My Diabetes Inklings

What’s Next Diabetes?

I probably have ranted on this topic enough for it to be common knowledge that my diagnosis has always been a confusing one. I don’t have the typical characteristics of a type 2 diabetic but neither do I fit neatly into a type 1 category. The decision to progress me onto insulin was a fairly easy one, considering that the oral tablets typically prescribed to those with type 2 did little for me. It was only after opting to go for multiple daily injections with the basal bolus regime that my HbA1c took a drastic dive and has been sitting between the 5-6% range ever since.

What I haven’t realised before discovering the Diabetes Online Community and talking to other diabetics is that my eating flexibility and freedom has been somewhat of an illusion. My previous diabetes healthcare team told me how much insulin to take with each meal and away I go with it. I typically only eat three meals a day and was anxious to eat between meals because I wasn’t given doses to cover the extra food I was eating. It was rare that I would have a carbohydrate (CHO) loaded snack in between meals anyway, but if I did, I struggled to calculate how much insulin I needed to cover it. More often than not it would be too much work for me to do all the calculations from scratch and I’d just give up. Maths was never my strong point.

It didn’t take me very long to find out about Oz DAFNE (Dose Adjustment for Normal Eating). Maybe now I will finally learn how to count my CHOs properly. So rather than eating to my insulin doses, I can adjust my insulin doses to my meals! How amazing would that be?! I was very excited. Until I was told that the course was only offered to people living with type 1 diabetes and of course at the time my diagnosis was a solid type 2. Why are there so many restrictions within the diabetes community for people living with type 2 diabetes? I could go on about the discrimination that goes on between people living type 1 and type 2 diabetes but that’s a rant for another time. Needless to say, I was shattered and felt very disappointed by the system. Instead, my dietitian gave me a formula to help me count CHOs. Have I mentioned that Maths was never my strong point? Well, there goes that alternative.

However, all this changed when I decided to see a private endocrinologist. My endo understood my quest to be lumped in with type 1 family because of all the restrictions I had been facing. For the moment, it is believed that I may have type 1B diabetes – a non-autoimmune form of insulin deficiency that is common among individuals of Asian descent. Because there’s no autoimmunity associated with it, there will never be any antibodies found. Despite that, it was made very clear in all our appointments that my diagnosis could still fluctuate if new research and diagnostic tools came out in the future. At my last appointment, we talked about going on the pump andmy endo commented that it could possibly be overkill considering how my control is excellent. I agreed but persisted with the fact that when I am looking to start a family I would definitely want to be on the pump, no second thoughts. I was also hesitant due to the thought of having something attached to me 24-7. I’ll just have to learn to be more graceful and less clumsy. (Yea right, like that’s going to ever happen).

The best thing about my new endo was that my view was respected, taken aboard and fully agreed with. I had been so used to dealing with rebuttals from healthcare professionals that I was thrown aback when it wasn’t dished out this time. Instead I had my endo’s full support. In fact, I was told that even if my diagnosis changed back to type 2, my endo would do everything to help me get the pump with subsidised consumables. At this point I’m pretty sure I pinched myself, thinking that I’m dreaming.

Following from that, my next step would be to learn to carb count properly. Since I am now able to access these programs, I have just booked into the DAFNE course. In the meantime, I’m also hoping to get my hands on either the InsuLinx or the Aviva Expert, which are blood glucose meters that helps calculate insulin doses to the CHOs you are eating. It’s basically like a pump but for multiple daily injections. Baby steps for me, but at least I feel like I’m progressing towards better diabetes management!

Julia gillard moving forwards

My Diabetes Inklings

Burnout? Watchout!

When you talk to many diabetes healthcare professionals, half of them often think that a diabetes burnout is just another thing like laziness and complacency from our end. Well, I can assure you that it is most certainly not!

With any chronic condition, it’s normal to feel like you’re ‘over it all’. You feel like don’t really care and you want to get away from it all. You start to ‘slip’ from your routine/regime and you feel like you are getting off track from your goals. You know what? I don’t think this just applies to people with a chronic condition. It can be applicable to those going through a mid-life crisis, or when trying to lose weight. It’s everywhere around us, so why is it so hard to accept that it happens for those living with diabetes too?

Lately, I have been feeling absolutely overwhelmed with all the projects I have taken on board. The early starts for the days with boot camp and late nights trying to fit everything into 24 hours, certainly doesn’t help either. I haven’t been keeping track of my sugars (oh the shame!). I do the bare minimum to get by – testing and injecting before I eat and taking my tablets as needed. My weight loss/exercise motivation has dipped tremendously. Particularly with the thought of always having to playing catch up with everyone else in the group. (definitely not a land person…just give me a swimming set and I’ll show these guys!) I’ve lost track of my healthy eating habits and have lapsed into my love affair with corn chips.

Sound familiar?

It’s times like these where I remind myself to take a step back and review. Some of the things I do include:

  • Writing goals down. A nice reminder of the things that are the most important to me.
  • Set realistic goals. Otherwise you will be setting yourself up for failure. No one wants that. We don’t want to feel like failures! 
  • Small steps. Write down one very achievable thing to do the next day that you think will get you back on track. Can be as simple as ‘test BGL before eating’. Be consistent and gradually build it up. You’ll be there in no time!
  • Create a to-do list & prioritise. This way I can make sure nothing gets missed, and the important stuff is out of the way asap.
  • Focus. My mind likes to think about everything at once and I have to always remind myself to just focus on the task at hand until it’s finished.
  • Break it up. Breaking a larger goal into smaller ones and rewarding myself along the way (like checking out the funnies on the interwebz) is a way to keep me motivated. 
  • Brainstorm. Sometimes, I find talking to someone about the thing I’m stuck on is a great way for me to review my next step and it’s always good to have a fresh brain to pick on.
  • Exercise. I aim for a minimum 30min brisk walk and this helps me take a break from the clutter in my mind.
  • Snack. Not on chips, preferably. I have the tendency to neglect my hunger when I’m busy. And when I finally realise my hunger, I’m usually on the verge of a hypo (or having one) and end up eating everything in sight. Recently my snack of choice has been nuts, but I’m going to try having bran as an alternative (to keep it interesting).
  • Rewarding myself! As I’m writing this blog post, I’m sitting at my favourite cafe at uni, sipping on an iced coffee and munching on a ham and cheese croissant. I don’t feel guilty taking time out for myself because I know I have done well this week and I deserve this! (BONUS: I actually remembered to bolus for this).

I find it’s crucial I don’t stop the important routines such as my diabetes regime or exercise. Once I stop, it’s so easy to make excuses not to get back into it. Motivation comes and goes, sometimes we just need to ride it out. Don’t be afraid to revisit your goals and make changes if necessary or try new things! ‘The definition of insanity is doing the same thing over and over again, expecting to get a different outcome.’

Don't forget to smile :)
Also, don’t forget to smile 🙂
My Diabetes Inklings

Overheard and Outraged!

The Setting:

Out having dinner with my boyfriend, I hear the familiar beep of the Optimum Exceed meter going off at the table next to us. I took a sneaky sideways peak to see a fellow diabetic testing his BGLs. The excited diabetic in me squealed in delight to see another one of ‘my kind’ around (as you do), but the calm, logical me played it cool. While waiting for our dinner to arrive, I felt like I needed to test myself too. Safe to say I got fairly distracted while testing myself as I caught myself eavesdropping on my new diabetic friend’s conversation with his mates about diabetes. Ok, I wasn’t really eavesdropping – I just heard one phrase that caught my attention. In the meantime, my boyfriend thought it was the funniest thing in the world as I got increasingly agitated and frustrated. I was pricking finger after finger but wasn’t getting a drop of blood out for my little test strip! After trying all the fingers on my left hand, I ended up bursting in into a triumphant HA! when I finally got a decent blob of blood. (Maybe it’s time to change my lancet? It’s only been a year or so!)

The Offender:

So what did I hear that made me disown him as a diabetic relation? ‘I feel sorry for everyone with type 1 diabetes. But I don’t feel sorry for those people with type 2.’ I’m sure he said why after that, but it didn’t matter – the damage had been done.

The Reaction:

It hurt. Almost heart broken. I fell silent for a while before the arrival of our food served as a good distraction.

The Vent:

Oh, the ignorance! What’s up with the hatin’?! Yes, obesity is heavily associated (mind the pun) with type 2 diabetes. Yes, the general public knows little about the difference between the types of diabetes that are out there. I can’t say I understand all the different types of diabetes out there. But I know the fundamentals – I know enough to know better. I understand how cruel the media is when they play up diabetes. I know how easy it is to play the blame game. ‘It’s your fault you got (type 2) diabetes – because you ate too much junk food and are lazy. You deserve it.’ Ouch! Imagine if someone said this to you and you are faced with this everyday. Not just from the media – but from random passer-bys or health professionals or friends or even family. Put yourself in their shoes for a moment and imagine how you would feel. Guilty? Ashamed? Depressed? Upset? Angry?

My perception of diabetes was severely disrupted the day I was diagnosed with type 2 diabetes. How could this happen to me? I have a healthy and balanced diet. I was a competitive swimmer for years and kept up my exercise after I stopped competing. And I certainly wasn’t overweight or old – I was only 20!

I felt guilt – maybe I did this to myself; it’s my fault I have diabetes.
I felt anger – why me?
I felt scared – what will my future hold; what’s going to happen to me?
I felt self-conscious – I am pretty stocky for an Asian – maybe I am fat.
I felt confused – I thought type 2 diabetes only happened to older people.
I felt judged – common comments from people include ‘but you’re not fat!’ (Thanks for the compliment I suppose)
I felt alone and isolated – who will understand?  

The more I read in a bid to understand diabetes in all its glory, the more I knew there’s much more to type 2 diabetes than the media lets on. For instance, there’s a strong genetic predisposition for type 2 diabetes and I suspected I drew the short end of the stick from the gene pool. Yet, even if a person’s diabetes can be plainly attributed to their poor diet and lack of physical activity, the media and public’s judgmental finger-pointing gives them little to no chance of turning their lives around. They are still people, and they have feelings too.

Inaccurate portrayal of diabetes in the media has led to this vicious cycle of bullying. We see it all too often – movie or tv characters who ‘developed’ diabetes because of excess junk food consumption during childhood, resulting in needing ‘an insulin shot a day to survive’ (puhleeze, you got nothing on my four injections a day!) They make it look all too easy. Type 1 diabetics hate to be grouped in with type ‘hollywood’ diabetes because they couldn’t have prevented their diabetes. It’s an autoimmune disorder! Their bodies attack its own insulin producing cells so they need insulin to survive. And it’s definitely not a walk in the park as shown in the movies. But neither is living with type 2 diabetes. Getting over the public’s judgements and harsh words are hard enough – they don’t need it from people in the diabetes community, where we are all meant to be supporting each other.

The Summary:

When it comes emotional and mental wellbeing, it doesn’t really matter the kind of diabetes you have. There are things we can all relate to – things we can poke fun at and things we all whinge about. But we need to work together as a diabetes community to combat the negative connotations that have been tagged onto living with diabetes. It’s not fair for all of us and it’s not going to change unless we change.

‘Be the change you want to see’