Arguments for getting a diabetic tattoo

After many weeks of deciding what do I have just received my Medic Alert bracelet, from www.theidbandco.com.  It arrived a day too late for my big bike ride last week so just to be safe I drew myself a sharpie tattoo. Thankfully I didn't need it and hopefully I will never need my Medic Alert, but if I did maybe it would be better to have something more permanent.

Why a tattoo? It will always be there just like my diabetes.  I will never be able to take it off or lose it.  If anything were to happen to me and I did not have my Medic Alert bracelet on then this could save my life.

Why not wear your Medic Alert all the time? Honestly I don't like it that much.  I have been Diabetic for 8 years and never even come close to needing something like that.  My arrogance could get the better of me and though I will always wear it while riding my bike (Assuming I remember to put it on at 5am when I get out of bed for training) I most probably won't be wearing it the rest of the time.  With a tattoo I wouldn't have that issue.

here are some examples

I am not really a tattoo person.  I like them on other people, I have even thought I might get one.  But I could never really get my head around the permanence of it.  I grew up religious, tattoos are not allowed in Jewish law, so there has always been that feeling in the back of my head that its just not something I should do. I have also felt that I do not need any more marks on my body.  I have many scars primarily from pouring boiling coffee on myself when I was two and walking through a plate glass window when I was 30.

Lets say that the order of importance of issues for getting a Tattoo are:

1. Religious objection
2. The permanence 
3. What to get

1. I have two answers to this.  Firstly I am far from observant, I have not been for many years.  Secondly I wonder if there is an argument here for Pikuach Nefesh (saving life).  I have discussed this topic before in relation to Yom Kippur.  The holiest day in the Jewish calendar where many Jews will fast for 25 hours to repent for their sins over the past year.  I am not allowed.  It is considered too dangerous for my health so I must eat and take insulin normally.  Many other laws are allowed to be broken not just for the possibility of saving someones life, but also to protect their health.  ie the issue does not necessarily have to be life threatening.  So here we have a very good argument against any Jewish objection to getting a Diabetes related tattoo.

Additionally you may have thought living in a Jewish country that there would not but such opportunity for getting a tattoo.  This is certainly not the case.  I feel that there are more tattoos here than I saw in the UK.  This could be because Israelis like to be "Davka" (doing something just because its the opposite of what they are supposed to).  Alternatively it's so warm here and so cold in the UK that there is just more skin on show so I am more likely to see them here.

2. This is much less of an issue with a diabetes tattoo.  My diabetes is permanent so is a tattoo, it almost makes sense that I SHOULD get one because of this.

3. Not a problem, a Medic Alert symbol with Type 1 Diabetes written over or under it.

Well I certainly have convinced myself.  Will let you know if and when I do it.

What do you think?

Meeting my medical professionals

Today I had my meeting with a nurse, dietitian and a Doctor, all of whom specialize in diabetic treatment.  Because of my change in regime due to my training I came armed with a bunch of questions as well as the past week and a half of documented sugars levels, insulin and food intake.  I see the same people every 3-6 months and have a blood test a couple of weeks before I go.  The blood test is Hba1c and once a year I have a full panel to check my kidney function, cholesterol and a few other things.  The most recent Hba1c result was 7.4% up from 7.0% the previous test 6 months earlier.  I was a little disappointed.  With my change in regime I was really hoping for an improvement in my result.  Sadly no, I have got my weight down from 91Kg to 87Kg (fully clothed).  I am happy about that but I really want to get down towards 80Kg.  I am sure that will come with time.

Both the appointments with the Dietitian and Doctor were productive.  I have an additional appointment with the dietitian and someone who can advise me on sport in a couple of weeks.  I hope that will be useful too.  I had a number of questions that I needed answering plus we talked about how my training was affecting my blood sugar.  The most interesting thing was that I have been making a mistake with my long term insulin.  I have been told to keep that constant and only vary the amount I eat and the amount of short term insulin that I take before and after exercise.  Additionally we calculated that I should be eating about half what I eat every hour.  I eat about 30g of carbs in energy gels and bars, I need to try to eat 15g on every hour.  I should also eat some slow burn carbs before I ride and take a small amount of short term insulin.

Hopefully my next meeting I will learn more about the food and insulin intake that I need to do long rides without hitting the wall and without having hypos during and then having huge swings after.

I had some questions prepared for the appointments, I have listed the ones that I have already discussed above with the answers I was given:

I have hard bumps around my injection sites, they are more noticeable to the touch not that I have lost some weight.  Is it hard insulin, and can it be released slowly into my system.  Will they ever go away?

A: It is not hard insulin.  I didn't fully understand (a consequence of us both speaking to each other in our second language) but I believe what she told me was that it is fibrous tissue that forms at the injection site as a reaction to too many injections in the same place over too short period.  They do not go away. (sadly as I am losing weight they are becoming more noticeable)


Can I get a Continuous Blood Glucose monitor?

A: No currently I am not eligible on my current Kupat Cholim (health plan) - Maccabi Gold.  I am not at risk enough and they are very expensive.  I am free to buy them at my own cost but they are very expensive.  Dexcom Medtronic Abbot.

Should I eat late in the ride to stop excessive glycogen breakdown?

A: I should eat throughout the ride to try to keep constant levels of blood glucose and avoid large swings in either direction.

Where can I get a medic alert bracelet?

A: The Israel association of diabetes has information about them on their website.

If I have a chocolate chip cookie that weights 45g total (it is home made so I know its flour, sugar, butter and chocolate) how much insulin do I need to take for it?

A: About 50% carbohydrate to 20 to 22.5g when estimating how much sugar to take.  Bear in mind that the chocolate and butter are fats which slows the uptake of sugar.  This makes such a food item less suitable for recovering from hypos

Why is my Hba1c so high?

A: Not sure, possibly from the high swings after riding.