A guide for my niece to help her through the first few weeks after her diagnosis with type 1 diabetes. Also part of my production project for CULT 3020.

1. Diabetes sucks, but here’s a secret:
it’s not the end of the world
Some real world, practical help for my favourite niece, from her (soon to be) favourite uncle.

2. So, you’ve got Diabetes...

3. ....and you have no idea what it
means...

4. ....besides having a lot to do with the
word.....

5. NO!

6. NO! You can’t just put your head in the sand!

7. But Diabetes isn’t all about “NO!”
• Yes, your life is going to change out of
necessity, but change doesn’t need to be a
negative.
• You can still do just about all of the things you
used to enjoy, we just need to arm you with
the knowledge of how to do it.
• You won’t enjoy all of the learning, but you
will feel better because of it. I promise you.

8. First things first.
I’m not “that guy” that’s
going to tell you what to do
and what not do to. I’m here
to help and the best help I
can give to you, is hope.
Hope that comes from
someone who’s been
through the hardest parts of
what you’re going through
and has managed to get on
top of it his own way. And
that’s the key here, find
what works for you.
So this is how we’re going to
do this....

9. .....ready?
I’m going to give you the kind of knowledge and
idea’s that’s so hard to find amongst the
hundreds of brochures and fact sheet’s that
you’re getting from the hospital or from your
visits to your diabetes educator and
endocrinologist.
(You don’t know either of these people yet, but you will soon)
And that knowledge is....

10. ....practical stuff.
Did that just blow your mind, a little?

11. Most of what you already know is
enough to get us started.
• You know by now that the reason you’re sick is because your pancreas has
basically failed in its number one function. “Why?” isn’t as important as what it
means from here on in and that comes next.
• Because of this, we now need to inject the insulin that used to be produced
naturally. Right now, you’re still going to be producing some of your own, so I like
to call these first few weeks/months “Diabetes with training wheels”.
• Most docs will refer to it as “The Honeymoon period”. It all amounts to the same
thing; you’re getting some help naturally for the time being, until you stop
producing your own insulin. This isn’t always good though and you’ll be pulling
your hair out at times when your blood glucose readings are out of whack.
Remember this though: we’ve all gone through the same thing and it always gets
better.

13. The stuff that matters most
Alright, the next thing I’m going to tell you is probably the toughest part to
grasp at the beginning. That said (like the rest of what I will teach you) it gets
easier with practice and patience. Always remember that, because you will
want to chuck it all in at one point or another. Just stick to it.
It’s called “Carb Counting” and I think it’s the #1 thing that
the medical guys should be helping teach you to begin
with, but they don’t.

14. What is it and why’s it matter?
• Put simply, “carb counting” is what we
need to do when we decide how much
insulin to inject at meal time.
• This is important because the dosage has
to be as close to correct as we can get
it, otherwise we’re running into hypo’s or
hyper’s (I’ll tell you about them soon).
• We only need to worry about the
Counting carb’s can be tricky
carbohydrate because that is the
substance that our body can no longer
access without insulin.
So how do we do it?

15. Nutritional Information
• Before we ever inject a meal-time dose of insulin, make sure you
know what you’re eating. More to the point, how many grams of
carb’s are in it. This is where the nutritional information on food
packages come into play. For a while, forget that “sugars” figure on
packages. It will only confuse you to begin with. Just focus on the
total carbohydrate in your meal.
• Now, we’re usually told that for every 15 grams of carb’s in a
meal, we take around 1 unit of insulin. Say the meal you want to eat
contains 30 grams of carbs, that would mean we would shoot for
two units of insulin. Not so hard is it?

16. Here’s an example:
That right there is the
most important number
for us. Just worry about
that for the mean time and
you’ll do well.
31g divided by 15g’s per unit
of insulin, gives us 2 units.

17. That’s some real world math for you.
Now that we know how much insulin to take, we
can take our injection, eat our meal and if our
sums were correct, we’ll feel just the same as
always.
Congrats. You just won your first
battle vs. Diabetes!

19. Not so bad, is it?
You just need to remember to do your best to
know your food. Know the food you’re eating
and you take away a lot of the fear of managing
your diabetes. You’ll be able to keep those
blood sugars down and that will help you lead a
long, healthy life.
Sounds good, yeah? Well...

20. ....now comes the bad part.

21. Question

22. Remember before when we did our sums?
When we get it right, its all happy times and we
feel great about it all. As I’ve mentioned before
to you though, patience and knowledge are
your two best friends. And here’s why: managing
diabetes is not a perfect science. It can be
hard, frustrating work sometimes and no matter
the work you put into it, your results won’t
always come out the way you expect.
It’ll happen more than you will want too.

23. This is where we you will run into the
most frightening (and sucky) part of
diabetes: hypo’s.

24. Some technical stuff first
• You’ll be aware of this by now, but “Hypo” is short for Hypoglycemia.
That’s a term that basically means low blood glucose.
• For all of the work educators and medical staff put into warning us about
the dangers of prolonged high blood sugar, not nearly enough is put into
educating us about the dangers of hypo’s. We’re told over and over of how
our eye sight, feet and kidney’s are stressed under high blood glucose and
long term exposure to them can lead to all kinds of trouble down the line.
• Now, you know that we need to try our best to keep out glucose readings
above 4.0 and below 6.9 mmol for our health, but what happens when we
drop below 4.0? Bad stuff. Real bad.
• While high blood glucose can cause us massive problems in the years to
come, low blood glucose can cause you trouble NOW.
• Here is a link to good fact sheet for you to print: Hypoglycemia:
International Diabetes Institute

25. There is a great irony to our
disease and this is it....

26. ...Insulin is what keeps us alive.
Yet it is also the most immediate threat to us.

28. Yup, it’s true and this is why.
• When we eat carbohydrates, our blood glucose rises. This is why we take
insulin, to allow the glucose out of the blood and into our system. Think of
insulin as a form of a key in that respect. In effect, insulin lowers the
amount of glucose in our blood. This is great when we’re doing it right.
• But remember before when we counted our carbs and did our sums? I
mentioned that sometimes we get it wrong. Well, when we get it wrong
and we take too much insulin for what we needed, our glucose can drop
low. Sometimes dangerously low.
• When this happens and we suffer a hypo, all the rules you learn about
avoiding excessive sugar and carbs go out the window. Hypoglycemia is a
life threatening event and you can NEVER forget that. At this point you
need a high sugar drink or snack and you need it quickly.
• Unfortunately though, it’s a part of what we live with and with my
help, you’ll be better prepared to deal with it when you’re faced with it.

29. Why hypo’s are the pits
When my blood glucose is low, I can’t think properly
because my brain is starved of its fuel. My hands shake
and I get a horrible feeling of anxiousness that is just
uncontrollable. It’s my bodies reaction to the low levels
of glucose and there is no feeling like it.
There is a great video blogger who goes by the name of
Diabeticfriend and he has a nice video on why he hates
hypoglycemia. It’s worth a watch:
Why Low Blood Sugar Sucks!
At the end of the day everyone reacts a little differently to
them, but the symptoms are all treated the same way.
WITH SUGAR!

30. No matter how long you’ve have the disease, hypo’s are always frightening, partially
because you feel out of control and not yourself. This is natural though and as you
experience this for yourself, you’ll become better at calming yourself and handling it
well.
As I was putting this together for you, I suffered a hypo myself, so I decided to film the
process to diagnose it and quickly show how to treat it. It’s not fun to experience, but
you can manage it well enough, I promise you.
Testing Blood for Hypo and Treating Hypo
You can never really predict when a hypo might
occur, which is why I want you to always carry
around something sugary and you enjoy. For
me, it’s a little box of jellybeans. Three colours
only for me, because I’m fussy. You love
snakes, so maybe that would work for you?

31. Remember the golden rule of hypos is to treat it
IMMEDIATELY with sugar. Do not muck around
and do not worry about eating “bad food”.

32. Good Bad

33. I think you can handle that one.
You can handle all this new added
pressure as well.

34. However.
The toughest opponent when dealing
with diabetes, isn’t your blood
glucose, it isn’t hypo’s or doctors visits.
It isn’t even the injections or prick
testing.

35. Its you.

36. The stress and extra pressure we, as diabetics, put on ourselves can be more than
any one should ever have to deal with. The worry associated with a disease that
you carry around with you 24 hours a day is the sort that can consume you and
become an obsession if you let it.
People will tell you “hey, forget about it”, but you know that’s not quite possible.
You can never forget. That’s a rule that I live by and it serves me well. But
forgetting and worrying are not the same thing.
Remember that you have a few extra daily tasks to do. Remember that you should
try and eat and drink healthy. Remember to not skip injections, for whatever
reason. But if something goes amiss and you don’t understand, don’t worry about
it. Diabetics are humans too and we all make mistakes.
I speak these words from experience as I know how hard it is, especially at the
start. I would stress myself out daily and it nearly broke me. I wrote a blog entry
four years ago that I want to share with you and I’d like you to read it later on down
the track when you settle in. I think it will help you when you’re feeling down.
The 24 Hour Exam

37. I’ve come a very long way since that time and I went through the worst period of it on
my own. So it can be done, even though sometimes it seems impossible. I’ll be here
with you right the way through the early months and anything I can do for you, I’ll do it.
Sometimes it will just be an ear and I am more than happy to lend you mine whenever
you need. It’s important though to include your mum and dad in this, because diabetes
is a tremendous strain on them as well. The worry they will feel daily isn’t all that
different from yours. They will worry tremendously about you when you’re sick or if
you’re off with your friends, so try not to keep things to yourself.
You can make managing this disease so much easier if you only remember to share your
problems with your support team and ask for help when you need it.
A cliché, but sharing your problems really helps.

38. DIABETES CHECKLIST
1. Try to do your best to take it all in early on.
2. Remember if you feel “funny” check your blood for hypo’s and treat them
immediately.
3. Always carry around some extra sugary foods or drinks, just in case.
4. The labels on food packages can really help you count those carbs’ and
work out an accurate insulin dose.
5. Never get too down on yourself if things don’t work out now and then. It
happens and it’s expected. We all have it happen, no matter how long
you’ve had the disease.
6. Ask questions! Always ask questions if you don’t know or are unsure. We
want to help you learn.
7. Last of all, remember......

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