What good is an insulin pump?

I met two people recently that I've known for a while, but I didn't know they have connections to type 1 diabetes. One person is a PwD and one is married to a PwD.

As always, the fact that I have an insulin pump comes up in conversation. And, as always, they ask "how I find the pump?" (that's an Irish person's equivalent of "Tell me exactly how you benefit from having it").

They don't really know what an insulin pump is or how it works. This doesn't surprise me because unless you are very interested in getting one you really don't do the research into it and in most of our diabetes clinics it's not really explained. (No need to promote what long waiting lists and lack of resources prevent you from providing).

Both people made the exact same comment of "but you still have to do the finger prick tests"! I wasn't expecting this comment so my response was insufficient. I had said something to the effect of "Well, yeah but I don't have to be messing around with two different types of insulin."

COMPLETELY, forgetting one of the best advantages of an insulin pump!

And I'm so kicking myself that I didn't think of this at the time but the point is you don't have to stab yourself with a needle 5-6 times per day, you only have to stab yourself once every three days. How could I forget that?


Next time I'll be ready! I hope.

http://blog.diabetv.com/differences-insulin-pump-injection/

One of the biggest questions that someone with type 1 diabetes may ask is, “what are the major differences between going on an insulin pump vs staying on injections???” well this is a very good question to ask. There are a lot of advantages and disadvantages between the two methods so let’s take a look at some of the more apparent ones to see which method is best for you.

• Insulin injections require a lot less training than pump therapy. Using a pump requires professional training and scrutinizing blood glucose management as opposed to insulin injections
• Insulin pumps mimic the function of the pancreas a lot better than insulin shots do making insulin distribution a lot more precise than insulin shots which helps reduce the peaks in blood glucose
• There is also a higher chance of developing DKA (diabetic ketoacidosis) while using a pump than when using injections (this can be caused when the tube is not correctly inserted under the skin and the user doesn’t notice)
• Insulin injections require multiple shots a week where insulin pumps only require one every three days or so (frequent injections can cause some resistance to insulin absorption).
• Insulin shots are more affordable than insulin pumps
• Insulin pumps require the use of only one type of insulin whereas insulin injections use at least two different types (a fast acting and a long acting insulin).

So whether you are looking for a more flexible method or if you just like to stick with your sliding scale at every meal, knowing the differences in the end will help you make the right decision regarding how you manage your diabetes.

I have moved to Blood Sugar Trampoline!

I've been playing around with a new name and a new look for my blog. And new focus. For more than a couple of months now.

Today I'm making the leap. I hope you'll come bounce with me and keep me company on the Blood Sugar Trampoline?

I will focus a bit more on my personal experiences living with type 1 diabetes and come out of the closet a bit more. I also think that you will find the diabetes information I've gathered over the years easier to find over at www.bloodsugartrampoline.com

Here it goes!

Diabetes Complications are Not a Sign of Failure

The complications of diabetes are real and people are living with them. People are also living in fear of them. Myself included. I am actively trying to overcome this fear because if I do end up with complications I don't want to feel like it is the end of my life. Or that I failed to manage my diabetes well enough. And I certainly don't want to be made to feel that it's my fault.

I don't believe just because I am doing everything in my power to manage my diabetes that I will be spared. I believe that if I have type 1 diabetes I still have the risk of developing complications. I strive to keep that percentage of risk low but it will never be zero.

I will not stop trying!

Image from http://www.coolnsmart.com/failure_quotes/

So, when a friend of mine, who has lived more than 50 years with type 1 diabetes and who lives with a number of the complications of diabetes, comes to our T1D meet ups and people imply she didn't take of herself, I get a little "upset"!

My friend has survived taking care of her diabetes when there was no such thing as a glucose meter! Imagine never know what your blood sugar was?!?

She has survived during a time when the phrase "carb counting" might as well have been a foreign language in Ireland. It didn't exist!

We also did not have Rapid Acting Insulins until the late 1990's. So, even if we did practice carb counting, it wouldn't have been much good to us. Sure, we could do a certain amount of carb counting on the insulins we took only twice a day but we couldn't fine tune it like we can today.

We also did not know that the tighter your diabetes control, the less likely you were to be at risk of getting diabetes complications. This research was only published in 1993 as the DCCT Trials.

93 years ago we died! Today, we have so many tools, technology and instant access to research that people with type 1 diabetes, who have been told for decades what they can't do are breaking all of those barriers.

So I ask you? Is surviving 50 years with type 1 diabetes and living with complications really not taking care of yourself?

My friends who live with diabetes complications may even say themselves, that they didn't do as much as they should have to take care of their diabetes. And I say you did the very best that you, and everybody else, knew how.

I am so lucky and proud to have friends like Deniabetic, who are helping me overcome my fears.

I have nothing to fear but fear itself

Image from http://james-the-nose.deviantart.com/art/
A-deer-in-the-headlights-122552318

I attended a diabetes meeting once where one of the other attendees said they wanted to see photos of all the horrible things that can happen to a person with diabetes if they don't take care of themselves. That this would motivate this person into doing more to take care of their diabetes. I understood this person's point of view, they were much older than me and may have seen the "dangers" of diabetes as being more imminent than I did.

For me though "the fear tactic" doesn't work. I've heard all the horror stories. I've heard all of the threats in relation to what I should and what I should not be doing to take care of my type 1 diabetes. And I have been paralysed into doing nothing by them.

I think it's a well known piece of advice that fear is not a good motivator to get somebody to do something. Do you like it when someone threatens you? Even if it's for your own good? Does it make you want do what they say?

For me, it, absolutely, does NOT! But you might ask me what does get me moving and doing? My answer is "Information and inspiration" ;-D

I don't test my blood glucose more because someone told me I should. I do it because it was explained to me why I should consider it and how to use the additional information (EDUCATION, can't. say. it. enough.). And I could see almost straight away how this improved my management of my type 1 diabetes.

I do remember, all those years ago, when I was told that I had to eat a strict "diabetic" diet and I absolutely HAD to take my insulin at exactly the same time every single day. If I didn't I would end up with all sorts of ugly diabetes complications.

But guess what? Some people do all the right things and still get complications. And some people don't take care of themselves and don't get any complications.

Those were the days when we had very little in the way of diabetes research or education to revert to. But by God we had fear! And it got me nowhere!!

What did motivated me to do all the things that I do to take care of my diabetes? Education, education, education and some more education. Can't say it enough times!!! And of course, a good support network:-)

DKA Kills and the Type 1 Diabetes Awareness Project

We don't know how many children or adults die in Ireland because of undiagnosed Type 1 Diabetes but we can be sure that it does happen here, just like it happens all over the world. 

As the news is travelling through the diabetes community of yet another life cut short, I'm awakened, with a jolt, as to why the Type 1 Diabetes Awareness initiative from Diabetes Ireland is so important... And needs to happen soon!

Diabetes Ireland are planning on launching this Type 1 Diabetes Awareness project early in the new year. 

Image graciously stolen from Diabetes Mine

Up to 23 Irish children are diagnosed each month with Type 1 diabetes. The majority of these present to their GP feeling generally unwell but 1 in 8 will not be correctly diagnosed at that time. 

This delay in diagnosis usually means repeated visits to the GP and can result in diabetes ketoacidosis (DKA) which is potentially fatal.

The aim of this project is to encourage GPs to consider Type 1 diabetes first, as a potential diagnosis when a child presents feeling generally unwell and secondly to raise awareness among the general population of Type 1 diabetes signs and symptoms (The 4T's; Toilet, Thirsty, Tired & Thinner).

However, Diabetes Ireland still need to find one quarter of the funding for this project. They are determined to commit to the February 2016 launch date but if they don't find the rest of the money they will have to amend the initiative, which would make it less effective.

Does anyone have a wealthy relative??? 

Image from http://res.public
domainfiles.com/pdf_view/
52/13526046019596.png

Maybe if we start sharing this with our friends and talking about it, the people who hold the purse strings will take notice that this is important to us?

Just in case you're wondering; what is DKA?

" Diabetic ketoacidosis is a life-threatening problem that affects people with diabetes. It occurs when the body cannot use sugar (glucose) as a fuel source because there is no insulin or not enough insulin. Fat is used for fuel instead.

When fat breaks down, waste products called ketones build up in the body." Find out more here. 

Walk Your Diabetic Feet To The Pathway of Good Foot Care

Our guest speaker at our November diabetes get-together in Co. Clare is a podiatrist from the local health centre (Thank you, Doireann). And I know that most people with diabetes know the basics of taking care of your feet, especially if you have been around diabetes for a couple of decades.

The reason I decided to post about our meeting is that the pathway to podiatry has changed a little in recent years and that is worth sharing this information (IMO).

But I have included an article which, coincidently, was published online this week, and contains some of the basics to lead up to the local information.

So, why do healthcare professionals stress the importance of good foot care?

“In almost all high-income countries, diabetes is a leading cause of cardiovascular disease, blindness, kidney failure, and lower limb amputation.” (from International Diabetes Federation). But a simple annual foot check can prevent or reduce your risk of developing serious problems with your feet.

“People with diabetes have special reason to take good care of their feet. High blood glucose levels may make feet susceptible to injury and infection. This is because the protective sensation in the toes or feet – your “pain alarm system” ­may slowly disappear with long term high blood glucose levels.” (from Diabetes Ireland)

The Foot "Issues".

The two feet problems that podiatrists (and people with diabetes) are on the lookout for are;

Nerve Damage

Nerve damage can cause you to lose feeling in your feet. You may not feel pain, heat, or cold in your legs and feet. You may not feel a pebble inside your sock that is causing a sore. You may not feel a blister caused by poorly fitting shoes.

Sores on your feet can become infected. If your blood glucose is high, the extra glucose feeds the infection in those sores and the infection gets worse. Nerve damage can also cause pain and lead to foot deformities, or changes in the muscles, bones, and shape of your feet.

Poor Blood Flow

Poor blood flow means not enough blood flows to your legs and feet through your blood vessels. Poor blood flow makes it hard for a sore or an infection to heal. This problem is called peripheral artery disease, also called PAD.

Sometimes, a bad infection never heals. The infection might cause gangrene. If you have gangrene, the skin and tissue around the sore die. The area becomes black and smelly.

Too much glucose in your blood from diabetes can cause nerve damage and poor blood flow, which can lead to serious foot problems.” (from the American National Institute of Diabetes and Digestive and Kidney Diseases)


Everybody with diabetes in Ireland should have a foot check by a podiatrist, children included, every year.

I know that some doctors and consultants might perform a brief foot check at your clinic appointment but our podiatrist (and lots of other reputable websites) state that if your foot check does not include a test using a tuning fork and a Monofilament tool.

Monofilament Tool

At your annual foot exam your healthcare professional will;

• Look at your feet for signs of problems, especially if you have nerve damage
• Test the sense of feeling in your feet using a Monofilament tool.
• Test how well blood is flowing to your legs and feet
• Show you how to care for your feet

How do access Diabetic Foot Care?

Referrals to your local podiatry service for people with diabetes are available from your GP, Public Health Nurse, Community Nurse, or Diabetes Clinic.

In Co. Clare, you can avail of a self referral form which is available at the Health Centre on Bindon Street in Ennis. It’s not available online. And we believe that this option is only available in Co. Clare.

Your very first foot screening with your podiatrist will assess you and place your feet in one of three categories; Low, Moderate or High risk.

If you are low risk, you may be referred back to your GP’s surgery for your annual foot exam. If this is the case then it will be your responsibility to schedule this. If you are referred to your GP, it’s really important that you keep a record of when your last foot check was and when to schedule your next one.

If you are Moderate or high risk of diabetes foot disease then you will probably continue to be seen in the Diabetic Foot Clinic, where they will send out your appointment to you in the post.

However, there are instances where the clinics fall behind in their appointments and it would be wise if you kept a record of when your last foot exam was and when your next one should be.

You can find more information from the HSE's Model of Care for the Diabetic Foot document, which was revised in October 2014.

Explaining Type 1 Diabetes to Non Diabetics

I spend a lot of my time "hanging" and communicating with other people with diabetes. I realise that I'm very lucky to have that when I have come across so many people who have never met anyone else with diabetes.

So, when I find myself in a situation where I have to explain type 1 diabetes to someone who is not a member of that community, I actually find it extremely difficult. Even when I know it's coming!

Two such encounters have prompted me to try harder in this and I sat down to considered the following;
- when I want to share my diabetes story where is the best place to start (without turning it into a rambling, never-ending tale)?
- And, how do I connect with people who have no connection to diabetes? How do I explain it so that they ask me good questions?

Here is what I came up with! And I did decide to try to keep it simple and specific to my diabetes, which means I know a lot of you will have lots more to add to it. But this is my starting point.

What is type 1 diabetes?

Type 1 diabetes happened to me when my body, for no apparent reason, decided to destroy the part of me that makes insulin.

What the heck is insulin?

Everybody needs insulin to be able to turn the food they eat, namely carbohydrates, into energy. If I don't have insulin, I will die of malnutrition, even though I eat.

Type 1 diabetes is kindof like an allergy to carbohydrate. I cannot eat carbs without taking insulin. And if I don't take insulin, what the carbs become once I have digested them, the sugar/glucose builds up in my blood and starts to do bad things to my organs.

What if, every time you ate any of these foods you had
stick a needle into yourself?

If I just didn't eat carbohydrate would that not make life easier?

A person without diabetes might respond to this with "What if you just didn't eat carbohydrate would that not make life easier?"

Not really, our liver, also, releases glucose and we can't turn that into fuel either. So, we actually have to take insulin to deal with that sugar/glucose that is being continuously released in the background.

So either way, we need to inject/infuse insulin or we die.

What if you just measure how many carbs you are eating against how much insulin you are taking?

One of the ways people manage their with type 1 diabetes is to measure how much insulin they take and measure how much carbohydrate they eat.

This is where I know I am going to lose you.

Type 1 diabetes is more complex than that. There are other factors that influence blood sugar/glucose (BS). Sure;

• Food brings BS up, but all foods raise BS differently. 
• Insulin brings it down.
• ANY physical activity has the potential to bring it up or down.

But there are things that influence BS that are not easy to measure.

• Hormones such as adrenaline, the stress hormone cortisol, menstrual hormones can raise or lower your BS. 
• Illness raises BS.

These are just a few, here's a list of 22 other factors that commonly influence BS.

Living with type 1 diabetes is tracking all of this and more. It's exhausting!


So all I need now is a guinea pig volunteer to try it out on? Oh and here's some more helpful tips to help explain type 1 diabetes to people.

Would you like to volunteer abroad and help people with diabetes?

I came across this group at a diabetes conference and not only do they have an interesting story but they also offer people with diabetes an interesting opportunity to volunteer abroad with people with diabetes.

I've checked with the organisation and they have said that you do not need to be living in the US to volunteer and in the past people from Ireland have volunteered with them. :-)

They are called AYUDA; American Youth Understanding Diabetes Abroad. The organisation was created in 1996, by two teenagers, Nick Cuttriss and his friend Jesse Fuchs-Simon. They were 14, when they met José Gabriel, an eight year old boy who lived in Quito, Ecuador.

José Gabriel, was six-months-old when he was diagnosed with type 1 diabetes in 1984. Eight years later, despite spending most of the family's income on his diabetes supplies, José's parents saw his health decline again. In an effort to understand what had gone wrong, José's family raised money for him to travel to see a diabetes specialist.

They discovered José and his parents had never received guidance regarding the management of the boy's condition and that José's blood sugar levels were not being managed correctly. For José and his parents, and for many other young people with diabetes, particularly in developing countries, the lack of diabetes education is as dangerous as a lack of insulin.

Nick and Jesse envisioned a youth-led organization that would educate young people with diabetes about diabetes issues, and help empower them to work effectively for positive change.

AYUDA's initial objective was to help with the need for basic diabetes education in Ecuador.Volunteers set up diabetes support groups in the corridors of a public hospital in Quito. These groups offered educational workshops and provided a forum for knowledge sharing. 

Since 1996, they have also recognised that the cost of diabetes supplies was making it impossible for many children in developing countries to manage their condition optimally and so they set about creating and managing diabetes supply banks. It costs approximately 3000 USD per year to care for a child with diabetes; the average income for a family of four in many Latin American countries is less than 1000 USD per year.

With the help of partners such as Insulin for Life, AYUDA works to ensure that families with limited resources receive essential daily supplies, such as insulin, syringes, and test strips at subsidized prices or free of charge. 

For more information on AYUDA and volunteering opportunities, visit the website at www.ayudainc.net or email info@ayudainc.net. They are now accepting applications for their 2016 projects in the Dominican Republic.

New Diabetes Products I came across at FFL 2015

The exhibit hall was huge at the Friends for Life (FFL) 2015 conference. I wrote a little about the whole FFL experience a couple of weeks ago which you can read about here.

While wandering, meeting people and talking to the company representives, I came across a couple of products I had not seen before. In the interest of sharing with people in Ireland I thought I would document them.

One of the last items I came across but one I have actually used since I got it is;

A Pump Key.

A wha, you ask! Well, this is a multi-purpose tool, but it is specifically designed to open the battery compartment of your insulin pump, instead of using a 5c coin, so you can replace your pump's battery.

Now fancy that!

I say that it's multi-purpose because it helped free my daughter from being locked into a hotel bathroom.

She also said that it was the most adorable thing she has ever seen!

It's available from Cute Diabetes Nik Naks. The Pump Keys cost $20.00 Australian Dollars (€13) and shipping to Ireland costs are $2.75 - $10.00, that's Australian Dollars, depending how many products are ordered. 

BD AutoShield™ Duo Pen Needle

This is another smart idea. I have stabbed myself with my needles a couple of times and it's usually a bloody mess. Those things are sharp and create a lot of blood when used accidentally.

So a shielded needle for insulin pens, to me, sounds like a great idea. Here's a video on how it works.

The BD AutoSheild Duo is available in Ireland. However, it is not available through the GMS (General Medical Services Scheme (GMS - medical cards) but I understand patients have been able to seek LTI (Long Term Illness) cover under compassionate grounds.

It's worth noting that BD also make a device that clips the needle off your insulin pen needle for safe disposal. This device is called the BD Safe-Clip, as well as many other items we use for diabetes. I also noticed that my lancet devices that comes with my One Touch Verio IQ blood glucose meter is made by BD!


I also came across stickers for your Insulin Pens from Lilly and stickers from Pump Peelz for Insulin Pumps.

Diabetes Friends for Life & MasterLab

In July, I was in a hotel resort. In Diabetes World, surrounded by thousands of people with diabetes, and at the Friends for Life 2015 Diabetes Conference. I felt like I was in a dream!

Those of you who have been following my blog for more than a year will know that I attended FFL UK last August and wrote about it for weeks. If you haven't seen those posts, here is the first one. Well, FFL US has given me enough material to write for months maybe even a year!

What is Friends for Life (FFL)?

The FFL conferences are organised by ChildrenwithDiabetes, an American non-profit organization dedicated to providing education and support to families living with type 1 diabetes. 

www.childrenwithdiabetes.com (CWD) was started by Jeff Hitchcock in 1995 in response to his daughter Marissa's diabetes diagnosis at the age of two. The idea was -- and continues to be -- to share experiences with other families, so that together, we can all make a difference in the lives of everyone living with type 1 diabetes.

In August 1999, a diabetes Mom on the CWD email list, Laura Billetdeaux, was planning her family holiday in Orlando in June 2000. She sent out an email to her friends on CWD asking if anyone was interested in meeting up there? 550 people from across the US showed up!

That was the first FFL! And FFL 2015 was their 66th conference to date.

Some FFL 2015 Facts.

- There were over 2,000 families, attending FFL 2015! That number, in itself is impressive, but when you consider how many people make up family then it's mind blowing!

- Anybody who is anybody in the world of diabetes attends this conference. Such as;

• Joe Solowiejczyk, who is coming to Thrive-abetes this October.

• Gary Scheiner, author of "Think like a Pancreas"

• Moira McCarthy, Diabetes Mom, Advocate, Autor of “Raising Teens With Diabetes: A Parent Survival Guide” 

• Tom Karlya, Master of Ceremonies and Diabetes Dad blog

• Scott Johnson from Scott's Diabetes

• Kerri Sparling, SixUntilMe

• Ed Damiano, Bionic Pancreas Builder

• Anna Norton, CEO of DiabetesSisters

• Kelly Kunik from Diabetesalicionsess and the #IWishPeopleKnewthatDiabetes hashtag

• Katy (pronounced Katie) Bigfoot Child has Diabetes

• Diabetes Hand Foundation staff; Mike Lawson, Melissa Lee, Emily Cole and Corinna Cornejo

• Sierra Sandison, Miss Idaho 2014 and #showmeyourpump and The Sugar Linings Blog

• Charles Kimble, professional race car driver and is the first licensed driver with diabetes in the history of INDYCAR. http://www.charliekimball.com/biography

• Manny Hernandes from http://www.tudiabetes.org/

to name but a few....

- It is huge. So big, some of the booths have play areas for the kids.
- They have childcare facilities, all ages of children programmes, tween and teen programmes, so that ALL of the grown-ups can fully experience the presentations.


They next FFL that might be of interest to folks is in London - however, this conference is sold out since last March.

But if you were planning your 2016 family holiday in America then why consider making the FFL 2016 conference part of your holiday in July? It's MORE than worth it!

I put together some of my photos from both of the conferences I attended in Orlando if you would like a better taste.

"Diabetes Hands Foundation, through the Diabetes Advocates program, covered the costs of my travel, registration and lodging while at MasterLab through a scholarship. That being said, the views and opinions expressed are my own

Reasons to be EXCITED!!!

This past week has been a little bit mental, what with children on mid term, a bit of a raffle going on, some wedding invitation making and a bathroom demolition (*%$#@@).

I really didn't think I would have time to write a blog. However, I just had to write a quickie for this. Thanks to Animas, I am starting my trial of a CGM with my Vibe tomorrow!!! It's been a year in the determination. 

I don't know if it will make a huge difference in my life but I will let you all know. I have been using the "wizard" features of my Vibe a lot more and this has smoothed out my numbers quite a bit.

The "wizard" features are "Our pumps can: > Calculate a bolus amount to cover the carbs in food (ezCarb) > Automatically calculate a correction dose of insulin based on the latest blood sugar reading and incorporate the insulin on board (ezBG)"  from http://animascorp.co.uk/animasvibe/animas-vibe-and-cgm-system

I am also looking forward to a very much needed holiday with my hubby's family in Minnesota, where I will get eaten alive by mosquitoes but will not have to worry about the weather.

AND, if that wasn't enough I have received my itinerary for the Diabetes Advocate's MasterLab conference. 

Friends for Life Conference Orlando

The Friends for Life conference (FFL) was started by the Childrenwithdiabetes.com organisation in the United States where families could meet each other and have a vacation in Disneyland.

Today, the FFLconference has evolved into a national mega-conference that 1,000 people with diabetes attend. It's open to ALL family members, including grandparents and now has programmes for the adults living with type 1 diabetes, as well as all the age groups of children and young people. They even have a FFL in the United Kingdom.

You may remember last August when I blogged almost endlessly after I had been lucky enough to attend FFL UK with my friend Christine!!!

The experience was fantastic and was where the seed of Thrive-abetes turned into a sapling.

So when I saw a post on Facebook from the Diabetes Hands Foundation offering scholarships to attend FFL or FFL MasterLabs I was jealous. Then! I remembered that I was married to an American and that we have planned to visit his family in Minnesota this coming July. I was actually going to be in the US while the conference is taking place and there fore less expensive to sponsor.

So I applied for a sponsorship!!! Hey, if you're not in, you can't win:-)

Guess what! Yep! I won a scholarship to the MasterLab advocacy conference which I have extended to include registration for FFL conference.


1st reason to be excited - I'm going to Orlando, Florida! I've never been before.
No. 2 reason to be excited I'm going to FFL!!!!!
No. 3 reason, well let me show you with this short video.

Finding Help with Carb Counting

One of the many ways people manage their type 1 diabetes is Carbohydrate Counting or Carb Counting. Carb counting has been a successful way to help manage type 1 diabetes while giving us a more flexible lifestyle since the 1990's. But it has only really taken off in Ireland since the noughts.

Carb counting is based on the idea that if the carbs in our food make our blood glucose levels rise consistently, then it makes sense to try and measure them and come up with insulin to carb ratios. It can be a lot of work in the first two or three weeks but after that it most of the work involved does not have to be repeated. 

So, if you are a person with type 1 diabetes and are interested in learning more about carb counting, where do you start?

In Ireland, there are two structured education courses for adults, DAFNE(Dose Adjustment For Normal Eating) and BERGER. 

The DAFNE course originated in Germany in the 1980's as the Düsseldorf Approach. It was designed by the diabetes team at the Diabetes Centre in Düsseldorf, led by Michael Berger. People learned to match their insulin dose to their food on a meal-by-meal basis. The aim is that they can keep healthy blood glucose control without a higher risk of severe hypoglycaemia. 

In 1998, a team from the UK adapted the Düsseldorf Approach creating the Dose Adjustment For Normal Eating (DAFNE). 

There are 6 diabetes centres in Ireland running DAFNE, click here for the list, and the diabetes centre in University Hospital Cork runs a variation of DAFNE, which is named after the original creator, BERGER.

The parents of children with diabetes have the CHOICE programme and that is run in the 5 paediatric diabetes centres that offer insulin pump therapy to their patients.

The six up and running paediatric diabetes centres offering the CHOICE programme are;

• Adelaide & Meath Hospitals, incorporating the National Children‟s Hospital (AMNCH), (Dublin)
• Children‟s University Hospital, Temple Street, (Dublin)
• Cork University Hospital, (Cork)
• University Hospital Limerick /University Hospital Galway, (Limerick / Galway)
• Our Lady‟s Hospital for Sick Children, Crumlin, (Dublin) 

• And soon to be up and running Sligo General

If you don't attend any of these centres, you might have access to a dietitian who would work one on one to teach you carb counting.

If this option isn't available at your diabetes clinic you should be able to find a dietitian who runs a private practise who will instruct you in carb counting, such as the services provided by Diabetes Insight in Cork. 

However, when you call to make the appointment be clear about the fact that you want to learn how to carb count and how to work out insulin to carb ratios.

If you are interested in learning more about carb counting, the wonderful people at InPut Diabetes in the UK have some excellent resources.

The National Diabetic RetinaScreen service.

Diabetic RetinaScreen was launched in 2013 and is an Irish government-funded screening programme that should ensure all people with diabetes over the age of 12 years will be offered a free annual diabetic retinopathy screening. The Diabetic RetinaScreen programme uses specialised digital photography to examine the eye.

Diabetes Ireland recommend that everyone with diabetes should have an eye screening once a year to prevent diabetic retinopathy and other diabetic eye complications.

So why did we need something new?
This service came about because not everybody with diabetes was getting an annual eye exam at all and because diabetic eye disease is still one of the most common causes of blindness in Ireland.

Another benefit of this system is that it provides a photograph of the retina, which means that your images can be viewed side by side, year on year, to check for changes.

Diabetic retinopathy can be treated if caught in time.

If you have diabetes, it is important to have the back of your eyes effectively screened every year.

How does it work?
This is my experience with this new service and I have understood that it works this way for most people. Although, I have read and heard about some issues that people have had getting on the register but I think most of these teething problems have been ironed out.

When the service was launched the public was encouraged to check that they were on the RetinaScreen register. The register was created from the information provided by healthcare professionals (GP's, diabetes clinics and endocrinologists).

I called the number on the website and the lady who took my call said that I was on the register but she would check that all the details were correct. We discovered that they had a very old address for me which meant that if I hadn't checked I would not have received my letter. I was glad I checked.

It's important to note that Diabetic RetinaScreen only accept referrals from healthcare professionals. If you're not on the register you need to request that your GP, diabetes clinic or endocrinologist puts you on it.

In October, I received a letter asking for my consent to be invited for a screening. This required me to call a number and agree verbally. This was easy too.

Within 3 weeks I received my letter of appointment for the 27th November 2014 at my local Specsavers shop.

I did have to call RetinaScreen to rearrange my appointment because I did not have someone to drive me on the date. This was painless to do also and the new appointment was within two weeks of the original date.

The day of my appointment, I arrived promptly and did not have to wait more that a couple of minutes from someone to check me in. We filled in the short form and then I was taken into the back area for the pressure tests. This involved me placing my face into a chin rest and the Specsaver employee operated a machine that shot a quick blast of air into my eye. This might sound harmless and it was, but I found it extremely difficult to keep my eyes open long enough to complete this test. He told me they only needed one good one but that they do it a couple of times just to be sure they have what they need. OK.

This eye pressure test, is known as a tonometry is a part of every routine eye exam, it measures the fluid pressure inside the eye. Increased pressure within the eye can be a sign of glaucoma.

Once we had done this, I returned to a waiting area outside of this room. Within another couple of minutes I was taken into the sight test room by the optician. She did a brief sight test, took notes and then administered the "dreaded" eye dilation drops. 

She was so lovely, she kept apologising for doing what she needed to do. I assured her that I'd had the drops done more that a few times and there was no easier way to do it. I would be happy once I did not have to go through having to drops redone because she missed or they didn't take.

With the drops accurately administered I went back to the waiting area to wait for them to take effect. This took about 15 minutes. The optician, then, brought me into the same room that I had the tonometry test done.  She performed a couple more tonometry tests and took the photo of my retina and I was done!

The whole process took 30 minutes.

I had a letter in a couple of weeks with my results. The letter stated that I had background retinopathy in the back of my left eye. This was a bit of a shock as all previous eye exams were reported clear. I suppose having a digital image that the reader can zoom in on is hugely beneficial in this case.

My level of retinopathy doesn't require any treatment yet but at least I know to make sure I don't miss any eye appointments.

If you have diabetes and would like to check you are on our register, please ring Freephone 1800 45 45 55 and choose option 1.

Benefits.

• Having a retina photo taken that can be used to compare the following years.
• Not having to supply a useless urine sample (my local public diabetic eye clinic required this and it became a pet peeve that will cause me to go into a rant and I am stopping that right now, another time, another place).
• Getting an annual eye screen, em annually and not every 2 or 4 years.
• Because I am a low-medium risk patient I'm not taking time away from someone who needs treatment from a specialist right now.
• People who are in the high risk category are fast tracked to an ophthalmic specialist.

Cons.

• There are a lot of actions required to get to the point where you get a letter with an appointment.
• That's the only one I can think of right now.

World Diabetes Day 2014

It's HERE!!!!

World Diabetes Day falls on November 14th every year - it's a global event! But what is it? Any why make a fuss about diabetes anyway?


Well, if you have type 1 diabetes, or any type of diabetes, its a day to celebrate being alive. If any of us were diagnosed before 1922 none of us would have what we have today, our children wouldn't have been born, we wouldn't be alive!

92 years ago a couple of scientists made it possible for people with diabetes to live. Before 1922, people and children diagnosed with type 1 diabetes died within four months.

So I celebrate the day that Sir Frederick Banting was born, November 14th. And I celebrate that he met and worked with Charles Best. 

AND, not only are people with diabetes living today, we are thriving! So I’m not really celebrating having diabetes. I’m celebrating life and the quality of it.

Life for a Child with Diabetes

People with diabetes in Ireland don't have it all when it comes to our diabetes. We don't have huge access to insulin pumps or continuous glucose monitors or structured type 1 diabetes education. Some of our type 1 clinics don't even have diabetes dietitians or diabetes nurse specialists. But, we do have unlimited access to access to insulin!

Do you remember the day you or your child was diagnosed with type 1 diabetes? Imagine if the doctor then told you that a vial of insulin cost so much money that you could not afford to buy it. Imagine you lived in a country like India, Haiti, or Ecuador, where no-one else could afford to organise a benefit night to raise money for insulin. What would you do?

"Without insulin, a child with type 1 diabetes will die within a week. In the developing world, many die without being diagnosed; for those who are, their family faces a sickening dilemma: pay for the insulin their child needs to survive or leave him to die." 

This is the situation for a lot of parents of children with type 1 diabetes in these developing countries. How is it possible that almost 100 years after insulin was discovered there are still children in the world dying from type 1 diabetes, not from complications but because they don't have insulin.

These children don't get the chance to worry about the danger of night-time hypos, or the risk of developing complications.

I’m very grateful to my government for paying for all of my diabetes medication and supplies. I know that if I did have to pay for all of it that I would find it extremely difficult financially. But if the government asked me to contribute to the cost in someway I would be able to do that. 

But, the government haven’t asked me and until they do I'm going to donate a little bit every year to the International Diabetes Federation's Life for a Child programme because I'm so lucky to be born where I was born.

Life for a Child is currently helping 14,000 children in 46 countries to have a reliable and steady supply of insulin, while working with the existing healthcare services to strengthen them.