Please open another tab then copy and paste into your URL box to viewIf you do decide to fast and get into difficulties, please cease fasting and get in contact with your Diabetes Healthcare Professional or GP.
Thank you for reading and please keep safe.
© 29 June 2014 MC
As you can see from the photograph having diabetes affects all shapes and sizes of feet.
With or without diabetes we all take our feet for granted but someone living with diabetes does not really have such a luxury, especially those diagnosed with type 2.
In type 2 because the diagnosis is at a later time in life and we may also be presenting with a compromised cardiovascular system – bad diets, lack exercise.
I am not being critical but honest as I know I also am guilty and waiting with baited breathe for my day of reckoning.
Foot complications occur in type 1 but usually, those with type 1 have an already regimented daily foot care regime.
Since September 2013 Diabetes UK have been promoting ‘Putting feet first: Diabetes Foot Care’ all in a bid to reduce amputations and improve foot care for people with diabetes.
Whilst working in the East of England, I came up with an idea regarding foot care for older people, it was dismissed. I had quite forgotten all about it until I attended the ‘Living with Diabetes Event.’
I was truly upset at the rendition of a tale from someone in the audience. It truly sadden me.
Their anger and frustration was totally recognisable, yes they were sad and grieved the loss of their toe but the main anger was that Health Professionals (HP), in their opinion, hadn’t listened – they had stubbed their toe and all they saw were health professionals concerned about diabetes.
The stubbing of a toe causes a stress within the body, as in pain, which increases blood sugars, as the body tries to repair itself. If the persons blood sugars are already high the healing process takes longer and slows down recovery. Dependent on when the HP became involved maybe why it can feel like everyone’s concern is about diabetes and not the primary cause- the stubbed toe.
Diabetes most probably exasperated the toes final demise but if a person is given information however harsh it may seem they then have coping mechanisms. Someone just saying “Yes, we know you have stubbed your toe but we now have to ensure that your diabetes is well controlled to ensure you don’t get any complications”, can be remarkably reassuring and instantly the person understands and engages with you.
I know I have probably made it sound simple and when faced with a HP be it Consultant, Doctor or Nurse it can be intimating but HP’s understand the theory and have experience of complications of diabetes.
So it can look like HP’s are totally obsessed with your diabetes control but it’s because they understand the down side of diabetes, if not controlled properly.
Don’t ever be afraid to ask, you are the person with diabetes, sometimes you need your hand held and like a child you need things explaining in simple terms – please don’t be afraid ask!
Never forget that Diabetes UK have all manner of helpful guides and information at a touch of a button.
Until next time, take care of you and yours
© 22 June 2014 MC
Since my last posting things have certainly been moving. I attended and spoke at Swrajit Sarkars first ‘Living with Diabetes’ event held on Saturday 31st May, at the University of Central Lancashire (UCLan), Preston.
A very successful event, Swrajit with an alliance with UCLan are planning to make this an annual event on behalf of the ‘Diabetes Research and Wellness Foundation’. There was a lot of interest via my website as in email inquiries, I promise that I will promote the Event via my site, next year nearer the time.
The previous day I appeared in the Lancashire Evening Post, Practice Management Magazine had asked for an article and it was suggested I sent it to all the Press contacts I have, and so gaining my 15 minutes of fame.
From this Press Release, I was invited to speak on BBC Radio Lancashire and I did that yesterday, on The Morning Show. I sound like a runaway train only accessible via bbciplayer for the next 6 days.
The link lasts for about 6 minutes in all.
As well as promoting myself and the business, I had the great privilege to attend a lecture given by Professor Bryan Frier, regarding ‘Hypoglycaemia’ (low blood sugars) at Ewood Park, Blackburn last Thursday, I have to admit to being in seventh heaven and as usual, came away with my head buzzing.
The loveliest of knock-on events from my “fame”, has been coming into contact with previous patients. One lady rang my office and the other wrote a small testimonial on my ABC blog. People are very kind and it is appreciated.
I have also realised a few areas of updates which I can write more about, the importance of foot care, understanding eye terminology, ‘hypo’s, driving and the DVLA’.
At the moment it is all swirling in my head but I promise to be more regular on my blog.
Take care until next time.
© 10 June 2014 MC
This Saturday 31st May, I have been invited to talk at the University of Central Lancashire’s ‘Living with Diabetes’, Event. I have 20 minutes in which to talk about my chosen subject ‘hypoglycaemia’, all I can say is that at this time my head is overflowing with ideas and information.
From February 2012 to October 2013, I had the great honour of working within the Diabetes Nursing Team of the Royal Liverpool Hospital on a Hypoglycaemia Project. I have to say I found great pleasure in my work and what we were trying to be achieved. I left just short of two months from collecting the last lot of Prospective data. In my period of notice, I was told I was the only titled ‘Hypoglycaemia Research Nurse’ in the UK and the data I was collecting and collating was mind-blowing.
Due to my loyalty and respect for my colleagues, I am loathed to share any information other than the abstracts I had published for both the Diabetes UK Professional Conference and two abstracts published in the American Diabetes Association ‘Journal of Diabetes’ supplement, one of which I wrote but had presented in another’s name. My silence is because the work is ongoing. All this information is swirling around in my head and I have the unenviable task of sorting it out and putting together for a power point presentation without boring everyone to death.
The main issues I need to share with you, that as Health Professionals in diabetes all know, is that ‘hypos’ are as damaging as high blood sugars. This is why we make such a fuss with regards to driving and night-time hypos, it is not as a way of punishment but it is information required for balance.
Those at risk are those treated with insulin or a sulphonylurea (gliclazide, diamicron, glipizide). Too much insulin will cause hypo and sulphonylureas can cause hypo’s because you are getting the pancreas to produce more insulin. Blood glucose monitoring is important when about to go behind the wheel of the car and prior to bedtime to prevent the most feared night-time hypos.
I realise that as someone living with diabetes you don’t want to own up to hypos, especially severe ones, in case you lose your driving licence but like drink drivers, it is not just you “at risk” but passengers and others on the road. So be sensible.
If an ambulance is called out because of a severe hypo, please do not refuse to go to a hospital for a check-up – hypos can cause damage.
Health Professionals remember if someone presents regularly with excellent blood sugars in their diary but a raised HbA1c, they could be ‘hypo unaware’ and its the correction of hypo’s that is falsely raising the HbA1c.
I had a man present at my GP consultation upset because a health professional had all but said his blood sugars were false and raised his insulin. On asking if he had ‘hypo’s’ he said ‘No!’ his wife said ‘Yes!’ and at the same time every day. His insulin reduced, his blood sugars remained within target and so did his HbA1c. His hypo’s stopped.
Another lady, I had known for a long time a real character, type 1 diabetes and on occasions had given us Diabetes Nurses the runaround but years later at a 1-2-1 session discussing hypo’s she had never been told that hypos were as harmful as high blood sugars.
I have a thing about older people who live alone, who get up in the middle of the night to the toilet. I know its within guidance now but I always allow for the HbA1c to run a little higher and blood sugars, especially at night, to prevent hypos and keep them safe. All about balance.
Glucagon does not work on older people with type 2 diabetes on sulphonylureas and makes their recovery time from a severe hypo longer.
Sorry if this feels like doom and gloom, it isn’t all bad with diabetes but I just needed to let this out.
Need any further information take a look at Diabetes UK website.
Be safe and have fun.
© 27 May 2014 MC
On several occasions, I have been asked to demystify diabetes, such as the 5 – 10 top tips in diabetes care.
The more I have thought about it the more complicated it seemed.
What I may think are the top ten tips may not be yours.
So I have decided that as in all dealings in any condition, we, the health professional have our own language that we bandy about and expect, YOU, the patient or carer to understand.
We may have told you once or twice before but as with most people in any intimidating environment be it “Clinic” or “Doctors Surgery” people are mostly too polite to say “Say that again! Slower and simpler”.
Not because you are stupid or simple, simply because it can seem all gobblygook.
The Americans as always have a simple way – The ABC of Diabetes so here goes….
A – A1c (USA) HbA1c (UK) is the ‘glycated haemoglobin’ and as you may be aware it is used to look at your blood sugar status retrospectively over the last 3 months, usually. It always amazes me how many people have never had this explained to them.
HbA1c gives you and your Health Professional the average of what your blood glucose is and if it is within the target. Always useful when wanting to change medication and to aid in the prevention of complications.
Target numbers have changed 48-58mmol/mol (new translation) 6.5-7.5mmol/l% (old translation) but the same target level.
B – is for blood pressure, a great way of checking your heart and kidneys are working effectively, aids the Health Professional and yourself in preventing complications such as heart attack, stroke and kidney problems
C – is your cholesterol, important for you to know what your levels are and the various parts of cholesterol. Aids in the prevention of heart attacks or stroke. It is important that you know what good and bad control is.
LDL (low-density lipids) bad cholesterol less than 2 mmol/l and needs to be lower than
HDL(high-density lipids) good cholesterol above 1mmol/l in men and above 1.2mmol/l in women.
Total cholesterol which needs to be less than 4mmol/l and
Triglycerides (bad cholesterol) less than 1.7mmol/l.
(Taken from the British Heart Foundation HIS3 Reducing Cholesterol Booklet)
That’s it, for now, I will continue with the alphabet over the coming weeks keeping you updated in simple terms.
Just so you know if there is anything you want to say, please leave feedback or any worries or concerns just email back, always between the two of us.
© 21 May 2014 MC
‘Since getting the new insulin pump, I have an appreciation for pockets.’
I smiled because it took me back to last August Bank Holiday, my family including grandchildren, were out for the day at Ingleton Falls when a young couple jogged past.
The young lady, tall slim with her midriff showing and a noticeable subcutaneous needle and catheter taped to her back. I instantly recognised it as part of her insulin pump, delivering insulin as and when it was required.
My daughter looked at me oddly as I smiled and she looked somewhat embarrassed as she stared. I whispered ‘diabetes – insulin pump’. My daughter caringly said ‘she must be really bad’. I replied ‘No she will have more control, her diabetes possibly hadn’t been so easy to regulate via pen devices’.
In my mind I wanted to say to this young woman ‘Well done you!’ Who had educated you, supported through your diagnosis and acceptance, given you the most positive of attitudes. In my assumption, she obviously had totally accepted her diabetes, it wasn’t a secret, if anything she was shouting out loud and clear I have Diabetes – so what!
I am not saying that all those living with diabetes do this because each person is different. We all have our own coping mechanisms.
What I am saying is be proud, it is hard work 24/7 when dealing with the diagnosis diabetes be it Type 1 or Type 2 and path it takes you along.
© 14 May 2014 MC
Guest Blogger: Brad Burton
Last week I went to MediaCity Manchester to improve my skills, regarding twitter with 4HubUK.
In a discussion about diabetes, business and networking, Brad Burton the man behind 4networking came into the conversation.
I tweeted that Naomi Timperley sent her regards and that I understood he had diabetes the answer came back “Yes, Diabetes Rocks! I was taken by surprise but totally delighted; I then asked if he could write a Guest Blog about his journey…..
Here it is, as written by Brad Burton himself – the title is his too. Enjoy!
A year or so back, the Doctor in a routine health check said, “I’m borderline diabetes, I should do something about my diet & health.”
Only fat people get diabetes.
I’ve no idea what Diabetes is TBH, but I know only really fat people get it.
So I kept on as I was, eating those KFC meal deals twice a week whilst on the road, driving up and down the motorway running my national business, motivating business owners all over the UK.
The first real signs that I may have had a problem, one night after a particularly boozy binge on a stag do, I got up 10 times for a pee, to be honest it was more like a p, as nothing really came out.
Pins and needles was also happening on my left hand.. Weird.
Google is my friend, as is often the case when you hit the internet for a self-diagnosis every ailment tells you, you’ve got cancer. Fortunately the results on this occasion kept pointing towards me having diabetes.
Nah… Surely not, after all its only really fat people that get it. Isn’t it?
I made an appointment to see the nurse, who took my urine and blood samples.
2 weeks later, I received a call from the Doctor, “Mr Burton, how are you?” after the cursory 15 seconds of pleasantries, he says “the results are back. You have type 2 diabetes.”
The moment, the phone went down, was the moment everything changed.
No longer was I drinking the 5-6 cups of coffee with 2 sugars in. I dropped to 1 a day, 1 sugar. I’ve not had a red bull since that conversation; I’d been known to have 3 cans on a big day. Those KFC’s banquet box meals with the lovely chicken gravy not had one since.
Things changed. My life was never going to be the same… it was pretty much over, or so I thought. Eating was always my thing, pissed off – eat. Happy – eat. Feeling melancholy – eat.
At my 7th Birthday party, my Dad had an eating competition with all the kids, to get rid of the food. I came 2nd. I’d eating lots and fast, as this was all about winning!
As a kid, one day I was scared to go to the toilet in the evening, i recall eating some sweets to give me power, a bit like Popeye.
Food, eating, consumption was always part of me. Almost hard coded in over the years.
34 years on from that Birthday party… I’d finally won 1st prize in my eating competition.
A diabetic bracelet.
So everything changed, water, I drink loads of it, butter, what’s that? Funnily enough you don’t need butter on bread like i once did.
I probably did 6 months straight of eating 100% perfect, the first 18 days of detoxing from caffeine and sugar were absolutely horrendous, dark dark days… but it passes.
I had a handful of cheat meals in those 6 months.
Went back to the Nurse for tests, and she said “My you have been good” your levels have returned back to normal.
Truth is I still have no idea about blood sugars or in fact the really ill effects of what happens if I choose to ignore my diabetes.
I don’t want to know, this would be a problem if i chose to put my head in the sand, but i don’t need to scare myself to death. Just be the best i can be.
At Christmas, hit it (food) hard for a few days and about 3 days in, I felt the symptoms returning, weeing, pins and needles and I tweeted from my @BradBurton account “Thanks for the warning signs Type 2. I really appreciate it x”
Would I prefer to not have type 2? Of course… but would I prefer to have type 2 over a heart attack. Of course. And that is where I was heading.
It’s part of me now, and yea i still have the odd curry, cheat meal, go crazy. But it’s just that, odd, cheat, odd treat. A life of food excess was none-sustainable. I’ve been hitting the gym hard and my weight is down from 16stone 3 to 15stone in last 8 months.
I look better than since my late 20’s, i feel better and those treat/cheat meals really are a treat right now and something I look forward to, rather than take for granted each and every day.
The truth is my hard diet, has slipped since those first 6 months, and I’m looking forward to getting my results back at next test to see have i still managed to keep it under control with the odd Snickers bar. My gut instinct is yes, if not we go back to being hard-core again. But never forget this, you are human; don’t beat yourself up if you fall of the wagon… Just get back on it as soon as you can.
My advice to you, the reader, if your Doctor says you are borderline diabetic, do something about it TODAY. As someone who was diagnosed with bacon retention, Diabetes Type 2 is avoidable; just don’t confuse your bad decisions with bad luck.
MD of 4Networking.
The Highest rated/reviewed business author on Amazon.
The UK’s #1 motivational business speaker.
Brad B http://BradBurton.Biz
Most likely “Keeping it real”
© 7 May 2014 BB/MC
I have to say on reading these blogs it can appear to be an easy task – far from it. I have to ensure I have your interest and I am able to get the message out regarding diabetes by enabling motivation. Most importantly I have to look for inspiration regarding topics.
As with most health professionals in all fields of specialties, we have the theory and practice but our greatest teachers are you, the person living with the various ‘long-term conditions’. Speaking for myself, I have the utmost respect and admiration for you all.
It has always amazed me when thinking about my vast career how many people, who have sat in front of me looking anxious and worried, with regards to their results and if they were in for the daunting telling off.
Early on in my diabetes career, I realised that the true expert wasn’t me but the person I was talking too. Be that a worried mother whose child has had a severe night time ‘hypo’ (low blood sugar) and needing support in the aftermath or the newly diagnosed adult with type 2 who believes that because they have the diagnosis their whole world has collapsed into the deep dark abyss and it’s the end.
You, the person living with diabetes and those supporting you, family, friends, and carers are the experts in your diabetes.
I have always maintained that I may have a grand title of Diabetes Specialist Nurse but the reality is, I am but a guest at your table, there for support and advice. Yes, the occasional kick up the old btm but I know that the people I have met would not want it any different.
You are not stupid, you know what to do to maintain good control, and I know this, as I have a tale:
I had a young lady in her early teens, clever bright with type 1 diabetes had been diagnosed as a toddler. Mum a single parent in an extremely stressful job as well as life.
I visited this family either once a week or fortnightly, being supportive looking at diets, activities, number of ‘hypo’s’ we went through everything all with the aim of trying to bring her HbA1c within set markers (three monthly blood test to check on the overall average blood glucose, over the last three months). I left their home each time concerned and worried was I actually making an impact.
Then on one such visit, she had to do a presentation in front of her class or year. She decided that she would talk about her diabetes and asked me if I would take a look to see if she had left anything out. So I looked, I couldn’t believe what she had written, I had spent weeks months visiting to aid her control and there in black and white was the evidence that she knew diabetes inside out upside and sideways.
A lot of banter followed and the lesson I learned was that as a health professional I can educate, support, hold hands to comfort but the expert in your care is not me, I may have access to research and evidence on the way forward in prevention, the real expert is you.
© 1 May 2014 MC
In working to launch Diabetes Complete Care UK you would not believe how much preparation and learning of new skills have had to take place. When aiming to be the best you can be, it is important that those who rely on you for their wellbeing know you will do almost anything to ensure this. At Diabetes Complete Care UK, we want people to realise that diabetes isn’t all doom and gloom that pre and post diagnosis you are the same person.
Diabetes Complete Care UK has now entered a totally new playing field, as the NHS embraces change so must we, which includes stepping out of the safety of caregiver and provider to a promoter. As many of you out there are embracing technology and new IT languages, so we are too.
Education especially diabetes health education is available in all quarters from your local Dose Adjustment For Normal Eating (DAFNE) and Diabetes Education and Self Management for Ongoing and Newly Diagnosed (DESMOND). To accessing education online via apps on phones to podcasts. Someone suggested that Diabetes Complete Care UK needed to contact the local radio show and offer to host a question and answer diabetes session. So in our innocence, we rang our local Preston FM and secured an interview. Our interpretation of an interview was somewhat different to what took place.
Please click on the link and listen, it took place on Monday 24th March 2014
From this Diabetes Complete Care UK will be on air at Preston FM’s Chat City with Hugh Parr every two months starting Friday 9th May 2014 @ 10.35 am. We are there to answer any queries or concerns that you have. To ensure your question is aired we will need you to email them prior to the 9th May. So this is a call out for your questions and concerns. It does not matter how simple or silly you think it is if it is causing you a worry we can help.
If received on time, they will be used on air on the 9th May or next time, if missed or unable to use you will receive an email with your answer. Let us also know if we are able to use your name on the radio to keep it real for the listener, with the area in which you live.
Making it even easier use the contact email box to the right of this blog and just put ‘Radio Show’ in the title box, for your question?
So looking forward to hearing from you.
© 23 April 2014 MC
Sounds like a good idea but a writer I am not.
My blog is a place in which I can share my knowledge and expertise simply for all involved and living with diabetes, including the innocent who stumble across my website or blog and take time to look read and learn.
As Diabetes Complete Care UK takes shape, there are expectations:
A website to let people know about the business
Self-promotion people need to know about you, so social media is the way forward Facebook, twitter etc.
Okay sounds like a good idea. So, here I am a Diabetes Specialist Nurse with over 20 years’ experience and still surprised by the sheer lack of knowledge patients have about their diabetes.
NICE regulators for guidance, who put in place a technical appraisal meaning it has to be done. Especially for newly diagnosed Patient Education for both type 1 and type 2 diabetes; you may have heard of DAFNE, BERTIE, XPERT, DESMOND all accredited, researched patient-centred, self-management education programmes.
I needed help what do carers and those living with diabetes need to know?
So I asked one of my Practice Nurse colleagues who has insight into what people with diabetes need or want? She works with a high Asian population GP Practice and, who are known to be at greater risk of diabetes.
- She told me to write about the risk factors, I was somewhat amazed, as anyone who takes a special interest in a subject instantly knows where to go for answers.
- She asked if I could possibly come up with simple information for easy translation.
Straight away I said Diabetes UK, they translate all their information into a variety of languages.
She surprised me by saying that the Asian community is unaware of Diabetes UK and have no idea how to access the information. This made me truly sad. The number of good works carried out by this charity and the monies plowed into research to ensure that there is equity across their services and still there are major gaps.
So here are risk factors were taken from the Diabetes UK website:
You are over 40 (or over 25 if you are South Asian)
You have a close family member with diabetes (parent, brother or sister)
You are overweight, with a large waist size (over 80cm (31.5 inches) for women, 94cm (37 inches) for men, or 89cm (35 inches) for South Asian men)
Being of South Asian, Black African, African Caribbean descent – even if you were born in the UK
You have ever had high blood pressure, a heart attack or a stroke
You’re a woman with polycystic ovary syndrome and overweight
If you’re a woman and had diabetes whilst pregnant (called gestational) or given birth to a baby over 10 pounds
If you have a severe mental illness for which you take medication (such as schizophrenia, bipolar illness or depression)
You’ve been told you have impaired glucose tolerance (IGT) or impaired fasting glycaemia (IFG)
Note: Some of these risks factors are genetic factors and there is little you can do to reduce them, so it’s best to concentrate on those you can change, such as your weight.
What does not cause diabetes (Diabetes UK)
Viruses or germs – you cannot catch diabetes like a cold
Stress, though it may make the symptoms worse in people who already have the condition
An accident or an illness won’t cause diabetes but may reveal the condition if it is already there.
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