Health Care

PRIMARY HEALTH CARE OPTIONS IN WELLINGTON CITY

You need to have a General Practitioner (GP) as well as a connection to the diabetes clinic with a hospital diabetes specialist. The notes following are good options for a GP if you don’t want to go to your family doctor anymore or you have moved away from where that is and now live in Wellington.

EVOLVE YOUTH HEALTH SERVICE

Evolve is a youth service based in central Wellington. We offer free & confidential health and social services for young people aged 10-25. We offer a range of services, activities and events in one awesome location to make it as easy as possible for young people to get what they need.

At Evolve everything is free. We won’t judge you or patronise you. We’re really discreet which means we won’t tell other people your business and you don’t have to feel embarrassed about anything here. 

Young people are actively involved in keeping it real at Evolve. We have young people as staff members and as volunteers on our Board.

Thousands of young people from all kinds of backgrounds, cultures and lifestyles have visited Evolve since we opened in 2004.

 

HEALTH CARE

Evolve has a team of friendly, non-judgemental doctors and nurses (clinicians) who provide primary healthcare services to meet pretty much all your health needs including sexual health, mental health, general check-ups, treatment and referrals. Clinics are available at Evolve every weekday and also at some schools around Wellington.

COUNSELLING

Our counsellors come from a range of backgrounds and have different skills and interests to suit different people. You can get a referral from our nurse for up to 6 free counselling sessions if there is something you’d like to talk through or work on with support from a professional.

Counselling sessions are by appointment only.

SOCIAL SUPPORT

We have social workers and youth workers who can help with things like finding a job or somewhere to live. They provide social work, group work, advocacy, information and advice.

YOUTH TEAM

Evolve’s youth team is a diverse group of young people who look after our reception space and lounge areas. They can help arrange appointments, provide peer support and supply information about services at Evolve and elsewhere. They also coordinate projects, events and activities that anyone can join in with. See our website for details of what’s on at Evolve.             

 

APPOINTMENTS

Evolve is open every weekday from 10am. Check our website for closing times.

To book an appointment with a nurse or doctor please phone or call into reception during opening hours

You can choose to register as a casual patient or enrol with our PHO.

All services are free* for 10-25 year olds.

* Charges apply for non-New Zealand residents. 

 

Where to find us

Map

 

Level 2, James Smiths Building, Corner Cuba & Manners Streets

 

PO Box 9076, Marion Square, Wellington 6141

Phone: 04 473 6204

Fax: 04 473 6216

Email: evolve@evolveyouth.org.nz

www.evolveyouth.org.nz

 

OTHER PRIMARY HEALTH CARE OPTIONS

Any GP practice in Wellington region

Student Health Service if you are enrolled at a tertiary institution

Vibe Youth Health in Lower Hutt

Kapiti Youth Service in Paraparaumu

Back to Top


More on Medical:

insulin  correction  testing  clinic  healthcare  issues

Exercise Stuff

Exercise is good for you and part of your diabetes management plan.

 REGULAR EXERCISE MAKES YOU

  • Insulin sensitive so your insulin works better
  • Lower your blood pressure
  • Lower your cholesterol
  • Keep your weight in the normal range for your age and height
  • Create a sense of well being
  • Strengthen your heart and lungs

 

THINGS THAT AFFECT BLOOD GLUCOSE LEVELS DURING EXERCISE:

  • Carbohydrate foods
  • Insulin levels
  • Intensity of the exercise
  • Duration of the exercise
  • Recent high or low blood sugars
  • Timing of exercise to recent food and insulin
  • Blood glucose before you start
  • Adrenaline in competitive sport

 

GETTING STARTED (NOW THAT YOU HAVE DIABETES)

  •  If you have just been diagnosed with diabetes or are starting a new activity or just getting off the couch the more likely it is that your blood sugars will go low and you will need less insulin. Talk to your diabetes nurse or doctor for advice!
     FUEL SOURCES
  • First fuel available for exercise is glucose which is quickly used up
  • Second source is release of glucose from the muscle and then the liver
  • Third source is fat – stored energy – which is used when the insulin level falls

Blood glucose

Effects of glucose and insulin on metabolism

Impact on performance

Too much insulin and not enough glucose available for the cells

Tired, poor performance. Correct low blood glucose before starting exercise.

4-10 mmols

Efficient fuel flow

Maximum performance

 

>10 mmols

If insulin level is OK then blood sugars will fall

Performance may be reduced but ok to do exercise

>15 mmols

Glucose likely to rise as not enough insulin on board

Tired, poor performance, check for ketones, have insulin and wait before exercising

 

INSULIN LEVEL

If you have too much insulin on board when starting to exercise your blood glucose level will rapidly drop. You will need to have a carb snack before exercising or you will need to stop to eat or drink during the exercise.

 If you have high blood sugars before starting exercise you don’t have enough insulin on board. It makes it difficult for glucose to get to your muscles so you will not do well at exercise and you will have even higher blood sugars afterwards.

 If you are between 5-10mmols you will be able to access body fat for fuel and keep your blood sugars stable.

 AVOIDING LOWS AFTER EXERCISE

  • Test before and after exercise
  • Keep a log book so you can see what you did last time you exercised
  • Have some glucose and snacks with you
  • Talk to your diabetes team about lowering insulin and increasing carb before and after exercise
  • Strenuous or long duration of exercise can cause delayed hypos, often during the night
  • Don’t forget to drink! Talk to your diabetes team about sports drinks and their appropriate use

GOOD RECOVERY DRINK RECIPE:

trim milk / 2 spoonsful of skim milk powder / 2 spoonsful of flavouring e.g. Nesquik

shake it up and drink it down within 30 minutes of finishing exercise. It will replenish your energy stores really quickly and help prevent hypos later.

GOOD REFERENCE SOURCES

John Walsh author of “Pumping Insulin” has excellent exercise notes in this book for people with type 1 diabetes. He has type 1 himself and is on a pump but the exercise principles apply if you are on a pump or daily injections

Back to Top


Read more on My Diabetes

school  living-with-diabetes.png  relationships.png  sickdays.png  tips.png   exercise  food alcohol.png    apps.png

Food

On this page

Carbs
Protein
Fat
Other important info

The great news is that eating with diabetes is just the same as the way that everyone should be eating!

There are a couple of things that a person with diabetes has to make sure of with their meals that other people don’t have to worry about so much – but in reality people without diabetes tend to do these things anyway!

Eating with diabetes is just the same as regular healthy eating

You need to eat regular meals and snacks

You always need to include a carbohydrate food in your choices (see below)

These guidelines help you to maintain a nice stable blood glucose levels, avoid hypos and be a healthy weight.

Back to Top

CARBOHYDRATES

Carbohydrate foods are the most important foods when it comes to your diabetes. The amount and timing of carbohydrate foods that you eat will directly affect your blood glucose levels, and whether these are too high, normal or too low (hypo).

If you eat too much carbohydrate you will need more insulin to keep your blood glucose levels stable, or they will be too high and if this happens regularly you increase the risk of developing nasty diabetic complications.

If you eat too little carbohydrate you could have a hypo.

The best way to manage your carbohydrate intake is to have three regular meals (4-5 hours apart) that are made up of about half the foods below and about half with other foods like meats/veges/fruit.  In between meals you could also have 2-3 snacks that also have some carbohydrate in them depending on your insulin type, how much exercise you do / don’t do and how hungry you are (for example, if you are still growing or recovering from being newly diagnosed with type 1 diabetes).

See the ‘carbohydrate snacks’ section for good snack ideas.

Carbohydrate containing foods:

  • Bread and bread rolls
  • Breakfast cereals
  • Dairy and soy milk, yoghurt, ice cream and custard
  • Fruit and fruit juice
  • Starchy vegetables like potato, sweet potato and corn
  • Rice, pasta and noodles
  • Baked beans and lentils
  • Snack foods like biscuits, chips, muesli bars
  • Sugars and sugary foods
  • Takeaway foods like pizza, fries and burgers

 

Back to Top

PROTEIN

Protein-containing foods should be about a quarter of your plate. This is like 1-2 palmfuls of the foods below per day. It doesn’t matter when you eat these foods in your day because unlike carbohydrates, these foods won’t affect your blood glucose levels.

Protein-containing foods:

  • Meat 
  • Fish 
  • Chicken 
  • Eggs 
  • Nuts 
  • Cheese

These foods are important for growth and repair in your body. You need protein foods to build muscle too!

Back to Top

FAT

We need some fat in our food choices too, but not too much or it can lead to weight gain and other bad side effects like high blood lipids.

Fatty foods are:

  • Butter 
  • Margarine 
  • Oil 
  • Cream

BUT there are also lots of places in the diet where fat hides as well, such as:

  • Crisps, chips and fries
  • Biscuits
  • Chocolates
  • Cakes
  • Donuts
  • Takeaways
  • Fatty meats – chicken skin, meat fat, salami, bacon etc
  • Fried foods

SO it is a good idea to only eat from this group of foods as a treat.

GOOD SOURCES OF FAT IN THE DIET ARE:

  • low fat milk, yoghurt and cheese
  • vegetable oils/margarine for cooking
  • nuts/seeds
  • avocado
  • fish

Back to Top

OTHER IMPORTANT STUFF:

TIMING OF MEALS

Depending on the insulin you’re on, you might need to eat a meal or a snack every 3 hours or so. If you forget to eat, skip meals or leave it too long until you eat, you might have a hypo. If you have an insulin pump, you can be a bit more flexible with the timing of your meals.

SUGARY FOODS

High glucose foods like fizzy drinks, cordials and lollies can make your blood glucose levels go too high. It is best to drink diet fizzy or cordials.

These foods can be used in small amounts to treat a hypo, which means they cause a quick rise in blood glucose so you know that means if you eat them when you’re not having a hypo they will make your blood glucose level rise quickly then too!

HYPO TREATMENT

To treat a hypo, you need to quickly eat or drink something sweet, wait 10 minutes and then eat something else straight away to stop the hypo from coming back.

To treat a hypo, quickly eat or drink something sweet like:

  • Mentos or
  • Dextrotabs or Vita tabs or
  • 125 – 200ml fruit juice or 
  • 1/3 – ½ can regular soft drink (not diet) or 
  • Honey or jam (2 teaspoons) or
  • 2-3 tablespoons of glucose powder dissolved in half a glass of water

Then eat something else to stop the hypo from coming back, like:

  • A piece of fruit or 
  • A slice of bread or 
  • Two plain sweet biscuits or 
  • A glass of milk 
  • If it’s just before a meal, eat or drink something sweet then eat your meal

Don’t forget to always carry glucose and snacks with you. Make sure you don’t ignore a hypo even if you’re worried about what everyone else will say. No one likes to be embarrassed, but ignoring a hypo can make you feel worse and can be more embarrassing if you don’t treat it.

HEALTHY FOOD AT SCHOOL/ UNI / WORK

Here are some ideas for lunch:

  • Sandwiches

try different types of breads like rolls, grain bread, Turkish bread, bagels, lavash or pita bread
use fillings like salad, low fat cheese, vegemite, ham, chicken, tuna, salmon, egg, baked beans, spaghetti or banana

  • Pasta, potato or rice salad
  • Fresh pieces of fruit eg. apples, pears, mandarins, oranges
  • Chopped fruit eg. rockmelon, pineapple
  • Fruit in zip lock bags eg. grapes, cherries
  • Crispbreads, rice cakes or corn thins
  • Pikelets, scones or low fat muffins
  • Low fat yoghurt or dairy desserts
  • Dried fruit boxes eg. sultanas, apricots
  • Dried fruit and nuts
  • Low fat milk drinks
  • Rice crackers or rice crisps

If buying food from the canteen/ café / dairy look for sandwiches or rolls, corn on the cob, reduced fat mini pizzas, pasta, soup or rice dishes as healthy options.

CARBOHYDRATE SNACK IDEAS

For snacks between meals, choose your favourites, stock up on

  • Fruit  eg. apple, pear, banana, orange 
  • Chopped fruit – rockmelon, pineapple, honeydew 
  • Fresh fruit salad 
  • Grapes or cherries 
  • Canned fruit snack pack eg. two fruits, peaches, pears, fruit salad 
  • Dried fruit boxes eg. sultanas, fruit salad, sultanas and apricots 
  • Low fat yoghurt 
  • Low fat dairy desserts 
  • Low fat custard 
  • Corn on the cob (frozen, defrost in microwave)
  • Pikelets or scones 
  • Fruit loaf, fruit bun or hot cross buns 
  • Crispbread or rice cakes with low fat toppings e.g. tomato, low fat cheese 
  • Popcorn 
  • Crumpets or English muffins 
  • Rice crackers with low fat dip 
  • Rice crisps 
  • Low fat fruit bars

FOOD FOR EXERCISE

Exercise or sport uses up blood glucose extra quickly so it can mean that you need some extra carbohydrate to stop you from having a hypo. Eating an extra carbohydrate snack for every 30-40 minutes of sport is a good guide.  Hypos can happen for 12-16 hours after you stop exercising, so keep an eye on your blood glucose levels and top up your carbs if you need to.

BEFORE SPORT:

  • A piece of fruit 
  • A small flavoured milk 
  • A muesli bar 
  • A fruit snack pack 
  • A crumpet or slice of raisin toast 
  • A ‘fun size’ chocolate bar

DURING SPORT:

  • A 100% fruit juice 
  • A cup of sports drink 
  • A piece of fruit eg. banana, orange

HEALTHIER TAKEAWAY OPTIONS

You may find as you get older you start eating out and eating more takeaways. Once a week is a good amount to fit in with a healthy diet.

Some healthy takeaway options:

  • Meat or chicken salad roll / wrap 
  • Doner kebab with lots of salad 
  • Plain hamburger with lots of salad 
  • A grilled chicken burger with lots of salad 
  • Baked potato (skip the butter) 
  • Toasted sandwich 
  • Corn cob
  • Sushi roll 
  • Vegie pizza or gourmet pizza
  • Toasted sandwich or focaccia 
  • Bowl of pasta with tomato based sauce 
  • Stir fried vegetables with noodles or plain rice

Try and have a similar amount of carbohydrate when eating out as you would usually have at mealtimes, and try and choose the options that are lower in fat.

  • A piece of fruit or 
  • A slice of bread or 
  • Two plain sweet biscuits or 
  • A glass of milk 

If it’s just before a meal, eat or drink something sweet then eat your meal and have your insulin when you’re half way through the meal. Do NOT forget to take your insulin! You may decide to reduce the amount of rapid acting insulin slightly because of the low pre-meal.

try different types of breads like rolls, grain bread, Turkish bread, bagels, lavash or pita bread

use fillings like salad, low fat cheese, vegemite, ham, chicken, tuna, salmon, egg, baked beans, spaghetti or banana

Acknowledgement: Dietitians NZ


Back to Top

More on My Diabetes

school  living-with-diabetes.png  relationships.png  sickdays.png  tips.png   exercise  food alcohol.png    apps.png

Alcohol and Diabetes

  • Alcohol moves quickly into your body without being broken down in your stomach the way food is
  • Within 5 minutes there is enough alcohol in your blood to measure
  • The liver wants to clear the alcohol quickly as it can’t release any glucose stores until it has taken care of the alcohol

ONE STANDARD DRINK – IT’S NOT MUCH!

  • 100mls wine
  • 30mls spirits
  • 1 can low alcohol beer 330mls
  • 300mls (half a pint) beer

HOW MUCH ALCOHOL CAN YOU HAVE?

  • 2 standard drinks for women
  • 3 standard drinks for men
  • Don’t drink on an empty stomach – have carbohydrate snacks like bread, crackers and cheese, popcorn
  • Drink other things in between alcoholic drinks like water, diet fizzy, juice (will provide some carb if there’s not much food around)
  • Never count the carbohydrates from alcohol as part of your food intake
  • Don’t swap alcohol for food
  • You may need to have more carbohydrates at bedtime and less insulin overnight and the following day
  • Exercise lowers blood glucose levels and drinking may lower them further so it’s good to remember this if you are dancing as well as drinking

BE PREPARED FOR HYPOS

  • It can be hard to tell the difference between hypo symptoms and getting drunk
  • Have your meter, some glucose and carb snacks with you
  • Make sure your friend/s know you have diabetes and what to do if you go low and when they need to call for help
  • Wear your medic alert bracelet / pendant

RISKS OF LOW BLOOD GLUCOSE

  • Because the liver is processing the alcohol it can’t release glucose stores if your blood glucose level starts to drop
  • Glucagen injections are not any use if you have alcohol on board and go into a hypo
  • So you need to eat when you are drinking alcohol
  • Hypos can occur overnight or even as late as during the next day

CHECKING BLOOD GLUCOSE / INSULIN DOSES

  • Before you go to bed eat some supper (no rapid acting insulin with it) e.g. multigrain toast, banana, milk drink OR pop into your nearest BK or similar!
  • Reduce your long acting insulin by 20% / temporary basal of -20% on your pump, more if you have been dancing
  • Next morning check again and have some carbs for breakfast, may need less insulin to avoid hypo
  • Drink plenty of water or diet drinks
  • Watch for delayed hypos

HANGOVER / SICK

  • Decrease insulin
  • Follow sick day rules
  • Keep drinking plenty of water or diet drinks; drinks containing sugar if not eating or your blood sugar is low

TAKE HOME MESSAGES

  • Always eat some carbs when drinking
  • Don’t drink and drive
  • Always have some hypo treatment / snack with you
  • Make sure your friends know what to do if you go low

More on My Diabetes

school  living-with-diabetes.png  relationships.png  sickdays.png  tips.png   exercise  food alcohol.png    apps.png

Insulin

On this page

Site Rotation
Injection sites
Different insulins
Websites
Advantages and disadvantages
Checklist
Sleeping

SITE ROTATION

It is really important that you rotate the site where you give your insulin. If you get a favourite spot it will get lumpy and prevent the insulin from being absorbed properly. You may notice that you are running higher than expected and wonder if the insulin is working properly; or you may have unexpected lows when the insulin is suddenly released from the lumpy tissue in a rush. The proper name for this is lipohypertrophy but it’s easier to call it lumpy and try and prevent it from happening!

Back to Top

INJECTION SITES

You can choose from the following areas:

  • Measure 2 fingers width above your tummy button and 2 fingers widths below it and then you can go along that line from each side of your tummy to the other. You can also go between the lines but not too close to the tummy button as the skin is too thin there
  • Do your first injection of the day on one side, the next injection on the other side and so on
  • Divide your tummy into 7 vertical sections and do your day’s injections within that vertical stripe
  • Or you can use your thighs – tops of your legs and sides (outer areas probably more comfortable!) but don’t inject your rapid acting insulin here is you are about to do some exercise – it will make the insulin absorb more quickly and could cause you to go low
  • Upper arms are another area but they are not recommended
  • Your butt is another place but it can slow down the absorption of the insulin as its a fat storage area

Whatever works for you is good as long as you don’t pick a favourite spot and keep hitting it with the needle. It will get lumpy! (see above)

Back to Top

DIFFERENT INSULINS

 PUMP THERAPY – ANOTHER OPTION FOR SOME PEOPLE

An insulin pump is a small computerized device , about the size of a pager or small deck of cards. It has the potential to mimic normal release of insulin from the pancreas, but cannot decide itself how much insulin to deliver – you must tell the pump how much insulin you need.  The pump contains rapid-acting insulin only, which infuses into you via a very thin flexible tube that attaches to a soft plastic tube or metal needle that sits under your skin. This insulin is delivered in two ways: as a basal rate, or as a food or correction bolus.

pump.png

The basal rate replaces your long-acting insulin. The rate is programmed to deliver a small continuous trickle of insulin that keeps your blood glucose stable between meals and overnight. The basal rate can can be varied throughout the day to meet your specific basal requirements. You can also temporarily reduce or increase your basal rates if need be. For example, you may want to reduce your basal rate if you are exercising (exercise makes your body more sensitive to insulin), or you may want to increase your basal rates when you are sick (being sick normally makes your body resistant to the action of insulin, so you need higher doses).

A bolus is a larger dose of insulin that is given to match the carbohydrates you eat or to correct a high blood glucose level. To determine an accurate bolus dose you need to be proficient in carbohydrate counting, which is the key to success on a pump.

A bolus dose can be delivered immediately (if you are eating a normal meal) or over a longer period of time if you are having a very low GI  or high fat meal or “grazing” over a longer period of time.

InsulinPumpProfile.png

Learning how to use a pump for your insulin is quite involved. You will need to be able to commit to a long period of working closely with your diabetes nurse specialist, your diabetes medical specialist, and your diabetes dietitian in order to develop the skills and knowledge to manage on this way of taking insulin. But once you have the skills, using a pump can give you the most flexibility in terms of lifestyle choices out of any of the current systems or methods for delivering insulin.

Back to Top

WEBSITES FOR MORE INFO ON INSULIN PUMPS:

To follow are the websites for the two PHARMAC funded insulin pumps and also a few suggested websites that may give you more information about pumps from people who use them. If you find any other good ones please let us know! It’s best to check the reliability of the website. There are lots of sites offering amazing cures and if only they were true – you wouldn’t be reading this! So do be careful.

For the  Animas Vibe pump check out  http://www.nzms.co.nz

For the Paradigm 512 or 712 pump check out 

Back to Top

Effective, safe use of the pump requires:

  • Commitment to checking blood glucose at least 6 times a day, every day.
  • Using carbohydrate counting.
  • Adjusting insulin doses based on blood glucose levels, carbohydrate intake, and physical activity.

The main advantages of pump therapy are:

  • Increased flexibility in lifestyle.
  • Predictable insulin delivery.
  • Precise insulin delivery.
  • Ability to accurately deliver 1/10th of a unit of insulin.
  • Tighter blood glucose control, while reducing the risk of low blood glucose.
  • Reducing episodes of severe hypoglycaemia.
  • Reducing wide fluctuations in blood glucose.
  • Helping manage the “dawn phenomenon.”

The main disadvantages of pump therapy are:

  • Risk of skin infections at the infusion site.
  • Risk of diabetic ketoacidosis (DKA) from pump malfunction or absorption problems.
  • Cost: if you do not qualify for Pharmac subsidies.
  • Checking blood glucose at least 6 times per day.
  • Letting others know that you have diabetes.

Back to Top

SELF CHECKLIST WHEN THINKING ABOUT PUMPING

  ASK YOURSELF THESE QUESTIONS:

  • Do you test and record your blood glucose levels at least 6 times a day?                        Yes**   /  No
  • Do you use your blood glucose results to adjust your insulin?                                         Yes**  /  No
  • Are you matching your meal-time insulin dose to the carbohydrates in your meals?      Yes**  /  No
  • Do you adjust your insulin doses according to your activity levels?                                  Yes**  /  No
  • Are you ready to be attached to a device that lets people know you have diabetes?     Yes*  /  No
  • Do you have realistic expectations? (it is not the “magic bullet” to solve your diabetes problems)                                                                                                                             Yes** / No
  • Are you comfortable with the technology and mechanics of operating a pump?          Yes*   /  No
  • Are you a problem-solver?                                                                                            Yes*  /  No
  • Are you prepared to practise good sterile techniques?                                                Yes*  /  No
  • Do you have family and/or peer support?                                                                      Yes  /  No
  • Do you call your healthcare provider if problems occur?                                              Yes**  /  No

 Your responses to these questions are all ideally “Yes” before starting on a pump. Those marked with a single asterisk are helpful and those marked with a double asterisk are required for successful pumping.

Back to Top

SLEEPING WITH AN INSULIN PUMP

http://www.loop-blog.com/

12 Ways To Sleep With An Insulin Pump

Posted: 14 Jul 2015 12:00 AM PDT

When I first got my insulin pump and got into bed, I asked myself, “If I have to wear this to sleep, where am I supposed to put it?” I quickly found there are many answers to that simple question. Like me, many people are initially unsure of how they will sleep with an insulin pump, but this challenge is not as difficult to overcome as it may first appear. We asked the DOC to tell us what they do and here are the top 12 ways to sleep with an insulin pump.

1. The PJ Clip

“Clipped to my pajama waist band. I specifically seek out thicker bands so the clip doesn’t make holes through the material over time.” – Kristin Mudd

2. The Undies

“I just clip my pump onto my undergarment and tuck the tubing inside the undergarment.  This allows me to buy whatever type of sleep wear that I enjoy.  My pump is safe and secure and out of the way.  After all we all want a goodnight’s sleep.” –  Kitty Castellini, MiniMed Ambassador

3. The Body Pillow

“I sleep with a body pillow on my side and I put my pump under the pillow. I switch sides a couple times through the night, but have somehow learned to move my pillow and pump with me in my sleep.” – Whitney Mielke

4. The Blanky Buddy

“In a pouch made from the same material as my sons favorite blankey! Made by his grandma for him!” – Christina Byerly

5. The Classic Pocket-T

“I have a t-shirt with a left breast pocket that I turn inside out and put my pump in that pocket during the night.” – Lee Bring

6. The Bra Clip

“Clipped to the strap on the middle of my bra. Pretty much wear it that way all day.” – Michelle Wilson

7. The Skilled Sewer

“I had pockets sewn into my night gowns. I put it in the pocket secure the pocket with a safety pen. Works really well!” – Pamela Swearingen Primrose

8. The Workout Shorts

“Workout shorts with a key pocket. Pump fits perfectly there. In the winter, workout leggings with a key pocket. Those with a t-shirt have become my favorite PJ’s with the pump.” – Meri Winchester

9. The Back Sleeper

“When I was playing with the Tampa Rays baseball team in 1998 I had a stress fracture in my back and I was told to always sleep on my back and so it grew to become natural to me to always sleep on my back so I put my insulin pump on the side of my pants when I sleep and it never gets in the way.” – Jason Johnson, MiniMed Ambassador 

10. The V-Neck Nighty

“I always buy nightgowns with button down or V-neck collars so I can clip my pump to the front of my nightgown. I use the pump clip not the holster so it weighs less. It’s also close enough to hear any alarms or adjust a temp basal rate if needed in the middle of the night.” – Peggy Sue Small

11. The Velcro Strap

“I slide it into a pocket attached to a Velcro strap I purchased from Medtronic. It straps around my chest and the pump is safely tucked away, but due to the clear window, I can see my numbers if I need to see them.” – Andy Inskeep

12. The Monkey

“I made a little pouch on a soft-cloth belt with a flap over the pouch in the shape of a monkey for my son, so he would answer this question by saying, “Monkey holds it.” If not Monkey, then Froggy, or Zeebie [zebra], or Stripey [striped, but no animal]. He’s asked for a lion next…” – Elizabeth Platt Hamblin

Not every one of these will work for you. And not everyone has someone to make them a monkey (though wouldn’t it be great if we did). But hopefully something here will help you get some much-needed zzz’s.

Back to Top


More on Medical:

  correction  testing  clinic  healthcare  issues

Correction

On this page

Using a correction factor

USING A CORRECTION FACTOR (ISF)

This is a method to estimate:

How much will 1unit of my rapid acting insulin (Novorapid / Humalog / Apidra) lower my blood glucose level (BGL)?

When will you use it?

To increase your usual insulin dose to correct high blood glucose levels at:

  • meal times
  • unexpected highs between meals
  • at bedtime but a HALF correction is recommended at this time of the day until you are confident it is working for you

HOW YOU WILL DO THIS?

Correction.png

Download pdf

Remember – your rapid acting insulin has approximately a 3 hour duration

SO if you have given a bolus at – for example 12 midday – by 1pm you have used up 30% and there is 70% remaining.

By 2pm you have used up 60% and there is 40% remaining.

By 3pm you have used up 90% and there is 10% remaining – NOW is a good time to correct a blood glucose level that is higher than you want it to be.

If you had corrected at 2pm with 40% still remaining (active insulin on board) then you must take that into account by working out how many units are still active from the 12 midday bolus and subtracting it from the correction you want to give now. Maybe it is safer for you to wait an hour (3 hours = 90% used up) and test to see if you are still above target. If you are correct and reduce that risk of hypo that comes from stacking boluses!

More on Medical:

insulin  testing  clinic  healthcare  issues

Testing

On this page

Testing tips
Testing Safely

TIPS FOR FINGER-PRICKING AND SHARPS DISPOSAL

  1. Wash hands in warm water and dry well. Warm water helps improve blood flow to the fingertips.
  2. Choose a different finger to prick each time:– The little finger, ring finger and middle fingers are usually best.Avoid using any fingertip that has a lot of fingerprick marks on it.
  3. Massage firmly from the base of your palm to the pad of your fingertip several times until fingertip is red and full of blood.
  4. Press fingerpricker to side of fingerpad, (not side of finger!). Push button and hold a few seconds before removing fingerpricker.Massage again from base of palm to pad of fingertip until a good drop of blood forms.  If not enough blood wipe away first drop then massage again.
  5. Apply drop of blood to target area of test strip and ensure it completely fills. If target area not completely filledyou may get a falsely low reading.If you are using a Caresens meter you must apply the blood at 90 degrees – the strip acts as a straw and sucks the blood up into the meter.
  6. Apply pressure to pricked fingertip with a tissue for at least 1 minute – this helps prevent bruising.
  7. Change lancet (needle) in fingerpricker after 10 – 15 tests. The sharper the lancet the more comfortable the fingerpricking.

           You can buy more lancets at chemists – they don’t come on prescription

Back to Top

TIPS FOR SAFE HANDLING AND DISPOSAL OF SHARPS

“Sharps” is the name for anything sharp that could cause injury and transfer disease or infection to another person.  Sharps include lancets from your fingerpricker, syringes and pen needles from insulin pen. It is your responsibility to dispose of your sharps safely.

  • Dispose of your sharps when they are dull, bent or have come into contact with anything other than clean skin
  • Buy a certified sharps disposal container from Diabetes Wellington or your chemist to keep used sharps in
  • If you cannot find/afford a certified sharps container, use an opaque, heavy duty plastic child-proof container (eg. a used bleach or dishwasher detergent bottle, or a glass jar with a lid)
  • Return full sharps containers to Diabetes Wellington (free to members or a gold coin donation) or bring to the Diabetes Clinic for disposal
  • Or check with your pharmacy to see if they dispose of sharps
  • Never share your fingerpricker, insulin pen or syringes
  • Keep all sharps out of reach of children

Back to Top


More on Medical:

insulin  correction    clinic  healthcare  issues

Help and Support

WHO TO RING:

When you are newly diagnosed and need insulin doses:
Ring either your nurse or diabetes doctor.

When you need a prescription:
Contact your GP

When you are sick:
Your diabetes nurse
Your doctor (GP or specialist)
And follow the advice on the sick day management page

When you have lots of highs or lows:
Contact your diabetes nurse or specialist


APPOINTMENTS

In Capital & Coast District Health Board you will be seen in outpatients diabetes clinic approximately every 6-12 months, although when you are newly diagnosed it may be a bit more frequent to start with.

At clinic you will see the doctor, and sometimes a diabetes nurse. Usually clinic starts off with a general chat about how things are going in general, how things are going with your diabetes and any problems are discussed. You should bring your meter and logbook with you so that the meter can be downloaded and the results discussed with you. Any changes to the insulin will be made at this point.

The doctor may examine your injection sites, thyroid gland, abdomen and feet. Any referrals to allied services will also be discussed – dietitian, podiatrist, psychologist.

Finally a prescription will be written for you to take away. The doctor is very happy to discuss any issues. If you need any further prescriptions in between specialist clinic appointments, you need to go to your GP.


LABORATORY TESTS

When you come to clinic the health care assistant will do a finger prick (you can use your own device) for an HbA1c blood test which indicates your blood glucose average for the last 3 months. Once a year, you will be asked to go to the community laboratory and have some bloods done (to check for related disorders) and a urine test. Every two years you will be referred to the optometrist and have a free photograph taken of your eye to check for any diabetes related eye problems.


EATING DISORDERS

Type 1 diabetes and an eating disorder is particularly challenging to live with – as the person and for those around you. Here is a fantastic NZ / Australian website with moving testimonies of people who have lived with this combo and are now flourishing, good resources and links for information, help and support. It’s www.deda.org.nz. Check it out!


 

Tips and tricks

At last I have someone sending me some tips and tricks! Thanks Naomi!! Would love to hear from you, please send them in.

Let’s face it; diabetes can be an awkward condition to live with at the best of times, and a downright dangerous one at the worst, but just like anything in life it’s possible to make it easy-as with just a few simple tricks at your finger tips. It’s all in the know-how and the practice and once you’ve got down some of the basics, you’ll find some of these will come as second nature.

Of course, no one’s expecting you to learn everything immediately, but take some time and consider which of these tips you might want to make a go at, and which ones work for you. You may even discover you’ve already found out some of these on your own!
That being said, if you’ve come up with something we haven’t, then feel free to drop us an email or share it with us on the forums. After all, diabetes doesn’t have to be a lonely condition and sharing what we know and looking out for each other can make living with diabetes seem a whole lot simpler.

Basic Management and Control

You’ve heard it plenty of times from doctors and nurses, and probably from your parents too, but getting in control of your diabetes is a pretty big deal. If anything, it can save you a lot of trouble in your later years, but more than that it will help you live life to the fullest and, often, all that’s needed is a little bit of preparation. The rest will fall into place. Here’s a list for you to look over:

  1. Don’t ignore it. Take control – This is first on the list because it’s the most important. There are always going to be times when we feel like denying we have diabetes or ignoring the complications it causes, but the truth is you need to take control of your diabetes before it ends up controlling you. After all, it’s pretty hard to deny you have diabetes if you end up in the hospital due to poor management.
  2. Aim for routine – Most people (diabetes or no) can really benefit from keeping a daily routine, but for people with diabetes it just makes everything so much more manageable. You’ll find waking and sleeping, eating and snacking, studying and exercising at the same hours every day will add consistency to your blood levels, improve your mood and save you from any nasty surprises. But don’t be afraid to try new things!
  3. Keep your insulin and blood meter in an easily accessible place – In other words, store it in the place you are likely to use it. For most of us that usually means the kitchen or dining area, but if you’re flat-sharing or living on campus this might require a little more strategy and negotiation. If you’re pretty bad at remembering to take insulin or check your blood, then keeping everything in plain view is a great idea. And for people always on the run, try sourcing a spare meter and insulin pen to have in your bag at all times.
  4. Make blood checking part of your routine – Yes, it’s aggravating making the extra effort to take blood levels, but then you probably thought the same thing about brushing your teeth as a child. You brush them without thinking too much about it now don’t you? The same can become true for blood checks. At the very least, try to whip out your blood meter before every meal and you’ll soon make a very useful list of blood levels you and your doctor can work with. Not to mention; knowing what’s going on with your body from meal to meal is exceptionally useful!
  5. Keep a record – This follows in from number 2 above, because once you’ve gotten into the habit of checking your blood routinely, it’s a simple-as to make a note of it. Just keep that pen and paper in the same area as your blood meter or, better yet, try downloading a phone app that you can record in with a couple of clicks!
  6. Check the record yourself – That’s precisely what it’s there for. While it may seem like something only your doctor or nurse are interested in seeing, they don’t have to be the only ones adjusting your insulin. Circle numbers that seem strange to you and keep an eye on patterns. Many meters also allow you to upload your results to a computer so you can see those trends and make your own decisions. At the very least, this puts the power back into your hands and allows you to make confident, informed decisions
  7. Consider alternatives – There’s no rule stating that you must stick with the method of control you started with. When I was first diagnosed with diabetes I was part of the first generation to use insulin pens. Before that we were using syringes and our absurdly bulky like blood meters took a minute and a half to calculate. Now we have all sorts of insulin from mixed to long acting to fast acting, as well as pumps for people with super busy lifestyles. Add to that the newest range of pocket-sized, ultra fast meters and you’ll everything you need to find the type of control that works for you. Awesome.
  8. Be prepared – Much of management and control is simply about making sure you have everything in the right place at the right time. No matter who you are, if you’ve got diabetes then you’re going to have hypos and highs from time to time and they have that funny, little habit of striking at the most inappropriate of moments. Usually when out and about, and nowhere near a kitchen, am I right? However, keeping the basics nearby and on-hand will give you the confidence that if something does go wrong it’s just as simple as retrieving what you need to make it right again. Here’s a checklist of things to remember to keep in your bag at all times:
  • Insulin
  • An extra pen, needle and cartridge
  • A meter
  • A fast-acting source of sugar (dextrose, non-diet soft drinks, etc)
  • A slow-acting source of carbohydrate (biscuits, banana, sandwich, etc)
  • A mobile phone
  • Money (for food or travel)

Back to Top


More on My Diabetes

school  living-with-diabetes.png  relationships.png  sickdays.png  tips.png   exercise  food alcohol.png    apps.png

Relationships

The following is an excerpt from a book Carrie Hetherington is writing. Carrie is in her mid 20s and has type 1 diabetes. She is amazing, full of energy, always got new ideas, started the petition on Caresens meters, now an ambassador for International Diabetes Federation (IDF), has written a book for kids newly diagnosed with type 1 and is now doing this book which isn’t out yet but you get a preview with her permission… and then when it is finally published we will let you know and you can buy it and help Carrie make millions (haha)!!

“You may be a man, a woman, a teenager, or a grandparent. You might have one husband, three wives, be divorced 6 times, or be relishing and enjoying your singledom. Whatever your current situation might entail, you have probably thought about dating at some point in your life. Even if it was giving your hand in marriage to your primary school sweetheart on the netball court with daisy chains and buttercups as your bouquet; truly believing you had married your soulmate.

Some may think dating is fun, some find it exciting or awkward, and some lock themselves inside, terrified by people and the world, refusing to step outside the front gate. My dear reader, if you are unfortunate enough to fall into the latter, you may need some extra support from a more qualified source!

It doesn’t matter if you live in England, New Zealand, or a yurt in the middle of Mongolia, we know that diabetes does not discriminate. When you confront dating and you have a naughty misbehaving pancreas, topped off with a reliance upon gadgets and tubing most ‘normal’ people have never laid eyes upon, things can begin to get tricky. Dating seems to take on a whole new dimension and questions we never previously considered somehow become the focus of our whole universe.

‘How do I tell my boyfriend / girlfriend?’

‘What if my syringes or pump make them run away?’

‘What if they take pity on me or treat me like an invalid?’

If you’re a teenager and you add in those self conscious pangs of low esteem…ok, scrap that, it doesn’t matter how old you are, that can happen to the best of us! Things can really begin to feel daunting for some people.

Most diabetics face this chronic, unpredictable little gremlin of a disease 24 hours a day, and will continue to do so for the foreseeable future until that blissful cure is discovered. Until then we must smile, find a silver lining in every moment and band together in laughter. Thriving, surviving and clinging to our sanity, or what little may remain of it.

This book was written to make you giggle hysterically, grin from ear to ear…maybe even shed a tear and hold your sides. To make you feel beautiful/handsome and confident, and approach those niggling questions with gusto, knowing that most diabetics will all face them at some point along their varied journeys, and you are never alone.

If you have found the love of your life, well you can have a jolly good laugh at the ridiculous predicaments the rest of us have confessed to end up in and count your blessings that you have survived this period of your journey. Congratulations.

Happy reading dear friends!