Listening to your inner voice – by Andy Broomhead
The physical effects of diabetes are generally well known, but the psychological impacts are a lot less obvious to those without first-hand experience of the condition. I think over the past few years, there’s been a growing recognition that people with diabetes need support in all aspects of life – physical and emotional.
I was talking to someone recently about why this is so important and attempting to explain that the almost constant diabetes inner monologue can leave people feeling overwhelmed.
In some of my peer supporting encounters (and my own previous experience), having those feelings and not having someone to turn to can be very isolating. It’s encouraging to see that psychological support is becoming more widespread through the NHS. Social media has been a great place to seek out support, and many voluntary organisations are now offering help with the emotional aspects of diabetes, both online and face to face.
For this month’s blog, I’ve tried to write down that inner monologue over a 24-hour period to share my psychological experience of diabetes. It’s always difficult to do something like this without altering what or how you think as you record your thoughts, but I’ve tried to stay as true to that inner voice as possible. Obviously other people go through a different range of emotions and experiences with their own diabetes, but hopefully this will provide some insight into why that emotional support can be important, and why you shouldn’t feel like you’re alone in what you’re thinking:
05:05 Mouth feels dry. Legs feel stiff. Is this high BG or a result of yesterday’s exercise? BG is 11.2. OK that’s not too bad but the exercise bike will lower that too much if I don’t eat. How many jelly babies will be OK? 4? Try 4.
05:20 Should I change my pump’s reservoir before work? 48 units should be enough until I get home right? Daily basal is 23 units a day… 5.5 units for breakfast at work… Don’t like changing it at work as there’s nowhere private. I’ll do it when I get home.
05:32 Should probably take everything [insulin vial, reservoir, cannula] with me just in case.
06:05 Think I need two more jelly babies. Need to be at a good enough level to drive after this [exercise]
06:30 Need to test before driving. Please be above 5 – I don’t have time to eat and re-test… BG is 5.9. Phew. Remember insulin, reservoir and cannula for work!
07:54 Re-test before breakfast – 4.4. OK. Three slices of toast is about 3.5 units. I’ll do 3 and that should bring me back up a bit.
08:30 Three biscuits is about 1.5 units – should be fine. No point re-testing again yet.
09:41 Feel a bit off – 8.2 – false alarm
10:08 Still not feeling ‘right’. Will test at 11am
10:50 4.1 *sigh* the ongoing mystery of what happens to my BG at about 10:30 continues. It’s always fine when I basal test. Could be insulin ratios maybe? Sometimes I think a Continuous Glucose Monitor (CGM) would make all this easier. An hour until lunch so a couple of jelly babies should cover it
11:38 Going running tonight – must get a sandwich for a few extra carbs
11:51 Fairly sure I’m low. 4.3. Fingers hurt. Just on the edge. One hour teleconference now so chance to eat lunch.
11:55 Oh – it’s a face-to-face meeting. Now have to take my lunch in and be the odd one out. I’ll just take my pack up with me – have the sandwich after. Stagger my carbs a bit. No insulin with lunch as it’s hardly any carbs
13:10 Check again before the sandwich – 8.2. Phew. Fingerpricker drew blood on third attempt. Fingers hurt. No label on the sandwich so I’m guessing 2.5 units.
15:06 Don’t feel right. Not sure if it’s the warmth of this meeting room or BG. Left my tester on my desk. Check when I’m back.
15:22 Finishing work early – test before getting in the car… 11.6 – Oops. Must have underestimated that sandwich at lunch. Pump says 1 unit of insulin still active. Bolus wizard says 0.8 unit correction – that’ll do. Don’t mind being a bit higher before I run anyway. Saves eating again.
16:20 Need to test when I get home
16:58 BG is 7.0. Not going to eat anything before I go running now. Must remember to set temp basal. Should change reservoir and cannula now, otherwise it’ll be too close to bed time when I get chance.
17:07 Hate having to find a new cannula site. The eternal trade-off between proper site rotation and knowing where it’ll actually stay put. Hope tube hasn’t bent on the way in. Will find out in a few hours I guess…
17:08 Pulling old cannulas off still smarts for a few second. Ow. Always a little unnerving to see the tiny hole in your stomach where the tube’s been.
18:08 Temp basal for 90 minutes should be enough to let the reduction kick in and do 7 miles. How much? About 75% right? Wait, how hot is it? Still pretty warm but it’ll be cooler in half an hour or so.
18:30 Test again before running – 7.7 Best have 4 jelly babies. Don’t want to end up hypo 3 miles from home
19:15 Bit late setting off but jelly babies and temp basal should mean I’m OK.
20:15 Quarter of a mile to go. What’s my BG going to be when I get in? Three point something probably…
20:28 7.4! One finger prick and blood from 3 holes on my finger… good to be back and showered and still in range. Tea now – need to work out my carbs…
20:46 I make it 82g carbs so 8.2 units. Seeded bread though so will go for a dual wave bolus – 50/50 over 4 hours should be about right. If I set it off now, tea should be ready in 10 mins.
21:31 How many carbs for a bit of this Easter chocolate? Not a massive piece – 1.5 units probably. Shouldn’t have thrown the box away.
21:42 One more tiny piece for free – no more button presses today
22:03 Bed. Should test again really but what’s the point when I’ve eaten so close to going to bed? Not going to tell me anything is it? This is a recurring problem these days. Would be nice to wake up with a BG in range before doing this all over again tomorrow. Night.
The Sheffield Diabetes UK Group’s meeting in June will be a discussion with one of the diabetes psychologists in Sheffield. There’s more details on the group’s website: http://www.sheffield.diabetesukgroup.org/events