park back up to the track, a song came on my music player which always grabs my heart – “A thousand Years” by Christina Perri. Now I am not a Twilight fan or follower, I don’t even know where I first heard this song (probably television), but there is something in the piano, the sweet sorrow of the tone, her breathy soft beautiful voice full of angst and desire and want and loss and love, and the words, the words which are not at all about what reaches out to me, yet still do. They all resonate with my heartaches and loves and journey and so many aspects of my life. And suddenly, suddenly I was taken to a place in time which I have both been and am coming to soon – the first year anniversary of the death my dear friend Denice, who passed away at the end of May last year. I know the exact time and day. I wrote a poem. It still hurts and I am anticipating this day.

Suddenly, I was in a timeline of my life with Denice. Our first meeting, our growing friendship, our love. Our children’s bond. Her cancer, her determination, her strength, her love. Foot spas and giggles and girl’s weekends and Christmas concerts. I was sitting with her, holding her, consoling her, being consoled. Learning and teaching and loving and growing.

And then she was gone. She was not in my timeline anymore. She had no timeline of her own. She just wasn’t. Tears began to fall as I ran.

And it hurts. You know that pain if you are human and you have loved.

“I have died every day waiting for you. Darling don’t be afraid I have loved you for a thousand years. I will love you for a thousand more.”

Time hey. She can be a bitch. Grab as much of her as you can and make the most of it

Helen

Helen Edwards – founder Diabetes Counselling Online, type 1 diabetic since 1979, Mum of 3, Interior Stylist & Blogger at Recycled Interiors

– See more at: http://www.diabetescounselling.com.au/diabetes-and-depression/flourishing-happiness-decorating-your-home-with-happy/#sthash.TL2Y9G6T.dpuf

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