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    To celebrate this year's World Diabetes Day we created an Infographic packed full of stats. With World Diabetes Day now over, the stats are still just a important. Take a look through and see what you think.

Friday, 31 July 2015


Last week I competed my DAFNE course and it was amazing! DAFNE stands for Dose Adjustment For Normal Eating, and it really does let you eat like a normal (non-diabetic) person. Having known Mel for a while I knew a bit about carb counting, but didn’t realise how much I was missing out on by not going on this course. The course was run by a specialist diabetes dietician and a DSN (diabetes specialist nurse). There were six people with type one in the room, which was interesting to learn how people dealt with all aspects of living with type one diabetes (T1D).  We were presented with a workbook, a blood glucose diary and a carbohydrate portion (CP) list. We were first taken back to basics with T1D just to make sure everyone was on the same page. The atmosphere was extremely relaxed and left room for questions for everyone to ask if need be. Throughout the week we talked about diets and insulin a great deal, and I was shocked to learn how my insulin actually works. 



Background insulin (also called basal) runs throughout the day to maintain the BG level in the body. Many people in the UK use Lantus or Levemir for this. As someone who used to take Lantus daily, I found that by around 20:00-21:00 my BG would start to peak, even though I hadn’t eaten any cake!! So upon this discovery I was recommended by the specialist diabetes nurse to split my background insulin. This has allowed me to alter my day and night time insulins as fit! Meaning reduced hypos in the night... massive win!! The diagram above shows that the fast acting insulins, such as Novorapid or Humalog, are injected at meal times to cater for the intake of carbohydrates at that time. This is where the counting of carbs takes place. From the diagram below it’s easy to see how (University of Columbia). 



Every 10g of carbs is called a carbohydrate portion (CP). For example in one slice of bread there are on average 15g of carbs. Or, in DAFNE lingo, 1.5 CPs. Everyone starts on a 1:1 ratio, so 1U of insulin for 1CP. So for that slice of bread I would inject 1.5U. Then when testing just before the next mealtime, providing your basal and ratios are correct, the theory is that you should be the same level! Hurrah! One CP should bring up your BG (blood glucose) by 2-3mmol/l and one unit of insulin should decrease your BG by 2-3mmol/l. However this is different for everyone so please talk to your DSN and dietician before trying this! Having had this explained I cannot understand why I was not told this right from the off when being diagnosed! And also, why I was initially on an insulin which lasted around 8 hours (fine for the night time) but therefore leaving me with no background for the day! But that’s in the past, so never mind. 



All these tools and more allow me to look at my blood glucose levels to see where the problem lies, and how to fix it. If I was low throughout the day I learnt how to decrease my morning basal, and when too high then to increase it. It’s truly amazing what I’ve learnt on the DAFNE courseI walked out of there on Friday with the confidence that I can now control my diabetes, and even better I know why sometimes things just don’t seem to go right! I would recommend everyone who has T1D attends this course! The freedom that this has left me with is amazing. The coursework book has everything you need with it and there’s online forums to have a cheeky browse through as well. Everyone on the course is there for one main reason, to control their diabetes monster. Everyone is in the same boat which makes you feel part of something amazing. Think about asking your diabetes specialist to refer you for DAFNE, it truly is life changing. 
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Thursday, 25 June 2015

Very frequently I receive emails from personal trainers looking for advice on how to help someone with diabetes train. Whilst I know that everyone's diabetes differs, along with their training goals and the training itself. I thought it would be helpful to write a blog about the things that I've found useful in nurturing a successful relationship between my coaches and myself in terms of training and my diabetes.

1. Personal trainers, before training your client take the time to find out about their diabetes. Not just what type of diabetes they have, but what that means, because type 1 and type 2 are not the same condition and both come with different needs, that are also reflected in training.

2. With this in mind, remember to consider that each person's diabetes is not the same, even if they do have the same type of the condition. Which means that even though you may have worked with someone with diabetes previously, don't assume that the next person will be the same.

3. Listen well, as each person with diabetes knows the ins and outs of their condition. So listening to what they have to say also includes listening to their limits. Or for example, if they say that they've struggled with numerous episodes of hypoglycemia in a day, the best thing for them might be to be flexible with the time or day of the session to enable them to sort out their blood glucose levels first. Someone new to diabetes or exercise may still be learning about how their condition reacts to training because day-to-day diabetes and blood glucose levels, in my experience, do not behave the same when participating in more sedate activities.

4. Whilst the 'normal' range for someone with diabetes can be suggested as being between 4-10 mmol. In my experience, it's not safe to train at the lower end of this spectrum, especially for continuous type exercises/ activities or high intensity work outs. I personally prefer a higher blood glucose level as glycogen stores will become depleted during training. With this said, adrenaline can have quite an effect on blood glucose levels and some training activities can be more adrenaline fueled that others.

5. Learn what hypoglycemia and hyperglycemia are from a reputable place such as from the NHS  or Diabetes UK, what blood glucose level constitutes each and what the associated symptoms are. Whilst I would consider myself a confident and independent athlete, both my coaches and my training group not only know the symptoms of both, but they also know how to help me if I can't help myself.

6. Carry a sugary snack with you, discuss with your client what they might like this to be. For example, jelly babies or dextrose tablets - not so that the person with diabetes being trained doesn't also carry their own hypo treatment. But that in case needed, you have something there for them too. It could also be helpful for you to have information on their 'ICE' In Case of Emergency contact.

7. Never try to interfere with a person with diabetes' medication, especially their insulin- this is best left with the trained medical professionals.

8. I've always found being able to plan ahead of a session really helpful, whereby the coach tells you exactly what the next session will be. This is because different types of training session have different effects on blood glucose levels. For the very strenuous sessions, it can be helpful to stock up on carbohydrate rich foods for the person with diabetes.

9. This might sound like a bit of a contradiction, but I've found it good in the past that the coaches that I've had, have never treated me differently because I have diabetes. Yes I might need to plan more and check my blood glucose levelsthroughout a session, but I can and will cope with the sessions thrown at me. I'd also be mortified if a coach ever said to me in front of the training group, that I couldn't do a session because of my diabetes.

10. Don't be afraid- some of my coaches have since admitted to me, that especially when I was first diagnosed, it was a little daunting training someone with diabetes. But the main thing is we've worked together and we've communicated effectively to create a winning partnership that has produced medals, titles and records, all whilst I've had diabetes. Do your research, listen, take your time and don't forget how important food is in managing diabetes and fuelling training and hopefully some of these tips based on my own experiences may help in a client's steps to training success.

By Mel Stephenson (please note that these are only helpful suggestions, each person's diabetes is different and safety in sport is paramount!)



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