Hi Claus,
What a fantastic post,. It is really inspiring to hear about how well you have controlled your diabetes for such a long period and that you are in fantastic shape, congratulations!
I am 34 years old and have been type 1 just over 7 years now. Fortunately I was living a very healthy lifestyle before it hit me and so I have continued in this vein with a real focus on my diet and insulin regime, this in turn has ensured that I consistently keep my HBA1C in the 6s year on year.
For me the condition has brought me considerably more 'in tune' with my body...sounds strange but over the years I have become much more aware of the impact that certain foods or even external factors can have on my blood sugars. Alot of this comes with experience and one of the greatest tests for any diabetic is the steep learning curve of those first few years with the condition. There is so much to think about and so much to learn in the respect of your own body and how best to apply insulin in order
to keep things in check.
I agree with your comment about the big "H", however this is a personal thing as I believe that some diabetics can suffer much more than others. For me personally I sense a hypo pretty much immediately at a sugar of <4mmol and as such they cause me no issue atall other than a light head. They are an inconvenience though and it is essential to carry glucose when on the move as there is nothing worse than being without something to treat with!
There is no doubt that being a type 1 promotes a healthy lifestyle. I am fitter and in better physical shape than any of my friends of a similar age and this is testament to the fact that armed with the correct knowledge and a relatively strict regime a diabetic can live a long a healthy life.
So a few top tips from me and my own personal journey, again this is by no means advice from a medical authority...
Try a diabetic pump. I moved to mine 2 years ago and have never looked back. Don't be put off my the fact that you have something attached (I was initially), it's like wearing a watch and can be removed in seconds for day to day activities such a showering/swimming etc.. I have two little boys who constantly jump all over me and the pump and cannular are as robust as anything, no pain and a hell of a lot more convenient than multiple daily injections (mdi's). The pump is so much more effective for me at controlling my sugars as different carb ratios & doses of Bolus/Basal insulin (patterns) can be defined throughout the day or even specific to day of week. Also you can quickly adjust up/down insulin dosage as required (something that injecting does not allow for) which is great for managing anomalies in sugars i.e during illness. There is even a specific way of managing those dreaded buffet situations or fast carbs such as pizza, the pump can 'drip feed' insulin over a defined period in order to manage those post meal highs which are the biggest associated risks.
NB. I'm not suggesting that a pump is for everyone and clearly people such as Claus are testament to the fact that mdi's can produce great control, however for me personally it has been a win win in terms of my control and also the associated lifestyle change of not having to inject anymore.
Keep a strict diet at breakfast. The most important meal of the day for any diabetic and for me a key way to control morning sugars when I am generally rushing about in commute or at the office. Oats are your friend here and I eat them religiously, slow releasing carb that will not spike your sugars and keep you full for longer. If you do not like eating them throw them in a smoothie as I do, great way to start the day. Go for wholemeal everything including pasta as it really makes a difference.
Don't overmedicate the highs! Again one of the benefits of a pump is that it tells you exactly how much insulin you need when correcting for highs (taking into account the insulin already in your system too.) When I wasn't using a pump I found that I sometimes got a little over enthusiastic when correcting highs which resulted in hypos soon after. Remember to consider when you last injected when applying a correction otherwise it can end up in a swing effect as stated by Claus.
Treat your sweet tooth with sensible low carb alternatives. Dark chocolate is a great way of doing this as it contains little sugar and is actually good for you in sensible quantities. I also eat tinned fruit and muller yoghurts mixed which are a great way of gaining a sweet fix with minimal impact. If you decide to go for a 'proper' dessert it is best done during the day.I find that
I can control the post meal highs better whilst awake and active whereas through the night my sugars will climb 3-4 hours post meal and remain high for a long period through sleep which is obviously not good.
Exercise. Very obvious but I have previously gone a few weeks without and the jump in my sugars was noticeable. I vary my exercise with a mixture of resistance training and cardio to keep things interesting. Like all things with this condition consistency is key and it is equally important to understand the impact that working out can have on your sugars in order to minimise the risk of hypo's. I have a specific pattern for my pump which reduces my basal rate by 40% during gym time ensuring that I do not go low, the pump gets removed completely for swimming and running as the intensity of exercising naturally controls my sugars.
Stress and illness will throw you out. I find that at stressful times my sugars can play up with unexplained highs. The key here is to obviously not get stressed and exercise is a great relief from the day to day things that can cause it. Equally illness will have a considerable impact and my tip here would be to try to not get too down on yourself during these periods. I'm not used to seeing consistent double figures and when I do it can leave e feeling anxious which compounds the issue, remember that these are short term blips and if you are generally well controlled will not impact on your overall targets. It is equally important to address them as quickly as possible and again this is where the use of a diabetic pump can come in handy
as the Bolus rate can be adjusted at any stage to compensate.
Lot's more to share but I am intersted to hear other thoughts and views, looking forward to reading the posts!
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