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tricky situations

As people with diabetes, we know the truth is that any simple situation can become tricky - even dangerous. And while our endo or educator is always there to give formal advice and support, some of the best information can come from casual chats with others in the same boat. Experiences they've had can become a light bulb moment in your own management. The committee members at T1V decided to share our experiences, and things we do to help stay safe and healthy in the 'real setting'. Ie, living with the darn thing every day! Click on the heading to see our discussion about the following:

Exercise:

There are no set rules here. Everyone has different regimes they follow when they exercise, and each time they exercise there is no guaranteed outcome. Here are our thoughts about it, and if you want more information, the links below are for resources we rate. (to find)

Carmen: "Exercise has been a steep learning curve. I used to always eat a banana or a big bowl of muesli (depending on the physical activity ahead) prior to a run/bike ride when I was first diagnosed a few years ago. I remember my first City-Bay 12km run after diagnosis. I started with a bgl of 23 (obviously felt terrible), and finished the run with a 3.1. The high blood sugar also made me need to go to the toilet mid run - awkward!! Also when I cycled I would have carbs before I started and then over a 4 hour period I would consume so much sugar just to stay over 5.5bgl. Everyone is different. Now I prefer to have no insulin and stick to protein. When I exercise regularly my blood sugars remain stable. When I miss a few weeks and get back into - I'm all over the place. Consistency is key (and actions speak louder than words!!)... and I need to make more time to exercise. I changed to having my long acting insulin in the morning (when I usually exercise) - and those hypos were less likely of an occurrence."

Kate: No matter how much I plan, prepare, strategise and overwork my brain cells, I can't find a simple, repeatable strategy for managing my sugars during and after exercise. Often I want to walk away from the idea completely because I get so sick of the rollercoaster sugar ride that follows. But really I suppose that is just something I'm going to have to swallow and learn to deal with each attempt and whatever it throws at me. It just feels like it defeats the purpose having to ingest so many calories carb loading when you are trying to burn them off for fitness and weight management. For me this is the most unfair aspect of diabetes!

Georgia: I was never a super athlete at school, was very uncoordinated when it came to sports, however I did give it a go. When I got diagnosed at 14, being in high school and having P.E lessons were daunting, as days would always be different and I would get nervous of my blood levels dropping, as I've gotten older I haven't had sport lessons to attend to but I do like to keep active, we go up the river quite regularly and I've always been more of a water baby, with water-skiing, wakeboarding, knee boarding and tube rides. I've been getting into a weekly routine of yoga and cardio, and although it is the last thing I want to do after work it does make me feel better. I recently went to South Africa and I love adventures, so Dad and I went White Water Rafting, without seeing the video it's hard for anyone to imagine how physically enduring and tiring it was, it went for 7 hours and in that time I never had any insulin, because it would have made my sugar levels plummet, however as a result I developed dehydration and keytosis and was sick for a portion of our holiday, stranded in the African Jungle, it was an adventure and I've definitely learnt my lesson, it's a balancing act.

Socialising and Partying

Now this applies nearly every minute of every day! Chatting in the lunch room, hanging with mates after school, and going out to parties or the pub. From the way we cope with stigma from peers, or the hazards associated with alcohol, there is an extra layer to contend with socially when you have diabetes.

From a safety perspective, alcohol is a major consideration and one that I have to be particularly careful of being a winemaker. Most people don't know that when you drink, the metabolism of the alcohol takes priority over sugar production in the liver, so with normal basal insulin rates flowing around, but less sugar than we normally produce, you can find yourself going low. Understanding this is key to making sure you keep carbs up and check OFTEN when drinking.

Carmen: When I have a hypo, it looks and feels like I'm drunk. It is always so awkward when I have a glass of wine in my hand as well. When I am drinking alcohol I always make sure I have a little bit less insulin, nibble on a few carbohydrates throughout the night. I have woken early in the morning to terrible hypos in the past. Especially if I have exercised before drinking as well. My trick is 4 vita-wheats with cheese just before bed.

Kate: There are so many elements to consider when socialising, particularly if drinking alcohol. The lack of choice of beverages at some venues can be a problem, with no sugar free mixers or high sugar cocktails really adding to the difficulty in working out insulin doses. I tend to stick to wine as it has no carb, or if available diet mixers and check my sugars regularly. Always snack during the night and I prefer to go to sleep a little high to make sure I don't go low in my sleep. I am pretty happy to chat with people about my diabetes in social situations - although I have short tolerance for know it all people telling me what I should and shouldn't be eating!

Georgia: Being a young adult, socialising is a large part of my life, when I was in high school I rarely went to parties and when I did turn 18 I didn't go out regularly, to put it bluntly, it was because of diabetes. Throughout having diabetes, there would be times when I would feel restricted and when I did, I found a way around it. It took some time testing my body and what my diabetes would do with alcohol in my system and I've sort of 'mastered' it, although it's not always the same. I tend to go low with alcohol with my sugar levels descending, so I always eat before bed as there's been times when I've gone to bed with a reading of 18mmol and woken up at 4mmol, it drops even after stuffing my face with popcorn, so with going out and going to sleep after it's important for me to eat.

Intimacy/Relationships

Awkward topic, for awkward moments! Making new friends, finding a partner or working through intimate moments with a husband, wife, boyfriend or girlfriend can be intimidating at times, or downright EMBARRASING at others. Do you tell people straight away or wait until your pump alarms and dobs you in first? Are you happy to chat about diabetes, or prefer to keep it private. These personal choices are going to affect how you trust others, and ultimately decide to invite them in to your life. Including siblings, parents, partners...

Carmen: newly single straight after diagnosis. I made sure I was upfront about my diabetes straight away. Just in case. Because. Hypos. At the wrong time. Awkward!!!

Kate: I think I got lucky being married prior to being diagnosed! My diabetes doesn't get in the way of my relationship at all - except when my pump alarms and wakes us both up in the night (or at other moments..)

Dieting and Weight management

No doubt about it, this sucks even without diabetes, so throw the extra thought and effort on top it is no wonder many of us give up trying to lose weight. Instead, a good option is to eat for nutrition, not for weight loss and you'll probably find that the food choices lend themselves to helping you stay in shape. Now to manage your sugars at the same time...!

Carmen: For someone that never ever dieted pre diagnosis. Then putting on some weight after diagnosis. I started dieting. And changing my eating habits due to incorrect information. I wish I just ate the way I did before type 1. I was always very healthy. Now I seem to always try different diets. I'm done! If I want to lose weight though - I just go carb free - so much easier to do in the summer months.

Kate: It is definitely harder to lose weight with diabetes because of annoying excess sugar intake when you have unavoidable hypo's. I tend to run my basal insulin lower when dieting and this helps reduce those hypo's.

Georgia: When I got told I had Type 1 diabetes, my diet changed pretty dramatically, having to change to to sugar free drinks and sugar free chocolate to rarely any heavy carbs, until we realised that it isn't about cutting foods out completely, it's about balance as it is for everyone, I still avoid high sugar drinks and lollies but carbs are an important part of my diet and although I am gluten free as well (double whammy) I still enjoy my pasta dishes - GF of course.

Grief & Stress

The way our body reacts to different situations is waaay too complicated to explain here, let alone get your head around from a website. The short version is there are so many hormones released which can have an affect on our sensitivity to insulin, usually sending us sky high or in weird instances, causing a low.

Carmen: Stress!! Whether it's jumping out of a plane or speaking in front of a large group of people. My bgl can go from 6 to 19 just because of the adrenalin running through my body. It gives me attitude as well. It's like having PMS time 10,000!! The only way I can explain it. It's really hard to explain to people who don't have type 1 diabetes.

Kate: Don't ask my kids this question! I'm sure they'll tell you I can get very snappy and grumpy a lot of the time! Diabetes lows can make me stressed and edgy, and life stress can make me high so this is a real mine field area of health. There is definitely extra reason to manage stress when you have diabetes. Now to practice what I preach... ;)

Georgia: My mood and attitude changes at times due to my blood sugar readings, when I'm low, I've had times when I've had extra bursts of energy or get really difficult and the opposite effect when my readings are high, I get extremely lethargic. My mood was a huge sign with diabetes, the way I was acting and overreacting was due to no management of my diabetes, now that I know, when I feel my mood changing I tend to check my blood, and most cases it's dropping other times I'm just in a mood like everyone else.

Coeliac

As if having Type 1 wasn't hassle enough, many of us have additional autoimmune health conditions adding to the difficulty of managing our sugars. Especially with the lack of accessibility to certain foods in most outlets, or even at people's houses, the extra burden of being super organised must weigh heavy on your shoulders.

Georgia: Early 2013 I had a biopsy to test if I was Coeliac, and I was, it was annoying and has been harder than having type 1 diabetes. There is a lot of awareness now a days but it can get really frustrating when there's absolutely nothing you can have when you go somewhere, and like I said most times there's an accommodated menu etc but a lot of people don't understand the seriousness of it, I've had people tell me that one bite wouldn't hurt and that I was making a 'big deal'. Before going on a Gluten Free diet, I rarely got sick I had the occasional sore stomach but aside from that nothing major. Going Gluten Free, your body gets use to the changes for me, I have no choice as later on in life if I didn't abide by the diet I would develop other problems, and I don't really need other problems. I've had the accidental gluten intake a time when there was chicken salt on my chips, I was in bed the next day unable to move for 6 hours. Like I said it's a lot harder for me having Coeliac, I miss out on a lot of foods and I went to a birthday one weekend and everything from the savoury to sweet, I could have none of it.

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"Type 1 Voice exists to improve people's experience of having type 1 diabetes and enabling dignified, happy and healthy living.

This is achieved through collaboration with government and industry as well as raising awareness in the workplace, school and the community."