Thursday, 24 May 2012

The School Lunch Debate: When Mystery Meat Is Truly A Mystery...


With the rising tide of juvenile type 2 diabetes, the debate on school lunches is one which is slowly starting to take the stage. It is, however, one of those subjects in which everyone has an opinion -- but not many have an actual evidence based opinion. Throw in the wrench that every school district is different, and you'll find mudslinging from all sides of the opinion spectrum:

Why can't parents just make healthful lunches for students? 

Well, right now, some schools are actually BANNING parents from preparing school lunches for their kids, claiming it is the parents making unhealthful meal choices. Of course, this is often true... No one can deny that. But it also makes many of us with diabetic loved ones CRINGE at the thought of what a school cafeteria lady, or health department, might think is a healthful school lunch. These places often lack in options. I'm thinking a main course of carbohydrates slathered in cheese and hot dogs, with a side of carbohydrates slathered in butter or salt, with a dessert full of carbohydrates, and a glass full of carbohydrates (because it has vitamins, so it must be good for your health, unlike that can of soda.) Your main sources of protein come from that powdered, grade A government issued cheese, and that powdered, grade A government issued milk. YAY. To top it off, throw an apple at it, for good measure, because apples make ANYTHING look healthy.

Some will argue, why can't parents just trust the school lunch system? 

'I always got healthful meals from the school system, and I turned out JUST fine.' I love these people the most. To them, anecdotal evidence is ALL the evidence that anyone will ever need, and it somehow, trumps everything. It's like seeing nothing but yellow parakeets, and assuming there are ONLY yellow parakeets in existence because that's all your local store carries. (Never mind that many of these folks have NO IDEA what a healthy meal even looks like, and tend to think that all a kid needs to do to stay healthy is to avoid candy and soda, and eat lots of fruitsandvegetables.)

Well, here's something that will blow your mind.

Did you know that the original idea of a 
'food pyramid' started  as a way to help 
ease food costs by spending money on basic, 
cheaper foods, and still get nutrition? The rest 
of the foods were meant as complements 
to enhance whatever nutrients were missing. 
Ever since the USDA started making low fat, 
high carb recommendations in the 80s, and 
implemented it's OWN food pyramid in 1992, 
obesity rates have skyrocketed.
The USDA describes their National School Lunch Program as: "a federally assisted meal program operating in public and nonprofit private schools and residential child care institutions. It provides nutritionally balanced, low-cost or free lunches to children each school day. The program was established under the National School Lunch Act, signed by President Harry Truman in 1946."

Right away, when you brush away the chaff... what should jump at you is the 'low-cost' descriptor used in this paragraph. What does this, casually thrown in, adjective have to say about this program? What is hidden between the lines? Well, what they don't tell you is that the National School Lunch Program started as a way to help a poor, starving population, through government subsidies --  the same subsidies programs which are still, to this day, overpowering our agricultural industry, and making it possible to produce mass amounts of low quality, less nutritionally dense foods. (McDonald's anyone?) When you invest in low quality, less nutritionally dense foods, they become LOW-COST, and easy to mass market to a multitude of industries, and other countries. Smaller farms CANNOT compete with the HUGE agribusiness industry that has come to dominate the markets, including... you guessed it -- the school lunch program market. While the school 'lunch ladies,' might VEND food for you, it usually comes pre-packaged, pre-made, or 'ready to make' sources, and local state federal agencies will contract their local school lunch program to a food service management company, to save a few bucks. If your local school district does not contract to one of these, they are the EXCEPTION.

The three companies, right now, that dominate the industry are Aramark, Compass Group, and Sodexo. They mass market less nutritional foods, serve nutritionally imbalanced meals, cut corners to save dollars, and contract with fast food giants to market to kids -- yes, including, soda manufacturers. Not only that, but they have been under investigation in the past, for serving foods SO low in quality, they were rejected by fast food industry safety standards. (It's gotta take a lot of balls to serve a kid something WORSE than fake fast food meat.) They have such a strong arm in the system, many of them have been able to lobby, and block legislation that would improve standards, including legislation that would have banned soda vending machines in some schools, for example. 

So when you throw in less nutritionally dense foods (so, even if you have a small serving of them, they're still not so great for you,) in an array of unbalanced meals (all carbs, and hardly anything else), no allowances for or enforcing of portion control (and just eat what you want, and how much you want of it), and the attending results of kids who will a.) not feel the stop and go of their hunger signals anymore, and b.) constantly feel hungry because they got no real nutrition, you will get increased likelihood of illness, development of chronic diseases, and a national fat kid tsunami.

That's right... every time your kid eats at one of these national school lunch programs, it's eating food that's probably worse than McDonald's. (And even if it would appear "balanced," the fact is... it's still food that is nutritionally inferior. Remember that. It's like comparing a home made creme filled cake, to a Twinkie. They are technically, the same thing, but that's where it ends. One of them still has FIBER, and many, many vitamins and minerals. I'll let you guess which one that is.)

Are you freaked out yet? YOU SHOULD BE.

Still, some people have blind faith in their National School Lunch Programs... And disbelieve or disregard those who try to stand up against it, and call for change. (Including some politicians.) But folks are fighting BACK. 


Folks like Sarah Wu, who "compelled by her own frustration with school meals — both as a mother and a teacher ... known anonymously as "Mrs. Q." committed to eating school lunch every school day in 2010 just like her students. Mrs. Q documented her experience and described the meals by blogging, tweeting and sharing photos on her blog Fed Up With Lunch: The School Lunch Project." Her blog is one of the first blogs to help capture national attention on this very concerning issue. Mrs. Q risked her employment on this... and there were many days I worried she'd get caught. Still, I cheered for her. Her voice has been effecting some serious awareness and change... but we need more.

More, nationally, as well as globally... Like little 9 year old, Martha Payne, from Scotland... who writes about her poor lunch school program at NeverSeconds. While you're not going to see her giving you an in-depth analysis on the corruption, and backdraft, of agribusiness subsidies... she will hold up every meal to critique, and scrutiny, so you can see with your own eyes what she and her peers are being served.

. . . 

America is at a critical point, right now... we are at a point where it's starting to matter very little what type of food you eat, because it was all cheaply made, and nutritionally bankrupt. Movies like "King Corn," "Supersize Me," and "Food, Inc.," have created some discussion... but quickly get swept under the rug as 'passing the buck,' and not taking personal responsibility for what we eat. But we are clearly living in a very obesogenic environment where it is getting increasingly difficult to make right and wrong decisions, and increasingly easy to be deceived. Yes, a lot of foods that make false health claims have food labels, and we could be better trained and educated at reading them... but what if we thought we were eating meat, and instead were getting meat with an incredibly high risk of bacteria, and lots of corn filler? What if it was given to us by a school lunch program, with no labels (just trust), and not the 'you should know better,' fast food industry?

Yes, we have freedom of choice, in America... as to what we eat. But to what EXTENT should we let the government and the food industry tamper with our food supplies? Market to us? To children who haven't yet developed some of the necessary critical thinking skills, and disciplines, to make good life choices? (Especially, when they don't even have a parent around, to help...) Or to populations with less income, less education, and less access to nutritious alternatives?

The rights and freedoms of those who want to make me less healthy (and not just by consuming more 'fats' and 'sugars,' mind you), start mattering VERY LITTLE to me... when the lives of children, and the future of our nations are involved.

I don't know how ALL chronic illnesses, cancers, and autoimmune conditions come to pass... but sometimes, I have a very good idea what might be contributing to their explosion... And it's not just having an extra piece of pie.











Sunday, 20 May 2012

Guest Blog Post: A Diabetes Service Dog for Sarah

Here at the Angry Type 2 Diabetic, we see 'ourselves' as a voice to ALL persons with diabetes... So, even though we generally use this space to share about our own type 2 diabetic experiences, we'd like to cheerfully lend the spotlight, this week, to our friend, Michelle. Michelle is a wonderful mom to a type 1 diabetic child, and she has a very important message to share with ALL of you. You may find Michelle's regular blogging space at The Tightrope Tango, and show her some follow love.  
My name is Michelle, and first I want to thank my good friend Lizmari for lending me space on her awesome blog. Lizmari is an awesome advocate for all people living with diabetes, regardless of type. She’s also the reason we enjoyed some pretty awesome Ice Cream Sundae’s last August.

Most people I talk to (and I talk quite a lot these days) have never heard of a diabetes alert dog. We all know about Guide Dogs for the Blind, and most of us have heard of dogs to assist people with other disabilities such as mobility, seizures, hearing, etc. Diabetes alert dogs are specially trained dogs that focus on the scent of their person, and let that person know when their blood sugar begins to drop to an unsafe level. These dogs are most commonly used by people with type 1 diabetes, but some with type 2 diabetes are also using diabetes alert dogs to keep them safe.

Why is this necessary? Well, a lot of diabetics either never have, or lose the ability over time to sense changes in blood sugar. My daughter, Sarah, is 12. She’s had type 1 diabetes for about two and a half years. Since the beginning she’s had trouble recognizing when her blood sugar is low, until it is dangerously low (sometimes in the 40’s and 50’s mg/dL). Normal blood sugar (for a non-diabetic) ranges from around 70mg/dL to 130mg/dL. If blood sugar drops too low, unconsciousness, seizures, and death can occur. Sarah has difficulty feeling drops in her blood sugar during the day, but she does not feel them at night, period. Since she’s been diagnosed, she has never… not once… woken because she felt a low blood sugar. That is scary. The JDRF (Juvenile Diabetes Research Foundation) reports that 1 in 20 people with type 1 diabetes will DIE of a low blood sugar. 1 in 20! That's not a typo. It's not 1 in 20,000, it's 1 in 20. (http://www.jdrftalk.org/2011/11/07/percentage-people-type1-diabetes-die-low-blood-sugar-hypoglycemia/). I can’t let my beautiful child become a statistic, so right now I set alarms for 10:30, 11:30, and 2am. Sometimes more, sometimes less, depending on her food and activity for the previous day.

But I’m not perfect, and I make mistakes.

Once, last December, she went extremely low (27mg/dL). She was unresponsive. It was only around midnight and I only caught the low because I checked on her and found that she was horribly pale and covered in sweat. I saved her life that night, because she was still dropping and the body can't sustain a blood sugar much lower than that for very long. If I hadn't checked on her, she very easily could have slipped into a coma and been gone by morning.

We tried a CGM (continuous glucose monitor) but Sarah has a metal allergy and gets a severe rash. This is where the diabetes alert dog comes in. Diabetes alert dogs are not for everyone. They require a lot of care. They eat a lot, they poop a lot. Honestly, in the beginning I thought that a diabetes alert dog was too much responsibility for a child. But my child proved me wrong by volunteering many hours every month with Guide Dogs for the Blind. She learned to handle, groom, and correct them. She grew to love her new friends, and has taken weekend responsibility for a Guide Dog puppy on a number of occasions. 


I believe that in a few years, maybe 5, maybe 20, that diabetes alert dogs will be much more common and understood. Discounting the fact that an alert dog is a living animal, an alert dog is a medical device, a tool. An alert dog is always on watch with their wonderful nose. An alert dog can think, and will go find help if their charge doesn’t respond to their warnings. Guide Dogs call it intelligent disobedience, a term that describes when a dog makes a decision to take an action outside its normal training that is in the best interest of their person. This could be a dog that leaves Sarah’s side during school to go take the alert to the teacher or other adult. This could be leaving Sarah’s room during the night to come into my room and let me know that Sarah needs help.

The last thing I’d like to say to everyone who reads this is to not discount the needs of someone with diabetes simply because they don’t have an obvious disability. Many kids, like my Sarah, are active, funny, enthusiastic, and because their health, food and activity is watched very closely, they often appear healthier than the average child their age. I’ve had a few eyerolls when I’ve told people that my bouncy child, who just exudes health and vitality, needs a service dog to keep her safe. For someone with type 1 diabetes, safe and healthy require a lot of work, lots of acting on instinct, guesswork, etc. It’s not as easy as it looks, and even with constant effort we have lows and highs that could not have been predicted. Diabetes is always. It never stops. It never goes away or gives us a break. Sarah takes large doses of insulin 4-6 times a day. Any one of those could send her to a fatal low if she or I misjudge the carbohydrates in her food or misjudge how her activity will affect her.

Can you be 100% right ALL the time?

At this time, diabetes alert dogs are not covered by insurance. Those of us who have made this choice for our child must generally pay for the cost of training the dog. My hope is that once the abilities of these dogs are more fully understood and accepted, more groups like Guide Dogs for the Blind can be formed to raise funds and provide these amazing dogs at low or no charge to the family. The first step in making this a reality is education. Tell someone you know about these dogs, and help spread the word. Even if you don’t know someone with diabetes, someone you know does.

Talk. Educate. Your words can help save someone’s life.

If you’d like to learn more about Sarah’s journey to a diabetes alert service dog, please visit either her facebook page at https://www.facebook.com/ADiabetesServiceDogForSarah or her website at www.pawsforsarah.com. Sarah’s dog is coming from Canine Hope for Diabetics in Riverside, CA, hopefully in early 2013. 



Saturday, 19 May 2012

Metformin and PCOS: Taking the Plunge... with Googly Eyes

"It is impossible to live without failing at something, unless you live so cautiously that you might as well not have lived at all." -- J.K. Rowling

I've been on every diet, I think. Every way of eating, or not eating, or thinking... or approaching. I've had the most success with intuitive eating, and with mindful control of carbohydrates, or lowered carbohydrate eating... and I stick to that.

People will say do this, do that, do the other... you're not doing it right, you ought to do x, y, and z... (while they ought to shut their pie holes.)

I've been on the chicken and lettuce diet, the LA diet, the beat juice diet, the LA Juice Fast diet... The 700 calorie a day, 36 grams of carbohydrate starvation diet... Weight Watchers, Doctor's Weight Loss, etc, etc...

You name it.

But with intuitive eating, and lower carb eating, I've lost the most weight and kept the most weight off long term -- AND, been happy.

Time passes by, however... and not in vain. I'm no longer 15.

Polycystic Ovarian Syndrome is taking it's toll on me, and while I've fought hard... with exercise, lowered carbs, birth control, and supplements for 20 YEARS.... I am now ready to admit that I need some help with it, and start a regular course of Metformin on top of my birth control regimen, and my Inositol.

A lot of people might see this as some sort of failure, or disappointment, but it's not. It's just a next step in management -- and in GOOD health. And my blood glucose numbers are fine, actually... But the hair that keeps camping on my face (while leaving my head), the continuous acne, darkening Acanthosis Nigricans around my neck, and the weight I've been putting on are NOT. I have MORE than paid my dues... and I'm quite happy to accept some help so that I don't spend more hours than I need to plucking hair. >:S

I don't feel bad about this decision; I actually feel quite relieved... I feel like maybe my ovaries won't get crushed under this weight, and I might have a chance (not that I want to, right now) to have a brat or two, one day. Who knows.

Or... maybe I might find a man who loves me and gets to see me while I actually still look like a woman -- and not, you know... like Homer Simpson. (Though there might be men out there who like the Homer Simpson look... Again, who knows.)

In any case, I am officially on Met... and no, my goal is not to get off of it, somehow. I will likely never get off of it. Even if my blood sugars are perfect; even if I weigh a 100 lbs. PCOS is a vicious disease... And in these 20 years, I've been so many different weights, it's not even funny. 170, 128, 190, 142, 248, 170... I know it's not going to go away, magically, with the next Dr. Douchebag's Book of Eat Green Raw Crap From the Ground, and Cure All Your Ailments with Monkey Poop.

So... why not do the NEXT best thing? Yes, I know you know...
PUT GOOGLY EYES ON THAT BIG ASS BOTTLE OF METFORMIN.

One should always put googly eyes on things one is hesitant to trust 

Take that, bitch. Ain't no one gonna make me feel like I'm downing horse pills. lol I will laugh at you... every time I see you. xD Bwahahahahahahaha.

What's in your pill and supplement arsenal? I'll show you mine, if you show me yours...






Friday, 18 May 2012

DBlog Week Day 5 : Setting the record straight

Today's DBlog Week topic asks "What is one thing you would tell someone that doesn’t have diabetes about living with diabetes?". Fortunately Karen seems to know how much we love the sound of our own typing: "Have more than one thing you wish people knew? Go ahead and tell us everything.". Well, since you asked...

Journalists
There is more than one type of diabetes. Actually there are *lots* of different sorts, and some of the 'types' are really just umbrella terms for a multitude of different, but fairly closely related conditions. This next bit probably bears saying slowly, because it seems that you have difficulty grasping it: Diabetes. Is. Not. Caused. By. Eating. Sweets. There, that wasn't so hard was it? In general terms you probably only really need to think about type 1 (around 10% of the diabetic population) which is an auto-immune condition where the body destroys it's own insulin-producing beta cells. Nobody knows what causes type 1 diabetes to develop. No-one. On the other hand there is type 2 diabetes, where the proper metabolism of carbohydrate begins to fail. Type 2 Diabetes makes up nearly 90% of the diabetic population and last time I looked *nobody really knows* what triggers its development either. Nobody. There does seem to be a genetic link (so you are more likely to develop it if a close family member already has it). It is also more common in certain ethnic groups. Additionally people who carry more weight seem to be more at risk of developing type 2. Let me say that again - AT RISK. This is not the same as cause. Perhaps 15% of people diagnosed with type 2 are normal weight or under weight at diagnosis. And bear in mind that perhaps 90% of the obese and overweight population do NOT have diabetes. Let's go over what we learned earlier - eating sweets does *not* cause diabetes. If a person is overweight it would be wise for them to consult their doctor to assess their risk of diabetes. The extra weight may be an indication that their metabolism is struggling to efficiently metabolise carbs - but please, please, please stop repeating that diabetes is a 'lifestyle' disease 'caused' by eating sweets.

Scriptwriters
This is getting silly. Please. For the love glittery cupcake-eating unicorns, will you PLEASE just have a two minute conversation with a person with diabetes the next time you have a Brilliant Idea about using insulin-dependent diabetes as a way to spice up your flagging movie/action adventure/medical drama. It really is Not. That. Hard! Time after time you get it wrong at the most basic level. The problem is you get things so messed up so often that 'normal' people will be beginning to think you have it right. You know there's this time-critical thing (a hypo) where the person can be minutes from oblivion. And you know that diabetes has to do with insulin, which is hard to come by on a jet plane struggling to make a landing, while Denzel Washington and Bruce Willis swap oily vests and wisecracks as they wrestle the deranged and inexplicably English-accented baddie into submission. It all looks ideal... How will our rosy-cheeked cherubic child make it through as she plunges into a hypo when the only insulin on board was smashed under the nasty Brit's suspiciously shiny shoe. STOP! Insulin will KILL her. If she is mid-hypo what she need is a little something from the kitchen. Hypo is *low* blood glucose. All she needs is a swig or two of Coke. We are very sorry that this is rather inconvenient in dramatic terms, but there you are. If she misses an insulin shot? Well unless she's on a pump (let's not go there right now) the chances are she has got *hours* - especially if she doesn't stuff her face. She might get a bit grumpy. Not very Hollywood, but I'm afraid it's all you've got.

GPs and NHS beancounters
There are all sorts of people. Tall ones, short ones, loud ones, quiet ones. Some are really clever, others not so much. A mixture of all of these people will be unfortunate enough to develop type 2 diabetes. Now given this bewildering variety, don't you think it is perhaps likely that one identical approach will not work perfectly for everyone. Diabetes, perhaps more than any other chronic condition will be affected by the behaviours of the patient. Some people will be happy to take your advice on what foods they should be eating to keep their blood glucose levels under control. You will give them advice based on your knowledge and understanding. What you believe happens 'on average'. The problem is, we are not talking about 'average'. We are talking about individuals. When a patient comes to you with a desire to test their blood glucose levels using an effective framework, and to use those test results to establish a varied and nutritious diet which does not spike their BGs please consider their future health. 80% of the NHS budget for diabetes care goes on treating preventable complications. Once a patient has spent a few months building up a picture of BG friendly foods, testing can drop back to a much lower maintenance level. There is no 'one size fits all'. Don't mistakenly jump to a conclusion of 'non-compliance'. If you are advocating a diet with lots of 'healthy' carbs for t2 patients, their problem might be *too much* compliance. The only way for a person to discover what foods, and quantities they can eat (and at what time of day) is with a meter. Not everyone will want to put the work in, but don't just automatically deny the means for people to control their diabetes.

80% of costs on preventable complications are absolutely appalling stats. Perhaps the time has come, at last, to rethink the high-carb/no-test approach if these are the results you are getting. I'll put it more simply for the hard of thinking: Give. Type. Two. Diabetics. Test. Strips. And. A. Copy. Of. Jennifers. Advice. Then. Support. Them. In. Keeping. Their. Diet. Balanced. And. BG. Friendly.

Thursday, 17 May 2012

DBlog Week Day 4 : Things we'd like to see

Today's DBlog Week topic is all about fantasy future D gadgetry. If we could have any dream diabetes device, what would it be?

I had a crazy notion to write a post about a futuristic BG meter that was actually accurate to within 5% of a lab reading 100% of the time. Or maybe a CGM that was actually affordable for anyone that wanted one. I even considered writing about a pump that was constructed with such inexplicable ingenuity that it *didn't* have to bleep and warble about a temporary basal rate Every. Single. Hour. Which might be useful for anyone that ever needed to set a TBR to run overnight and values their sleep. But no. Let's at least keep this within the bounds of the possible.

I'm not even going to write about the cure. That's only a mere ten years away after all (well it always has been, ever since I was diagnosed in 1991, so I don't see why we should start changing that now).

What I would like to see (and I suspect some white-coated boffin in a gleaming laboratory is already working on this very thing) is an intelligent insulin. I can remember having conversations with people when I was first diagnosed who would say things like, 'Ooooh, I could never inject myself!'.

Like that was the hard part.

Let's face it after the first three or four hundred - the injections are a doddle. All the other stuff. The adjustment. The guessing games. The carb counting. The unexpected 'helping hand' given by the liver. The moving goalposts. The messy, confusing, illogical variability of it all. That's what I want rid of. Heck, I don't even mind carrying on with a fingerstick BG test every so often just to make sure things are toddling along OK.

So in my dream-world of the future, I just need to inject a whack of IntelligentInsulinTM pending every day (it could be every few days, but I don't want to push it).

Once absorbed the IntelligentInsulin just sloshes around in my bloodstream bound-up and inert. Ready and waiting. I chance upon a sweet and sickly cupcake. As soon as I start eating it, and my BG begins to rise the IntelligentInsulin senses the change in my levels and immediately begins to work (none of this '4 hour profile' nonsense). Once the carbs are dealt with, IntelligentInsulin stops and waits again. Very tiny amounts of it working every so often to counter glucose released from my liver keeping my levels rock steady. If my BG falls below 4.5 (81), IntelligentInsulin stops working entirely and allows my liver a little room to top things up into a safe zone. When I eat a massive fat-laden uber-carb pizza-with-extra-dough-balls-and-garlic-bread IntelligentInsulin effortlessly matches the stop-start absorption of the food. Even when I have an entire cream-filled Pavlova meringue for dessert. Which is a neat trick since I have a horrendous cold at the time. And have not been to the gym for 2 weeks.

All I have to do to manage my diabetes is keep my level of circulating IntelligentInsulin topped up with an occasional injection, and take an occasional BG test to check things are OK. And that is all.

Welcome to the future ladies and gentlemen.

Wednesday, 16 May 2012

DBlog Week Day 3 : A little less of that please

Today's Diabetes Blog Week topic is 'What is the one thing you could do better'. I suspect I'm not the only one to be thinking, 'What... just one?'. Ask us what we do brilliantly and many of us will struggle. Ask us where we need to improve and suddenly a hundred things are jostling for pole position.

For the last two or three years I've been working working working... Trying to improve things. Trying to fix things. Reading and learning and experimenting. I have rarely kept better records. I have never tried so hard in the attempt to keep my BGs in range for as much of the time as I possibly can. But there is an aspect of my diabetes that I have made no progress on whatsoever. None. And it really needs fixing.

I still get too grumpy about out of range results. Every time.

In the old days I would get frustrated with diabetes' randomness. I still like to rage at the randomness every now and then, for old time's sake, but these days I am more likely to blame myself. I suppose this is a genuine downside of putting extra effort into controlling my diabetes. Results that I would not have batted an eye at a few years back now cloud my mind with 'Why's' and What if's'.

I still beat myself up.

All the time.

'Gah! I got the carb count of that meal waaaay off'
or 'I *knew* the fat in that would slow down the carbs'
or 'Stupid, stupid, stupid. I massively overestimated the fat-based carb slowdown and now I'm high'
or 'Low after the gym. Again!'
or 'High after the gym... Shouldn't have had those extra carbs'

These days, with Artoo I have even more ammunition to beat myself up with.

'Not enough of a TBR...'
'Too much of a TBR...'
'Should have/should not have used that square wave/dual wave/duration/split/timing...' (delete as applicable)

Carb counting? Exercise adjustment? Basal profiles? Food choices? Snacking?

In reality it is all of these things and none of these things that need improvement. All the time. I am reminded of a brilliant post by Kim of textingmypancreas entitled 'What we aim for'. We put in all this work. We make all this effort in the hope that nothing will happen. Nothing, as Kim points out, is a pretty lousy reward.

Occasionally I have had brief moments where my meter seemed to have slipped into some parallel universe of BG nirvana and almost refused to give me an out of range result however much I misbehaved. My problem is that once I had glimpsed that I began to want it all the time. Even though I know deep down that is impossible. Diabetes is too fickle, too variable. The goalposts move too often and chasing down the new 'normal' takes time and involves 'out of range' information to base decisions on.

Jane is forever encouraging me to relax a bit and give myself a break. As with so many things in my life I really need to listen to her.

Tuesday, 15 May 2012

DBlog Week Day 2 : One good thing

When I looked down the list of topics for DBlog Week I knew this one was going to give me some trouble... Something about diabetes that I nearly always do well? Talk about a hypodermic in a haystack. Tomorrow's topic of something I need to improve on is noooooo trouble at all. How many would you like? How long have you got? But something diabetes-related that I do well? Hmmmmm...

I nearly wimped out and posted about how brilliantly supportive and understanding my family is (however grumpy I get). Or how amazing the information, hints and tips are that come flooding from all corners of the DOC at the first keystroke of a 'Bah! Having a rubbish day today' tweet. But then it struck me as I fished a fluffy fruit pastille out of my pocket to counter what might (or might not) have been a slight dip in BGs. There is a little thing that I have done ridiculously well ever since I was diagnosed. Every day! It's so much a part of my life that I no longer even think of it, but occasionally when it is mentioned to non-D types I get met with a raised eyebrow and just a hint of "Well that's a bit weird" behind the eyes.

I am amazing at carrying hypo treatments around. I don't think I've gone anywhere in the last 20-odd years without pockets full of goodies 'just in case'. In sweetie-carrying terms I am way more reliable than a Werthers Grandfather (who only managed a measly 15 years). I have treatments. I have backups. Occasionally I have backups of my backups.

Just after I was diagnosed I was advised that I'd have to carry something sweet on me at all times. I found a little tin in a giftshop that had a nice vintage-label design printed on the lid. Initially I carried dextro-energy tabs in it, but they were vile and I discovered that it was just big enough to carry three of four sachets of sugar - the kind you get in cafés and coffee houses so took to carrying them instead. For many years I siezed hypos as an opportunity to have a funsized chocolate bar (even after I knew that chocolate was nothing like fast-acting enough really). I would have chocolate in my coat pocket and the tin in my jeans. The tin became my 'last line of defence'. If ever I was anywhere and the shops were shut or there was just nothing around I would at least have something that might keep me going. I began to develop heirarchy of treatments based on their suitability to the time of year. Skittles and Jelly Babies come in small bags in some funsize assortments and are virtually indestructible in a jeans pocket during the Summer - even in 80% humidity and scorching temperatures on a brief stay in Singapore.

These days my weapon of choice in tackling hypos is certainly Fruit Pastilles. A whjole pack is just a tiny bit too long until you have had the first two or three but I like to think the extra strain that puts on the tube gives it a lovable 'crumpled' quality. And the hypo-addled T2 came across and helped out a few months back didn't seem to mind. (I was able to give her a spare pack that was acting as the backup to my backup).

And the tin still goes with me. Everywhere. There's not a scrap of paint on it now, of course. It has been polished to a gleaming shine by thousands of hours in my pocket, and is just very slightly dented.