I was quite impressed when I saw this insulin pump, seems to stand out from the ones currently around. I don’t doubt it will take a long time before it is available to us brits on the NHS, most likely because of the expense. It’s always nice to see new technologies and advancements, and I hope that one day I will have one as suave as this.

I found out that the device lets you share information with other devices, such as PCs, mobile phones and other mobile devices. It also has built in applications, such as blood glucose meter, food library and activity monitor. This sounds like a great idea, I especially like the built in food library, means I would not longer have to carry about my carb books.

It’s not yet approved for sale in any part of the world, but with such an advanced device, I’m sure it wont be long before it’s out there.

They currently only have one image of the product on their website, however they do have lots of videos at this page: http://www.cellnovo.com/products.html

Following up from my previous post, Gareth Johnson forwarded the response from the deparment of health. The response is as follows:

Dear Gareth,

Thank you for your letter of 20 October to Andew Lansley enclosing correspondance from one of your consistuents about Type 1 diabetes. I am replying as the Minister responsible for policy on diabetes.

I note your constituent’s concerns about the number of people in the UK with Type 1 diabetes and I also note their call for medical research into the issue.

Your constituent may be interested to know that the Department of Health funds NHS research and development through the National Institute for Health Research (NIHR) and is currently providing infrastructure support for 88 studies specifically concerned with Type 1 diabetes via the diabetes clinical research network formed in 2005.

Alongside other organisations that represent the voice of people with diabetes, the Department works with the Juvenile Diabetes Research Foundation (JDRF), which focuses on finding a cure for Type 1 diabetes.

Your constituent may also be interested to know that the Department is also funding the Yorkshire Diabetes Register project. The aim of the project is to describe the epidemiology of diabetes, investigate the molecular and environmental causes of the disease, and facilitate health services research.

In addition, the Medical Research Council (MRC) funds a broad portfolio of diabetes research amounting to £28.1 million in 2008/09. Of this, £6.6million was directly relevant to type 1 diabetes. While many of these studies involve both Type 1 and Type 2, they include underpinning studies and studies on the prevention, treatment and downstream consequences of Type 1 diabetes.

Neither the Department’s NIHR nor the MRC usually ring-fences funds for expenditure on particular topics. Research proposals in all areas compete for the funding available. Both organisations welcome applications for support into any aspect of human wealth and these are subject to peer review and judged in an open competition, with awards being made on the basis of the scientific quality of the proposals made.

I hope this is really helpful.

Yours sincerly,

Paul Burstow

So today was a normal today, until I went to lunch with my friend Shelley. We met in our usual place, and had our usual lunch together.

We got chatting about diabetes and the insulin pump, I was asking her some questions about the cannula’s. This is something that had bothered me after watching a YouTube video of a girl inserting one, and I don’t have a problem with needles but this really freaked me out. I didn’t like how long the needle was, so I told Shelley about this and how it freaked me out, so she got a spare cannula out to show me.

Well I am glad it wasn’t as long as the one in the YouTube video, I feel much better now. She also managed to persuade me to insert it, I was so nervous and I am not even sure why because it was nothing. It didn’t hurt; in fact I didn’t even feel a thing! It was really nice of her to share her supplies with me, and I am really glad she did, I am going to leave it in for 2 or 3 days to see how it goes.

So with just over a month to go (or 35 days, as I am counting) I am looking forward to a new era with Diabetes, and hopefully this will help me improve my control.

P.s. Excuse the crazy PJ’s!

The way in which HbA1c results are being presented is changing. From June 2011 the values of HbA1c will be expressed as mmol/mol rather than a percentage.

Below is a table comparing the two values, to help you gain an understanding of the differences.

The recommended target for someone with diabetes is 6.5% and 7.5% therefore 48 mmol/mol and 59 mmol/mol. A non-diabetic reference would be 4.0% and 6.0% therefore 20 mmol/mol and 42 mmol/mol.

If you wish to calculate your HbA1C from percentage to mmol, DiabetesUK have one here.

There is a lot of terminology that I have often never heard of before, on websites, forums or even in conversation. So I thought it would be a good idea to write some of them down and explain them, so that I can help others that don’t understand certain terminology.

Amylin (Islet Amyloid Polypeptide)

Slows the rate at which digested carbohydrate appears as glucose in the blood and thus reduces total insulin demand

Brecon Group

The professional association for clinicians in Wales specialising in the care of children with diabetes.

CHCs

Community Health Councils: the statutory bodies representing the interests of patients and the public in the NHS in Wales. Visit the website of the Board of Community Health Councils in Wales.

Basal

This is referred to as the slow acting insulin used to cover your bodies own glucose stores

Beta cells

Pancreatic cells responsible for the production of insulin, amylin and C-peptide

BG

blood glucose (this is the measurement of glucose circulating in the blood)

Biphasic insulin

An insulin mixture containing both fast acting and slow acting insulin, usually injected twice daily

Bolus

This is referred to as the fast acting insulin used to cover food, typically carbohydrates, some cover for protein as well.

BP

Blood Pressure

Brittle diabetes (labile diabetes)

Most often seen in type 1 diabetics

BS

Blood sugar

CHO

Carbohydrate (Carbon Hydrogen Oxygen)

C-peptide

A by-product of normal insulin production

Double diabetes

Comprises symptoms of both type 1 and type 2 diabetes

DAFNE

Dose Adjustment for Normal Eating: an intensive five day education course for people with Type 1 diabetes. The course focuses on adjusting your insulin dose to give you more freedom to choose what and when to eat. Visit the DAFNE website.

DAFYDD

Dose Adjustment for Your Daily Diet: an education programme for people with Type 1 diabetes based on BIDAC (Bournemouth Insulin Dose Adjustment Course). The BIDAC course is delivered for one day a week over a four week period.

DESMOND

Diabetes Education and Self Management for Ongoing and Newly Diagnosed: an education programme for people with Type 2 diabetes, delivered over one or two days. Visit the DESMOND Project website.

DRSSW

Diabetic Retinopathy Screening Service for Wales: an all-Wales service aiming to offer annual screening with a digital camera for diabetic retinopathy to all people with diabetes in Wales aged 12 and over. Visit the DRSSW website.

DSNs

Diabetes Specialist Nurses: nurses specialising in the care of people with diabetes, and work alongside specialist physicians and other professionals to support people with diabetes.

Fulminant type 1

G.I

Glycemic index. A G.I value tells you how rapidly a particular carbohydrate is turned

G.L

Glycemic load. A G.L value takes into account not only G.I, but also the total quantity

GAD (Glutamic Acid Decarboxylase)

Antibodies test

GDM

Gestational Diabetes Mellitus

Glucagon

A hormone produced in the alpha cells of the pancreas

Glycogen

The storage form of glucose in animals and humans

Glycogenesis

Glucose storage, mainly in the liver and muscles

Glycogenolysis

The breaking down of glycogen stores in liver and muscle tissue

GNG (Gluconeogenesis)

The generation of glucose from non-carbohydrate carbon substrates

HBA1C

HbA1c is the scientific shorthand for Glycosylated Haemoglobin

HCP/HP

Health care professional

HDL

High Density Lipoprotein (the “good” cholesterol)

Honeymoon period

The period of time after a diagnosis of type 1 diabetes when there is better than expected blood glucose control

Hypo

Hypoglycaemia (this means blood sugar level is too low)

Insulin

A hormone which causes most of the body’s cells to take up glucose from the blood

Insulin analogues

Genetically altered versions of insulin

Insulin antibodies

An immune response to exogenous(injected) insulin

Insulin resistance

Normal amounts of insulin are inadequate to produce a normal insulin level.

Ketoacidosis

A severe accumulation of keto acids in the blood, resulting in acidosis

Ketones

Ketone bodies are acids left over as a byproduct of ketosis

Ketosis

A process in which your body converts fats into energy

Lantus

Long-acting insulin analogue used as a basal(background) insulin, which is normally injected.

LDSAGs

Local Diabetes Services Advisory Groups: sometimes known as a Local Implementation Groups (LIGs). These are teams of professionals, managers and people with diabetes who are working to improve local diabetes services. Contact Diabetes UK Cymru to find out how to get involved in your LDSAG.

Levemir

Long-acting insulin analogue used as a basal(background) insulin.

LHB (Local Health Board)

Welsh equivalent of a PCT (Primary Care Trust)

Liver dump

The common term given to glucose production from the liver

Low-carb diet

A proportional reduction of dietary carbohydrate
An idiopathic subtype which has a very rapid onset and no honeymoon period.

MDI

Multiple Daily Injections – an insulin regimen adopted by the majority of type 1 diabetics

MODY

Maturity Onset Diabetes of the Young refers to a number of dominantly inherited, monogenic defects of insulin secretion. There are currently eight different varieties of MODY

Nephropathy

Damage to or disease of the kidneys

NICE

National Institute for Clinical Health and Excellence

NSF

National Strategic Framework

PCT

Primary Care Trust

PDSNs

Paediatric Diabetes Specialist Nurses: nurses specialising in the care of children with diabetes. They are often the main point of contact with the NHS for the family of a child with diabetes.

Peripheral neuropathy

Damage to the nerves of the peripheral nervous system

PP

Post prandial (this means a period of time after eating, usually recorded as 2 hours but often 1)

Primary care

This usually refers to the care you receive at your GP’s surgery, from your doctor, the practice nurse or other professionals based there. The Assembly Government is keen to move more diabetes care into primary care.

Pump

Insulin Pump, used as an alternative insulin delivery method to MDI. The pump is connected to you 24/7 and pumps tiny doses of insulin thorought the day, with the ability to give extra doses at meals times and with snacks.

QOF

Quality and Outcomes Framework. This is the framework through which general practioners (GPs) are paid by the NHS. Payments are made for accumulating QOF points, and with diabetes accounting for 93 of the possible maximum of 1,000 points, there is a h3 incentive for GPs to provide a range of diabetes services.

Retinopathy

Non-inflammatory damage to the retina of the eye

Secondary care

This is the care you receive from specialist professionals, usually in a hospital. This includes the care you may receive from a diabetologist or DSN.

SHA

Strategic Health Authority

Somogyi effect (rebound hyperglycemia)

A high blood sugar (hyperglycemia)

Type 1 (autoimmune)

The most common form of type 1 diabetes

Type 1 (idiopathic)

All forms of type 1 which occur without a known cause

Type 1 (surgical)

Diabetes caused by partial or complete removal of the pancreas

Type 1.5

Latent Autoimmune Diabetes in Adults (LADA), also known as slow onset type 1

Type 2

Diabetes mellitus type 2 is most often attributed to insulin resistance and relative

WAG

Welsh Assembly Government: the body with overall responsibility for manging and overseeing the NHS in Wales. Visit the Assembly Government website.

WIDAC

Wrexham Insulin Dose Adjustment Course: like DAFYDD, this is an education programme for people with Type 1 diabetes based on BIDAC (Bournemouth Insulin Dose Adjustment Course) model.

WEDS

Welsh Endocrine and Diabetes Society: the professional association for physicians specialising in diabetes in Wales.

X-PERT

An education programme for people with Type 2 diabetes, run as six weekly sessions. It is available in a number of areas of Wales. Contact your Local Health Board to find out what’s available in your area. Visit the X-pert website.

Young-onset type 2

Anyone diagnosed with type 2 under the age of 45 is considered young

Consistently high blood glucose levels in the short term can lead to diabetic ketoacidosis (DKA).

Ketoacidosis happens because of a lack of glucose entering the cells, where it acn be produced as energy. The body therefore begins to use stores of fat as an alternative form of energy, in turn this produces an acidic by-product known as ketones.

Ketones are harmful to the body, therefore it will try to get rid of them immediately by excreting them in urine. When ketones are present and the blood glucose levels are riding, the person often becomes increasingly thirsty as the body tries to flush them out.

If the ketones continues to rise, ketoacidosis willl develop. Ketoacidosis means acidity of the blood, this is due to an axcess of ketones in the body). The harmful effect becomes more appararent, and nausea or vomiting may begin and you can get dry skin, blurry eyesight and deep and rapid breathing.

If you start to vomit the body will become even more dehydrated and less efficient at flushing the ketones out, which will make the levels rise even faster. As the ketones rise it may be possible to smell them on he breath, apparently it smells like pear drops or nail varnish.

If by this stage it hasnt been treated, the ketones and blood glucose will continue to rise, which will result in a coma which could be fatal. However at any of the stages above it is extremely dangerous, and should be treated immediately in order to limit damage.

Anyone with diabetes who adminsters insulin could develop ketoacidosis. Diabetics that are controlled with diet or tablets have also been know to develop ketoacidosis.

Ketoacidosis often occours when you are unwell, this is the body’s response to the illness and infection, so it releases more glucose into the bloodstream, which stops insulin from working properly.

When ill, even if you are not eating it is very important to still take insulin. More frequent blood tests are required in order to keep an eye on blood glucose levels.

Ketones are detected by a simple urine test, and these test strips are available on prescription. If your blood glucose is high (usually over 15mmol/l) or you have any symptoms of ketoacidosis you should test your urine for ketones.

If you do have a high level of ketones in your urine (this is shown on the ketones test), and a high blood glucose level you should call your doctor or diabetes specalist nurse immediately, or go to the nearest A&E.

Within the blood stream there are red blood cells. Red blood cells are made of a molecule called haemoglobin. Glucose sticks to the haemoglobin which makes a ‘glycosylated haemoglobin’ molecle, called haemoglobin or A1C or HbA1C. The more glucose in the blood, the more haemoglobin A1C or HbA1C will be present in the blood.

Red blood cells live for 8-12 weeks before they are replaced. Measuring the HbA1C can tell you how high your blood glucose has been on an average for the last 8-12 weeks. A normal (non-diabetic) HbA1c is 3.5 – 5.5%. In diabetes 6.5 – 7.5% is good.

The HbA1C is the best way to check diabetes is under control. HbA1C levels equare to the glucose levels, so a HbA1C of 10% means the average glucose level for the previous 8-12 weeks was 13mmol/l. However at lower levels, there is less difference. So a HbA1C of7% means an average glucose level of 8mmol/l.

Generally speaking if you are 6.5% or above you are diabetic, and if you are 6.0% or less you are not diabetic. However if you are inbetween both levels, you will be at risk or diabetes, or have ‘pre-diabetes’.

It has been confirmed, I am getting my Insulin pump on the 11th of January 2011. At the moment I don’t know whether to be scared or excited. It will be a great step towards gaining tighter control of my diabetes, but I know it will require a lot of work to get it there.

My pump session on the 11th of January will be with someone else. I think it will be good to go through this with someone else, as they might ask questions I don’t think of.

The pump I will be getting is the Accu-Check Combo System, which my friend Shelley Bennett from Circle D also has, which is good, so if I have any questions I have someone to ask.

I have recently read ‘Insulin Pump Therapy Demystified: An Essential Guide for Everyone Pumping Insulin‘ and found it extremely useful, it explains all the basics of pumping, like the meaning of basil and bolus. I thought it explained it all really well, so I have passed it around my family for them to read, so they can understand also.

There are a few things im worried about, like where to put it. I have heard some people keep it in their bra, or attach it to their belt. Im conerned it will affect what I wear, and I really dont want it to restrict me. I have seen some cases on the Accu-Chek site, under the ‘cases’ tab. I think I will buy two cases, one to protect the pump and another for my leg, so it is easier to wear dresses.

Its 62 days until the big day now, and I’m sure as the date gets closer I will get more scared. So if anyone has any useful advice, please share

Well, as you may or may not know I am a Type 1 Diabetic. I feel there is not enough awareness around the differences between Type 1 and Type 2 Diabetes. So I have written an article, hopefully, that will help to explain the differences and bring more awareness.

When I have previously told people I have Diabetes, I have had comments like “you have Diabetes? But you’re not fat!”, this to me, shows that people know far more about Type 2 than Type 1.

According to Diabetes UK, there about 2.6 million people in the UK with Diabetes. Around 90% of these have Type 2. Therefore, I calculate that there are about 260,000 people in the UK with Type 1.

Type 2 Diabetes is often because of a high insulin resistance, where the cells cannot use the insulin produced efficiently, therefore the glucose is not removed from the blood very well, leading to a high blood glucose level. Type 2 Diabetes can also be caused from a deficiency of insulin, this can be because the pancreas gets exhausted by trying to produce enough insulin to lower the blood glucose. For some people who have insulin resistance, gaining weight can make the resistance worse, therefore making them eventually develop Type 2 Diabetes, which is why the government have various campaigns on obesity and diabetes. A large number of people who are not overweight develop diabetes, because they have a worse than normal insulin resistance.

There are various different medications that Type 2 Diabetics can take. The most popular are Simvastatin, Metformin and Byetta. Simvastatin is a drug that can lower blood glucose, but can also help lower cholesterol. Metformin is a drug that slows absorption of glucose, and also the liver’s production of glucose, therefore helping to lower blood glucose levels. Byetta is based on the saliva of the Gila Monster lizard, which was found to contain blood glucose lowering properties. Byetta can also help with weight loss, as it makes you feel fuller sooner.