Diabetes by Numbers – by Andy Broomhead

When I got diagnosed, I remember the Specialist Nurse telling me that really, my lifestyle shouldn’t be different to that of any other normal, healthy individual. Walking out of the clinic, laden with insulin pens, needles, test strips and other paraphernalia I was sceptical to say the least but of course she was right.

A low fat, low salt, low sugar, high fibre diet with plenty of fruit and veg is probably what most of us should be eating most of the time. I suppose the difference is that the consequences of not eating sensibly are a bit more severe for diabetics.

What I didn’t grasp at the time (and perhaps only subconsciously realise now) is all the diabetes maths involved in managing my condition – it really can be an overload of numbers at times. I’ve recently been dieting having put on a lot of weight and lot of my waking hours are spent devoted to all the figures I need to keep on top of things.

What do you see? 2 slices of toast? 190 calories? 31g of carbs? 3 units of insulin?

On a daily basis I’m remembering and adjusting numbers for:

• Long acting insulin
• Quick acting insulin
• Carbohydrate content of food
• Blood glucose levels
• Calorie content of food
• Exercise time

I’m also doing calculations in my head to make sure I can keep my blood glucose level throughout the day. I think diabetes gives you a new way of looking at things and a new appreciation for how your body works.

It seems quite daunting at first – and it can be even now. One unexpected hypo or BG level in the 20s has me going back over what I’ve been doing to try and understand where I’ve gone wrong. I’ve noticed this a lot more recently as my exercise regime has made my blood glucose levels a lot more sensitive to insulin.

In the 11 years I’ve had diabetes a number of things have made life a lot easier, and not just advancements in medication and testing. I use a phone app to track my daily diet which helps me monitor both my calorie and carb intake (and therefore my insulin doses). Eating out is no longer something that worries me as I can usually find nutritional information for most restaurants online.

It’s easy to forget that whilst there are so many fellow diabetics, the way in which everyone manages their condition is completely different. It took me a long time to organise myself into a daily routine that allows me to stay on top of my condition without it becoming a full time job. There’s a lot of support out there from places like the Diabetes UK Careline, GP, Specialist Nurses and from other people with diabetes themselves. Finding the right routine for you is the key to making all the numbers a lot less stressful and just another part of your day.

Finally, I was recently offered a place on a two year clinical study comparing the effect of the DAFNE course on people with multiple daily injections (MDI) and insulin pumps. I’ll find out which group I’ll be in (staying with MDI or getting a pump) nearer to Christmas. Hopefully I’ll have more to share on that next time.

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Know the feeling. I live by spreadsheet – actually a Filemaker database, recording all food I eat plus insuling & BM tests and watching the ratio of carbs to insulin. Plenty of room for error, though: despite plenty of data built up over the last couple of years, it is still difficult to be sure if the hour of cycling last night at an output of 170 watts will cause the carb:bolus insulin ratio to be 10 or 15 or 20and when. Even harder if the exercise is longer: soemtimes, the carb: insulin ratio is over 70 (ie 70 grams of carb to 1 unit of bolus, with basla at similarly low levels).