quotes Archives - Diabetes Counselling Online

Basal Bolus Insulin: Is It For You?

November 30, 2014 by Imagine_David Leave a Comment

"Now I have started insulin I feel like exercising; I have so much more energy"

“Almost all patients with type 2 diabetes will eventually fail to respond adequately to oral hypoglycaemic drugs and will require insulin therapy. A regimen of bedtime intermediate-acting insulin in combination with daytime oral drugs is acceptable to patients, simple to start and results in rapid improvement in glycaemic control. It can be started safely in general practice and is the most practical way of implementing insulin in the face of a worldwide epidemic of type 2 diabetes.” Source HERE

A basal-bolus injection regimen involves taking a number of injections through the day. If you are using a mixed insulin twice a day, did you realise that you are injecting 4 does of insulin?

006 — **“My life is so much more social since I started on a basal bolus regimen”**

A basal-bolus regimen, which includes an injection at each meal, attempts to roughly emulate how a non-diabetic person’s body delivers insulin.

That is, the normal response of the body when carbohydrates are ingested is for the pancreas to produce and release insulin into the blood stream so that the glucose can be shifted into the muscle tissue for use as a source of fuel. See Link for Life: Insulin

A basal-bolus regimen may be applicable to people with type 1 and type 2 diabetes.

"My days are irregular, this might be just what I need" — **“My days are irregular, this might be just what I need”**

What is a basal-bolus insulin regimen?

A basal-bolus routine involves taking a 1) longer acting form of insulin in an attempt to keep blood glucose levels on target through periods of fasting and 2) separate injections of shorter acting insulin to manage meals.

What is basal insulin?

The role of basal insulin, sometimes refrred to as ‘background’ insulin, is aimed at keeping blood glucose levels at steady levels during periods of fasting.

When fasting (time when not eating e.g. overnight or between meals), the liver releases glucose into the blood and into our bloodstream, with a purpose of fueling our body’s cells.

Basal insulin is therefore used to help keep blood glucose levels on target, and to allow the cells to take in the glucose released by the liver for energy. Basal insulin is usually taken once or twice a day depending on the insulin.

Basal insulin acts over a relatively long period of time – usually between 12 and 24 hours.

If you are an Australian resident you can obtain FREE diabetes counselling and education HERE

What is bolus insulin?

A bolus dose is insulin that is usually taken immediately before a meal in an attempt to keep blood glucose levels on target following a meal. Bolus insulin needs to act rapidly as the meal starts to be digested. The actions of these type of insulin is usually a) it starts working to lower the bgl within 15 minutes of being injected – mimicking the role of the pancreas for people without diabetes b) last in duration for between 2-4 hours.

Bolus insulin is most often taken before meals, but it is also possible to take some during or just after a meal if the appetite is hindered by illness or e.g. the inability to predict the meals carb content if eating out.

If you think that this type of insulin regimen is for you, then talk to your diabetes educator or endocrinologist about the pros and cons for you.

Some of the advantages of a basal-bolus regimen

One of the main advantages of a basal-bolus regimen is that it allows you to fairly closely match how your own body would release insulin if it was able to.
It can allow you to give less insulin over the course of the day relative to a mixed dose of insulin.
It may assist with weight management.
If your day is irregular or you work shifts, this regimen may be helpful for you.
If you like to count our carbs and eat different amounts of carbs relative to your situation, appetite and time restraints

Disadvantages of a basal-bolus regimen

One notable disadvantage is that a basal-bolus regimen involves taking more insulin injections each day.
This may prove problematic for some people more than others.

Have you asked yourself how you can improve your diabetes self care plan with your medication?

Talking to your doctor or diabetes educator about this type of insulin use may be just the thing you need.

“…..once insulin therapy is started, a plan needs to be in place for the appropriate adjustment of insulin”

More information ca be found HERE & HERE & HERE

Kind Regards,

David

Diabetes Educator @ Diabetes Counselling Online

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Too much sugar hey? On taxi drivers & molotov cocktails

September 3, 2014 by Helen-Edwards 10 Comments

the beautiful running venue for the weekend

I have gone to the national diabetes scientific conference, held every year, for the past 15 years. This year, I decided to take a break from all things diabetes and went to the ProBlogger 2014 conference instead, seeking inspiration and ideas for both this blog, and my other blog at Recycled Interiors. Ironically, after booking to go to this in May, I was later asked to be keynote speaker at 2 sessions of the diabetes conference, including the new consumer session – maybe next year. Did any of you go along?

I won’t bore those of you not interested in blogging with all the content, as I am sure lots of other people will be doing that sort of round up if you want to find out more in depth about content. Or you can hop on Twitter hashtag #pbevent or instagram, where we apparently blew the record out of the water for most instagram pics from one event, and were trending on twitter! I really think this blog has the power to make a difference to the lives of people with diabetes and no matter what else I do in life, will continue to offer ways for you all to connect with each others stories.

Instead I am talking about my experience of the event with 6 inspirational quotes today and a bit of a summary – some of which you may connect with. These are key messages that relate to life in general, not just blogging.

To begin with, here is something that happened on the way from the airport to the hotel. You might relate. So I am sitting in this taxi and the driver is a quiet talker – have you seen that Senifeld episode? He was talking about the weather as there was a huge wind that day, which we felt on the somewhat precarious descent into the airport, and how the beaches were shut. I mentioned how I was there when I was 12 and how different it was then, and that this was the trip after which I was diagnosed with type 1 diabetes. Are you guessing what comes next?

“Ah, too much sugar hey!”……….

At that point I nearly opened the door and jumped out. I wanted to let him have it. I didn’t. “Oh no it’s nothing to do with that” I said. Screaming inside “you DICKHEAD”. A few minutes later the brakes screamed to a halt as we nearly plowed into another car. Now I really wished I had jumped out. We kept driving. He kept quiet talking, explaining how he had been looking at someone and didn’t see the other car. Whatever. Maybe you had too much sugar, I thought.

Just after the molotov cocktail incident, waiting in traffic

On we went, into the back streets near the beach, him telling me this was the easiest way to the hotel, so close I could almost feel the soft pillow beds at the QT Hotel. And then bam. There was a police cordon. I kid you not – 20 police cars and people everywhere. I later found out some dude had threatened to have a molotov cocktail in his backpack. Welcome to the Gold Coast.

We doubled and tripled back and got stuck in traffic and an hour and 10 minutes after leaving the airport, I was finally at my hotel. You have never met a happier diabetic. Get me some sugar I shouted. Happily, this was the worst part of the weekend. The rest was amazing, awesome and inspiring. Despite my introvert tendencies.

Are you more of an introvert or an extrovert? I used to think I was an extrovert. People would call me that due to my LOUDNESS and my TALKINGNESS (not sure that is a word, well spellcheck didn’t think so but I like it). But then I got older. And I stopped drinking and going out. And through a pile of events and horrid things I was exposed to, I stopped feeling safe and started feeling scared. And anxious. And little by little I became so introverted I almost disappeared….

That was a tough time. But I went through it, and I climbed out, and I was me again. The same but different. I didn’t like drinking, or bars or clubs anymore. I didn’t like being crushed in the mosh pit at a concert. I didn’t really like going out to parties anymore, or noisy footy games. I was definitely here, but I was a more gentle version of myself. I DID still love loud music, at home, on my own terms.

Do you work from home? Lots of bloggers I know do. I spend most days from 9 am until 3 pm totally alone other than radio national. I do have a team who work with me for my diabetes work, and I do have meetings, conferences, workshops, client styling appointments, my studio and lots of reasons to be with people. But many hours are spent in solitude. It is then that I get most of my inspiration. I guess that is a true introvert.

I also need time alone to breathe. I become suffocated when there is too much noise, too much light, too many smells – I experience sensory overload and my creative brain starts to freak out a little. So you can imagine me at ProBlogger this weekend with over 500 excited, loud and fabulous people! Don’t get me wrong, I have been to HUGE events, I was even a speaker at two sessions of the 10,000+ International diabetes conference in Melbourne last December. I can get up in front of a huge crowd and deliver a presentation. And I love to talk. But I prefer intimate, 1-1 conversations and I find it hard to push myself into already established groups or conversations. Maybe that goes back to feeling like an outsider as a kid. Maybe.

My experience of being with 550 people was therefore one of being quite alone. Isn’t it funny how you can be alone, when you are in a room full of people? In fact sometimes you feel more alone than when you are actually alone – do you know what I mean? I wandered around the crowds a bit, trying to catch eyes and feeling a bit like a twit.

I did meet a few wonderful new friends who I am sure I will continue to connect with, such as Trudie from My Vintage Childhood, who I had a deep connection with, and some who I had followed or connected with online for a long time. I pushed myself to the cocktail party (but stayed only an hour!) and it was my chance to meet a bloggy idol of mine, Carly Findlay. That was cool.

I did feel the most alone however, when in the 45 minutes between sessions and the cocktail party, I had to change my pump, had high BGL’s, followed by a crashing low on arrival at the noisy party. The free orange juice was welcomed but there was no #itmakessenseifyouhavediabetes because I had no D-friends there- although there must have been some in a crowd of 550 people.

One of the highlights of the weekend was meeting Reservoir Dad and Edenland on the cab to the airport to fly home. Like the last hour of the disco, I hooked up with them as we staggered out of the hotel into the sunshine, to wing back home, Reservoir Dad sure he would die as his plane crashed and burned. This was one of the funniest 45 minutes of the weekend. These people blog it real and do social good with their words. Do yourself a favour and check out their blogs.

One of the downfalls of being an introvert is sometimes you leave it too late, and sometimes you have regrets. I have nothing to regret from this weekend however. I did it on my terms, retreating to my room when needed. On that I highly recommend staying in the hotel where a conference is being held,especially for those of us who are sugar challenged- I could go change my pump site, have a moment of grab some food when what was offered was not suitable. I had always stayed away at events, but it was a great little security blanket to have a room onsite.

ProBlogger is definitely one of the best things I have ever done. The organisation, communication, content, speakers venue, food and all aspects, were outstanding. There were no sessions where I did not take something away with me. And I did make some new friends. Also I got to run on the beach twice, see the ocean, the sky and the sand. I had a king size bed to myself for 3 nights. I ate what I wanted. It was good.

Here are some takeaway things I have which you might find useful as a blogger and a human being.

And here’s to the introverts and the extroverts and those in between,but not to ignorant taxi drivers. #itmakessenseifyouhavediabetes

Helen

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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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It’s not easy to be me- journeying to the #self: how #melancholy is part of #happiness

March 13, 2014 by helwild 2 Comments

Our inalienable rights are ‘Life, Liberty & the Pursuit of Happiness’- nothing in there about Health, or Wellness, right?

I was counselling someone today, someone who is actually older than I am, despite me having just had a birthday & feeling extremely ‘senior’ as a result. LOL! I had something of a ‘light bulb’ moment. I thought, it’s not depression that I live with, it’s melancholy. And is that such a bad thing? Once you realise your own mortality, which for many people is actually before the age of 10, isn’t melancholy part of the background to our lives? It’s not a word that is used or celebrated nowadays, it could even be called ‘unfashionable’ to acknowledge melancholy. It seems that you have to be always ‘happy’ to be considered ‘normal’: if you’re not obviously happy, then you must be ‘depressed’. I don’t believe that’s true.

Although melancholy gets a bad press sometimes, being equated with deep depression, it has also a more poetic & lighter side. Many poets, composers, artists, writers from various cultures have felt melancholy. ‘Melancholy is sadness that has taken on lightness’ by Italo Calvino ‘There is no such thing as happiness, only lesser shades of melancholy.’ Robert Burton. ‘Sweet bird, that shun the noise of folly, most musical, most melancholy!’ John Milton and ‘There is no coming to consciousness without pain.’ Carl Jung. When you can acknowledge that it’s actually OK to be sad, not permanently deliriously happy, to be in fact somewhat melancholy, you can accept your state of being & find that ‘happiness’ & ‘beauty’ can encompass melancholy. ‘I don’t want to get to the end of my life and find that I just lived the length of it. I want to have lived the width of it as well.’ Dianne Ackerman

Of course that melancholy can be a spiderweb, it can creep into everything, it still takes work to maintain calm in the midst of chaos: to maintain serenity, joy. The tools of mental wellness remain the same. We are all living with diabetes. Now that’s just not fair. It basically sucks. At the same time, many of us are trying so hard to ‘live our lives to the full’, whatever that may mean. Whether it’s helping others, striving for a physical ‘high’ that will reward us, striving to be successful in a career, or in love, earning more money to purchase whatever it seems we want; our time is busy busy busy. Multi tasking is a way of life. We are attached to screens for much of our waking time. We are ‘communicating’ with more people than ever before in the history of the world. We need to take ‘down time’, & to use that time to be present in the real world. This might be as simple as exchanging our gym session for exercise outdoors, appreciating the world as it passes us by. It might be turning off screens for a 2 hour waking period every day: or for an entire day a week, & focussing on the people we are with & the world around us. Or to be alone. It might be remembering we have more than 3 senses: more than our eyes, ears & fingers. It might be reminding ourselves that we are more than our diabetes, or our child’s diabetes, that we still have other interests, & other people in our lives. It might be focussing on Breathing, on silence, on music: on watching your child sleep. It might be preparing and eating a meal with pleasure, not guilt, sharing our pleasure with others, not with self judgement or self criticism. It might be that we need to give ourselves a break, to celebrate how hard we are trying, to let go of guilt or shame. We need to use that wise voice in our head to counsel ourselves as we would another, to be kind to ourselves as to another, to say, ‘It’s OK, nobody’s perfect, you’re doing OK’.

It can be hard being Superman, or Superwoman. Even Superman feels melancholy sometimes.

Helen Wilde

Helen is a Senior Counsellor with Diabetes Counselling Online, Teacher, parent of a person living with Type 1 diabetes since 1979, & living with Type 2 diabetes herself since 2002.

You may find it helpful to talk with one of our team by visiting http://www.diabetescounselling.com.au/welcome/our-team-counsellors-ambassadors/

)

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You Can’t Eat That!

March 11, 2014 by Imagine_David 7 Comments

People around us are generally helpful, caring and concerned.

But what do you say when these people make mistakes about diabetes management?

On a social media post recently Gwen commented: “Frustrated after a conversation with co-worker today who told me I didn’t need a diabetes dog I just need to take better care of myself so I don’t get highs and lows. If she knew a thing about diabetes it would be different. Also says my spouse does not need to know more it’s my responsibility. Had to walk away!!”

How would you manage this conversation?

Might you try saying something like:

How about you come over to dinner sometime, let sit down and eat together. We can then talk about the things I need to consider just to enjoy a meal with a friend.

Hand them a copy of the

“Ten Commandments for Avoiding Negative Scenes with Diabetic Loved Ones” by Richard Rubin

Thou shalt not act like a Police person.
Thou shalt not ignore diabetes.
Thou shalt not lead your loved one in the paths of temptation.
Thou shalt not criticise when your loved one succumbs to temptation.
Thou shalt not talk about your loved one’s diabetes in public unless invited to do so.
Thou shalt offer support and comfort, especially when things aren’t going well with the diabetes.
Thou shalt have the patience of a Saint when your loved one is acutely hypo- or hyperglycaemic.
Thou shalt deal constructively with your own natural fears and resentments.
Thou shalt be especially sensitive in public situations
Thou shalt find out what works and do it.

Marys’ response was: “I would be frustrated too. But this would be a good time to educate your coworker a bit.”

Jane said: “this would get me mad as well because your husband needs to know about your condition. I bet she hasn’t got diabetes. It’s got my goat up just reading about it. My husband got one at his workplace. This foreign guy was drunk, went to work and got caught sleeping on he job. He says he’s got diabetes. We don’t believe him. I’ve got diabetes and people like these people who say they got it make me so mad.”

June said: “I would love to force her to go threw a day with us and let her see how it really fills…let’s see how well her day starts knowing the first thing she does as soon as she opens her eyes and before she even gets to pee is prick herself and check her bgl…. then start her day…..every day..”

A little extreme maybe, but a good point. Most people who don’t have diabetes have no idea of the reality of living each day with diabetes. They are fed media information that is often inaccurate and misleading.

Share Your Story - It May Enhance the understanding of diabetes amongst friends, family, colleagues. — Share Your Story – It May Enhance the understanding of diabetes amongst friends, family, colleagues.

Workplace Education

One strategy that could be helpful in the workplace is have the management organise on International Diabetes Day (or similar) a screening check for all staff. This cold incorporate talks from health professionals, and from people in that workplace who have diabetes.

I’m not sure of the statistics here in Australia, but according to Kaiser Family Foundation data, the American Diabetes Association’s workplace cost calculator estimates that for a company with 1,000 employees:

100 employees have diabetes
27 of them are undiagnosed
250 have prediabetes

I suspect Australian stats are quite similar.

Friends and Family

Is dealing with this problem of misguided comments the same with friends and family?

This may be a little different, easier, to manage as you have an emotional relationship with these people. What strategies have you used in this situation? What has and hasn’t worked?

Fact Sheets

Might you share with anybody who makes ignorant comments about you and your diabetes a ‘fact sheet’ about the realties of living with diabetes?

What might you write in this ‘I Live Every Minute with Diabetes’ fact sheet?

How about people reading this blog make some comments below as to what they would write on this fact sheet. Make something that is a team effort here to be shared by all.

One reply posted said: “Never listen to ignorant people. Every one of us is different and we do what we need to in order to take care of ourselves. But just because someone hasn’t heard of it doesn’t make them ignorant, just makes them uninformed…like me!!!”

This problem of being hounded by people who do not understand diabetes has the potential to cause ‘diabetes burnout’ if heard often enough from friends, family and in the workplace.

You might like to read the book: Put the Brakes On Diabetes Burnout @

http://www.diabetescounselling.com.au/shop/put-the-brakes-on-diabetes-burnout/

“Experiencing burnout is not about being weak or being a ‘bad’ person. It is nothing to be ashamed of. Diabetes burnout can happen to any person with diabetes at any time, in particular after a period of high voltage stress, ill health or difficult diabetes control. Or it can have no obvious triggers apart from being worn down by years of self-management. What is common to all cases of diabetes burnout is that it can lead you into rough seas with no promise of calmer waters on the horizon. This is different to the experience of depression but can sometimes be related to, happen alongside, or even lead to, depression.” – See more at: http://www.diabetescounselling.com.au/shop/put-the-brakes-on-diabetes-burnout/#sthash.5CToUkM3.dpuf

Many Hands Makes Light Work - make a contribution to a workplace fact sheet about diabetes by commenting below. — Many Hands Makes Light Work – make a contribution to a workplace fact sheet about diabetes by commenting below.

Travel Safely my friends.

Kind Regards from

David – Diabetes Educator @ Diabetes Counselling Online

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