RACH Diabetic Clinic Newsletter No.30
Welcome to our winter newsletter.Although the adults amongst us are hoping for a fine winter the children are often hoping for lots of snow. Remember if it snows and they are out playing in the snow it can lead to the blood glucose dropping quite quickly. Make sure they have plenty snacks with them and check regularly.
Accu-check Aviva Expert and InsulinxMeters
These metersare blood glucose meters which have software to help calculate an insulin dose based on how many grams of carbohydrate eaten. They will also take into account your blood glucose level and if high will offer a correction dose of insulin. There are however 2 situations when this correction advice should not be used:
High blood glucose AFTER a hypo
Sometimesafter treating a hypo you can have a rebound high blood glucose level. If you have treateda hypo which has resulted in a higher blood glucose level and you are due to givefast acting insulin for a meal, do not give the suggested correction as this may result in another hypo.However other episodes of hyperglycaemia should be corrected.
Your meterwill NEVER appropriately calculate how much extra insulin you will need to clear your ketones. If you are ever in any doubt about how to correct ketones, read your Sick Day Rules leaflet or contact the diabetes team or the Medical ward.
If you are in any doubt about how to use these metersplease contact the diabetes team.
Do you want to get involved in diabetes research? Are you concerned about your risk of developing diabetes? We continue to recruit relatives of people with diabetes to the Trialnet study. Participants are screened for antibodies that measure the risk of developing diabetes in the future. For more information or if you are interested in taking part contact our research nurse Victoria Thomson 01224 550267 or
Do you know your targets?
We are often asked what blood glucose level or HbA1c you should aim for. A general guide would be the following:-
HbA1c: Your HbA1c is measured at every 3 monthly clinic visit. It is recommended that you keep it below 58 mmol/l. Pick up a leaflet explaining what HbA1c is at your next clinic visit.
Blood glucose: Aim for 4- 8 mmol/l before meals and no more than 10 mmol/l at other times.
If you find it difficult or do not know how to get your blood sugar in target you can discuss it with any member of the diabetes team or at your next clinic visit. We are here to help!
Insulin Pump update
In the last 6 months we have started9 children on insulin pumps and we are planning 10- 15 starts in the next 6 months. We are currently trying to find out who is still interested in pump treatment so make sure you fill in the questionnaire at your next clinic visit. Pump information sessions are planned for the following January, March andMay. If you are interested to find more about pump treatment contact Isla.
Just a reminder that the Diabetes Nurses do not have large stocks of meters and insulin pens. The stock held in the hospital is for new patients only. If you need an extra pen they are
available on prescription from your family doctor. Replacement meters are available from the company (the number will be on/in the box of your old one or can be found on their website)
We are delighted to let you know that Dr Sun has been appointed as a consultant to the diabetes team. She is well known to you as she has been part of our team for many years as a junior doctor.
Although Dr Houlsby officially retired at the beginning of 2013 he continues to work part time covering the clinic on a Friday morning.
Many of you will also have seen Dr Revolta who has joined the team as a trainee. He will be with us for at least the next 6 months.
Diabetes UK Holidays
The details for holidays next summer will be available very soon. If you are a member of Diabetes UK it is usually in the winter Balance magazine, otherwise check the website for more information. The holidays are a great way for children to meet others with diabetes.
This is a simple recipe that we’ve printed before. With so many of you carbohydrate (CHO) counting we thought we’d show you how to work out the carbohydrate in your own recipes.Ingredient / Quantity (g) / gCHO/100g / CHO in total
Self Raising flour / 200 / 68 / 136
Sugar / 30 / 100 / 30
Butter / 25 / 0 / 0
Semi skimmed milk / 125 / 5 / 6.25
Total CHO / 172.5
Makes 8 large scones
Total per scone / 172.5 ÷ 8 = 21.5g per scone
If make 10 small scones / 172.5 ÷ 10 = 17.2 g per scone
Rub the butter into the flour. Add the sugar then stir in the milk to form a dough. Roll out to 2cm thick and cut into scones. Place on baking tray. Bake at 220ºC for 8-10minutes.
Linda (secretary to the medical team) 01224 550125
Appointments (to change your appointment): 01224 552667
RACH 01224 552734
Dietitians RACH: 01224 552630
Out of hours emergency number: 01224 550380