Diabetes: Discussion thread.

[Trendseeker]

Could have been this one?
https://www.theguardian.com/australi...el-beer-garden

[b0son]

Originally Posted by DFB FGXR6

This time, he was much more insistent about turning the alerts on. Recent news of a diabetic killing 5 people while driving with low glucose and not having the alerts turned on

He had alerts turned on, but chose to ignore them. One way or another someone was going to provide him with a table so he could have lunch.

Sorry, but he was a stubborn old fool and I hope they throw the book at him. Diabetics lived for years without apps and real-time monitoring. Hell, even us non-diabetics know what low BG feels like, my diabetic dad went for years without a monitor just by feel.

Hasnt stopped his lawyers from trying to get him off describing this as nothing more than a medical episode. But at what point do you hold him responsible? He ignored *nine* alerts.

[prydey]

Originally Posted by b0son

. Hell, even us non-diabetics know what low BG feels

Sorry to be blunt, but no you don't.

[b0son]

Originally Posted by prydey

Sorry to be blunt, but no you don't.

Plenty of people get reactive hypoglycemia these days since plenty of people are obese and/or have T2D.

[DFB FGXR6]

Originally Posted by b0son

He had alerts turned on, but chose to ignore them. One way or another someone was going to provide him with a table so he could have lunch.

Sorry, but he was a stubborn old fool and I hope they throw the book at him. Diabetics lived for years without apps and real-time monitoring. Hell, even us non-diabetics know what low BG feels like, my diabetic dad went for years without a monitor just by feel.

Hasnt stopped his lawyers from trying to get him off describing this as nothing more than a medical episode. But at what point do you hold him responsible? He ignored *nine* alerts.

From what I was told yesterday, yes he ignored the warnings from the sensor. And in that regard, he has no argument to make.

I guess my intent with the post was to say the sensor can be used against you in a case like this. In this case, he is quite rightfully screwed.

I've had Diabetes since 1992. The stuff that I had to use to manage my diabetes is a world away from what is used today. My parents had to pin me to the bed to give me injections from nasty syringes, no pretty pens with tiny little needle tips, huge lances to draw blood from, glucose meters that were the size of a brick and took ages to deliver a result.

It's now 2024 and I have only been on a glucose sensor for two years now, and I still refuse to have a pump. So, I know what it takes to manage the condition with or without modern tech.

Originally Posted by b0son

Plenty of people get reactive hypoglycemia these days since plenty of people are obese and/or have T2D.

Not to discredit or argue with you, more out of curiosity, can I ask what symptoms you get when presented with hypoglycemia? It can be different for every person, so I'm interested to hear what someone without a full diabetic diagnosis experiences.

Personally, I decent level hypo for me can be quite a nasty feeling -

- Elevated heartbeat
- Lethargy
- Sweating
- Shortness of breath
- Pins and needles in my extremities
- Blurring vision (black lines in extreme cases)
- Loss of coherence (extreme cases)

I've been close to lights out a couple of times as well. Quite often, all of the above then leads to fatigue, headaches and exhaustion later on.

[b0son]

Racing pulse, cold sweats/clammy hands, pale skin, tremors in hands. I used to get these episodes when I was younger and underweight after major physical activity. Then when I got older and overweight, it would happen after having a softdrink on an empty stomach - 5-10min later, hands get clammy, hands shake, heartrate goes up. Stops happening altogether when I lose weight.

My dad refuses to go on a pump, but he manages his sugar pretty poorly. Wildly overestimates how much sugar he needs to get himself back to a healthy range. So his BGL is chronically high, and he has eye issues now :/

[DFB FGXR6]

Originally Posted by DFB FGXR6

This has been a long time in coming, so I'm not surprised, but I was officially diagnosed with Celiac disease today.

Celiac Disease and Diabetes go hand in hand, they are both autoimmune conditions with 6% of diabetics living with both diseases.

I'm not going to go into the symptoms other than to say I had been experiencing these for many years now, it all sort of makes sense now.
The result of Celiac disease can lead to malabsorption of key nutrients, which in turn leads to a variety of other issues including iron deficiency, bone density problems, fatigue, weight loss and poor liver function.

Ten years ago, there was limited options for gluten-free food. However, with more awareness of the condition, finding suitable substitutes and changing my diet has been relatively easy. And I'm slowing feeling better too...........although a bout of Covid put a spanner in the works. At least now I have some answers.

For anyone with a Diabetic in the family, it's good practice to be tested for Celiac as well. There are three main tests for Celiac disease, two being simple blood tests. The first blood test only detects if you have Celiac disease in your system, the second test is actually a gene test. If you come back with positive results for the gene test, you are more than likely going to develop Celiac at some stage. For this reason, it's important to ask for both blood tests so that you can be aware of it popping up in the future. Once you have positive results from both blood tests, you then require a gastroscopy to confirm your condition and then go on a gluten free diet.

Nearly two years on, I'm finding the gluten-free food thing to be an exercise in frustration. The section in bold above still applies, finding gluten-free food is relatively simple. However, what I find most frustrating is the lack of consistency in how these products are offered.

It's safe to say that most gluten-free food is tasteless cardboard. To get flavor into the mix, they then lace these foods with sugar and salt and therefore end up having a high glycemic index. Ironically, that is not ideal for a diabetic. As a carbohydrate lover, finding nice bread is a challenge, I would kill for a lovely chunk of handmade artisan sourdough smothered in butter and vegemite! Gluten free pasta on the other hand is very palatable.

The lack of consistency though comes down to availability. On countless occasions, after finding a product that I actually like, it ends up being discontinued shortly after. So, I then have to do the whole trial and error thing again, over and over as products come and go. It's exhausting.

I have to say, over the last couple of months, I've gone off food. It's become a necessary evil to me.

[prydey]

Sorry to hear.

If it helps, let me know (via pm if you prefer) what products you are having trouble finding, or finding edible versions of in GF form, and I'll let you know what my wife buys. My wife is coeliac, as are most of her family.

I know it is difficult to find decent bread products. She always asks subway what wraps they use but the people serving generally don't know. Like you say, GF pasta is pretty good. I have that as well to save cooking 2 different meals, and it's fine.

I agree it would be frustrating if you find something you like and it gets discontinued.

[DFB FGXR6]

It's amazing how much power stress can have on blood glucose levels. Wednesday was not a good day. Despite being active and not eating all day, my BGL's were above 15.0 for most of it.

[prydey]

My daughter came in to us in tears on Thursday night... She doesn't know how it happened but her insulin pump had the screen smashed. She was genuinely upset so we believed her. She did golf at school that day but I think she'd remember being hit in the midriff with a golf ball.
Thankfully these devices are covered by a no questions asked warranty. Being a medical device new ones are sent out urgently.
Unfortunately being a Friday it's still at the mercy of the courier services so won't get the new one until Monday.



Had to get out the pens to get through the night Thursday night.


We have a spare pump as a back up but they aren't plug and play due to the settings being constantly fine tuned as the person grows. So Friday we updated the settings and then had to wait for the insulin on board from the pens to run out and then connected the spare pump Friday night.

Highlights the importance of having some sort of back up or emergency plan when you have an autoimmune disease.

Thankfully we've been dealing with it for around 20yrs and it wasn't our first case of pump failure.

[DFB FGXR6]

Originally Posted by prydey

My daughter came in to us in tears on Thursday night... She doesn't know how it happened but her insulin pump had the screen smashed. She was genuinely upset so we believed her. She did golf at school that day but I think she'd remember being hit in the midriff with a golf ball.
Thankfully these devices are covered by a no questions asked warranty. Being a medical device new ones are sent out urgently.
Unfortunately being a Friday it's still at the mercy of the courier services so won't get the new one until Monday.

image

Had to get out the pens to get through the night Thursday night.
image

We have a spare pump as a back up but they aren't plug and play due to the settings being constantly fine tuned as the person grows. So Friday we updated the settings and then had to wait for the insulin on board from the pens to run out and then connected the spare pump Friday night.

Highlights the importance of having some sort of back up or emergency plan when you have an autoimmune disease.

Thankfully we've been dealing with it for around 20yrs and it wasn't our first case of pump failure.

Bugger! I know that feeling of having to go back to old school measures, its heartbreaking.

[DFB FGXR6]

I spent a couple of days in hospital this week, which poses additional diabetes management challenges. That sounds counter intuitive doesn't it, you'd expect to be in safe hands in a hospital, but in reality, it's a very touchy subject.

First, the setup.

Because your immune system is already compromised, an infection takes over much easier and is harder to treat/control. Also, when your body is fighting infection, it begins to effect BGL levels and insulin absorption. This then compounds if you are not eating (either fasting or not able to keep food down), your body starts to release Ketones to break down fat for energy, which in turn increases your BGL's despite not eating.

Because I was sent to the emergency department expecting a long wait and at least an overnight stay, I took my own insulin and supplies. I've been in hospitals enough to know what ends up happening.

There are two things that happen when a diabetic is in hospital. The doctors and nurses freely admit that the patient will know their diabetes management better than they will. I've been told that by countless health care professionals dating back to when I was 6 years old. In fact, I had two anesthetists tell me that they learnt about diabetes from a textbook, but I learnt about it because I actually live with it. Every doctor and nurse on this hospital visit told me this.

The second thing that happens is that those same doctors and nurses question my insulin needs. In one instance, I was given a meal high in carbohydrates. After eating, I informed the nurse I would need to have insulin, because they have to chart it in the records, I was following procedure by informing them. I was then asked why I needed insulin. Umm, I just ate carbohydrates and I'm not doing much physical movement. The nurse then had to phone the doctor for advice, who then halved my intended dose. The result? I ended up sitting above 16 mmol/L for most of the night.

When needing to fast for a procedure, they generally recommend cutting my long-acting dose to run me a little higher to prevent hypos while fasting or when under anesthetic. I agree with this move. But every time, the BGL's in the hour or so before the procedure ends up being above 10 - 12 mmol/L. This then leads to a fuss being made over the higher reading. But that's what they told me to do and what they asked for?

On this visit, those same two anesthetists mentioned above told me that it's just as dangerous to be high as it is low for long periods of time, which is correct but that's the textbook speaking. To nail a perfect number (under 10 but above hype level) is hard at the best of times, but being ill and fasting, and with ketones starting to be a factor, achieving their textbook number is virtually impossible. Prior to that, my nurse had already phoned the doctors about my BGL and ketone levels before I was sent to theater, which clearly, they agreed on because I was sent to theater shortly after. Once I was delivered to theater, my nurse was then given a grilling over the BGL and ketone readings and so another round of consultation.

Obviously, there are a lot of bases to cover here, and a lot on the line. So being careful is probably a good thing. But meddling in my insulin management works against them and me.....................despite telling me I will know best.

[prydey]

Originally Posted by DFB FGXR6

Bugger! I know that feeling of having to go back to old school measures, its heartbreaking.

Yes, sometimes it seems trivial but to those dealing with it, the smallest things can be annoying /upsetting.

Also the back up pump is a different brand so doesn't link up with her cgm. So her levels are a bit of a roller coaster today. That then affects a range of other things like emotions and feeling off.

[prydey]

Originally Posted by DFB FGXR6

I spent a couple of days in hospital this week, which poses additional diabetes management challenges. That sounds counter intuitive doesn't it, you'd expect to be in safe hands in a hospital, but in reality, it's a very touchy subject.

First, the setup.

Because your immune system is already compromised, an infection takes over much easier and is harder to treat/control. Also, when your body is fighting infection, it begins to effect BGL levels and insulin absorption. This then compounds if you are not eating (either fasting or not able to keep food down), your body starts to release Ketones to break down fat for energy, which in turn increases your BGL's despite not eating.

Because I was sent to the emergency department expecting a long wait and at least an overnight stay, I took my own insulin and supplies. I've been in hospitals enough to know what ends up happening.

There are two things that happen when a diabetic is in hospital. The doctors and nurses freely admit that the patient will know their diabetes management better than they will. I've been told that by countless health care professionals dating back to when I was 6 years old. In fact, I had two anesthetists tell me that they learnt about diabetes from a textbook, but I learnt about it because I actually live with it. Every doctor and nurse on this hospital visit told me this.

The second thing that happens is that those same doctors and nurses question my insulin needs. In one instance, I was given a meal high in carbohydrates. After eating, I informed the nurse I would need to have insulin, because they have to chart it in the records, I was following procedure by informing them. I was then asked why I needed insulin. Umm, I just ate carbohydrates and I'm not doing much physical movement. The nurse then had to phone the doctor for advice, who then halved my intended dose. The result? I ended up sitting above 16 mmol/L for most of the night.

When needing to fast for a procedure, they generally recommend cutting my long-acting dose to run me a little higher to prevent hypos while fasting or when under anesthetic. I agree with this move. But every time, the BGL's in the hour or so before the procedure ends up being above 10 - 12 mmol/L. This then leads to a fuss being made over the higher reading. But that's what they told me to do and what they asked for?

On this visit, those same two anesthetists mentioned above told me that it's just as dangerous to be high as it is low for long periods of time, which is correct but that's the textbook speaking. To nail a perfect number (under 10 but above hype level) is hard at the best of times, but being ill and fasting, and with ketones starting to be a factor, achieving their textbook number is virtually impossible. Prior to that, my nurse had already phoned the doctors about my BGL and ketone levels before I was sent to theater, which clearly, they agreed on because I was sent to theater shortly after. Once I was delivered to theater, my nurse was then given a grilling over the BGL and ketone readings and so another round of consultation.

Obviously, there are a lot of bases to cover here, and a lot on the line. So being careful is probably a good thing. But meddling in my insulin management works against them and me.....................despite telling me I will know best.

My eldest daughter, also T1D since 5yrs old (now 24) works as a dietitian in Flinders hospital. She is often having discussions about Dr's not staying in their lane. Sounds like a common theme in most hospitals.

[DFB FGXR6]

Originally Posted by prydey

Yes, sometimes it seems trivial but to those dealing with it, the smallest things can be annoying /upsetting.

Also the back up pump is a different brand so doesn't link up with her cgm. So her levels are a bit of a roller coaster today. That then affects a range of other things like emotions and feeling off.

I had to remove a glucose sensor a day after it was put on for a MRI. At the time, I didn't have a spare at home, and it was a Friday so no chance of getting one for a few days. This was back when I was still paying $95 + postage per sensor. It was such a gut punch as I had to go back to the annoyance of finger pricks, not to mention throwing $95+ down the sink.

[Citroënbender]

Sorry to read about your hospital experiences. I hope it was resolved to a satisfactory level.

I believe public health is getting worse, from my regular interactions with it. With all the tech improvements, biomedical advances and the much-touted “AI” you’d think it should be improving.

[prydey]

Spent the night in hospital in Brisbane last night. Up here on holidays visiting the folks and as luck would have it, my folks ended up with covid while we are staying with them. It's their first time.

As is so often the case, if there is something going around my daughter will catch it, guaranteed. So yep, covid round #5 for her. Anyway, while she's had severe cases and mild cases, this one has been pretty rough. What didn't help was that on top of covid she had a insulin cannula blockage, which does happen occasionally. So while your bg levels often trend a bit higher when you're sick, hers went very high. By the time you realise you're not getting insulin it can be hours of running a high level and it's not as simple as just pumping more insulin in. The risk of overdoing the correction is significantly more dangerous so you have to bring it down slowly. Due to feeling incredibly nauseous from the covid and the high levels she couldn't hold anything down. Not eating is bad. As a result she ended up with ketones. Got as high as 2.9....

Battled the fluctuating levels (bg and ketones) all day but by the night ketones were still present, and bg was up and down and nausea was making her very sick.

Never great getting sick when you're away as the dr's and hospitals are all different. Ended up going to hospital around 11pm and they were that busy we didn't walk out until after 8am. Didn't get seen until around 1am and didn't get a bed until closer to 3am and it was after 5am by the time a Dr got around to seeing her. Then after all that there seemed to be confusion as to why we were there and they were more concerned about treating the high levels rather than the nausea. We've been dealing with diabetes in our kids for nearly 20yrs so we kind of felt like they were treating us like we were overreacting by being there. But if your child can't even keep water down it is very difficult to get on top of ketones. Anyway, they did get some anti nausea treatment in to her a couple of times over the 9 hrs we were there which did do the trick. By the time we left her ketones were minimal, her bg had settled down under 10 and she'd held down a sandwich.

It was made slightly more traumatic as they wanted to put her on a drip but she has very elusive veins. 2 nurses tried in both arms but failed. Then the Dr tried with an ultrasound machine and still took a couple of goes. Then once they started the saline it was clearly very painful and had to take it out after all that.

So yeah, quite the night. Absolutely bombed now. Due to drive back to Adelaide on Friday but given my wife and I have escaped covid so far while 3 others in the house got it, as soon as my daughter feels better we'll get on the road.

While our treatment in the hospital wasn't the best I did feel sorry for the dr's and nurses. They were clearly run off their feet and so many people lose their manners in a hospital. So we could tell they were all a bit losing their patience and had lost some of their personable touch

[DFB FGXR6]

Originally Posted by prydey

Spent the night in hospital in Brisbane last night. Up here on holidays visiting the folks and as luck would have it, my folks ended up with covid while we are staying with them. It's their first time.

As is so often the case, if there is something going around my daughter will catch it, guaranteed. So yep, covid round #5 for her. Anyway, while she's had severe cases and mild cases, this one has been pretty rough. What didn't help was that on top of covid she had a insulin cannula blockage, which does happen occasionally. So while your bg levels often trend a bit higher when you're sick, hers went very high. By the time you realise you're not getting insulin it can be hours of running a high level and it's not as simple as just pumping more insulin in. The risk of overdoing the correction is significantly more dangerous so you have to bring it down slowly. Due to feeling incredibly nauseous from the covid and the high levels she couldn't hold anything down. Not eating is bad. As a result she ended up with ketones. Got as high as 2.9....

Battled the fluctuating levels (bg and ketones) all day but by the night ketones were still present, and bg was up and down and nausea was making her very sick.

Never great getting sick when you're away as the dr's and hospitals are all different. Ended up going to hospital around 11pm and they were that busy we didn't walk out until after 8am. Didn't get seen until around 1am and didn't get a bed until closer to 3am and it was after 5am by the time a Dr got around to seeing her. Then after all that there seemed to be confusion as to why we were there and they were more concerned about treating the high levels rather than the nausea. We've been dealing with diabetes in our kids for nearly 20yrs so we kind of felt like they were treating us like we were overreacting by being there. But if your child can't even keep water down it is very difficult to get on top of ketones. Anyway, they did get some anti nausea treatment in to her a couple of times over the 9 hrs we were there which did do the trick. By the time we left her ketones were minimal, her bg had settled down under 10 and she'd held down a sandwich.

It was made slightly more traumatic as they wanted to put her on a drip but she has very elusive veins. 2 nurses tried in both arms but failed. Then the Dr tried with an ultrasound machine and still took a couple of goes. Then once they started the saline it was clearly very painful and had to take it out after all that.

So yeah, quite the night. Absolutely bombed now. Due to drive back to Adelaide on Friday but given my wife and I have escaped covid so far while 3 others in the house got it, as soon as my daughter feels better we'll get on the road.

While our treatment in the hospital wasn't the best I did feel sorry for the dr's and nurses. They were clearly run off their feet and so many people lose their manners in a hospital. So we could tell they were all a bit losing their patience and had lost some of their personable touch

Did she get onto the anti-viral meds?

I've only had Covid once, when I tested positive it was on a Sunday, so no doctors. I have a retired doctor as a client, he insisted I get onto anti-viral ASAP. So, I called the afterhours doctor service and waited till midafternoon to be phoned back by an on-call doctor, only to be told that I didn't qualify. My doctor client asked me if they could read, because he read out a paragraph confirming all diabetics are eligible for anti-viral meds. So, I phoned again, and waited to mid evening, again to be told I would have to phone my GP instead. I looked up the price of the anti-viral meds as a private customer, to fill that script was over $1100.

By the time my regular doctor phoned me late on the Monday, she immediately wrote me a script, so I have no idea why those on-call doctors were hesitant, I guess the government didn't want doctors writing up and billing the government for $1100 per script. By that stage, it was boarder line if it was worth taking them as you really need to be on them ASAP. Still, I noticed a significant improvement not long after taking them, I'm not sure if it was the anti-virals, or if I was just lucky, but it didn't knock me down like I was expecting.

It was very frustrating jumping through hoops to get them, especially when you are under the weather and lightheaded, you just want to get on with resting not dealing with incompetence and laziness.

As for your hospital wait, I'm assuming you clearly highlighted your daughter is a diabetic with significantly high ketone levels and poor glucose control. I'm not suggesting your daughter is poorly controlled all the time, but if there is one thing I have learnt from my doctor client, its that you need to be very clear the health implications surrounding poor glucose control in situations like this, in a way it forces their hand to prioritize your case. From my perspective, for all the bad that comes with diabetes, you need to use it to your advantage in these situations.

Annoyingly, my last visit to the emergency room and short stay in hospital, it was alarming how out of touch the doctors and nurses were when it came to glucose control. I mean, its pretty silly to ask why I should need insulin after eating sandwiches and ice-cream (shoot me, I was stressed out and hungry after not eating all day, I wasn't going to knock it back). One doctor told me that they always say to diabetic patients that they learnt about diabetes by living with it 24/7, whereas they learnt about in a textbook.......................seconds before giving me a wrap over the knuckles for a 12.1 glucose reading after fasting all night and battling an infection.

[prydey]

No antivirals used so far. I think they're loath to give them to younger people.

Yes, we are always very clear about our daughters condition and having ketones did get us bumped up the queue pretty quick, relatively speaking. It's not really taking advantage (not that you meant it like that) because ketones are actually very serious.

At least they were happy to use the cgm data to monitor her bgl. Sometimes they insist on still doing a fingerprick, with their ancient budget finger prickers rather than trust the technology that the patient uses and relies on every day.

My daughter was feeling nauseous so it got refused anyway but one of the nurses early on mentioned that all they had to offer was sandwiches but they weren't on the diabetics menu or something. I was waiting for my wife to fire up, but thankfully she just let it go through to the keeper. A diabetic menu, especially for someone on a pump should be the same as everyone else. Many hospital protocols can be out of touch.