BDEC BertieBitesJuly 2019

Hi from Gloria

Gloria

Hi, my name is Gloria Mee and I am the administrator/secretary to the Diabetes Nurse Specialist Team. I have worked at The Royal Bournemouth Hospital for nearly 29 year’s starting out as an NVQ Health Care Assistant. I then transitioned to a secretary working in Gastroenterology, Secretary to Associate Director of Nursing in Professional Development and now working in BDEC (Diabetes & Endocrine). Unofficially, I have proudly held the role of Agony Aunt to colleagues, staff and patients.

I enjoy the variety of my work in my current role as it offers different challenges on a daily basis. I also take great personal reward in assisting patients and filtering enquiries to our Nursing Team.

The hospital has played a big part of my professional life along with helping to run a family business. I have been privileged to watch the hospital develop over the years and will be sad to say goodbye when I finally retire in the next couple of years.

In my spare time, I am mostly found being Super Mum and Nanny to my two beautiful daughters and three Grandchildren. In my own time I enjoy my Pilates, swimming and skiing with my family.

Arcado LoungeDrop-in

The drop in at the Arcado Lounge, Christchurch, was a great success. Families and Patients attended, we chatted and drank coffee whilst feeling festive. It was a good opportunity for young people to chat about life with diabetes, challenges and successes, whilst parents got advice and support where needed and the opportunity to swap stories about supporting a child who has diabetes.

WelcomeBelisa LopesBelisa Lopes is a Diabetes Dietitian, covering Emma Allison’s maternity leave. She has previously worked as a weight management Dietitian in Portugal and as an inpatient Dietitian at Poole Hospital.

She is currently working at both Transition Diabetes Teams at Poole and Bournemouth. She loves to live in Dorset, with amazing beaches! She loves baking, reading and crafting.

Weather and diabetes

Here are a few storage tips and guidelines:Insulin not in use should be stored in the refrigerator (2-8degrees). Insulin in use i:e the insulin in your pen or pump can be used out of the fridge for no longer than 28 days (15-25degrees). After this time it should be thrown away and a new cartridge opened. Insulin that is not stored correctly may not work as well as it should and you may find your blood glucose levels will begin to rise.

Always protect your insulin from exposure to light and extremes in temperature either heat or cold.

Never leave your insulin/ pen in a car or on a windowsill where it can be exposed to high temperature or light. This is also the same in the winter months when it is freezing temperatures which can also affect how your insulin works.

Be mindful when out and about as in the UK last summer temperatures reached up to 38 degrees in some areas. This means that when you are thinking of taking a trip to the beach your insulin pen will need to be protected from the heat. Also remember that in hot

Rebecca’s StoryMy name is Rebecca. I am 24 years old. I have been Type 1 Diabetic for just over 20 years. Almost feels ironic that I was diagnosed on Diabetes Awareness Month…Which is why I’m sharing my experience and story. I know there are other Diabetics out there who are struggling to cope, but they forget they’re not alone. I handle my Diabetes fairly well. But that doesn’t mean I have been in complete control.

When I was 4 years old, I collapsed, and wouldn’t wake up. I don’t remember anything that happened, but my

weather lots of sunbathing can increase your blood glucose levels too, and your insulin may be used up quicker.

Here are a few frequently asked questions…..Why am I supposed to store my insulin in the fridge?Because insulin is a protein dissolved in water – like all proteins if not stored correctly it will spoil. This means that the protein will break down (or denature) and the insulin will not work very well and your blood glucose levels may go up.What is the best temperature to store insulin?Insulin should be stored between 15-25 degrees (room temperature) when in daily use. Any that is not being used should be stored unopened in a refrigerator between 2-8 degrees

Can I use insulin straight from the fridge?Injecting insulin at room temperature is much more comfortable that injecting cold insulin. Some people say it stings and they can feel it going in if cold. Insulin in pumps used staright from the fridge may get more bubbles in it.

Is insulin ruined if it freezes?Do not use insulin even after it has thawed as freezing will affect the properties and it will not work as well as before in lowering your blood glucose. Throw frozen insulin away.

What can I do to keep my insulin at the recommended temperature?For insulin pens we recommend Frio packs, which can be bought over the internet and come in individual pen sizes or larger. Or you can put the pen in a normal freezer bag with an ice pack, try not to let your pen touch the ice or ice pack directly as it could make the temperature of the insulin too low. If you are planning a winter break you can use the frio pack to store the insulin which will help it stay at an optimum temperature. If you are skiing you can put it inside your ski suit.

Don’t forget insulin is absorbed slower in the cold weather as the body warms up it absorbs more quickly increasing the risk of hypos.Some of the other things to think about are:

Mother told me from her experience what it was like. When she first noticed I was drinking loads and using the Ladies Room more than normal, she wanted a diagnosis. She found a leaflet about Diabetes at our GP, and was pretty sure that was it. She had no knowledge or experience with Diabetes, as no-one in our family had it. On the day I was diagnosed, Mother phoned for an ambulance after one more GP claimed I was “fine”. The ambulance rushed over, and took both me and Mother to hospital, which was roughly 10 miles away. When we arrived, the doctors gave me 2 hours to live, and noticed I had Acute Ketoacidosis in my system. Those doctors saved my life that day. Even when Mother talks about how one doctor, Dr. Antoinette McAulay, helped the most, she breaks down crying, being so thankful for her. I spent a while in the hospital (unfortunately, I don’t know how long), but I remember the last thing before we left, Mother explained about Diabetes and how things will be…“different”.

Things did change, despite the fact I have no memory of not being a Diabetic. I remember when I was 5, I screamed at my parents saying I didn’t want to be Diabetic anymore. I remember yelling how much I hated taking insulin, and I was tired of doing blood tests. Mother calmed me down, and explained carefully on how important it was for me to rely on these blood tests and injections, and the potential consequences if I didn’t do as I was told. Did that scare me? If I said no, that would’ve been a lie. Ever since then, I have taken my blood tests and my injections.

School life was very hard when I was kid. Not because of my Diabetes (luckily), but because I was surrounded by children who didn’t understand. When I was in Year

3, I got bullied for being Diabetic. Kids would say things like “she eats weird food”, “stay away from her, or you’ll get Diabetes”. It really knocked my confidence, so I eventually told Mother. She came into my class to give her own Lecture. I remember sitting next to her as she taught my “classmates” about my Diabetes, and why I had to do what I had to do. Ever since her Lecture, no-one bullied me for my Diabetes…for five years, but I’ll talk about that later. As I grew up in that school, I had to leave lessons early or even in the middle so I could take my insulin. I remember if my sugar level was over 13, my teacher would tell me to go and do some star jumps in the hall. No-one was watching, and I really didn’t care if I looked silly. Diabetes may have been my focus, but I wasn’t going to let it rule my life anytime soon. I was a lonely kid, because I was the only one in school with Diabetes. I knew I was different from everyone else. I’m pretty sure that was why I was picked on.

When I moved to a new school, things were the same: Same students, same routine of insulin, same loneliness. But this time, I met someone who was also Diabetic. It was a shock as I did feel like I was the only Diabetic in the Area. We weren’t exactly friends, but we got along really well. I remember we took turns to use the Medical Room, so we could take our insulin. It makes me giggle remembering how when the other girl was done, she would say “okay, it’s your turn!”. When I was in Year 8, we were finally learning about the importance of Diabetes. The class I was in had a lot of bullies, so I kept quiet about my condition.

Unfortunately, one boy said “Hey! Aren’t you Diabetic?”And despite the fact I got shy and embarrassed, I felt happy to talk about my experience with Diabetes. I even showed my Science teacher my insulin. Looking back, I don’t know why he was so interested…But when that lesson ended, one girl complained “how embarrassing can you get? You looked like an idiot! An idiot who takes drugs to live!” I was really hurt by her comment, and when I told my teacher, he didn’t help. He said I was taking “good drugs” to live. I wanted to scream and cry.

Luckily, no-one bullied me for being Diabetic after that, but that girl’s words did knock my confidence. I was always scared to take insulin in public, just in case I was called a “druggie”. I was even scared to take my insulin when a police officer was present, and my sugar levels were high. Luckily, I have a letter on me about my Diabetes, so I don’t get too worried. It was last month when I attended the MCM Anime Convention at the Excel, and they were doing a bag search. I didn’t know about this, I was so scared they were going to confiscate my insulin. I panicked and explained I was Diabetic, and surprisingly, the lady who was searching my bag was totally okay with it. She let me in, and we had a fun time. It happens a lot wherever I go, and I forget how common Diabetes is. Even when I was in Uni, everyone was supportive, and convinced me to take my insulin in public. Even when I suffered a Hypo

People often ask about taking insulin on holiday especially when travelling abroad and how to keep it safe for use. However in the UK with the extremes in temperature we have been having it is just as important to make sure it is kept safe for use.

during a lesson, my friend had a spare fruit bar on her, and she let me have it. Eating was strictly not allowed in the classroom, but we all broke that rule. The teachers didn’t mind, and they especially didn’t mind when I treated my Hyper or Hypo.

What I want to do in life is become an Entertainer for kids, whether it would be dressing up, or maybe being a Teaching Assistant. I’m not going to let my Diabetes rule my life. Sure, it’s important for me, such as taking the right insulin, checking your sugar levels constantly, but it’s not on my mind 24/7. I just live as though I am normal, but with a Pancreas that doesn’t work, that might be tricky. But I don’t mind. Being Diabetic is what makes me me. In my spare time, I love to animate in 3D. I like to make models (even though I’m not great at making them), I like to animate expressions, and I love the feedback. How I have over 6,500 subscribers, I don’t know. I am aware how on Social Media, people think Diabetes is “cute” and “sweet”, but I’ve turned my experience into a comic series. I created the models, and made comics to raise awareness so people understand what we Diabetics go through on a daily basis. I think it’s slowly working. Not to mention I have loads of fun making them. Even my best friend is supportive and said the comics made her laugh. She also said that it gave her an idea on what being Diabetic is like. She was the one who gave me a life-changing piece of advice: “If you can’t look at the bright side of life, try and polish the dull side.” Ever since then, I’ve looked at things differently, and managed my Diabetes a bit better. I may have background Retinopathy because of some hiccups, but I’ve made some changes to make myself feel better at the same time.

It’s been 20 years…I’ve been to hospital a few times; I’ve had dangerous Hypos and Hypers, and I’ve been in embarrassing situations because of my Diabetes. Will it stop me from doing the things I want to do? No. Will I stop running and swimming in fear of getting a Hypo? No. Will I stop travelling to places in fear of being called names? No. I may be a Type 1 Diabetic, but it won’t take over my life. I’m happy right now. I have plans to look forward to; I have friends I can talk to. Diabetes can go and sit in a corner whilst I enjoy life, as long as I am careful. Enjoy your life, and don’t let your Diabetes make you worry or stress. There’s always someone you can talk to if you’re worried. And believe me when I say this: They’re closer than you think. Now I’m going to go and plan an animation. It was nice sharing my experience with you!

See you soon! Bye!

1. Keeping well hydrated in hot weather - none of us remember to drink enough and this is even more important in really warm environments 2. Keeping your fingers and toes warm in cold weather. We know that people with diabetes are prone to reduced sensation in fingers and toes particularly if someone has had diabetes for a long time. If that is the case then you may not feel the cold quite so well and risk getting frost bite. It may be worth investing in some cosy socks and gloves.3. Testing blood sugars in cold weather may be a challenge a. Firstly getting your fingers out may not be fun if it’s really cold b. Secondly getting your fingers to bleed may be challenging in the cold c. Your blood glucose meter doesn’t like being cold and may not work so keep it tucked away. Pumps don’t like the cold much either!

Have fun!

Anne

Mother told me from her experience what it was like. When she first noticed I was drinking loads and using the Ladies Room more than normal, she wanted a diagnosis. She found a leaflet about Diabetes at our GP, and was pretty sure that was it. She had no knowledge or experience with Diabetes, as no-one in our family had it. On the day I was diagnosed, Mother phoned for an ambulance after one more GP claimed I was “fine”. The ambulance rushed over, and took both me and Mother to hospital, which was roughly 10 miles away. When we arrived, the doctors gave me 2 hours to live, and noticed I had Acute Ketoacidosis in my system. Those doctors saved my life that day. Even when Mother talks about how one doctor, Dr. Antoinette McAulay, helped the most, she breaks down crying, being so thankful for her. I spent a while in the hospital (unfortunately, I don’t know how long), but I remember the last thing before we left, Mother explained about Diabetes and how things will be…“different”.

Things did change, despite the fact I have no memory of not being a Diabetic. I remember when I was 5, I screamed at my parents saying I didn’t want to be Diabetic anymore. I remember yelling how much I hated taking insulin, and I was tired of doing blood tests. Mother calmed me down, and explained carefully on how important it was for me to rely on these blood tests and injections, and the potential consequences if I didn’t do as I was told. Did that scare me? If I said no, that would’ve been a lie. Ever since then, I have taken my blood tests and my injections.

School life was very hard when I was kid. Not because of my Diabetes (luckily), but because I was surrounded by children who didn’t understand. When I was in Year

3, I got bullied for being Diabetic. Kids would say things like “she eats weird food”, “stay away from her, or you’ll get Diabetes”. It really knocked my confidence, so I eventually told Mother. She came into my class to give her own Lecture. I remember sitting next to her as she taught my “classmates” about my Diabetes, and why I had to do what I had to do. Ever since her Lecture, no-one bullied me for my Diabetes…for five years, but I’ll talk about that later. As I grew up in that school, I had to leave lessons early or even in the middle so I could take my insulin. I remember if my sugar level was over 13, my teacher would tell me to go and do some star jumps in the hall. No-one was watching, and I really didn’t care if I looked silly. Diabetes may have been my focus, but I wasn’t going to let it rule my life anytime soon. I was a lonely kid, because I was the only one in school with Diabetes. I knew I was different from everyone else. I’m pretty sure that was why I was picked on.

When I moved to a new school, things were the same: Same students, same routine of insulin, same loneliness. But this time, I met someone who was also Diabetic. It was a shock as I did feel like I was the only Diabetic in the Area. We weren’t exactly friends, but we got along really well. I remember we took turns to use the Medical Room, so we could take our insulin. It makes me giggle remembering how when the other girl was done, she would say “okay, it’s your turn!”. When I was in Year 8, we were finally learning about the importance of Diabetes. The class I was in had a lot of bullies, so I kept quiet about my condition.

Unfortunately, one boy said “Hey! Aren’t you Diabetic?”And despite the fact I got shy and embarrassed, I felt happy to talk about my experience with Diabetes. I even showed my Science teacher my insulin. Looking back, I don’t know why he was so interested…But when that lesson ended, one girl complained “how embarrassing can you get? You looked like an idiot! An idiot who takes drugs to live!” I was really hurt by her comment, and when I told my teacher, he didn’t help. He said I was taking “good drugs” to live. I wanted to scream and cry.

Luckily, no-one bullied me for being Diabetic after that, but that girl’s words did knock my confidence. I was always scared to take insulin in public, just in case I was called a “druggie”. I was even scared to take my insulin when a police officer was present, and my sugar levels were high. Luckily, I have a letter on me about my Diabetes, so I don’t get too worried. It was last month when I attended the MCM Anime Convention at the Excel, and they were doing a bag search. I didn’t know about this, I was so scared they were going to confiscate my insulin. I panicked and explained I was Diabetic, and surprisingly, the lady who was searching my bag was totally okay with it. She let me in, and we had a fun time. It happens a lot wherever I go, and I forget how common Diabetes is. Even when I was in Uni, everyone was supportive, and convinced me to take my insulin in public. Even when I suffered a Hypo

Type 1 Diabetes and EatingDisorder - What is it?

You may have seen these kinds of difficulties called ‘Diabulimia’ in the media. ‘Diabulimia’ is not a recognised mental health diagnosis, instead it is a term that has been used to capture the patterns of thoughts, emotions and behaviours described above. Because these sorts of difficulties are not yet properly understood and research in this area is still in its infancy it has meant that until relatively recently healthcare professionals have not always known how to spot the signs, how to ask the right kinds of questions and how to offer the right kind of support. Over the last few years however a number of people who have experienced these sorts of difficulties have started to speak openly and honestly about their experiences, and, diabetes and eating disorder experts have started to come together and commit to developing the knowledge base to fill this gap and improve the support and treatments available for people with T1D and disordered eating / insulin omission.

How might it develop?There is not one factor that causes an eating disorder in T1D to develop, it can be a combination of many things including social, emotional, and physical factors. There is evidence to suggest that living with T1D is in itself a risk factor for disturbed eating behaviour and eating disorders. In this way diabetes

treatment goals can ‘teach’ or intensify some of the vulnerability to an eating disorder mind-set:

1) Having to carefully read food labels2) The focus on weight at clinic appointments3) Having to eat to treat hypos which can affect weight4) Being constantly aware of carbs (and other nutritional values like calories) in food5) Feeling shame over how diabetes is managed6) A difficult relationship with the diabetes team7) Difficulties keeping to a healthy weight

(Taken from Diabetes UK, link below)

Although deliberate insulin omission in T1D can be for the purpose of weight control it is important to understand there are other possible motivating factors for insulin omission:

• Fear of hypos• Denial of having diabetes• Embarrassment of checking blood sugars and giving insulin in front of others.• Wanting to have a break from diabetes management (possibly as a result of diabetes burnout)• Fear of needles

What is the impact of regularly missing insulin doses?Without insulin blood sugars build up quickly (hyperglycaemia) and can cause the person to go to the toilet a lot. Calories taken in through the food eaten pass straight through and out in the urine. This means the body does not get the energy it needs from food and it starts to break down body fat instead, causing weight loss.

If someone takes less insulin than their body needs it may have pay offs, but weight loss achieved in this way comes with significant risks. Running blood sugars high without insulin to bring them down can send the body into diabetic ketoacidosis (DKA) which can be fatal. In the longer term not taking insulin can risk damaging vision, the kidneys and the nerves in the feet (diabetes complications when high blood sugars damage the blood vessels.)

Opening up, the first step….It can be difficult and daunting to take the first step to breaking out of the pattern of taking too little insulin. A helpful first step often described by people who have experienced these difficulties is to open up to a trusted person you know, whether that be a friend, family member or healthcare professional. If you have been keeping the problem a secret it can feel difficult to speak up for the first time, however the other person’s response may surprise you, even if they don’t completely understand, they will usually feel some relief to know what has been happening and they can help you think through your next steps.

These are some of the common thoughts and feelings that can get in the way of opening up for the first time:

1) Feeling ashamed about what has been happening. Be kind to yourself, remind yourself of the fact that humans the world over engage in behaviours that they know are not necessarily good for their health eg smoking, eating unhealthy foods, avoiding exercise etc. Taking the risk to confide in a trusted other person could help you share the burden of what has been happening and to work out together what to do next.

2) Being in denial that this pattern is a problem. For example “I’ll wait till there are some complications; I’ll make some changes next week, next month.” The ability to ignore something upsetting in life is a valuable tool that can help us cope during difficult times when there is nothing else to do to resolve the situation. However, when denial becomes the only way of coping it can be a problem. Using denial all the time can be based upon a belief that there is nothing that can be done to improve your situation. However, although it can feel frightening or overwhelming in the short term to talk about your

feelings with someone else it is a really important first step for long term recovery and it can open the door to taking the first steps to address it.

3) I’m indestructible. For example “Other people will get complications, not me.” It is common to live life feeling as if we are invincible not really considering our own health. In fact to protect our emotional well-being it can be helpful to create a bit of distance from thoughts about how fragile life can be. However, it can be helpful to try to listen to other people’s concerns when they voice them and try to catch typical automatic responses of “I’m fine”. Sometimes reading other people’s stories of hope and recovery can build your confidence in taking the first steps to making changes.

4) I don’t want another diagnosis, I’ve got enough problems. Speaking up about patterns of eating and insulin omission does not have to mean another diagnosis. As a team we are more interested in looking with you at the patterns that have developed and help you to consider ways of breaking out of them that work for you.

5) Fear - “If I speak up about it then I’ll have to make changes, and I’ll put on weight.” If you have been fearful about putting on weight then it is completely understandable that you will be concerned as to what happens next. Speak with the team about your concerns and they will work with you to put together a plan that feels comfortable for you. Starting to talk about this with someone else can help you to feel in control of the next steps that happen to get the balance right between restoring health and feeling more confident in your body.

For more information:http://dwed.org.uk/ DWED is the only current charity in the United Kingdom that supports and advocates for people that struggle with both type 1 diabetes and any kind of eating disorder

https://www.diabetes.org.uk/guide-to-diabetes/life-with-diabetes/diabulimia Diabetes UK

Some people with Type 1 Diabetes (T1D) experience an eating disorder that is linked to their diabetes. They might reduce or stop taking their insulin in order to lose weight and/or because of fears of gaining weight. When someone has T1D they need to take insulin to live and so to persistently not take enough or to miss it can be life threatening. It is thought that these types of problems can affect around 1 in 10 men with T1D and about 4 in 10 women (aged 15-30) with T1D.

during a lesson, my friend had a spare fruit bar on her, and she let me have it. Eating was strictly not allowed in the classroom, but we all broke that rule. The teachers didn’t mind, and they especially didn’t mind when I treated my Hyper or Hypo.

What I want to do in life is become an Entertainer for kids, whether it would be dressing up, or maybe being a Teaching Assistant. I’m not going to let my Diabetes rule my life. Sure, it’s important for me, such as taking the right insulin, checking your sugar levels constantly, but it’s not on my mind 24/7. I just live as though I am normal, but with a Pancreas that doesn’t work, that might be tricky. But I don’t mind. Being Diabetic is what makes me me. In my spare time, I love to animate in 3D. I like to make models (even though I’m not great at making them), I like to animate expressions, and I love the feedback. How I have over 6,500 subscribers, I don’t know. I am aware how on Social Media, people think Diabetes is “cute” and “sweet”, but I’ve turned my experience into a comic series. I created the models, and made comics to raise awareness so people understand what we Diabetics go through on a daily basis. I think it’s slowly working. Not to mention I have loads of fun making them. Even my best friend is supportive and said the comics made her laugh. She also said that it gave her an idea on what being Diabetic is like. She was the one who gave me a life-changing piece of advice: “If you can’t look at the bright side of life, try and polish the dull side.” Ever since then, I’ve looked at things differently, and managed my Diabetes a bit better. I may have background Retinopathy because of some hiccups, but I’ve made some changes to make myself feel better at the same time.

It’s been 20 years…I’ve been to hospital a few times; I’ve had dangerous Hypos and Hypers, and I’ve been in embarrassing situations because of my Diabetes. Will it stop me from doing the things I want to do? No. Will I stop running and swimming in fear of getting a Hypo? No. Will I stop travelling to places in fear of being called names? No. I may be a Type 1 Diabetic, but it won’t take over my life. I’m happy right now. I have plans to look forward to; I have friends I can talk to. Diabetes can go and sit in a corner whilst I enjoy life, as long as I am careful. Enjoy your life, and don’t let your Diabetes make you worry or stress. There’s always someone you can talk to if you’re worried. And believe me when I say this: They’re closer than you think. Now I’m going to go and plan an animation. It was nice sharing my experience with you!

See you soon! Bye!

You may have seen these kinds of difficulties called ‘Diabulimia’ in the media. ‘Diabulimia’ is not a recognised mental health diagnosis, instead it is a term that has been used to capture the patterns of thoughts, emotions and behaviours described above. Because these sorts of difficulties are not yet properly understood and research in this area is still in its infancy it has meant that until relatively recently healthcare professionals have not always known how to spot the signs, how to ask the right kinds of questions and how to offer the right kind of support. Over the last few years however a number of people who have experienced these sorts of difficulties have started to speak openly and honestly about their experiences, and, diabetes and eating disorder experts have started to come together and commit to developing the knowledge base to fill this gap and improve the support and treatments available for people with T1D and disordered eating / insulin omission.

How might it develop?There is not one factor that causes an eating disorder in T1D to develop, it can be a combination of many things including social, emotional, and physical factors. There is evidence to suggest that living with T1D is in itself a risk factor for disturbed eating behaviour and eating disorders. In this way diabetes

What do I do if I feel unwell

treatment goals can ‘teach’ or intensify some of the vulnerability to an eating disorder mind-set:

1) Having to carefully read food labels2) The focus on weight at clinic appointments3) Having to eat to treat hypos which can affect weight4) Being constantly aware of carbs (and other nutritional values like calories) in food5) Feeling shame over how diabetes is managed6) A difficult relationship with the diabetes team7) Difficulties keeping to a healthy weight

(Taken from Diabetes UK, link below)

Although deliberate insulin omission in T1D can be for the purpose of weight control it is important to understand there are other possible motivating factors for insulin omission:

• Fear of hypos• Denial of having diabetes• Embarrassment of checking blood sugars and giving insulin in front of others.• Wanting to have a break from diabetes management (possibly as a result of diabetes burnout)• Fear of needles

What is the impact of regularly missing insulin doses?Without insulin blood sugars build up quickly (hyperglycaemia) and can cause the person to go to the toilet a lot. Calories taken in through the food eaten pass straight through and out in the urine. This means the body does not get the energy it needs from food and it starts to break down body fat instead, causing weight loss.

If someone takes less insulin than their body needs it may have pay offs, but weight loss achieved in this way comes with significant risks. Running blood sugars high without insulin to bring them down can send the body into diabetic ketoacidosis (DKA) which can be fatal. In the longer term not taking insulin can risk damaging vision, the kidneys and the nerves in the feet (diabetes complications when high blood sugars damage the blood vessels.)

Opening up, the first step….It can be difficult and daunting to take the first step to breaking out of the pattern of taking too little insulin. A helpful first step often described by people who have experienced these difficulties is to open up to a trusted person you know, whether that be a friend, family member or healthcare professional. If you have been keeping the problem a secret it can feel difficult to speak up for the first time, however the other person’s response may surprise you, even if they don’t completely understand, they will usually feel some relief to know what has been happening and they can help you think through your next steps.

These are some of the common thoughts and feelings that can get in the way of opening up for the first time:

1) Feeling ashamed about what has been happening. Be kind to yourself, remind yourself of the fact that humans the world over engage in behaviours that they know are not necessarily good for their health eg smoking, eating unhealthy foods, avoiding exercise etc. Taking the risk to confide in a trusted other person could help you share the burden of what has been happening and to work out together what to do next.

2) Being in denial that this pattern is a problem. For example “I’ll wait till there are some complications; I’ll make some changes next week, next month.” The ability to ignore something upsetting in life is a valuable tool that can help us cope during difficult times when there is nothing else to do to resolve the situation. However, when denial becomes the only way of coping it can be a problem. Using denial all the time can be based upon a belief that there is nothing that can be done to improve your situation. However, although it can feel frightening or overwhelming in the short term to talk about your

feelings with someone else it is a really important first step for long term recovery and it can open the door to taking the first steps to address it.

3) I’m indestructible. For example “Other people will get complications, not me.” It is common to live life feeling as if we are invincible not really considering our own health. In fact to protect our emotional well-being it can be helpful to create a bit of distance from thoughts about how fragile life can be. However, it can be helpful to try to listen to other people’s concerns when they voice them and try to catch typical automatic responses of “I’m fine”. Sometimes reading other people’s stories of hope and recovery can build your confidence in taking the first steps to making changes.

4) I don’t want another diagnosis, I’ve got enough problems. Speaking up about patterns of eating and insulin omission does not have to mean another diagnosis. As a team we are more interested in looking with you at the patterns that have developed and help you to consider ways of breaking out of them that work for you.

5) Fear - “If I speak up about it then I’ll have to make changes, and I’ll put on weight.” If you have been fearful about putting on weight then it is completely understandable that you will be concerned as to what happens next. Speak with the team about your concerns and they will work with you to put together a plan that feels comfortable for you. Starting to talk about this with someone else can help you to feel in control of the next steps that happen to get the balance right between restoring health and feeling more confident in your body.

For more information:http://dwed.org.uk/ DWED is the only current charity in the United Kingdom that supports and advocates for people that struggle with both type 1 diabetes and any kind of eating disorder

https://www.diabetes.org.uk/guide-to-diabetes/life-with-diabetes/diabulimia Diabetes UK

BDEC in partnership with

Do you haveType 1 Diabetes?

The Royal Bournemouth and Christchurch Hospitals, Castle Lane East Bournemouth BH7 7DWDr Helen Partridge (Consultant)01202 704610 helen.partridge@rbch.nhs.uk

Anne Milsom (Diabetes Specialist Transition Nurse) 01202 704888 anne.milsom@rbch.nhs.uk

Jackie Ryder (Diabetes Specialist Nurse)01202 704888 jacqueline.ryder@rbch.nhs.uk

Belisa Lopes (Dietitian)01202 704929 Belisa.Lopes@rbch.nhs.uk

Lindsey Rouse (Psychologist)01202 704888 lindsey.rouse@rbch.nhs.uk

Julie Baker (Consultant Secretary) 01202 704610

Contact details

When it comes to snacks, we all like the odd treat, but how good are we at eating them in moderation? Do we know which snacks are better choices for our health? Below are examples of some healthy snacks to use as a guide for a better and more balanced snack choice and also a ‘treats’ list which are examples of those we should eat in moderation. Remember if your snack contains carbohydrate you should be giving some short acting insulin for it.

Snacks Snacks Snacks...

Healthier Snacks that are lower calorie/carbohydrate/saturated fatSugar-free Jelly25g almonds/walnuts¼ pot reduced-fat hummus & vegetable cruditéBoiled eggSmall Apple2 satsumas80g blueberries1 handful grapes2 kiwi fruits2 small plums10 strawberries1 small box raisins1 rice cake with fruit/peanut spread25g lighter cheese4 breadsticks2 crispbreads with 0% cottage cheese

Treats that are higher calorie/carbohydrate/saturated fatBiscuits/CookiesCakeBakewell Tarts/Mice Pies/Apple PiesChocolate Mini RollMuffins (Chocolate/blueberry/carrot)CrispsSweet/toffee popcornChocolate barsJelly Sweets/hariboSweetened beverages, including syrup teas and coffees

For further advice please visit :BDA: www.bda.uk.com/foodfacts/home

Reference: www.diabetes.org.uk

BDEC Beach Picnic Come along, Bring Family and

Friends

5TH SEPTEMBER at 6-8pm

OPPOSITE THE OCEANARIUM

BY BOURNEMOUTH PIER

FOR MORE INFORMATION CONTACT JULIE BAKER ON 01202 704610

No Need To Book,

Bring Your own Food and Drink!