Fancy a Ruby, me old China Plate?

I like a good curry, the hotter the better – Chicken Vindaloo is a favourite of mine. Best served with basmati rice which has a relatively low glycaemic index (GI) than other types of rice, but only allowing myself a small portion of naan bread as that does tend to give me a high blood sugar spike. No reason I shouldn’t enjoy a beer with the meal! Alcohol has a sort of topsy-turvy relationship with blood sugar, sending it higher with the extra carbohydrate, but then lower as the liver turns to processing the alcohol rather than releasing glucose. Brandy would have the same effect, although some people find their control is better with spirits than beer.

Estimating the carbs in a plateful of curry can be difficult though, especially if served in a restaurant. As well as an indeterminate quantity of rice, there will also be sugars in the sauce. Generally though, the calculations for my insulin doses are reasonably good, and I always remember to include an extra amount for the sweet treat I indulge in after the savoury meal. Eating sweet things with the meal will help to lower the overall glycaemic load, so the cake or pudding can be eaten with less fear of a sugar spike – another good reason for eating curry!



I’m really looking forward to a nice Ruby Murray,
But I must do a Banting and Best,
For before you indulge in a hot spicy curry,
You must do a blood sugar test!

I’ll work out the size of my grandfather’s nose,
Before a peck of my old speckled hen,
For you must be precise with your insulin dose
When you inject with your insulin pen!

You can choose to be pecked in your Old Auntie Nellie,
Or perhaps in your Old Fife and Drum!
But in public it’s best to inject in your belly,
As your bum may be too much for some!

Would you Adam and Eve that a nice Britney Spears,
Or even a stiff Fine and Dandy,
Can be supped with your meal? (That’s a bottle of beer,
Or a generous helping of brandy!)

You might want to finish your Lilley and Skinner
With a treat like a big Sexton Blake –
With the lowered GI from the rest of your dinner,
There’s no reason you shouldn’t have cake!

The Carrot and the Stick

Some people have recently said on the forum how being told the bare, unpalatable truth about the consequences of poor blood sugar control has really made them sit up and start getting serious about their diabetes. If you let your guard slip then terrible things can creep up on you before you know it. So, sometimes tough love can be what is needed should complacency or rebellion set in. On the other hand, a person might find that encouragement is the key to success, possibly by being given the opportunity to get funding for an insulin pump with all the wonderful flexibility and enhanced control that brings. I feel that, currently, I am driven to keep good control mainly due to the fear of complications. This is not to say that I am in constant dread, but that I have an incentive to do everything by the book to give myself the best chance.

Diabetes nurses, so pleased you could attend,
Your patients will be glad you came – on you they all depend!
Today we’ll learn a technique called the carrot and the stick,
If carrots do not work for you, then the stick might do the trick!

Now, if a patient comes to you and their levels have been poor,
You might suggest a pump for them, describing its allure,
But sometimes a really harsh approach is the one that you should pick –
Frighten them with neuropathy and beat them with that stick!

They must avoid complacency, so keep them on their toes!
A pump might be a carrot dangled right before their nose,
And if you get their hopes up that a pump may soon be theirs,
You’ll be their favourite DSN – a nurse that really cares!

Assess your patient carefully, decide which method’s best,
But make sure that they know that they must inject, record and test,
For minor inconvenience they’ve everything to gain,
Avoiding complications and a life that’s filled with pain.

Injection Hokey Cokey

I’ve recently changed from using the top of my hips as my injection site to using my tummy. The area on my hips where I was injecting had started to become a little sore, although I did use alternate sides to allow some healing to take place between jabs. It’s very important to rotate your injection sites as injecting too often in one place can lead to the formation of fatty lumps, which may then cause the insulin to be absorbed at unpredictable rates – you may get virtually nothing being absorbed into the bloodstream, and then suddenly get a ‘surge’ which might then present a danger of hypoglycaemia.

You also need to bear in mind that different sites have different absorption rates, so this might be something you need to take into consideration when injecting. Particularly fast will be a limb that is in heavy use, such as the thigh of someone going for a run, so again this must be borne in mind when choosing where to inject. The needles are tiny and rarely hurt, but doing it over 1500 times a year will gradually take its toll, so keep rotating those sites!

You can stick it in your tummy,
You can stick it in your thigh,
But don’t always use the same old place,
And here’s the reason why:
Too often in a single site
Could cause some lumps to form,
Absorption then could be quite poor,
Erratically performed.

Different sites for different tasks,
Please also bear in mind,
Absorption rates will vary
From place to place you’ll find.
The tummy is the quickest,
A plump behind is slow,
And fastest is a limb in use
As runners ought to know.

It’s yet another element
We have to factor in
To calculate four times a day,
Our dose of insulin!

Given the choice...

Diabetes is one of those hidden conditions, at least so long as the potential complications are held at bay. People wouldn’t know you had it most of the time, unless maybe they were to see you testing your blood or injecting insulin. I’m quite fit and healthy overall, so sometimes it’s hard to believe that there’s anything wrong with me at all. But, several times a day I am reminded about it, when I have to test, plan a meal, decide what I can and can’t eat, calculate insulin doses, plan exercise, evenings out, days away – the list goes on. It’s a chronic condition and you cannot escape from it. Ignoring it will most likely result in feeling very bad and even possibly becoming very ill.

There’s nothing to stop me having all the things mentioned in today’s poem, except that it would be an absolute nightmare trying to keep my blood sugar levels anywhere near to normal range, so I wouldn’t enjoy it. I’ve been trying to pluck up courage to eat a pizza that I’ve had in my freezer for a month now, but every time I take the packet out and read the ingredients list, I’m put off – 150 grams of carbohydrate and 45 grams of fat. It just doesn’t seem worth it. My habits have changed quite a lot over the past year and I feel that maybe I’ve become a little obsessed with keeping my insulin doses as small as possible. I think, subconsciously, I think that the lower the doses go, the less diabetic I am, which is nonsense of course. So I just have to get on with it, like millions of others, until the Cure arrives!

No diabetes – let’s see what that means,
A big slab of butter, some bread and some beans,
A huge stuffed crust pizza – pepperoni and cheese,
Sausages and burgers, as much as you please,
Chocolate cake, biscuits, and puddings galore,
A whole box of jaffa cakes – perhaps even more!
Pineapple fritters fried deep in a pan,
With a mountain of chips, all part of the plan!
A gallon of fruit juice, or as much as you like,
Without any danger of a blood sugar spike!
I’m not saying I’d eat all these things if I could,
But a choice in the matter? Now that would be good!

Nearly cured!

Back in April, with the warm spring weather revitalising me after a particularly cold and harsh winter, my insulin requirements had suddenly started decreasing at an alarming rate. Each night I would reduce my dose of Lantus, but each morning I was waking to blodd sugar levels bordering on hypoglycaemia. My daily novorapid doses with my meals were also decreasing, although not at quite the same rate. Eventually, I seemed to settle on a dose of 8 units of Lantus which allowed me to both go to bed and wake within range, without additional snacking.

I’d been expecting, now that the colder weather and darker days have arrived, that I might experience a seasonal increase in my insulin requirements to match the decrease I’d had earlier. Not so. My requirements have started declining again, now to six units of Lantus. I can only surmise that I have recovered some residual beta cell function and am producing a low level of ‘home grown’ insulin to supplement my injected doses. Certainly, when I read of others’ experiences, I seem to have far fewer problems with keeping my levels within range, and certainly never experience the frighteningly high levels that some people get.

I don’t really think I am on the way to being cured, but it’s a nice thought to have! It is more likely a cure will come from the good work of the Juvenile Diabetes Research Foundation

Since diagnosis there’s been the allure
Of a highly unlikely spontaneous cure!
For my insulin doses have shown such a fall
That maybe one day I won’t need them at all!

I started on twenty of Lantus as ‘slow’
But in April discovered that this sent me too low,
So I started decreasing it, two units a night,
But still a month later it just wasn’t right!

Now I’ve reduced it by seventy percent
It does make me wonder where the rest of it went!
From twenty units to six, and should I need fewer,
Then surely that constitutes a virtual cure!

Perhaps it’s my pancreas that’s been resurrected,
With beautiful beta cells no longer neglected,
Pouring forth insulin, potent and pure,
I’ll take that for now! It’s nearly a cure!