Looking after your Diabetes in the Hot Weather

Enjoying the sun is a given during the summer. However, the hot weather can bring with it hazards for individuals living with diabetes.
Take extra precautions to ensure that your diabetes and wellbeing stay under control during the long, hot summer days.

Keep your Feet Safe

Warmer weather means more time spent outdoors, playing sports, swimming at the beach and wearing open toed shoes. All of these activities can put your feet at greater risk of sustaining an injury, so it is important to take extra care in keeping them protected.

Take precautions such as inspecting your feet before and after exercising, not walking across hot sand or roads barefoot and treating any cuts or abrasions as soon as they occur. If you experience any injury to your feet, be sure to seek help from a medical professional.

Remember, it is always recommended that individuals living with diabetes have annual foot check-ups from a healthcare professional.

Heat, Insulin, Testing Strips and Meters

If you use insulin to treat your diabetes, you will need to be cautious of how you store it during the warmer days. Insulin is to be stored at temperatures no higher that 30o degrees, and no lower than 5o degrees.

If your insulin appears to be discoloured, or has solid particles, it will need to be discarded. Remember to never leave your insulin in a car on a hot day or stored directly on ice. To keep your insulin at the right temperature use a cooling pack or Esky, but never store it directly on ice.

Exposure to extreme heat can also compromise the accuracy of blood glucose monitors and testing strips. Be extremely mindful to never leave you meter, strips or insulin in direct sunlight, or in a hot car.


Be Careful of Heat Stroke

During the summer, the risk of developing heat exhaustion increases. Symptoms include headaches, dizziness, nausea and vomiting, tiredness, muscle cramps, stomach cramps and pale skin. As some of these symptoms are similar to hypoglycaemia, it is important to remain vigilant.

Never assume the heat is the only thing responsible for these symptoms, and test regularly to ensure that your BGLs are not low.

Marian_BoilerPlate.jpgMarian is a Diabetes Educator and an Accredited Exercise Physiologist at Diabetes WA.

 

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Make it your year!

I am not necessarily one for New Year’s resolutions.

It all seems great on the night of celebrations, making declarations of sweeping changes I am going to make or goals I am going to reach. I’ve been there. In the weeks, and sometimes even days, that follow though, my resolve seems to wane and I often return to a “business as usual” mode of operation.

This year, I intend to do things a little differently, to bring attention to some of my habitual ways of thinking and patterns of doing, and put my energy into simpler things.

My youngest son Jack started kindy in February, which feels like an epic milestone. He has gone to day care since he was a baby, but suddenly it all feels so different, this quiet shift from toddler to boyhood.

I am watching with awe as Jack grows out of tantrums (well, mostly), finding his words more easily, and developing this wonderful sense of humour. He is dressing himself and heading off on the ‘walking bus’ with his brother Locky and the other kids on the street.

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It is inspiring to watch Jack embracing school full force and adapting to new situations in this time of transition. It also opens up this space for me to think about some of the shifts I would like to make in my own life.

Like many kindys, Jack attends three days one week and two days the next.

Aside from my husband and I getting back in the groove of who picks up whom when, what this means is that once every fortnight, I have a day off ALL TO MYSELF. I joke that I don’t like to talk about it too much, for fear it might disappear or be taken away, or that someone will fall ill with gastro and it won’t happen, but it did.

This past Wednesday I had a day for me.

I went to yoga in the morning and I felt such stillness and peace of mind. I was able to bring my attention to the practice and be present in the moment in the room. There was no agitation or expectation, no rushing or comparison. It was beautiful.

I found myself so full of gratitude that I could ‘fill my own cup’ by simply connecting with the breath.

Afterward, I took some time to truly contemplate the wisdom shared by our instructor and remind myself the importance of applying that knowledge in my everyday life.

How vital it is to bring my attention to the present moment, whatever it may be, and meet the needs of that moment, with compassion and without judgement. How important it is to challenge myself to extend beyond what is comfortable, whether it be a holding that difficult yoga pose for an extra thirty seconds or taking on something new in my personal or professional life.

I thought about how often and easy it is to let the fear of falling over, or failing, hold me back from taking chances and reaching my true potential.

This year, I am setting intentions rather than resolutions.

To dance more, see live music and devote more time to writing. To reconnect with friends and have more date nights with my husband! To remain committed to my yoga and meditation practice and bring greater awareness to what it is that makes me happy and what I need to thrive.

And I’m going for it.

Whether it is on the yoga mat or at home or work, I am being gentle with myself as I move along my journey and I am giving myself permission to falter. There will be challenges, but I know this is going to be my year. Make it yours too!

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Alcohol and Diabetes

Can I still enjoy a drink now that I have diabetes?

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As with most things, moderation is the key! Guidelines for alcohol consumption are the same for people with diabetes as they are for the general population. Try not to have more than 2 standard drinks per day for both men and women, while having regular alcohol free days.

We know that alcohol consumption in excess of these recommendations places us at greater risk of developing heart disease, certain cancers, liver disease, stroke, dependency and mental health problems. There are some conditions including pancreatitis, liver disease, difficulty managing diabetes, high blood pressure or other complications, where you may be instructed to not drink at all. Women who are planning a pregnancy, pregnant or breastfeeding are also instructed not to drink alcohol. You may wish to talk to your GP if you are unsure.

Although alcohol can still be enjoyed in small amounts in people living with diabetes, there are a few things to be aware of. Alcohol is very high in kilojoules and low in nutrients. Drinking excessively can contribute to weight gain and hence, increase our risk of diabetes related complications and other health conditions. Another factor to consider is the type of food we usually consume when we are drinking. If you are anything like me, it will probably involve a bit too much cheese or other calorie dense snacks which further contribute to weight gain.

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Drinking alcohol can also have an impact on your blood glucose levels – causing both high and low blood glucose levels. For people using insulin or certain types of oral medication to manage their diabetes, hypoglycaemia (blood glucose levels less than 4 mmol/L) is a risk with alcohol consumption. Because our liver is so busy trying to deal with the alcohol, it cannot release stored glucose to prevent us going too low (as it normally would). This effect can last for many hours after we drink. Alcohol may also mask the symptoms of hypoglycaemia, meaning you and others around you may not realise you are having a hypoglycaemic event. It is always a great idea to carry some quick acting carbohydrate with you (like jellybeans) just in case you experience a hypo.

In order to avoid hypoglycaemia, you may wish to increase how many time you are monitoring blood glucose levels. You may choose to have a small carbohydrate snack before bed. You may choose to try low-alcohol (not low carb) drinks and or mix your drinks with diet mixers like diet lemonade or soda water. If you are uncertain about other alcohol choices, you may wish to talk to your GP, diabetes educator or dietitian about drinking alcohol safely.

So yes – people with diabetes may be able to safely enjoy alcohol if it is done sensibly and with a few precautions! Cheers!

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Marian is a Diabetes Educator and an Accredited Exercise Physiologist at Diabetes WA.

High Intensity Interval Training (HIIT) – is it suitable for people with diabetes?

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By now we probably know that exercise and physical activity are good for us. So why is it that in 2011/12, 70% of those living with diabetes did not meet the physical activity guidelines according to the Australian Institute of Health and Welfare (2015)? Probably due to a lot of factors! One of the most common barriers to being able to meet physical activity guidelines is time. This is not surprising given the hectic lives we all lead.

You may have heard that the benefits of exercise increase as physical activity levels rise. But, is there such a thing as ‘bang for your buck’ when it comes to exercise? Some may argue, yes! Current physical activity recommendations suggest we should try to include, if possible, some activities which are vigorous in nature due to its overall health benefits. These guidelines suggest 75-150 minutes of vigorous activity per week when compared to 150-300 minutes of moderate intensity activity per week. So, can even shorter, more intense bouts of exercise achieve the same benefits? Emerging evidence suggests that brief bouts of very high intensity, followed by short recovery periods can improve cardiovascular fitness for less time spent exercising.

Some of the confusion surrounding HIIT stems from the inconsistent definitions of the required length of interval and heart rate intensities to see benefits. A commonly used protocol involves 4 intervals at 85-95% maximum heart rate that last for 4 minutes with 3 minutes recovery between each interval. When you include a warm up and cool down, your total exercise time is still at about 40 minutes. Having said this, some argue that you can achieve improvements in fitness by using just one interval – 1×4 minute interval!

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While more research is required in this area, the initial findings are very promising. But is HIIT suitable for everyone, and in particular, for those with diabetes? Early research suggests HIIT may improve the way our insulin works, improve our waists circumference and improve beta cell function (insulin producing cells). As with any new exercise regime, a chat with your GP or exercise physiologist is a great idea to establish which exercise is right for you. As the name suggests, high intensity interval training is done at high intensities, therefore some additional factors may need to be considered.

HIIT may not be suitable for those with certain heart conditions, complicated diabetes management or certain musculoskeletal problems. We know that for some people with diabetes, some musculoskeletal injuries occur more commonly. Sensible and slow progression of exercise is therefore important for someone with diabetes. For those requiring insulin or some types of oral medication, risk of hypoglycaemia (low blood glucose levels) may also need to be considered. It is a good idea to monitor your blood glucose levels more frequently when commencing new exercise regimes.

So, what is the best exercise for me? Usually, my answer to this question is, “the one which you can see yourself actually doing”. HIIT will certainly not be for everyone and more research is needed before HIIT becomes part of standard recommendations for people with diabetes. But, if it is something that you feel will suit you, discuss with an exercise physiologist or your treating GP.

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Marian is a Diabetes Educator and an Accredited Exercise Physiologist at Diabetes WA.

Winston the Wonder Whippet

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Like many pets and their owners, Kaylene Burnell and her dog Winston are the best of friends.  But Kaylene and Winston, the pure-bred whippet, have an extra special bond. Winston is literally a life-saver for Kaylene.

Kaylene and Winston met through the charitable not-for-profit organisation Paws for Diabetics Inc after Kaylene had been living with type 1 diabetes for almost 30 years. Being hypoglycaemia unaware, Kaylene does not experience the symptoms most people do when their blood glucose levels get dangerously low.

“I have an amazing family and I love them all dearly,” Kaylene said. “I spent a lot of time in hospital and when I wasn’t in hospital my family would have to monitor me very closely. My husband Andrew ended up having to leave work and become my full-time carer as I was scared to go out on my own.

“It was during one of my many hospital admissions that my nurse told me about Paws for Diabetics Inc and when I was discharged from hospital we joined the organisation.”

In September 2008 Winston, a puppy at the time, arrived at Perth airport and was put to work straight away. When Kaylene and her family arrived at the airport to collect him, unbeknown to her or any of the family, Kaylene was experiencing a hypo. As soon as Winston was released from his puppy crate he alerted her, so Kaylene did a blood glucose test and confirmed what Winston had told her.

“He saved my life at our very first meeting,” Kaylene recalls.” Since then Winston has saved my life so many times that I have lost count.”

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Dogs have a naturally heightened sense of smell; they have around 220 million scent receptors in their nose as opposed to the five million that humans have. Professional trainers have learned to harness these skills by training dogs to recognise certain smells. These include the different scents the human body produces when their blood glucose levels are too high or too low.

The specially-trained dogs give their owners warning well in advance of an impending hypoglycaemic episode, allowing for prompt treatment.

“Winston will alert me in various ways depending on the situation and where we are,” Kaylene said. “Sometimes he will just sit and look intently at me, sometimes he will get my attention by softly whimpering and licking my hands, face or feet.

“He will also alert me by tapping me with his paw, putting his paws on my lap or nudging me. Sometimes if we are out walking, he will stop and stand in front of me to stop me from walking any further until I have tested my blood glucose levels.”

Despite having an insulin pump fitted a number of years ago, Kaylene sometimes doesn’t hear the alarm due to mild hearing loss, but Winston does and will alert her to it. Winston will often alert her before a CGM has even registered that there is a problem.

“Winston and I have been a successful working team for eight years now,” Kaylene said. “Going out in public is easier now as I’m a lot more confident, and I can do a lot more without my family having to worry about me, because they know that as long as Winston is with me then I am safe.

“My family and I thank God every day for Winston. We are also very thankful to Winston’s breeder and Paws for Diabetics Inc for all the love, care and support that they have given us over the years and for helping me to train Winston to be the wonderful diabetes alert service dog that he is today.”

Kaylene now volunteers with Paws for Diabetics Inc acting as Secretary, Fundraising Coordinator Australia-wide, as well as the Area Coordinator for Western Australia. Her husband Andrew is a committee member and the whole family attends markets and events, making and selling various handmade items to raise funds for the organisation.

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Feeling overwhelmed by your diabetes?

Whether you have only recently been diagnosed or have been living with diabetes for many years, understanding and taking care of your diabetes can be overwhelming. It is not uncommon for people living with diabetes to experience periods of frustration, guilt, worry and fatigue. We are only human! Helping our pancreas and our insulin to work as they should is a tough gig.

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Often, people without diabetes don’t get it. What is so hard about pricking your finger every now and again? Just don’t eat sugar, that’ll fix it. Diabetes does not live in isolation from other day-to-day stressors. As with life, there are days were everything goes to plan and everything feels effortless – diabetes is not a big deal, I can do this. Then there are days were we feel we shouldn’t have got out of bed – diabetes is hard, I don’t know if I can do this. On these days it is easy to get swept up by things like, the worry of long-term complications or that my last BGL was not within target range. It is not hard to see how these feelings might then start to effect other aspects of your day-to-day life including work, relationships, school and managing kids. Not surprisingly, this is a time where it is not uncommon for people to ‘give up’ on their diabetes in order cope with other aspects of their life.

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Looking after your emotional well-being will go a long way to prevent and manage diabetes-related distress. So how do we look after our emotional well-being? First and foremost, as the title of our blog suggests, it is not just about the numbers. Blood glucose monitoring is a great guide to help us make management decisions about our diabetes, but it is just that, a guide. Trying not to let the numbers ‘rule’ you, will go a long way in improving your emotional well-being. Think of your readings as just one piece of the puzzle, that one number is not a reflection of who you are.

If you are feeling overwhelmed by your current diabetes goals, or feel as though you are not achieving them – that is OK. You might find that re-visiting your goals may help find some perspective. You do not have to achieve everything NOW. It is ok to make your goals slightly smaller and easier to achieve. Being able to achieve your goals, even if you perceive them to be small, will give you more confidence and make you feel better about your progress. It is important to make your goals SMART – Specific, Measurable, Action based, Realistic and Time specific. This way it is much easier to get started and to know when we have actually achieved our goal. Most importantly, don’t forget to reward yourself. You are dealing with a complex condition, not to mention dealing with the rest of your life – achievements are worth celebrating!

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You are not alone. Try connecting with people or friends who might be experiencing similar struggles. There are a number of support groups around – click here (external link) to find a support group in your area or for online options:

 

Sometimes you might find that talking with a health professional such as a psychologist, diabetes educator or your treating doctor can help you find way to cope with the demands of diabetes. You can talk to your GP about how to access these services – often there are very affordable or free options.

Quick links:

 

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Marian is a Diabetes Educator and an Accredited Exercise Physiologist at Diabetes WA.

The perils of the checkout

As I sit to write the boys are in the bath, happily playing after a pretty big day. They attended a seven-year-old birthday party where the weather was sunny and beautiful and they ran around with all their mates at the nature playground. When we departed the boys were given their token party bag, which they clutched with glee despite my repeated words that they were not to open it until we were in the car. The minute they were locked and loaded in their car seats, they began to devour the mix of lollies and sweets in their bag, wrestling with wrappers and trading for their favourites. Needless to say, that afternoon they were sugar-crazed and rambunctious. I was exhausted. It was only when they were tucked into bed that they finally began to come out of the sugar haze that had ruled the day.
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In general, the boys are healthy eaters. Their school lunches are filled with corn, carrots, apples, and watermelon. They do eat biscuits and cakes, but in moderation. We talk about ‘always’ foods like fruit and veg, ‘sometimes’ foods like chocolate and lollies and those ‘rarely’ foods like Twisties! I am not the mother who makes them green smoothies and spirulina shakes, but I can whip up a pretty mean beetroot cake and zucchini slice. We eat dinner together as a family most evenings, something that numerous researchers and academics say is a predictor of kids staying out of trouble and succeeding later in life.

I will say one activity that can be challenging is getting in and out of the grocery store without a heap of rubbish making it into the trolley. I love that many of the larger shops have now placed baskets of free fruit, like apples and bananas, at the entrance and I admit when my four-year-old Jack and I enter we often take two or three! I go in with a list and a plan. I try to linger in the fresh produce section, exploring the various types of fruit and veg, trying samples, and pointing out new and unique vegetables that we have never seen before. I also try to skip the aisles with chocolate, chips, and cookies and divert the gaze of the children when passing packages of tiny teddies and other confectionary items. It’s not easy, but the greatest challenge lies before us at the checkout.

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When we have finally crossed everything off our list and we approach the checkout I pray that we whiz on through without having to linger there for long. When we do get caught there is often a chorus of “may I have this?” and “can we get that?” as the boys are faced with lollies, sweets, and soft drinks. Of course, all of these items are strategically placed perfectly at their eye level.

Rather than letting this stress me out, I use it as an opportunity to talk about the importance of healthy eating, things that are naturally sweet, and the ingredients in food and non-food (those things filled with numbers and emulsifiers). We talk about how tempting it can be but how we really don’t need any of the things that we see. I can see other adults or parents giggling or even listening, but I know they too have been faced with these perils. It’s a challenge, but one that we often rise to and I celebrate every time we make it through without something extra.

I have seen that there is a new wave of stores that are lining the checkout with fresh fruit and veg or basics for cooking that we often forget as we wander through the aisles of the grocery store. How wonderful this is, and could be, to have your children ask for an apple or some grapes as you wait to pay rather than a chocolate bar or fruit tingles. It’s slowly catching on and hopefully, will become the norm someday. Until then, I will continue to have some strategies in place every time we go to the shops and keep the faith that we can make it out alive!

Eye health

Sight is commonly considered the most important of our senses. It is fundamental to many of our daily activities and independence. With World Sight Day just around the corner (13 October 2016), it is a timely reminder, particularly for those living with diabetes to review how we are caring for our vision.

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Although people without diabetes experience many of the same eye conditions, those with diabetes are at greater risk of developing these conditions and at a much younger age. For many of the common eye problems we see in diabetes, the earlier they are detected and treated, the better the outcome. This highlights the importance of regular screening for your eyes. Often there are no obvious signs or symptoms of these eye problems in there early stages. Regular screening is often the only way to detect early changes to your eye.

An eye check is recommended upon being diagnosed with diabetes and then every two years. Some people may require more frequent eye checks in certain situations – talk to your GP to establish what is right for you. Eye checks are completed by an optometrist or eye specialist (ophthalmologist).

Eye problems relating to diabetes can be classed as short term and long-term problems. For those of you who have ever been told you have high blood glucose levels, you may have noticed a change to your vision temporarily? This short term problem can be due to excess fluid being drawn into the lens of the eye as a result of high blood glucose levels. This fluid causes the lens to swell and change shape, resulting in blurred vision. As our blood glucose levels return to target range, the lens will return to its normal shape and vision should return to normal. As this change in vision is temporary, we recommend waiting a few days until your blood glucose levels return to target range before thinking about changing your spectacle prescription.

Increased blood glucose levels over a long period of time can also increase our risk of developing other long-term eye problems. Some of the most common long-term eye problems include diabetic retinopathy, glaucoma and cataracts.

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Diabetic retinopathy

When blood glucose levels are high over a long period, damage to blood vessels can occur. Small blood vessels in the retina at the back of the eye are susceptible to this damage. To try and rectify the situation, our body tries to grow new vessels to make up for the damaged ones. The only problem is, these new vessels are small and weak which makes them easy to rupture, causing bleeding to the back of the eye. If detected early, diabetic retinopathy can be treated very effectively and loss of vision can be prevented.

Glaucoma

This condition affects the greater population, however it is more common in those with diabetes. Glaucoma is when there is damage to the optic nerve due to a build-up of pressure inside the eye. Left untreated glaucoma can progress and lead to irreversible eye damage and even complete loss of vision. As with all of these eye problems, early detection with regular eye checks can allow for very effective treatment and prevention of loss of sight.

Cataracts

Cataracts are a common eye condition, usually seen in an older population. People living with diabetes are at greater risk of developing cataracts at a younger age. Cataracts occur when the lens of the eye becomes cloudy and reduces our vision. Effective treatment of cataracts occurs with surgical intervention.

Reduce your risk

Your risk of developing these eye conditions can be lowered by keeping your blood glucose levels, blood pressure and cholesterol close to target ranges. Regular eye checks with your optometrist or ophthalmologist will ensure early detection of eye problems as well as prompt treatment to preserve sight.

Take a good look at your eye health today!

Quick links:

Vision Australia (external link)

World Sight Day (external link)

Looking after your eyes fact sheet (external link)

 

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Marian is a Diabetes Educator and an Accredited Exercise Physiologist at Diabetes WA.

Introducing Diabetes WA new workshop – MedSmart

Confused about diabetes medications? It’s not surprising given there are so many different types and brands. We are however, lucky to live in a world where we have many choices of medications which can be tailored to our individual needs.

When first diagnosed

When you are first diagnosed with diabetes, you may not need medication straight away. However, diabetes is a progressive condition so you may find that your medications and/or the dose of your medications may change.

Types of medications

Medications for diabetes come in all shapes and sizes. While most are in tablet form, there are also medications which we inject, including insulin. Each type of medication works in slightly different ways to manage your blood glucose levels. Being on one medication or another does not relate to how well you are managing your diabetes, it is simply what works best for you in your situation.

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So, if our diabetes medications are likely to change over time, how do we know when it’s time?

Your medications should be reviewed regularly and at least yearly as part of your diabetes annual cycle of care with your GP. Other reasons for review may include experiencing any negative side-effects, being confused about your medications, not receiving desired effect of your medications, difficulty taking your medications or changing circumstances with your health or lifestyle. Pharmacists may also be involved in Home Medication Reviews which can also be arranged by your GP if required. For more information, click here (external link).

For more information about your diabetes medications including, how they work, how to take them, problem solving, common side-effects and how to address them, you may be interested in our new MedSmart program. For more information about MedSmart click here (external link).

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Quick links:

Other helpful links:

NPS MedicineWise (external link)

 

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Marian is a Diabetes Educator and an Accredited Exercise Physiologist at Diabetes WA.

 

I have type 2 diabetes and just started on insulin – what does this mean?

Why me? 

Have I done a ‘bad’ job at managing my diabetes? 

Have I failed? 

Does it hurt? 

Do I now have type 1 diabetes?

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What do I do?

These are just some of the questions that might be going through your mind when your doctor says, you need to start injecting insulin. As with trying anything new, you might be feeling a bit overwhelmed with what’s to come and what it all means for you and your life.

Placing blame does not help the situation. Diabetes is not anyone’s fault. Starting on insulin is not your fault and you have not ‘failed’! Diabetes is a very complex and multifaceted condition with many factors contributing to the overall picture. Some things are within our control, while others are frustratingly out of our control.

The ‘pooped out’ pancreas

In type 2 diabetes, our pancreas does initially produce insulin. The insulin however, has some difficulties opening the rusty locks into our muscle cells (insulin resistance). In response to the insulin resistance, our pancreas tries to produce more insulin. The pancreas can keep up with this demand for quite a long time, especially when we start to help it by exercising, considering our food intake and taking medications. But sometimes our pancreas just gets ‘pooped out’ and slows down. The age of our pancreas, how hard it has been working and whether it is genetically predisposed, are all factors which might see our pancreas slow done its insulin production. When this happens, sometimes it needs a helping hand, which is where injecting insulin comes in. Just as we might change oral medications for our blood pressure, cholesterol or pain relief, our diabetes medication will change over time. This might depend on our changing lifestyles, age or circumstances. Insulin is just another tool we can use in our diabetes management.

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So do I have type 1 diabetes now that I am on insulin?

Type 1 diabetes and type 2 diabetes are like chalk and cheese. Type 1 diabetes is an autoimmune condition where the insulin producing beta cells are attacked and destroyed by our own body. People living with type 1 diabetes do not have the ability to produce insulin and therefore, must inject insulin from the day of diagnosis.

Type 2 diabetes is not an autoimmune condition, rather a complex metabolic condition where our body has difficulty utilising glucose due to insulin resistance and/or reduced insulin production. There are multiple mechanisms involved in type 2 diabetes involving the pancreas, the liver and the inefficient use of insulin (or locks on the muscle door).

So when you have type 2 diabetes and commence insulin, you still have type 2 diabetes. You have not developed an autoimmune condition. You are simply someone who has type 2 diabetes and are using insulin to help treat that diabetes.

Does it hurt?

Here is the size of the needle that are used to inject insulin – they are tiny! Often 4mm long.

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Most people do not find insulin injections painful. Talk to your diabetes educator to make sure you are using the correct technique to ensure effective insulin delivery and to minimise any discomfort.

What do I do?

While insulin is a very safe and effective diabetes treatment, there are some extra things you may wish to consider. Our pancreas is a complex and sophisticated organ and although we are pretty clever, it is hard to be as good as your pancreas in delivering insulin. We need to keep an eye on the balance of insulin and glucose available in our blood. You may find it useful to talk to a diabetes educator and/or dietitian to make sure you are getting that balance right.

Quick links:

  • NPS MedicineWise (external link)
  • ADEA (external link) – find a diabetes educator
  • MedSmart is a new SMART program run through Diabetes WA. It contains all the information you will need to manage all your diabetes related medications. For more information or to book into a MedSmart session, call 1300 136 588.

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Marian is a Diabetes Educator and an Accredited Exercise Physiologist at Diabetes WA.