First status updates

So we’ve arrived at day 2 in the hostpital (if you don’t call the afternoon I got admitted).

My glucose levels are still fluctuating and I had my first Hypoglycemia (low blood-sugar) today, yaay :/ Luckily I noticed it in time (sweating and shaky hands) and medical staff was nearby.

The doctors are monitoring my levels and are adjusting my insuline schedule accordingly.

Signs of Hypoglycemia
Signs of Hypoglycemia, from diabetesselfcaring.com

Training

Before I can leave the hospital, I need to be able to take care of myself of course. And since I won’t be staying extra, as I have a (short) vacation scheduled, they’re giving me a superspeeded training focused on staying safe.

I will be invited back in a week or so for more in-depth information that’s also more aimed at everyday processes and long-term vision.

Insulin injecting

Today I’ve also done the full measure-and-inject procedure by myself (assisted by a nurse) for the first time. Before that, I received a lengthy explanation on how to measure my glucose levels using a drop of blood from my fingertips, on how to prepare the insuline pen, and how to inject myself.

For those that don’t know how this works, a quick run-through:

  • First of all, you want to make sure your hands are clean. Hygiene is important.
  • You’ll need a measuring device, a paper-like strip, a needle-jabber*, a needle cartridge, an insulin pen, an insulin needle, and insulin.
  • The paper strip is plugged into the measuring device and the device will turn on automatically.
  • The needle-jabber is loaded with a cartridge and you use it to pierce one of your fingers at the sides near the top.
  • Some blood will come out of that wound, although you may need to put some pressure on your finger to see actual blood come out.
  • You bring the measuring device with the paper strip close to the drop of blood, so it can be sucked up by the tip of the strip.
  • The measuring device will give you a read-out of your current glucose levels.
  • The doctor will have given you a number which correspondents with a certain amount of insulin to be taken at a certain time (breakfast, lunch, diner).
    Based on your glucose levels, you may need to add to or subtract a certain number from that base value to get to the actual amount of insulin to be given at that time. **
  • You attach the needle to the insulin pen, and clear it of air by sending some insulin through it.
  • And then finally, you seek a spot on your belly that hasn’t recently been injected or bruised, and you inject the insulin with the pen.
  • The insulin needle is removed after injecting and stored in a needle container for safe displosal. After a certain amount of jabs, you also rotate the cartridge of the needle-jabber to get a fresh needle.

* Very official medical terms ;)
** It is EXTREMELY important to dose correctly! Too much insuline sends you into Hypoglycemia (hypo), too little might result in Hyperglycemia (hyper).

Note that that is the procedure for the short-working insulin. Which I need to do 3 times per day. Before injecting the daily dose of long-working insulin I don’t need to take a measurement but the rest of the procedure remains the same.

Long- vs short-working insulin

To keep it simple: the long-working insulin provides a base amount of insulin throughout the day to ensure my body can always turn some sugar into energy, while the short-working insulin is meant to boost the insulin in my body so it can process incoming sugars from a meal.

That’s why I need to inject myself 3 times per day with short-working insulin (breakfast, lunch, diner) and 1 time with the long-working.

Diet

I’ve also gotten a visit from a dietist whom explained me in a nutshell which foods should be preferred and which I need to look out for.

If you’ve ever heard about the Food Triangle (not exactly the same as the Food Pyramid), you should be able to figure out most of it. On top of this reversed triangle, you’ll see you need to hydrate frequently by drinking water. Below it some food categories are sorted by how frequent you’ll want to eat them, with vegetables and fruit on top in the dark-green section, together with bread, pasta, rice, tofu, beans, etc. In the light green section we find fish, dairy products like milk, yoghurt, and cheese, eggs, and chicken. The orange section consists out of butter (fats) and (red) meat. The red section isn’t even part of the triangle and consists out of “food” anyone should avoid, like soda, fastfood, alchohol, candy, etc.

Voedingsdriehoek by Vlaams Instituut Gezond Leven vzw
Voedingsdriehoek by Vlaams Instituut Gezond Leven vzw

For people with diabetes, this triangle is slightly updated/annotated. Where possible, long sugars/carbohydrates in e.g. whole-weat pasta or rice, or brown bread should be preferred over their “white” counterparts. Raw veggies are preferred over cooked/steamed, same for fruit with peel vs without, and non-sweet veggies and fruit over e.g., carrots and apples. This is to ensure the body also received enough fibers and not too much sugar.

A useful mnemomic to help with this is to think of the taste of the vegetable/fruit (sweet or not) and whether you need to chew a lot (apple with skin, raw veggies).

Dairy products apparently also are something to be careful with as the lactose in the milk also contains carbohydrates which your body turns into glucose. Cheese being the exception as the riping process gets rids of those carbs.

Chipped

As I was already informed about yesterday, I’ve also received my monitoring sensor.

This tiny white dot holds a tiny needle-like sensor that pierces just below your skin. It connects with a reader and/or an app on your phone (over NFC) so you can get glucose readings without needing to jab your finger.

In my case, the app of Dexcom won’t run on my phone for some reason (which they only tell you about after registering an account), so we had to switch to FreeStyle Libre. Luckily the hospital has more than 1 brand of sensors in stock 😅.

A box containing a Freestyle Libre glucose sensor and a monitor
Freestyle Libre glucose monitor

Using NFC, the phone can get a readout from the chip by holding them near each other. Apparently the chip also holds something like 8 hours of readings, which get synced when you tap the chip with your phone. There must also be some kind of background communication, as you can setup a separation alarm for when your phone is out of reach of the chip for more than 20 minutes, and you can set up lower and upper boundaries for your glucose so that your phone warns you when you’re going to get Hypoglycemia/Hyperglycemia.

Finally, you can link the app to the account of your hospital so your Diabetes Care and Education Specialist can monitor you even outside the hospital. That way, if you get into trouble you can give them a call and they can already track your history.

Update on diagnosis

As I mentioned earlier, my diagnose is Type 1 Diabetes where my body is having an autoimmune response which causes it to attack my pancreas. However, to be 100% certain of that diagnosis, they’ve drawn some extra blood today which will be examined for antibodies. It can take about 3 months to get those results back.

Tomorrow I’ll also be getting an ultrasound of my abdomen. This is mainly to rule out pancreatic cancer.

Once that’s done, I should be able to get discharged and go home.

A few more follow-up moments are already scheduled, mainly to further update my insuline schedule.

More side-effects of being diabetic

Having to regulate your insulin and change your diet is sadly not all that comes with being diagnosed with Diabetes.

I’m not allowed to drive my car anymore until I get a medical clearing, for which I need to have stable glucose levels for at least one week. I’ll also need to renew my medical clearing every 5 years.

Diabetes can also affect your eye’s retina, so I need to schedule yearly check-ups with an ophthalmologist.

And as I mentioned in my previous post, I will eventually lose all pancreatic functioning, making me completely reliant on insulin injection, likely delivered by an insulin pump.

Updates

I don’t expect there to be much news tomorrow or until my next follow-up. My main focus now is to enjoy the rest of my vacation without issues to keep my glucose in check, or at least avoid another Hypo.