Living with Diabetes

On this page:

A Day in the life
#IWishPeopleKnewThatDiabetes website
Living with Diabetes
Bad Diabetes Day?
Leaving Home
Diabetes Burn Out
Problem Areas in Diabetes (Paid questionnaire)
Tattoos and Diabetes
Steroids and blood glucose levels


A Day in the life

“I originally made this video for my journalism class at my college. Follow me through a (quick) day-in-the-life with Type 1 Diabetes! If you’d like to contact me, tweet or message me on Twitter ! I love hearing from other diabetics!”

Devon Arbenz


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Join others to let off steam, get support…whatever you need!

Try out this new website which encourages tweets and posts about what you wished people knew about diabetes. This is what the creator of the page says:

Welcome to #IWishPeopleKnewThatDiabetes Initiative website, a place where people (Yes, THIS MEANS YOU,) can share their thoughts and feelings about what they wish people knew about life with diabetes and go beyond the 140 character limit of the twitter hashtag, and in whatever media format they feel comfortable.

My name is Kelly Kunik and I’ve lived with type 1 diabetes for 38 years and I’ve been blogging about all things ‘diabetesalicious’ for the past 8 years, here and will continue to do so~

Back in April, 2015, I wrote this blog post, which turned into #IWishPeopleKnewThatDiabetes Day on Twitter.

The past few months I’ve reached out to a few Diabetes Online Community friends to submit posts on and this site was born!

It’s my hope that this website becomes a place where people living with diabetes can share their feelings in various mixed media formats to inspire and educate others in the process.

And a place where people sans diabetes can come away with a better understanding of what it’s like to live with diabetes.

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Living with Diabetes

Do you have those terrible, awful, no good days with diabetes? I think most of us do. And sometimes you have more than your fair share. I have been lately. This week I have had approximately 5 out of 7 days like that. So I was thinking that we need to have some things we can turn to when these days hit.

Here are my 5 things you can do when you have a bad day with diabetes.

Scream and shout – if you wake up with a blood glucose level that makes no sense at all, have a day that is more like living on a bouncy castle than solid ground, or can not work out what the hell is happening, then feel free to let it out, scream and shout, whinge, complain, even have a cry. Letting these emotions out is useful and helps you get to number 2.

Nut out what to do about the situation – if you are facing one of those days with diabetes what can you do to get it sorted? Can you tweak things, go for a walk, have a rest day to recover, or make some changes to your overall management?
Talk to someone – this is so important. Tell someone close to you, post it on facebook, call a friend. You need to share these shitty days so they don’t hold as much control over your life.

Call your diabetes team – if you are having more than your fair share of bad days with diabetes maybe you need to call your diabetes team and get some input about what changes may be able to help.

Let it go – sometimes, once you have had a scream and a cry, worked out what to do about the current situation, talked to a friend, written a blog post, called your team – the only thing you can do is let it go. Tomorrow is a new day and the next and the next. You are more than your diabetes and you can learn to lessen its grip on your life and focus on something else. Put some music on loud, take a walk, paint a picture, go op shopping, tidy the house, take a short holiday, make love, cook, visit a friend. Do something other than diabetes and watch its tricky little face fade into the background.
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Bad Diabetes Day?

ONE STEP AT A TIME
This is a wise blog post from Melinda Seed, a type 1 in Australia, who blogs a lot on various topics.

Is it any wonder we can feel overwhelmed?

Eat healthy, lose weight, test basals, test boluses, count carbs, know GI factors, check bsl 10 times a day, cut down saturated fat, control your cholesterol, exercise, don’t sit…….

I know when I start to think about “improving control” there are so many things to think about you can either get analysis paralysis or then, who hasn’t suffered the frustration of enthusiastically launching into a get fit/healthy program only to hypo massively at the end of day one and your diet plans fade away amongst the detritus of emptied jellybean, biscuit and chocolate packets.

It’s all too overwhelming, either to think about or to cope with all at once. There’s a cliche “it’s a marathon not a sprint” and that’s true for diabetes. Sporting metaphors don’t really do it for me, so I prefer to think of it like taking each year of school at a time. You’d fail if you were expected to do calculus in Kindergarten, right? It’s a bit like that, one step or lesson at a time is all you can do.

Choose one action that will move you forward from where you are now, even if it’s tiny, just get started. Say it’s reducing your a1c then choose 1 thing, for example, making sure that without fail you test last thing before you go to bed and first thing when you wake up-or whatever other action you think might help. Getting your overnight sugars right (well as right as they can ever be, you know what I mean) can have a really big impact on your a1c and it’s while you’re sleeping, so win-win.

Similarly if you’re at the doctors and get some sort of lecture about improving your control, ask what is the one thing you can do to have the most impact on improving your a1c. You don’t have to agree with the doc about the particular action if you don’t want to but it is an effective way of focusing on something practical rather than the overwhelming notion of “improving your control”.

What’s the one thing you can do today?
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Leaving Home

Check out this article from Diabetes New Zealand magazine.
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Diabetes Burnout

Burnout is not the same thing as depression. It’s when diabetes just feels overwhelming, things are not going well, you’re fed up / frustrated / irritable / etc etc etc

William H. Polonsky has written a great book called Diabetes Burnout and it’s worth reading this. He also has lots of short clips on You Tube (just search by his name) and his website is also worth a look.

So if you are feeling burned have a go at the PAID Questionnaire in the section of the website (PAID = problem areas in diabetes, sadly doesn’t involve payment!). This comes from the Joslin Centre in Boston, USA which is a great centre for diabetes management, research and treatment. Do the questionnaire, print it off and take it to your next diabetes appointment, either with your nurse or doctor. You may be surprised at your responses and it may help breakthrough some of the negative stuff you are dealing with.

Polonsky also recommends:

Give yourself a break instead of beating yourself up when things go wrong
Be honest with yourself and use positive self talk
Find support that is encouraging for you Identify barriers to your management of your diabetes
Make a plan and stick to it each day

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PAID QUESTIONNAIRE – Problem areas in diabetes

PAID Questionnaire
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Tattoos and Diabetes

Tattoos are created by using needles to inject ink under the skin. Having diabetes doesn’t mean you can’t have a tattoo, but before deciding to have one done you must be well and ensure that your diabetes is well controlled. You must let the tattooist know that you have type 1 diabetes.

Getting a tattoo can be quite a long process depending on what design you have chosen. You can expect your blood glucose levels to rise while it’s happening, but you also need to be prepared for hypos depending on how long the procedure is, and how you react to stress.

The main complication is impaired healing as high blood glucose levels can increase the risk of infection and slow the healing process down.

Other things to consider before getting a tattoo include:

  • Where will you put it. Some websites suggest certain areas should be avoided such as your butt, shins, ankles, feet and where you usually inject your insulin
  • What design you choose. If you are using it as a medic alert then it needs to be clearly visible for paramedics
  • Checking out the tattoo parlour first. Are they registered? How do they sterilize equipment? (They should have an autoclave to sterilize equipment). Do they use a new sterile needle with every tattoo? Will they wear gloves?

If you feel unwell or see any sign of infection after your tattoo has been completed, you should seek immediate help from your GP, ED or diabetes healthcare team.

AFTER-CARE

Taking care of your skin immediately after getting a tattoo can both prevent infection and help keep it looking great.
Acknowledgements: Diabetes UK; Harvard Health Blog

After a tattoo session is over, take off the bandage within three to five hours. Wash your hands with antibacterial soap and warm water, then wash the tattooed skin. Pat dry with a paper towel or clean cloth towel.

  • Allow the skin to air dry for 5 to 10 minutes. Then apply a very thin layer of Vaseline, Aquaphor, or other ointment.
  • Repeat the washing, drying, and moisturizing process three to four times a day for four days.
  • When the tattooed skin starts to shed a thin flaky layer of skin, do not scratch or pick at it. At this point you can switch to a moisturizer—don’t let your tattoo get dried out for the first few weeks.
  • Call your doctor if redness or swelling persists after a few days, you have a fever, or you notice a rash in or around the tattoo.

POSSIBLE PROBLEMS

  • Allergic reactions – you may suffer a reaction to the substances used in the inks and equipment.
  • Skin infection – the tattooed area of skin may become infected if the studio and/or tattoo equipment is not clean or proper aftercare is not applied.
  • Scarring – tattoo application can cause the formation of an oversized scar known as a keloid, which can be irritable and slightly painful.
  • Blood-borne diseases – if the tattoo needle or ink has not been sterilised, it could put you at risk of blood-borne illnesses such as Hepatitis B or C.
  • Wound healing – high levels of blood glucose could delay healing of the tattooed skin and increase the risk of infection.
  • Change of heart – having a tattoo removed is much harder and more expensive than having one done, so make sure you are 100% sure about your tattoo plan before going ahead with it.

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Steroids and blood glucose levels

What are steroids?

Steroids are medications used to reduce inflammation and suppress the immune system. Steroid treatment is commonly prescribed for short periods of time to treat conditions such as rashes, musculoskeletal pain, injury, and respiratory ailments. However, steroids can also be prescribed for longer periods of time to treat certain inflammatory disorders, autoimmune disorders, and organ transplants. While steroids can help reduce inflammation and reduce pain, they can also significantly increase blood glucose levels in people with diabetes, as well as individuals with impaired glucose tolerance or pre-diabetes. Why is this? Steroids increase the liver’s release of glucose, and cause insulin resistance, which leads to insulin (either injected or made by one’s own pancreas) working less efficiently.

What if I’m prescribed steroids and have diabetes?

First, let your prescribing doctor know you have diabetes, because they may be able to prescribe an alternative medication that will not affect your glucose levels. If alternative medication is not an option, inform your diabetes healthcare team immediately so they can determine what adjustments need to be made to keep your blood glucose levels within your target range. Your pharmacist and your healthcare team should be your chief resources for questions about any medication that you are taking.

What should I keep in mind while taking steroids?

1. Steroids don’t elevate glucose levels consistently throughout the day, so you may need to check your blood glucose more frequently. Your healthcare team will determine how often. You may find this glucose monitoring guide helpful.

2. You may need to increase your insulin doses to accommodate the increase of insulin needs. Talk to your healthcare team about using the temporary basal rate or adjusting your basal pattern if you are on an insulin pump, and adjusting using your mealtime insulin dose. If you are doing multiple daily injections you may need to increase both your background long acting insulin and your meal time bolus which you can do by lowering your carb ratio and your ISF / correction factor, or if you are not using those tools, generally increasing your meal bolus a few extra units.

3. Test your blood for ketones, as directed. Notify your healthcare team immediately if your ketone levels are over 0.6 mmols, your glucose levels remain high after their advised insulin adjustments, or you’re experiencing nausea, vomiting, or shortness of breath.

4. Carry fast-acting carbs, such as glucose tablets/gels, fruit juice, or Mentos, to treat hypoglycemia in case your glucose levels drop.

What if I change or stop my steroid dose?

Eventually, your healthcare team will taper down your steroid prescription. It’s important to not stop your steroids prematurely, as this may cause significant illness. When your steroid doses are tapered, your insulin doses will likely need to be lowered as well. Continue to check your glucose levels as advised, and discuss your insulin regimen with your healthcare team.

Being under the weather is no fun, but if you have diabetes and are prescribed a steroid, frequently testing your blood glucose and proactively communicating with your healthcare team will help you stay healthy!
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Read more on my diabetes

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School, Work, and Uni

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School
Massey University
Victoria University


At School

At school it’s a good idea to make sure the school is aware that you have type 1 diabetes. Either you, your parents or your diabetes nurse should do some education with the teachers, especially the PE teacher so they know how to help you if you have a low at school or are unwell. Your diabetes nurse can provide a management plan for the school that is individualised to you.

You should have a hypo box at school with some form of glucose in it (Vita tabs, Dextrotabs, Mentos, juice boxes), some follow up carb (biscuits, small muesli bars) and a Glucagen kit (orange box). This can be kept at the office, usually the best place for high schools as you are changing classrooms all the time. You should also have a civil defence kit at school in case of emergency. You need to arrange to keep insulin in a fridge, some test strips and some extra carb foods (tinned beans, tinned rice pudding, muesli bars etc). It’s your responsibility to check the expiry dates on your insulin and test strips.

Once you are doing NCEA credits you need an exam letter for special conditions which your diabetes nurse can supply. You are registered with NZQA. If you have a hypo during the exam, for example, you can use the evidence on your meter (dated and timed correctly!) for any claim afterwards.

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Massey University, Wellington

ABOUT US

In Wellington, the Health and Counselling Services are combined and operate as a single service providing professional medical and counselling services to students.

SERVICES

The Student Health and Counselling Centre offers high-quality holistic health care. Holistic health care has a direct relationship with educational excellence and is dedicated to promoting the development of students to their highest potential. The health centre’s policies and practices are designed to provide a safe, professional and private environment and to support students’ goals through independent thought, freedom from ignorance, understanding of self, and by ethical conduct. The clinic is accessible, welcoming and cost effective to all Massey students.

The centre is staffed by doctors and nurses, counsellors, a physiotherapist and a nutritionist. It offers a general practice service, including ACC, sexual health and family planning consultations.

The Student Counselling Service at Massey Wellington offers a confidential, professional service dealing with issues such as relationships, self-esteem, grief, anger management, sexuality and abuse. All counsellors are members of a professional body and follow the appropriate Code of Ethics.

Counselling offers an opportunity for you to talk to someone who will listen without judging you. We offer a private, free and confidential service and look forward to meeting you during your time at Massey Wellington.

ENROLMENT

All current students are entitled to access the health and counselling service. SHCC is part of a PHO (Capital Primary Health Organisation). Students choose to either ‘enrol’ with SHCC or be seen as a ‘casual’ patient (enrolment means that you choose SHCC to be your main provider of primary health whilst you are at University). Enrolment forms are available at the centre or can be downloaded here.

COMMUNITY SERVICES CARD

Most students are entitled to a community services card. An application form is available at the Centre. You must have already sent in your completed application form to be eligible for a free doctor’s appointment.

EXISTING MEDICAL CONDITION

If you have any ongoing medical conditions – eg asthma, epilepsy or diabetes – please inform the nurse at the SHCC as soon as possible. This is in order to provide you with the most appropriate treatment in the event of an emergency.

LOCATION

Student Health Centre (SHCC) Third Floor, Student Services Building, Wellington

CONTACT US

Tel: (04) 801-2542 or ext 62211 Fax: (04) 801-2547

OPENING HOURS

Normal Opening hours: Mon – Fri 8.30am to 4.30pm
During Semester Break: Mon – Fri 9am to 4pm

EMERGENCIES

AFTER HOURS AND WEEKENDS

The After Hours Medical Centre 17 Adelaide Road, Newtown Tel: (04) 384 4944
Healthline : 0800 611 116

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Victoria University, Wellington

TE RATONGA HAUORA TAUIRA

Excellent student focused care and support is available for students who have Type I diabetes at Victoria University of Wellington.

If you are a current student at Victoria you can register as a patient at the Student Health Service and almost all of your diabetes health care including laboratory tests can be completed on campus.

Our Diabetes team includes GPs Dr Cathy Stephenson Dr Sandra Bennett, and Practice Nurse Amanda Trueman. Kirsty Newton, Diabetes Nurse Specialist from the Diabetes Clinic at Wellington Hospital, visits the Service every three to four weeks during Trimester I and Trimester II. Dr Jeremy Krebs, Clinical Leader of Diabetes and Endocrinology Service at Capital & Coast District Health Board, sees students at our clinic on the Kelburn campus at 7 Friday morning clinics which are held throughout the academic year.

We have regular coffee meetings and education sessions including carbohydrate counting, healthy nutrition, alcohol and type I, and there is a Facebook group too.

Students have direct email and text access to Amanda which makes it easier to arrange repeat prescriptions, or when you need a new meter or insulin pen, or you are feeling unwell.

The work of the Diabetes Team at the Student Health Service was featured in the Nursing Review magazine. Check it out.

We also work closely with other services at Victoria to ensure students are able to access dental care, medic alert membership, are able to sit university examinations where they are can check their blood glucose level and eat and drink.

The Student Health Service provides full primary health care for all your other health care needs too, and for students who register as patients there is no charge for routine nurse and doctor appointments.

The Student Health Service is strongly committed to providing students who have Type I diabetes with the best nursing and medical health care possible. We want students to enjoy their time at Victoria, to achieve academically while also safely and effectively managing their health.

More information about Student Health Service is available.

If you are considering studying at Victoria University of Wellington and you would like to visit or talk with Catherine at the Student Health Service please give her a call on 04 463 5308.

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More on My Diabetes

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