Feeling the Pressure

I went to the doctors yesterday to find out the results of some blood tests I had done earlier in the week. I was feeling a little nervous as I haven’t been particularly active over the past couple of months due to the hot weather and my knee injury – try as I might, running is the only form of exercise that I enjoy, and anything else is a poor substitute that bores me to tears!

First up was the HbA1c, the 6-12 week average of my blood sugar levels. Last October it was at a very comfortable 5.6%, but I expected an increase this time. Happily not! I was 5.6% again! Hurrah! Next, liver and kidneys – both fine, inner sigh of relief. Being less active and trying to stay cool in the hot weather had led me to imbibe rather more of the amber nectar than health authorities might recommend, so pleased I had escaped admonition. Then – cholesterol. I stopped taking the statins I had been prescribed eight months ago because I was suspicious about the effect they were having on me. Thankfully, my cholesterol was also fine at 4.5!

All well and good so far, but then came the deflating blow – my blood pressure is still high. This, despite increasing my medication. Very disappointing, although I still think there’s a big element of white coat syndrome that makes it high simply because I’m anxious and fearing the result! After discussion with the doctor we agreed that it may be due to the fact that my weight has increased quite a lot over the past few months, and reducing this (though I’m not actually overweight) should help lower the blood pressure. So it’s time to get serious and get out running regularly again! Strange for me – I’ve never had to think about losing weight before in my life, so I can only blame the diabetes…well, why not!

I need to lose nine kilograms,
That’s twenty pounds or so.
I lost an ounce, or twenty eight grams –
There’s hundreds more to go!

So thank you diabetes,
I’ve never been this way,
I’ve always been light, and that was despite
Eating four thousand calories a day!

A horse between two bread vans
Would constitute a delicate snack,
I’d eat at least two on my way out to work,
And another two on the way back!

It’s not because I am lazy,
Or fill up my belly with junk!
It’s you that I blame diabetes
For the fact that my gravy boat’s sunk!

So I’ll say farewell to you biscuits,
And go put my running shoes on,
I’ll be lighter than air and they’ll all wonder where
That nine kilos of lard can have gone!

Riding the Beer-O-Coaster

Alcohol can have quite an effect on you when you have diabetes – it’s a far more complicated situation than just getting drunk! After I was diagnosed I didn’t drink alcohol at all for several months – not because I was scared to or anything, just didn’t fancy it at all. Eventually, though, life started to return to normal. I found that I had little choice when drinking in a pub, as nearly every drink contains sugar of some sort. Really, the only drink available in most pubs is diet coke, which I do not enjoy drinking. Even then, you cannot be sure that the barman has actually given you the diet version – getting the ‘full-fat’ version without knowing could have a big effect on your blood sugar levels without you knowing and accounting for. So, I decided that I would only drink something that was ‘predictable’ – beer! It expands my choice, and I know what’s in it and what effect it has on me and my levels.

The unusual thing about drinking beer when you have diabetes, however, is that in spite of the sugar/alcohol content of the beer, it can actually cause your levels to fall, and if you aren’t careful then you could have a hypo. Even worse, should you have a hypo whilst drinking, people may just assume that you are drunk and not accord you the necessary assistance. When you drink, as a rule, your blood sugar levels will climb. However, as your liver then begins to process the alcohol, it will be diverted from releasing the steady, low level of glucose that it normally constantly produces (the reason why we need ‘basal’, or background insulin). So, as a consequence of this, your levels will fall. Moreover, the liver will suspend this glucose production long after you have stopped drinking, and may continue through the night as you are sleeping, leading to the risk if a night-time hypo.

The solution is to make sure that you snack on carbohydrates as you drink – crisps, chips, kebabs etc. This will give you a store of glucose to keep your levels up without your livers assistance. Once again, you need to use ‘trial and error’ to determine just how much you can drink and need to eat in order to keep your levels within range – a tricky balancing act, and not always successful after a few beers!

Come, climb aboard the Beer-O-Coaster,
You’ll find it an exciting ride!
First you’ll find your levels rising,
Just before that rapid slide!

The Beer-O-Coaster makes you dizzy,
Are you high or are you low?
It will keep your liver busy,
Help reduce the glucose flow…

Through the night and through the morning,
Feel your sugars hit the floor!
Better heed the doctor’s warning –
Build a carbohydrate store!

When you ride the Beer-O-Coaster,
Eat some food with every drink,
And before your senses leave you,
Make sure you stay in the pink!

The Liver Dump

Something that diabetics might encounter is an increase in blood glucose levels in the morning, above what they might expect when taking account of their bedtime levels and what they have (or haven’t) eaten for breakfast. People who don’t have to regularly test their blood glucose levels might be oblivious to this – if you don’t know the numbers then how can you compare? So, what’s going on? There are two possible reasons that have been put forward – the ‘Dawn Phenomenon’ and the Somagyi Effect’.

Put simply, the dawn phenomenon results from the liver releasing extra stores of glucose to give a person a ‘boost’ as they wake up and face the day. The ‘Somagyi Effect’ results from a person dropping very low during the night, and stress hormones released in response cause the liver to ‘dump’ extra glucose into the bloodstream to bring the levels back up. Sometimes, the liver does more than enough and the person wakes up with high levels. Some people experience these effects more than others. Personally, I have always been fine in the mornings, even on the low side in the early days, but it is interesting to learn yet more about the way the body works, that I previously took for granted.

There’s a great, more detailed, explanation here:

http://www.diabetes-support.org.uk/joomla/dawn-phenomenon


‘Come on Bill, it’s nearly time –
The Sun’s just coming up!’
‘I’ll be there in a minute Spike,
Just let me drink this cup!’

Billy Rubin and Spike Mackay
Were on the early shift,
Their job to stoke the levels high
With a liver glucose lift.

‘We’ll get this fella up to speed
And ready for the day
With all the glucose he will need
So he can work and play!’

‘Remember how, the other night
His level dropped right down?
We called in all the guys on site
And really went to town!’

‘Aye, how we laughed when we found out
His levels went so high!
He didn’t have a clue about
The real reasons why!’

‘But not today, I’ve heard he tests
His blood at three each night,
And if he’s low he snacks and rests
He’s putting up a fight!’

‘We might find out our jobs are gone,
And we’ve been superceded!
There’ll be no Dawn Phenomenon!
We’ll be no longer needed!’

‘Don’t worry Bill, it might get slow,
But there’ll never be a slump –
There’s always work, I know it’s so,
Here at the Liver Dump…’