Man, I am cream-crackered (shattered) ((exhausted))! It has been a hectic but amazing schedule – especially recently with all the end of year / world diabetes day events taking place. To be honest, on my end it has been a pretty hectic but amazing year all round – given the Global Tour project in going around 6 continents of the world in just 75 days during the summer…

Faster than Phileas Fog, and type 1 diabetes only empowered it!

With my ‘diabetes regime’ I’ve always been somewhat old-school. It is an exciting time to live with type 1 when you think of all these developments in technology which are advancing and advancing. The latest Pumps and Continuous Glucose Monitors are seemingly coming out as rapid as iPhones. It wasn’t so long ago I ‘upgraded’ to an iPhone7+… and now I’ve heard people talking about iPhone10??!! The news fairly recently about Animas pulling out of the pump market I assume would cause some concern; however, my observation was that it is probably because the market is so strong now they couldn’t quite keep up.

The old-school methods of mine have been simple finger-pricks and multiple daily injections using disposable insulin pens. Most conferences I get asked: “why are you not on a pump???” and the response is usually “because I can’t get enough of those injections.” Earlier in the year I was volunteering out in Uganda at The Sonia Nabeta Foundation’s Camp ‘Waromo’ (we can). The children living with diabetes there were amazed by the insulin pens I had and how far ‘technology has advanced.’ In far too many parts of the world those big nasty looking syringes, which some of us may recall from long ago in the western world, are all that’s available – and there is still a lack of access to those in many locations. So my use of an insulin pen is still a very fortunate device – and most importantly, it works. Being comfortable with your diabetes is always the most important step.

 (Sonia Nabeta Foundation, Camp Waromo)

On the technology development front, however, I have recently had the great pleasure of becoming a Dexcom Ambassador in the UK & Ireland; Mr Old School seemingly isn’t so old-school anymore! I have my blood glucose data – effectively my day-to-day health in diabetes talk at least – on my phone! Using the Dexcom G5 – being someone who is admittedly techo-difficult – has been very straight forward for me. That is one of the aspects which I would initially credit the most; I like to keep things simple and this is indeed simple to use. It is not over detailed with all the science and data-words.

Through my experiences with sports and exercise, for many years I’ve always said “it is not about the number” when asked about “what level to be before an activity” – it is about what that number is doing which counts. Using a Dexcom G5 certainly highlights the importance of this, and gives the advantage of knowing exactly the rate of which levels are either increasing or decreasing. It goes without saying what an advantage this is, to be able to make accurate predictions in advance because of the data on your screen. Screen being your phone screen! Mobile-health will definitely be the future; everybody lives off of bloody ‘apps’ these days, so that future is clearly already beginning.

 (My Dexcom G5 – graph at the bottom and one arrow facing downwards to indicating blood glucose levels decreasing fast. If double arrows are facing down, blood glucose levels are decreasing very rapidly)

For ‘alerts’ there are a variety of options you can choose from, warning you of rapid increasing / decreasing blood glucose levels or informing you of being a hyper or hypo level – and furthermore of being at an urgent hyper or hypo level. The alert sounds range from a ‘5-0 siren’ to a ‘nerd-alert.’ My choice for a hypo is the ‘baby crying’ alert – literally the very irritating (sorry mothers) sound of a baby crying, repeatedly. It was a reflection of how I can feel when hypo!

For a hyper, I have the rather catchy ‘tacataca’ alert – a Brazilian Samba-esque beat – because when hyper it is good to samba some sugars off…

It has been an absolutely jam-packed schedule since being on the Dexcom (such has been my whole year!) and it started on the 1st of October where I ran a half marathon trail race in Targu Mures, Romania. Instantly the Dexcom had its positive uses: the race didn’t go as planned. With that I had adjusted my basal insulin and carbohydrate consumption doses in line for me to run at a certain pace and in a certain time, to get the best of my blood sugars whilst performing. On Turning No 1 during the race, heading into the woods, I got crowded out by a group of runners, tripped and sprained my vulnerable left ankle. In refusing to quit the race, it altered everything: my pace and length of time to be active out there – these finer details will impact blood glucose levels. In having my phone in a runner’s belt, I was able to keep on top of my blood sugars constantly, which definitely gave an extra advantage when things didn’t go to plan.

 (Ascotid Trail Race, Targu Mures)

Later that night, post run, my baby-crying alert sounded as a hypo kicked-in… and I was in a bar. This very drunk possible Dracula’s bride approached, heard the annoying baby crying sound and, in a moment of shire astonishment on my face, grabbed my phone and launched it across the bar. Fortunately the phone was, somehow, still okay – and the baby was still crying…
With event coming after event, it does take a lot out of you and that also impacts blood glucose levels. When feeling quite burned out, personally this makes me more vulnerable towards crashing hypo. In lacking a bit of energy. Having the G5 CGM on me though has been very helpful, regardless of the bloody baby crying! Being able to keep on top of it all a lot easier and make slight alterations.

And on the other side of that, when travelling place to place for events, long hours either flying or on a train – most recently from London to Newcastle and back – blood sugars can tend to run a little bit higher with the lack of activity. Knowing helps and the simple part of the G5: I’m able to know a lot more easily.

When speaking at events, okay, I’m quite a laidback person who says it as it is. Regardless, there is that element of adrenaline which kicks in and also can rise blood glucose levels. To see that on a data graph, on your phone, is also really interesting. My biggest ‘stress’ day was in hosting the #T1Dglobal17 conference in Greenwich. It was my own event! And the first I’d ever done like it!! So of course there was aspects of nerves going on: making sure we had enough tables for exhibits, making sure the registered guests could find it first and foremost and could settle in comfortably, getting the time schedule on schedule… well, near enough on schedule. The event was different in the approach too, in having panelled sessions, which meant chairing those sessions. With a fantastic cast from healthcare professionals, UK type 1 and global type 1 advocates, trying to ask them all the right questions and get the most out of each of them, in a short space of time – as for each we could have spoken all day – was a big challenge. In the end, I put my Dexcom alerts on silent as blood sugars were running quite high through the day!!! But, again, at least I was able to be aware of that and therefore able to do something about it during the breaks.

Hosting the world in my home was amazing. Friends made because of living with diabetes, from across 6 continents of the world, in the same place at once was insane and incredible. A very surreal experience: waking up to the sound of Daniela from Costa Rica singing like Pocahontas in the shower, at 6.30am… then going downstairs to find Sana from Pakistan making the tea, Mohammad from Kuwait doing ‘Pilates’ in the garden and Fred from Ghana, snoring on the sofa…

It is a small diabetes world, after all. And where we can find that extra element of support, it goes a long way – from emotion to technology.

(Proper Fish & Chips with Daniela & Paula, Costa Rica; Sana, Pakistan; Fred, Ghana; Mohammad, Kuwait)