Taking diabetes on holiday

I'm sure I'm not the only one to be sorely frustrated by the fact that we can't take a break from our diabetes. It's with us when we're at work, when we're visiting friends, when we're exercising. It even has the cheek to follow us on our summer holidays!

Holiday breaks are certainly a time to unwind and forget about the stresses of everyday life. Even though those of us with diabetes, can't just 'forget' about it, there is no reason why we can't enjoy ourselves, too. We just have to remember that diabetes will be staying with us, for a while. Whether you are taking a holiday in the UK, sunbathing in Lanzarote, or skiing in the French Alps, there is so much to remember. Not only do we have to remember the usual clothing, sun cream, passports, we also have to remember our MEDICATION.

Arguably not so much of an 'end of the world' feeling if you're on holiday in the UK, but it really is important to remember the everyday essentials, so that you can continue to maintain your sugar levels, when you are on holiday. There are lots of things that will affect your sugar levels - level of activity, mood, diet, temperature. It is difficult to know quite how your diabetes will be affected, with the temporary change of lifestyle. Some people will find the hot temperatures make their sugar levels drop rapidly. Others will be more lenient with the food they eat, thus leading to a rise in sugar levels. However, everyone is DIFFERENT. 

It might also be worth going the extra step, and learn the country's language - if faced with an emergency, you would need to be able to make your way to a hospital. 

Remember, it is ok to let your hair down when you're on holiday, but listen to your body. Look out for the signs of a hypo. Don't neglect your blood glucose meters, and do remember to take the right dose of insulin/tablets, for what you are eating. 

For more guidance on what to remember when going on holiday with diabetes, check out the Diabetes UK website or visit www.diabetes.co.uk/travel

Working with diabetes

Managing your diabetes is a very personal thing and how (and with whom) you choose to share that with can also be a very individual thing.  Some people choose to be very open about it whilst others can be more reserved – and whatever works best for you is obviously the best thing.

 

But is there a certain amount we should disclose about our condition regardless of how much we might want to?

 

I recently started a new job (actually my third different workplace in the last 12 months – the price of being a contract worker) and I haven’t really talked a lot about diabetes since I began.  I have my tester and diary out on my desk all the time, I openly use my pump in the lunch room but I haven’t really explained any of this to my new colleagues.  I’ve told them I have type 1 diabetes but I’ve not elaborated any further than that.

 

I think the main reason is that I don’t want to make other people feel uncomfortable because of it.  Or that I don’t want people to feel any sort of responsibility towards me because of it.  That said, in a previous job, I ended up explaining to two of my co-workers all about type 1 diabetes in great detail when we had an overnight stop in London for some meetings.  It turned out that they were very curious and felt a lot more informed as a result.

 

I’ve always been very independent with my diabetes and whilst my immediate family and close friends know what they need to know I’ve never felt at ease automatically giving that same information to colleagues – partly because I’ve never felt like I needed to. 

 

But is it being responsible for your own health to tell people what might happen, how to treat a hypo and what signs to look out for?

 

I suppose the answer is always a pretty personal thing too.  If you’re going through a phase where your control isn’t as good as you’d like, or you don’t get hypo warning signs then maybe it’s more prudent to be open with your colleagues than if you’re a lot more confident in how your daily routine affects your diabetes.

 

What we should always remember is that there should be no stigma attached to having diabetes and you should always be able to speak openly about what it means for you and what it might mean for your colleagues too.

 

If you’re not sure about how you should broach the subject or want someone to talk to, don’t forget you can contact us in confidence to talk things through.

 

Andy

@AndyPeerSupport

andydiabetespsn@gmail.com

Where's your support network?

There are few things in this world that we can do entirely alone. As children, we needed help to learn to ride a bike, we needed someone to teach us learn to swim. Growing up, we needed the help of teachers and professors, to pass academic exams. We no doubt needed help in our first jobs, someone to guide us in the right direction. Someone to show us the ropes, and to point out where we went wrong.

Living with diabetes is no exception, yet many people often feel like they have to go through it alone. Maybe because they don't know anyone else who has the condition. Maybe because they feel like a 'burden' on their loved ones. Maybe they even feel guilty for having diabetes, and don't feel anyone else should have to put up with it, too.

This is very far from the truth, and very far from the expectations. Diabetes is a condition that doesn't yet have a cure. Until the day that we have a cure, we have to live with the condition. There are no 'holidays' from it, we cannot postpone the condition from ourselves. There is no escape.

There are no doubt times when we wish we could run from diabetes. Lock it in Room 101 and carry on as normal. Diabetes is the cause of so many cases of depression and anxiety, and of course, that could then have a knock-on effect with diabetes, itself.

When we feel like this, it is easy to want to lock away not just the diabetes, but lock ourselves away, from the rest of the world. To some people, this is a coping mechanism. They may need time to think. However, what about those who do this because they feel they have no one to help them get through this?

Diabetes UK has a number of branches when it comes to support networks. This is something they pride themselves on. and rightly so:

Careline: Dedicated helpline for people with diabetes, their parents, partners, friends, colleagues. The helpline is staffed by trained counsellors, who are there to answer ANY questions you have relating to diabetes. Very useful if you have a quick question, or if you need someone to just listen to you.

Local support groups: These have been running for many years, and give support to those with diabetes, on a much more local and personal level. Some groups focus on providing support, some look at ways to raise money for Diabetes UK. Many groups have guest speakers, covering a range of topics. Find your local group.

Diabetes Peer Support Volunteers: This is all about talking to someone who knows first hand what it's like to live with diabetes. They might not be healthcare professionals, but they CAN share their experiences, and help you to work out your issues.

There is a wealth of information out there, in the local community, and within the diabetes online community. As peer support volunteers, we really want to find a way to support YOU. Who do you talk to about your diabetes? Do you have someone you can talk to? Let us know, and let us listen to YOU. Because no matter what anyone thinks, it's all about YOU.

Have a break, have a kit kat

If you have diabetes, how many times have you heard the following five words...

"Should you be eating that?"

This is a question that is wrought with guilt, doubt and perhaps even frustration. Should you really be eating something that tastes so nice, and has a higher sugar content than that salad you had for lunch? Maybe. Maybe not.

When someone with diabetes is initially asked that question, there are many possible replies and reactions. The person could be overcome with a horrible feeling of guilt. Maybe they shouldn't put their body through the extra sugar? How will this one slice of cake affect them, in years to come? Will it? Maybe if they chose a piece of fruit, instead of the cake, their health will be better.

As peer support volunteers, we are in no position to tell someone what they should and should not be eating. We are not healthcare professionals, and cannot say what the consequences of eating something in particular, would be. However, what we can say is that we understand how tough it can be, to constantly have to question every piece of food, every drink, and whether we can afford to.

It may seem like people who don't have diabetes, are trying to dampen the person with diabetes' spirits. Why should someone with diabetes be allowed a custard cream/chocolate digestive, every now and then?

Like everything, 'unhealthy' food is ok to have, every once in a while. There is no food that someone with diabetes, is categorically not allowed to have. Everything is ok, if it is in moderation. The odd chocolate digestive with a cup of tea, will not affect that person's sugar levels in the long run. It may cause a spike, on that day, but it won't rule the person's sugar levels in the long run.

Of course, even within the two main types of diabetes, there are different attitudes and approaches to what someone eats. It has been suggested that those who are insulin dependent, are at an advantage, as they can take into consideration the extra sugar they consume, when they are judging how much insulin to give themselves. Those who treat their diabetes with tablets, may be more inclined to shy away from the sugary food, as they aim to maintain their sugar levels, through tablets only twice a day (rather than at every meal time).

Whatever your attitude toward food and drink, what other people say, shouldn't make you feel guilty, or like you're in the wrong. It is YOUR diabetes, not their diabetes. No one knows your body as well as you do. If you want the occasional treat, this is ok. Everything is ok, in MODERATION.

We may not be healthcare professionals, but if something is bothering you, in regards to your diabetes, please feel free to talk to us. We have many contacts, within the healthcare profession, who will have the answers to your questions, if we don't.

Food, Glorious Food

Chances are if you’re diabetic that at some stage someone has said to you “Should you be eating that?!” as you reach for a biscuit or some chocolate.  Food and diet in general is obviously one of the most important things to consider when you have diabetes and can cause difficulties for some people who are unsure about what to do for the best.

I remember the first few supermarket trips after I was diagnosed 12 years ago.  As a university student I was faced with the timeless battle of buying the “right” food on a budget.  I think that first trip took me an hour and a half as I poured over food labels, laboriously trying to find the “healthiest” food on each aisle.

In truth that was partly due to still being in a state of shock at being diagnosed, and partly due to not being fully informed about what choices I had regarding food, and how I could use my insulin to manage what I wanted to eat (to a certain extent anyway).

Whilst the picture above is a little tongue in cheek (what about cake with poison for example?), it’s not really far from the truth.  That said, it’s probably wise to make a little distinction between what you can eat and what you should eat.  Perhaps surprisingly the answers to these questions are not really much different whether you’re diabetic or not.

What you “should” eat which is basically a healthy balanced diet which is low in saturated fat and salt and high in fibre and contains lots of fruit and vegetables.  That’s basically what anyone should be eating, regardless of diabetes.  That’s not to say that a sweet or sugary treat is off limits of course, but they should be eaten in moderation rather than making up a part of your daily diet.

So what steps can do to make some improvements to your diet?

Eating a lot of foods that are high in saturated fat can increase your cholesterol which in turn increases your risk of heart disease which is something you obviously want to avoid.  Limiting your saturated fat intake and switching to lower fat spreads or using skimmed milk can help.  The NHS Live Well site has some good information on reducing your fat intake.

It’s also worth taking a look at the Eatwell Plate which gives a good guide on what proportion of your daily food intake should come from which food groups.  You might find that making a few small changes will give you some big benefits.

There are also other resources you can use when reviewing your diet.  Diabetes UK have a guideto healthy eating with diabetes which includes over 250 online recipes.  You can also make an appointment to talk to a dietician via your GP or Diabetes Centre at your local hospital.  They can offer a number of options for you depending on your circumstances.

Finally, you can always talk to other people with diabetes about their experiences, either via this blog, Twitter/Facebook or using one of your local groups.  It’s always good to be able to speak to other people in a similar situation to yourself as sharing tips and frustrations can often be a good way of finding out something new.

You can find us on Twitter at @AndyPeerSupport or @LouPeerSupport or search Facebook for “Diabetes Peer Support Sheffield” or “Essex Diabetes Peer Support”

Brand new year, brand new you?

The beginning of another year is always filled with promises – no more junk food, lots more trips to the gym, lose tons of weight, travel the world. The list of typical new years resolutions, is endless.

How about we stop for a minute, and think about what we really want from 2014. Do we really want to exhuast ourselves at the gym 7 days a week? Do we really want to cut all ties with the things that we love? The answer is probably no. And the good news is, there's no need to.

When it comes to diabetes, taking care of one's self, is really important. People with diabetes are more likely to come across complications in old age, if they don't care of themselves, today.

However, there is a difference between taking care of one's self, and overworking the body. Working out 7 days a week, and having no form of enjoyment, will most likely lead to exhuastion, tiredness, and a desire to stop everything, all together.

The important thing in looking after yourself, both your diabetes and your general health & fitness, is learning to find a balance. You don't have to be a gym buff. The Department of Health recommends 150 minutes of exercise a week. This is less than 3 hours a week. What's even better, is that this doesn't mean 3 hours in the gym. You might be surprised at what counts as exercise...

How many times have you taken the lift, instead of walking? Try to take the stairs once in a while, perhaps. Or how about taking a nice stroll to meet friends for a coffee?

Try cycling. Find a local park, and enjoy the breeze, as you cycle your way to fitness.

Even those mundane tasks around the house that need doing – vaccuuming, DIY, gardening.

You might want to get family and friends involved. It is a lot easier to keep at something, if you have a reason to keep going.

Building up your activity gradually, makes it easier to stay active. You might even discover you quite enjoy a particular activity!

Diabetes is a very unpredictable condition. That doesn't mean that it should control us or stop us from doing things. If you are worried about doing a certain form of exercise, because of how your diabetes might be affected, it might be worth talking to your Diabetes Nurse or Consultant. There are a lot of people with diabetes, who also regularly blog about they sports they take part in.

More importantly though, listen to your body. No one expects you to be running marathons next week, or climbing mountains next month! Take it one step at a time, remember to check your sugar levels before the activity, during if possible, and after. You are more likely to have a hypo up to 24 hours after exercise, so it is perhaps wise to monitor your levels the next day. If you feel low during the activity, stop and treat the hypo.

Useful Resources
Diabetes UK – Getting Active and Staying Active
Diabetes UK – Blogs from various people with diabetes, who take part in sports

A Wonderful Christmastime

It's beginning to look a lot like Christmas.  But it's also beginning to look a lot like a potentially difficult time for people with diabetes.

Christmas is traditionally time for indulging in those things that we may not always allow ourselves (such as a complete tin of Quality Street in one sitting) and that can lead to blood glucose levels that are higher than normal.  Without wanting to go into too much detail here, I wrote a blog for Diabetes UK last year about coping with Christmas which may offer some useful tips when considering that extra mince pie.

What often gets overlooked is the added stress that Christmas can bring.  Mad dash for last minute presents, work nights out, travelling to visit friends and family can all cause extra stress that can not only lead to increased BG readings, but can also make you feel a bit down.  In fact those two things alone may become a bit of a viscous circle. 

It's important to be able to spot those signs and know how to manage them as best you can.

The first thing to remember is that there's really no such thing as a "bad" BG reading.  Of course there are numbers you probably should be happier with than others, but the concept of "good and bad" shouldn't really apply to your blood glucose.  Being stressed because your BG levels are "bad" is a counter productive thing.

Testing more frequently and remembering the principles of how to correct your BG (either up or down) is important.  As a rough guide, one unit of quick acting insulin should reduce your blood glucose by about 2-3mmol though obviously everyone is different.  Equally, approx 15g of fast acting carbohydrate (think Jelly Babies) should raise your glucose within about 10 minutes if you're feeling hypo.  Whilst it might be tempting to reach for that selection box to treat a hypo, chocolate won't do the job effectively.

Don't be frightened off those extra treat foods because you think they make your diabetes unmanageable.  If you've got a smart phone, the Carbs & Cals app can be quite handy for some things, even if it's only to give you an estimation of what the carbohydrate content of some food is.

Being prepared for the stress of last minute shopping, seemingly endless queues of traffic and those (almost) inevitable family arguments after a few festive sherries.  Not only do these things obviously have an emotional impact on you, they can also increase your BG.

If you end up feeling like Christmas is becoming a frustrating time, try not to be too hard on yourself.  Remember that managing diabetes on a 'normal' day is often very difficult and the numerous changes to your routine that Christmas brings can make you feel like you're out of control.

Suffering in silence rarely makes things any better.  Peer Support volunteers such as myself and Louise can help answer any questions you've got (and hopefully give you a few tips on how we've learned to tackle Christmas) as well as pointing you in the right direction for other bits of useful information.  Our details are in the opening post of this blog and we're here to help if we can (or just to chat about what your least favourite present is!)

The most important thing to remember is that Christmas is a time for fun and celebration.  Diabetes shouldn't get in the way of doing any of that.

Merry Christmas!