Saturday 22 March 2014

Natvia: giving back pancake day to people with D!

It's possible that when Natvia sent me two tubs of their all natural sweetener to try out with accompanying Bundt tin, they may have been overestimating my cake-making abilities just a tad.  The Great British Bake-Off may be all the rage at the moment, but unless they appreciate a beautifully microwaved omelette, I won't be on the show any time soon.

The people at Natvia: clearly not familiar with the
Presswell cookery skill level.
But there are plenty of ways I could use a decent sweetener in my life.  Since products containing aspartame became wildly unpopular after consumers discovered the many damning reports of links to cancer, toxic ingredients, notorious side-effects and the often too-bitter after-taste, there hasn't been a great deal on the market. Until recently.  

Natvia, a sweetener made from the Stevia plant, is a superb alternative.  The texture is similar to that of sugar, but with a cleaner, lighter taste.  In short, the leaf of the Stevia plant is ground up and blended with Erythritol, a naturally occurring nectar (found in melons) in order to give it the grainy texture of sugar.  It is low GI and can be used spoon-for-spoon in place of sugar.

Most of the time I've learnt to just cut sweetener out all together, but there are two major - very major - exceptions.

Coffee, and pancakes. 

The Presswell's do lent!
There is simply no substitute for a delicious morning coffee (or ten) with a dusting of sweetness to take the bite out of it  Sadly, aspartame-based sweeteners have a knack for adding a cheek-sucking bitterness that can ruin even the finest rich Columbian. Natvia, on the other-hand, with its sugar-mimicking taste gave me the sense for the first time in years, that I was enjoying a genuine barista-made coffee.  

The other treat that delights the palates of those living in the Presswell household, is pancakes.  And not these fandagled Banoffee/chocolate-marshmallow/peanut butter/cocoa crunch/strawberry ripple/chocolate raspberry pancakes.  I mean the genuine article: plain old-fashioned sugar and freshly squeezed lemon.  But with 5g of GI  blood-glucose spanking carbs in every teaspoon, sugar is a nightmare for people with D the world over.

This year however, I was just 6 pancakes into the stack Jamie had prepared us by the time I was thanking the gods for Natvia.  Never have I enjoyed a lent so much in living memory.  Mainly because diabetes and something called the Glycaemic Index, had other ideas!

So thank you Natvia, for giving me back pancake day!

You can get yours by shopping here. And remember, pancakes are for every day, not just for lent!

Monday 10 March 2014

MyStar Extra: The first home HbA1c device in the UK

When Menarini stopped manufacturing their home HbA1c testing kits at the end of 2012, I was gutted.  I deal with blood tests the way a cat deals with the hoover: through a mixture of hiding, hissing, and eventual submission.  So being able to check my HbA1c every few months by simply squishing a large drop of blood onto a piece of gauze and sending it off for a lab-standard result, meant it wasn't so naughty of me to put off my annual blood tests until the 'tow the line, Presswell' letters started arriving from my clinic.

When I was invited to attend a symposium for Sanofi's new Blood glucose monitor, the MyStar Extra, which claimed to have an on-board A1C calculator, I was just a little bit excited.  As well as offering a swish looking machine, the on-board A1c calculator can be done by following a few simple steps.

1) Set up a profile day.  

This is the process of taking a full profile of seven blood tests throughout the day, at certain times. These are before 11:00 'fasting' test, followed by a further post-breakfast test by 11:00 (so it's a good idea to make your fasting test before 09:00 to give time for the post-meal test).  Then a pre-lunch and post-lunch test between 11:00 and 15:59 (again, a pre-lunch test of before 13:00 gives time for the second test). The pre-dinner and post dinner between 16:00 and 20:59 (again, a pre-dinner test of around 18:00 allows time for the post-dinner test).  Finally the bedtime test of 21:00 - 23:59.  This is called your 'profile day', and by selecting the 'tick' button on the machine, you have now set up your profile.

2)  Fasting blood results.

Once your profile day is up and running, conduct six more fasting blood test results and BAM! You're done.  You're estimated HbA1c result is ready to be viewed!

So, the big question is, how accurate is it?  

Conveniently, two weeks before my MyStar Extra glucose arrived I had my yearly hissy-fit blood
panel done, so now would be a great time to test-drive the system.  I was convinced my result would have gone up after a chaotic few months, but the lab result was the same as last year - 6.6% (49mmol in 'new money').

I eagerly awaited the result of first MyStar A1c test.  


...6.8% (51 mmol, in new money). Pretty darn close, if you take into account the two-week gap and the fact I did the profile day on the same day I went to my local legendary high tea parlour, giving slightly skewed results.  And plenty good enough to help me keep a monthly eye on my A1c along the way.  

As with many things, there is one small down side: the limited A1c calculator range. As someone aiming for pregnancy-perfect A1cs so that Jamie and I might bring our own nappy-factory into this world, I need to aim to get my A1c under 6% to ensure my risk of complications during pregnancy are reduced.  Having scoured through the guidance manual, it seems that the A1c calculator will only go as low as 6%, until you just get the warning 'A4'.  On the plus side, a result of A4 will tell me my A1c is now below 6% (or above 10!) but still, it is this level of accuracy I need to aim for in the next year or so, so it is somewhat disappointing that levels lower than 6% won't be reported. Of course, it hasn't been tested on pregnant people yet so using it so would be entirely off-label.

That said, to have an at-my-fingertips chance to get an estimated A1c in between visits to the clinic is a god-send. It means I have that extra tool in the diabetes arsenal and means I have another way to feel empowered over, and in control of, my condition.

All in all, a big thumbs up!

Wednesday 5 March 2014

Eating Disorder? Unexpected.

"I'm a fraud", I thought, as I sat beneath a brightly-coloured and decidedly 70s-esque 'flower power' sign with luminous lettering, welcoming me to join in with 'Eating Disorder Awareness Week 2014'.  I was painfully aware of the emaciated girl sitting across from me, avoiding eye contact with me at all costs. I was avoiding hers, too, in fairness.  Could you have picked a more inappropriate week to come here, Anna?

I was sitting in the waiting room of the April House Eating Disorders suite in Southampton, having been referred after an emotional out-pouring to my dietician at clinic some weeks before.  I had told her through choked-up tears how all my adult life I had been overweight, except for a brief stint in my early 20s of extreme dieting, over-exercising and dabbling with diet pills (the ones that have no label and are kept 'out back' at the beautician's).  I explained that I had been on every diet going but remained obese and utterly ashamed of it; ashamed of myself.  Worse still I was gaining weight, again.  I cried and asked her for help, because I had recently found myself behaving in an inexplicably compulsive way around food - a way I had never noticed before, but which would explain why I was the weight I was, despite always exclaiming to people "I just don't know why I can't lose weight!"

I was asking for help.

Now, a few weeks on I found myself in a clinic with clinical psychologists and a host of other degree-holding professionals all wanting to take what I said seriously.  The thought now of being branded with the label 'has an eating disorder' was becoming a little too much for me.  I had said for some time that my eating was disordered, but an eating disorder?  No.

I picked at the label on my drinks bottle and shuffled my feet - left over right, right over left - all the while making sure my eyes didn't meet with anyone else's. It would be mortifying to see the looks of 'what are you doing here?' on their faces.  

"What are you doing here?" I angrily demanded from myself.  "You don't have an eating disorder, you just need to diet and lose some weight. You're just fat, that's all".

As I toyed with the idea of simply getting up and leaving - of not wasting everyone's time - the decision was all too swiftly taken away from me.  "Anna Presswell", a voice called. 

"Oh God.  Shit.  This is going to be mortifying when they tell me I shouldn't be wasting their time. Just get through the 2-hour assessment and GO!"

Lucy, was my assessor's name.  She was warm and friendly, with a clip-board full of questions about my life that in any other situation would be considered obscenely intrusive.  Perhaps the hardest question of all was "When did your issues with food start?". I still couldn't answer it, truth be told.  

We trawled through questions about eating, lifestyle, living arrangements, diabetes, food-regimes and my feelings towards myself.  Half-way through I was convinced that I would never need to see Lucy again, because I was clearly not in the right place, and we both knew it.

"Have you ever self-harmed?", "No".  
"Have you ever tried to take your own life?", "No". 
"Have you ever made yourself sick?", "No".  
"Do you have a desire for an empty stomach?", "No". 
"Are you isolated from loved ones?", "God no".

I was right.  This is dreadful.

"Do you exhibit frantic behaviour around food?" "Um, yes". 
"Do you hide your eating behaviour from loved ones?", "Uh, yes". 
"Do you eat to the point your stomach is uncomfortably full?", "Well, yes".  
"Do you eat in secret?", "Yeah". 
"Do you experience shame after eating?", "Every single day".  

The yeses started to multiply. And the questions went on.  The open-ended questions left me in tears because I had to explain things I'd never before said out loud.  Each one exposing more of my twisted relationship with food.

I told Lucy about what had brought me there: about the day when I decided to have a chocolate bar after work, and found myself six minutes later having eating four chocolate bars and three packets of crisps. Of how I saw people watching me in the car park as I ate the chocolate bars in three enormous mouthfuls, but was too frantic to care. Of how I came home, already disgusted with myself and feeling the blood sugar rise from the chaotic eating my insulin could never catch up with, and about lying to my husband about having bought myself one chocolate bar as a treat.  Of how ashamed I felt when I caught myself lying about food to one of the few people I could have told.

As the session drew to a close I suddenly found myself desperate for Lucy to tell me that I wouldn't just be left hanging if their services weren't going to be right for me.  I suddenly realised how glad I was that I hadn't run off at the start of the day.

"So, if you aren't able to help me, will anyone else?  What if I don't have a diagnostically recognised condition, can anyone still help me, or is this it?".  My eyes pleaded with her.

"Anna, our decisions about who we can work with and whether our service will be suitable for someone are made at our Wednesday morning team meeting.  But unofficially, it's clear to me that you have some real issues around food, and we would recognise those issues as an eating disorder.  You are on what we would call the binge-eating disorder spectrum.  And I am confident that we have something we can offer you."

With that I found my head in my hands as I let out a mixture of sobs and cries, as I found myself thanking Lucy.  I was grateful, but I didn't know what for.  I was relieved, but I couldn't understand why.  I felt lighter, but I had no idea what this meant.  

My relationship with food has always been, complicated.  I was diagnosed at four years old, when my parents were forced to impose strict rules around eating.  Sometimes I went hungry; sometimes I was forced to eat when I didn't want anything.  It kept my body healthy, and for that I am grateful.  But what that diagnosis did to me emotionally, is only just being picked at 27 years down the line.

Monday 3 March 2014

Diabetes UK Professional Conference: Twitter 'must follows'

Unless you've been stranded at sea for the last month, you will have felt the growing buzz of excitement around the DUK professionals conference taking place this Wednesday and Thursday in Liverpool.  Think all the big movers and shakers in pharmaceutical companies, healthcare professionals, advocacy and DUK representatives all under one roof, exploring D-topics from A to Z.  

Sadly, after three invites to the conference swooped in at too-late a stage to register as press, meaning a 10-hour round trip for a one-hour talk, I won't be able to go this year.  But what I will be doing instead is staying glued to Twitter where I have it on good authority there will be a group of everyone's favourite bloggers and D-advocates. 

So if like me you weren't able to wangle a way in, keep completely up-to-date on what's happening by following these Twitter peeps, who will be at the conference and tweeting as it happens. 

Twitterererers are...

Lesley at InPuT (T1 herself and chairman of a charity advocating for access to diabetes medical technology)
Annabel at Understudy Pancreas (mum of a proper-cool chick with T1 and blogger extraordinnaire)
Chris, aka Grumpy Pumper  (Grumpy bloke with T1)
Laura at Ninjabetic  (20-something T1 Ninja with advocacy running through her veins)
Paul at T1HbA1c and GBDoc (GBDoc creator and all round energetic T1 champion)

And the hashtag to follow is #DPC14!

If you are also at the event and will also be tweeting about it, put a comment below or email me! (