Winning at insulin

Tell your friends

A while ago one of the wonderful people at the Juvenile Diabetes Research Foundation happened to show me a leaflet that they were developing aimed at teenagers with Type 1. I leafed through a few brightly coloured pages addressing the usual issues that it is generally assumed are at the forefront of all teenagers minds - drugs, alcohol, sport and sex - in an upbeat tone that admirably didn’t seem to be trying to sound hip, let alone sick, gnarly or fit as. Good for the kids.

But then I turned to a page that offered something I was not expecting, something genuinely innovative and truly useful. What if your friend gets diagnosed with Type 1 diabetes? Speech bubbles across the page contained quotes from young diabetics with little wisdoms they really wished their friends knew - from the practical to the hilarious. One little sentence has stayed with me ever since and always makes me smile. 

Don’t always blame it on a hypo - sometimes I just get angry.

I can’t begin to explain how true this is. 

Hang on, yes I can. At least in a way that all female readers will understand. Here we have the diabetic’s equivalent of the distilled rage that bubbles up any woman who thinks and speaks, when a man finds himself on the losing side of an argument and all he has to explain the fury he has provoked is raised eyebrows and an earnest nod of the head followed by that quiet death knell for equal and happy coexistence of the sexes. Time of the month. 

Why is it that an emotion can be voided because it is anatomically explicable? Is it the time of the month? Is it time for a Fruit Pastille? Or is it some other chemical reaction in the body that happens when someone says something so sickening/arrogant/ignorant and your mouth spews bellowing noises and steam comes out of your ears?

I don’t think it should matter. We all know a lot more about why our bodies do things than we ever have done. Let’s check ourselves though. Let’s try not to become so lazy as to use this sense of understanding to write off another human being’s feelings.

Thanks, Sir Pancreas

Adrenalin. I’ve always been told that stress is something that can affect my sugar levels because when we’re stressed our bodies send out adrenalin, allowing us to flee, caveman-style, from an approaching sabre-tooth tiger/angry wolf/neighbour’s big dog. I remember my nurse telling me that I should beware of this around exam season. I thought this a little strange given that, although I do get quite tightly-wound when I’m preparing for exams, it’s never reached the stage where I feel the need to leap out of my bedroom window and run for the hills.

So this adrenalin effect has never been something I’ve thought about that much. That changed recently, when I was in a situation for the first time where I had to call for the police. Without going into the details, I was worried that people might be in danger and there was nothing I could do about it on my own. It was only after all the policemen had left and I was back in my room trying to remember what I was meant to be doing with my day that I realised that I was sweating. I checked my blood sugars. 13.7. A-ha, I thought. This must people that adrenalin thing people talk about.

I don’t know what it says about my lifestyle that I’ve never felt this effect in all the four and a half years that I’ve had diabetes. Perhaps I’m just preternaturally cool-headed. But when I realised what had happened it made me strangely satisfied. I was satisfied to have been able to observe the most intricate workings of my body in action, real-life, with no laboratory conditions or dramatic reconstructions. For just a moment I was watching my cells do their thing and it felt I was like snooping on a dress rehearsal at the Royal Ballet, or looking through glass at a colony of ants.

Carbs & Cals - what a little gem!

Natalie King used to be one of the lovely people who works at JDRF. She’s gone on to different things now but she was the fantastic person who introduced me to the equally fantastic ‘Carbs & Cals’. This book is the king of carbs counting resources. Every type of food is meticulously photographed on a plate in up to six different portion sizes, for those times when an entire dinner-plateful of mash is the only thing that will do. 

I don’t know why it has taken so long for someone to realise that nobody’s brain thinks of mash by the ounce or the half cup and what we really need is to see it on a plate, maybe with some sausages on top, (strictly to help get a sense of scale).

I’ll warn you now, it’s a dangerously compelling book. It’seven more possible now that I’ll never get round to that New Year reading list languishing somewhere on my bedside table. What better way to drop off than with a head filled with pints of cider, bowls of pasta and a few spring rolls?

Oh, and did I mention there’s an iPhone app to match?

Not lost in Brixton

I have lived in London since October. Back home, if I arranged to meet someone at a place I’d never been before this would always involve approximately five minutes of discursive dialogue between me and that someone until we were both satisfied that I knew exactly where I was going.

It’s not like that in London. I would have given up counting the number of times I have set out of my front door with nothing more than a scrap of paper with a postcode or a street name to guide me to my destination, if I had ever started. Despite having an iPhone equipped with Google Maps and the divine London Bus app, I still depend hugely on my mini A-Z that is always in my handbag. Some people laugh, others eye my pocket atlas enviously as they wrestle with a flapping internet printout. What is certain is that nobody finds their way around this city exactly the same way I do, but we all get where we’re going.

This is pretty much the spirit in which I write this blog. Hopefully we’ll all get where we’re going (with happy eyes and perfect HBA1Cs) and when we do we can have a nice chat about the missed turnings and delayed trains, but more importantly, about our sneaky short-cuts and the fact that we all made it.

Food… carbs, sugar, insulin and party time

I’m going to talk more about carb counting, but some other time. Right now what I want to talk about is FUN. 

In all the advice and information I’ve received about living with diabetes (from here on in: winning) nothing ever fully addressed the fact that pretty much the most important question in my life is, when is the next time I’m going to do something fun, huh?

While it’s relatively easy to win a 9-5, ham sandwich for lunch and a biscuit at 3pm kind of schedule, what I really want to know is, what about when what you have is less of a schedule, more of a cloud of possibilities, including but not limited to dancing like a hatter, picnics by the sea, playing Roxanne and driving off into the sunset.

I’m not going to try and cover all this in one go. So let’s start with something quite sedate, but really really really difficult to get right (in my experience). It seems like the most innocent and lovely thing in the world. A friend calls you up and says, ‘You know what, chum, you’re great. I want to spend my Orange Wednesday with you, pizza and then an Oscar front-runner.’

I find pizza so difficult. Do you? Here’s a factoid that might help to begin with:

A sort of normal slice of thin-crust pizza is about 15g carbs. 

And here’s the added complication:

Pizza is very, very fatty. I’m not trying to make you feel guilty. But if you will go to Pizza Express then you are making life a bit more challenging. Because of the fat in the cheese on pizza the carbohydrate is processed super-slowly by the body.

Just shout if you know this all already. 

So if you inject yourself with the however much insulin you need the insulin will overtake the carbs and you might find yourself quivering and snarling over your Caprese (mmm goats cheese). In my time I’ve found a few different ways to win here. These are my ideas:

• Have a salad or some spaghetti bolognese. Ask for a pizza without cheese. Or at least don’t go for the Quattro Formaggi.
• I sometimes injected half the insulin in needed just after I finished the pizza, then the rest an hour or two later. Try variations on this in the comfort of your own home in preparation.
• Then I got an insulin pump and everything was so much easier. More on me and my pump to come…

What ideas does anyone else have for how to win at pizza? Or any other problematic but yum foods… Chinese is always tricky, with lord knows how much sugar hidden in the sweet chili sauce. What about canapes? Or sticky puddings?