I need to be more active. My Diabetes control has been pretty non-existent this year. Thankfully, my new Fitbit gives me an easy way to measure my (lack of) progress, and I’ve started making better use of short gaps in my daily schedule to get outside more often.
Home must be here somewhere …
I had an hour gap between shifts this morning, so I took our dog out for a walk in our area. The nice thing about walking with her is that she tends to move at a pretty fast pace (once she gets past the anxiety of being in a new space). It’s mostly her way of trying to return home as quickly as she can, wherever that is.
The upside of that is that we tend to have a pretty brisk walk so I can get my heart rate up a bit. Today we only walked for about 15 minutes or so. Next time, we’ll head out further, I think.
I’d like to do at least half an hour at a time, at a fast walk. I’m also contemplating buying a pair of decent running shoes and getting back into running. The challenge is that Winter is setting in. The prospect of running in the cold rain doesn’t thrill me.
I haven’t written about my journey with Diabetes for a while and I thought I’d share some updates because my Diabetes has changed. I am now an insulin-dependent Diabetic but that is ok. Well, it is now but it wasn’t when I made the transition.
The reason why I want to share this post is because I really struggled to find other people’s stories about their experiences with Diabetes which I could relate to. Perhaps my experiences will be helpful to someone else who is going through something similar.
It is scary when your body changes and your Diabetes progresses/deteriorates. It is especially so when you can’t peg it to a particular cause. It helps to know that other people have been through (and are going through) what you are dealing with.
Background
So, as you may know, I was diagnosed as a Type 2 Diabetic a few years ago. It was a shock, initially, but I realised that it was actually a blessing. Before I was diagnosed I was way overweight and not doing much about it.
Two of the ways I started to take control of my condition were to eat healthier and to exercise more often. I shed about 20kgs of fat in my first year or so and I’ve managed to stabilise at a much healthier weight.
My levels were pretty stable until about December 2015 when something went wrong and my Diabetes deteriorated/progressed (I’m never really sure whether to describe it as a deterioration or a progression – Diabetes is a progressive condition, it will become more advanced over time).
When it all changed
We’re (me and my doctor) aren’t sure what caused the change but my blood glucose levels started to rise dramatically in mid to late December. The main factor that comes to mind is that I was pretty sick. I developed a chest infection that was about a day away from pneumonia (before I saw my doctor and started medication). Getting sick always pushes up my blood glucose levels so I initially ignored the spike when I saw it in my routine self-tests.
That was my first mistake.
Tip: Do your tests regularly, even if you know something is distorting the results.
When my high levels persisted and I still felt sick, I started testing less frequently. I just attributed the high levels to my illness.
This is called “compounding” my first mistake.
Tip: Keep testing regularly so you have consistent data for later.
Then, after I recovered and my high levels persisted, I decided that my tester must be faulty and procrastinated dealing with it for a couple weeks. In the meantime, my levels continued climbing while I focused more on improving my diet.
This was my second mistake.
Tip: Focusing on your diet is great but don’t procrastinate seeking help if you notice a problem. Go talk to your doctor, even if you feel like your habits created the problem.
Although the shock forced me back into a more disciplined diet, it took me far too long to go to my doctor and confess my neglect and seek help. To my credit, I even took a notepad and made notes, determined to fix My Problem and Return to Controlled Diabetes.
The change
My doctor referred me to a specialist (again) and told me to go have blood tests done and my feet examined. Why my feet? Well, one of the warning signs of poor control is peripheral neuropathy – loss of sensation in your extremities, like your toes. That leads to toes and other parts of your body being deprived of blood and falling off. It isn’t the fun part of Diabetes (there aren’t many).
My HbA1c blood test series confirmed my fears. My blood glucose levels had risen dramatically. My spot blood glucose test put me at 258mg/dl – the upper end of the normal range is 140mg/dl. My HbA1c put me at 8.4%. My levels should be under 6.0% or so. The HbA1c is one of the key metrics for Diabetes control which I clearly lacked.
My doctor decided it was time to change my medication. I was previously on a dose of Metformin, twice a day. It was a slightly increased dose but otherwise roughly the same medication I had been on since I was first diagnosed. The change was to switch me over to a pill called Januet which combines 50mg of insulin with the Metformin, twice a day.
When my doctor mentioned adding insulin it scared me. I don’t like needles at all and the prospect of injecting myself wasn’t a happy one. Fortunately, there was a pill option for me!
For some reason my condition progressed/deteriorated to the point where I now needed insulin to control my Diabetes. Initially the Januet was a sort of test run. The idea was to monitor my levels and see if they came back down to a normal range on the new medication. If they did, the new medication would become part of my new treatment regime.
Taking steps to regain control
That was a reality check for me and it reminded me of the importance of doing my self-tests regularly, even if I don’t like what I see. The point is to be aware of the problems because that awareness is your first step towards addressing them.
Managing Diabetes isn’t just about the medication although that can be critical. I noticed that my blood glucose levels rose on the days when I ran out of my Januet and returned to just Metformin. I am insulin-dependent and that means that, given my current lifestyle, I need the insulin to stabilise my blood glucose levels. Period.
Something else that makes a noticeable difference is exercise. My mother visited us in April and we did a lot of walking during one of the weeks she was here. On an average weekday I walk around 5 to 6 kilometres. When we were on holiday with her and touring locally, we walked 8 to 11 kilometres. I noticed that all that walking helped bring my levels down, usually to below 120.
Another big realisation was how much of an impact stress can have on my blood glucose levels. It can cause a huge bump in my levels.
Diabetes isn’t a disease although living with it can be challenging. It is easy to pick up bad habits and eat the food you know you shouldn’t. I also noticed that my body has less of a tolerance for carbohydrates and eating more than a little pasta and bread can really push my levels up. We have switched to wholewheat breads and pastas but even those seem to be problematic so I tend to avoid them.
Walk more
My morning routine has changed a little since I wrote about it just over two months ago. I now start work at 7am instead of 6:30am and that means that I miss the bus I used to take to the train station. The positive side of that is that I have to walk to the station. That, of course, means more exercise every week day.
Unfortunately I spend most of my working day sitting and that isn’t good for me (or anyone). I put my back out in the holidays and sitting every day probably delayed my recovery by about a week too. I try make a point of getting up and going for a walk out the office for a bit every day. I don’t always do remember to do that, though.
Get out of the office more often
I do make a point of leaving the office for lunch, though. I understand why many companies offer their employees food. They want to keep employees close to their workstations so they can eat and get back to work. I don’t think that is particularly healthy and, if anything, I need to leave the office for lunch just to give my mind a break and get some outside air. It helps a lot with work stress too.
This morning I tested myself: 121. I’ve managed to stabilise my levels in the last two months or so and just need to remain vigilant and disciplined to maintain that. I plan on living a long time and I am constantly reminded of the importance of taking better care of myself as I grow older.
It’s a work-in-progress
I am due to do another set of blood tests in the next week or so, along with my long overdue feet examination. Being Diabetic is very much a work-in-progress but, on balance, it has been a positive thing for me and my family. I am in better condition than I was in the years before my diagnosis and that is just going to be increasingly important in the years and decades to come.
As I wrote in the beginning of this post, I wanted to share my experiences in case there are other Diabetics who are going through something similar. There is a lot of information about Diabetes on the Web but I haven’t seen many stories from Diabetics who face challenges I can relate to. Perhaps my experiences will help someone who is going through something similar and isn’t too sure what to make of it all. It can be scary when your body changes like this.
We’re now into March (wow, right?!) and I published some new stuff over the weekend that you might have missed; about work stress, Diabetes and a fresh perspective on Death. I understand, you have weekend stuff to do. Here are a couple things you might be interested in.
My Diabetes recently taught me that work stress can be deadly. I always knew stress was harmful but it was only when I saw that reflected in my blood glucose tests that I realised just how much. Here is a little post about the lessons I learned:
imonomy, my employer, moved to new offices recently and I spent a little time capturing little details early one morning. Here is a peek inside our new offices:
I watched a short video that included a audio track by Alan Watts talking about life and death and part of his narrative really caught my attention and I had to share it:
Diabetes recently taught me a powerful lesson about work stress. My blood glucose levels went through the metaphorical roof in December. “Through the roof” is probably an understatement. I went so far above the recommended levels it was like trying to find your house from a passenger jet flying overhead.
When I think back to December a few possible causes come to mind:
My diet wasn’t as good as it could have been. I had slipped back into some bad habits with high GI foods and a little more sugar intake than I should have.
I was pretty stressed at work. It was the holiday season and and the end of the quarter so we were under pressure on two fronts.
I picked up a cold (what doctors call a “viral thing” and what I am going to start calling “Viralthingitis” in future) and it degenerated to borderline pneumonia before I finally took a few days off to rest.
My blood glucose levels always go for a loop when I get sick and I tended not to test myself every two days like I am supposed to when I got sick. Firstly, it was pretty disconcerting to see my levels jump so dramatically and, secondly, I was lazy in my approach to monitoring my levels.
December became January and my levels were still really high. I eventually contacted my doctor in late January and she sent me for blood tests. The results confirmed my high readings (I thought my tester may have been faulty) and when I went to discuss the results with her partner, she couldn’t really attribute the changes to specific triggers. It could have been the virus. It could have been my poor control. In all likelihood it was both and, in retrospect, probably some stress too.
What was clear was that my body had changed. I was stricter with my diet in January and my levels still didn’t reduce so my medication changed to include insulin (still pills, thank goodness) and I’ve been on that for just over a month.
Last weekend I finally saw my levels drop down to the upper limits of “normal” and I thought I was on the path to not dying early. The following work day I arrived at work at our new offices (we just moved to a great new space in Tel Aviv from Ramat Gan).
The first day in the new offices was fairly stressful for me for various reasons. I realised how much my work stress affected me emotionally when I found myself being pretty short with our kids that night even though they were actually pretty well behaved. It was only the following morning that I saw just how much it affected me, physiologically. My blood glucose test result jumped dramatically again.
When I saw the blood glucose test result that Monday morning (our week starts on Sunday) I was shocked. I had been working so hard on bringing my blood glucose level down to a normal range and keeping it there only to see this dramatic change in such a short time period and due to stress at my office. It really shifted my perspective on work stress. Not only were the issues that caused the stress affecting me emotionally and impacting my relationships with my kids and wife, the stress was potentially deadly in the medium term. If I had this sort of stress on an ongoing basis, it would literally kill me.
That particular realisation was powerful because it gave me a new and very personal perspective on unhealthy working environments. It also reminded me that there are two ways to handle stressful situations. The first is to change the situation and defuse the tension. The second is to change your attitude towards the situation and remove the triggers.
Work is often stressful and a level of work stress is a given. When your stress increases to the point where your health is so dramatically affected by it, it is probably time to rethink either how you respond to stress or find another job (if you can). I certainly found myself with that choice that Monday morning. I opted for changing how I’d respond to the sorts of issues that caused my stress. That is often easier said than done and it takes a constant effort to make those little course corrections throughout your day but if you consider the alternatives, you don’t really have much choice. It can literally be a matter of life and death.
I know banting seems like all the rage these days but I just don’t get it. Well, I roughly understand what the basic rules are but this diet and others like it seem to be, well, fads. At the moment banting is huge and people swear by it (I hear there are crop circles and everything) but what happened to moderate, yet fairly well rounded eating habits?
Before I continue I should probably point out that I’m not a dietician so don’t rely on what I am about to say or leap off tall buildings, even if you are wearing a red cape.
I had to change my diet a while ago when I was diagnosed as diabetic. What I really liked about the meal options my dietician gave me was that they made a lot of sense. She took me off sugars (diabetes – obvious, right?) and put me on to low GI foods which included carbs, fruits, vegetables and so on. I also stuck with relatively low fat meat, dairy and other foods which tend to have fat content.
My amazing wife switched our family’s diet almost overnight to this healthier option and I started exercising a lot more. I lost about 15 kgs by eating better and exercising more regularly and started to feel a lot better than I had for a long time. It was a little tough in the beginning because I was used to all the sweet stuff but I found a balance between small quantities of the “bad sweet stuff” I used to eat and my healthier meal options and it literally changed my life in a very sustainable way.
Food, to me, is something to enjoy and eat in moderation. Sure, many people can’t eat certain types of food and adjust their diets accordingly but when a diet becomes a hardship, it tends not to be one you’d be motivated to stick with. Also, add the seemingly fanatical banting supporters to the mix and it becomes a hazard carrying a loaf of bread in the vicinity of a bantite (what do you call banting adherents?).
Clearly banting has worked for a lot of people but it just seems like a fad to me which will be replaced by whatever post-paleo, neo-banting diet rolls around next …
Today is World Diabetes Day (I forgot but my wife kindly reminded me) so I thought I’d share some of my experiences and journey with Diabetes so far.
The one thing that really stands out for me is how I have changed in the last 10 months or so. I don’t remember being thin since my teens and I have people telling me that I am skinny now. It sounds a little superficial but this is quite a big thing for me. These photos of me will probably give you an idea of my physical transformation. This first photo was taken on 7 February, around the time I was diagnosed.
Shortly after I was diagnosed
This second photo was taken the other day (it’s an ID photo update so I wasn’t making much of an effort to smile).
November 2013
Initially being diagnosed with Diabetes seemed like a tremendous burden. Now I see it as one of the best things to have happened to me (after meeting my amazing supportive wife and having our equally amazing children).
A few thoughts about my experiences with Diabetes on World Diabetes Day in 2013. Less than a year after my diagnosis and I could see the positive effects of it on my lifestyle.
