Happy Blogaversary

The very first post on the Thriveabetes blog was the 28th January 2015 - the blog has been running for 2 years!!! I'd like to celebrate our Blogaversary by through it back to you. We have covered so much in two years and I have to say I'm enjoy posting your stories that you have bravely shared with us. Now I need some fresh ideas and I've put together a brief survey to find out what you like to read.

It should only take a couple of minutes and I'd really, really appreciate it if you could fill it out.

Thriveabetes Reader Feedback

Would you like to write for us? Contact me via email at Grainne@thriveabetes.ie

Accessing Insulin Pumps

The buzzword in diabetes care these days seems to be “Insulin Pump”. And there is a lot of frustration in the diabetes community about the lack of availability of them. NOTE: If you have a child with type 1 diabetes age 6 years or younger; you should have access to an insulin pump almost immediately as per the HSE’s “ Model of Care for the Provision of Insulin Pumps for the treatment of Type 1 Diabetes in the Under Five Age Group” see here.

So, I thought I would pull together some of the information I have into a post to help people increase their odds of getting any piece of diabetes tech. Plus, dispel some myths around insulin pump therapy and accessibility.

Thank you to Davina Lyon from Diabetes T One for the suggestion for this post.

It might seem like some people have unlimited access to all of this technology but most people with type 1 diabetes in Ireland do not! Mostly people gain access to this tech by being knowledgeable, persistent and not being deterred. Oh, yes, and they also attend a diabetes clinic that offers all of this.

Firstly, The FreeStyle Libre is available to buy in Ireland since November 2016. So there is only one significant block to accessing this technology - affordability. The application process to have this device included on the Long Term Illness Scheme is ongoing and we will keep you informed. This website; http://www.freestylelibre.ie/ is where you can buy the Libre.

Whether it’s an Insulin Pump or a Continuous Glucose Monitor (CGM) that you're after, or just curious about, here is my advice to you on finding out more;

1. Do your homework!

Find out as much as you can from different manufacturers websites, from reputable diabetes websites and from online support groups. And not just in Ireland-go beyond. Start with this really good website; InPut Diabetes, for finding out the basics about how all these diabetes devices work.

The companies offering insulin pumps in Ireland are; Animas - Rep of Ireland Telephone; 1800 812 715, Email: https://www.animascorp.co.uk/contact Medtronic - Rep of Ireland Telephone; 01 5111499, Email: https://www.medtronic-diabetes.ie/contact-medtronic-diabetes

Other pumps available in Ireland but not included in the HSE tender; Roche (Insulin Pump only… for the moment) Rep of Ireland Telephone; 1800 882351, Website; https://www.accu-chek.co.uk/gb/products/insulinpumps/index.html?product=insight

2. Decide if the piece of technology is for you.

These devices do not work for some people and may require huge changes in your lifestyle. When I was deciding if I wanted to take the insulin pump leap a friend gave me this book to read; Insulin Pump Therapy Demystified: An Essential Guide for Everyone Pumping Insulin by Gabrielle Kaplan-Mayer available from Amazon.co.uk

3. Does your diabetes clinic or consultant run an insulin pump programme?

This is really important! There are a number of clinics who do not have the resources to run insulin pump programmes, which means they cannot offer you what they don’t have. They also might be embarrassed about not being able to offer this programme to you and may suggest that you are not a suitable candidate. This really tests your commitment because you might have to change clinics and consultants to pursue it.

4.Now, you can talk to your Diabetes team about your idea.

Have your research ready to present and be ready to state exactly what you think this piece of technology will do for your diabetes management and be as specific as you can.

THE APPLICATION PROCESS This is, actually, the most straight forward bit of the complete process. Really it is! All the hard graft has been done.

Once your diabetes team agrees to submit an application for the HSE funding for your diabetes technology I would suggest that you ask that they include you in all correspondence. This might require a couple of phone calls to your clinic to request copies of letters/replies to/from the HSE.

The next step is either funding approved or denied. If you are approved then you will need to coordinate with your diabetes team to schedule your training. Again, this might require a number of phone calls and navigating the availability of the specialist trainer which in some clinics can be very frustrating. See Davina’s blog post re; 3 rescheduled pump start dates;

HOW I GOT MY INSULIN PUMP AND CGM

I have written about my journey to an insulin pump and how I got my CGM on my personal blog page; Blood Sugar Trampoline. There is a bit more detail there, plus, I wrote it when it was all fresh in my mind. Here are some of the basics. And you can read Davina's experience above, along with other members of the Irish Diabetes online Commuity here.

I began my journey to my Insulin Pump in 2008. I had decided that maybe I should investigate what it was and how it worked. I turned to the internet and the dozens of online communities in the English speaking world for more information, I met some sales reps at diabetes conferences and acquired more reading material and I read a book specifically on insulin pumping. The more I read the more my decision was made.

The first bump in my journey was discovering that my consultant didn’t have the funding to offer an Insulin Pump programme and therefore couldn't offer me one. At this point, I was part of a type 1 diabetes support group that met often in Ennis, Co. Clare and had found out from another member of the group about a consultant who did offer insulin pumps.

I had a good relationship with my Endo and asked if she would be ok with me transferring to another consultant and she wrote me a referral. She was AWESOME!!! I’m still sad that she moved.

Between a letter of reference being mislaid, a waiting list being very long and lots of phone calls from me following up with everyone concerned I finally got connected to my pump on June 3rd 2010.

Knowledge, determination and persistence - all with lots of politeness, paid off. It continued to pay off when my insulin pump was due for an upgrade and the availability of a CGM became a possibility. I got this in November 2015. I wrote about the process I went there for that here.

I hope that this post has cleared up some misunderstanding around the whole topic of accessing diabetes technology and maybe helped you in your quest.

Here are some of the funding options available to you for accessing a CGM.

We are always looking for stories from the Irish Diabetes community to share and if you would like to share your story with Thriveabetes, email me, Gráinne at Grainne@Thriveabetes.ie

Managing Type 1 Diabetes and College

Happy 2017 and welcome to our first post of the year! This post comes from Emma Wright from Cork and a university student in her twenties. When Emma was 11 years old, she developed Pancreatitis, a condition that is rare in children, and as a direct result, she was diagnosed with Type 1 diabetes at the age of fourteen.

Emma travelled to Australia, as many Irish do, on the work/travel visa in recent years and started a blog about her travelling with type 1 diabetes to help and support other people living with type 1 that may be considering doing the same.

You will find out more about Emma and her travels here.

I asked Emma to write about managing type 1 diabetes while in college. This is something that is a huge challenge for students with diabetes, as it’s usually the first time that you are out on your own as an independent adult navigating the world. Emma has some really good tips here that really help her managing life in college.

Thank you Emma for contributing to Thriveabetes as a guest blogger; you can follow Emma on Emma Wright's Blog.

We are always looking for stories from the Irish Diabetes community to share and if you would like to share your story with Thriveabetes, email me, Gráinne at Grainne@Thriveabetes.ie

Managing Diabetes in College

Starting college is an exciting and rewarding experience. Not only are you taking the first steps towards your career but you are also becoming independent for the first time. Independence for most means being able to go out when you want and learning to be smarter with your money but as a person with diabetes, independence also means having to rely on yourself for your diabetes management. This can be tough, especially if you are used to having family members around who remind you to check your sugar levels, help you when you are having a hypo and who are generally there for support.

Being in college, you are instantly exposed to new people and new surroundings and you don’t necessarily want to be dragged down by the thought of having to check yourself or inject/pump in public. But as great as college is, the most important thing is to look after yourself so you can enjoy college to the fullest. What good is it to be battling low or high sugar levels on a night out or at a societies event? None is the answer! You want to be able to have fun and enjoy your time in college without the added worry of uncontrolled sugar levels.

So as a college student myself, I have included my top tips for managing diabetes in college:

1. If you are living away from home, you NEED to tell everyone in your house/apartment that you have diabetes. You would be surprised how a lot of students you live with might accidently drink the Lucozade you have in the fridge, leaving you with nothing to treat a hypo! I understand it might be daunting, and maybe even embarrassing, to tell everyone you have just met that you have diabetes but believe me, it might save your life. As well, you should explain what the Glycogen Kit is and when it needs to be used, just in case you are ever in a situation where you are unresponsive and may need it to be administered. Quite often, these housemates will also turn into friends who will be able to keep an eye on you when you aren’t feeling great with sugar levels. But just in case, I would always recommend having hypo treatment in your room and in your college bag at all times too.

2. Remember to test. Yes, it is so simple but it can be so hard to remember when you have classes back to back for hours at a time and diabetes is the last thing on your mind. It’s easy to get hungry and tired, and all you want to do is eat without having to finger prick and just give insulin for the carbs you have eaten but it is crucial to know what your sugar levels are before food in case you need to give a correction with your dose. I would suggest setting an alarm on your meter or phone for particularly busy college days - it will come in handy, trust me!

3. Eat as best as you can! It can be tough to eat healthily on a budget (and with loads of student meal deals on offer) but you can do it! Going to supermarkets for your food shop is a must, particularly the cheaper ones, so that you get more for your money. Also look at the reduced section for cheaper food that might be close to its use by date, it is still just as good if you eat it on the day you buy it or if you freeze it. I would also suggest when cooking, to make extra and freeze it, for those days where you don’t feel like cooking – you can just pop it in the oven or microwave! I often weigh out the carbs as I divide it into lunchboxes and put it on a label on the lunchbox so when I go to eat it, I already know how much to bolus for.

4. Stay connected. By this, I mean always stay connected to your loved ones and your diabetes care team! It can be easy to get caught up in college life and forget to give a text to your family or give a call to your diabetes team when you need some help and guidance on your diabetes. Always keep up to date with all hospital appointments. It may be a nuisance to get to your appointment but it’s better to do that than miss out on the opportunity to have your eyes checked, for example. You don’t want to delay treatment for any complications you may have!

5. Stress effects sugar levels and coming up to exam time, you may find you have not got enough hours in the day to complete essays and study. This will be stressful! Just be mindful of your sugar levels during these times and give yourself some more insulin if needed (if on a pump, you can do a temporary basal rate at an increased rate). You should also try and exercise regularly during your college terms but particularly during these times of stress, it will be a great reliever of tension, will help you to relax and sleep better as well as help lower insulin resistance.

Once you have followed these tips, you will find your rhythm in college and diabetes won’t be such a struggle to manage. Like everything, practise makes perfect and just try your best to keep your sugar levels stable. I would also recommend registering with the Disability department in your college and make them aware of your diabetes. It isn’t essential to tell lecturers of big classes that you have diabetes, mainly because you can drink/eat in classes and do as you please, as long as you are quiet! But if you have smaller classes, then I would recommend letting your teacher know about your diabetes just in case you have to treat a hypo or hyper sugar level during class time.

I hope this helps you for your time in college! Best of luck in your studies and remember to have fun!