7.1 and rising!

Hmmm, despite my optimism of a couple of weeks ago, my blood sugar readings are creeping up again. I test once a day, varying the time of day I take a reading, and my average is now up to 7.1, which I'm pretty sure will be enough to convince the hospital I should be taking insulin. I have been drinking more beer than I should lately, which probably hasn't helped, but I've also been doing a fair bit of cycling and swimming, so I suspect that the capability of my pancreas has also taken a bit of a dive.

The beer thing is my one real weakness - I had no trouble giving up cakes, biscuits etc, but find it almost impossible not to have a pint if I'm in a pub! Clearly my binge drinking days are over, but even if I'm out for just a couple of pints a few nights in succession, I can expect the blood sugar levels to start rising. I have until 20th September to get my blood sugar levels down again so will try to cut down as much as possible on the ale, though it's unlikely that I'll cut it out altogether. Crap, I know, but true.

I know that I'll have to inject insulin at some point, and I know that plenty of people do so everyday and just get on with it, including several people I know. I also know that it isn't painful. All the same, I feel apprehensive about what it will mean to have to inject regularly, to carry insulin with me at all times, and to live with the risk of hypos. So far, to be honest, diabetes has not impacted too heavily on my life - apart from making me change my eating and drinking habits, which is no bad thing, so going on to insulin will be the first really major change for me as a diabetic.

Anyway, 20 days to go til my appointment - let's see what happens.

Trouble Brewing

This plaque, in Park Street, near Borough market, commemorates an incident in 1850 when a group of brewery workers set upon General Haynau, the 'Butcher of Austria', who was notorious at the time for the brutality with which he had put down rebellions in Hungary and Italy.

'The Hyena of Brescia', as the General was known, was visiting Barclay and Perkins, which was then London's largest brewery, when the workers recognised his name in the visitors' book and attacked him with brooms and stones. They chased him down to the George Tavern on Borough High Street, where the police had to rescue him by ferrying him across the river by boat.

Despite an outraged reaction from the Austrian Embassy, the Foreign Secretary Lord Palmerston rather impressively sided with the brewery men, saying they were just 'expressing their feelings at what they considered inhuman conduct' by a man who 'was looked upon as a great moral criminal'. Although Queen Victoria eventually intervened and a conciliatory letter was sent, the Austrians still snubbed the Duke of Wellington's funeral in protest. The draymen had the support of the public though, with a number of folk ballads appearing in their honour. One of these included the line "Make his back and sides to swell, till he roars aloud with dreadful yell, the fellow that flogged the women" (in Brescia, Haynau had ordered his troops to strip and flog women suspected of espionage).

There was also international support for the workers - on a trip to England in 1864, for example, the Italian revolutionary Giusseppe Garibaldi made a point of visiting the brewery to thank 'the men who flogged Haynau'.

How times have changed, eh? It's a shame that there wasn't a similar incident during Pinochet's recent sojourn in Britain. What would have been the chances of a plaque being erected to that?

Paperclip stuck in my heart...

This is me with punk rock legend Patrik Fitzgerald at the 12 Bar Club last night. It was his first London gig in 9 years, as he's been living in semi-retirement in New Zealand, but was lured back to Britain by a resurgence of interest in his songs.

He was a real DIY music pioneer. Some of his early records were recorded in his bedroom in East London, and it was pretty inspiring to hear him on the radio in my bedroom in Suffolk during my formative years. My friend David and I wrote to him in 1979 to ask for the words and chords to his song 'Ragged Generation For Real', and were totally thrilled to receive a handwritten reply from him (which David still has to this day).

It was great to finally meet him, and to interview him for the radio. The gig was brilliant - he played most of the well known old stuff - 'Trendy', 'Irrelevant Battles', 'The Bingo Crowd', 'Safety Pin Stuck In My Heart', - as well as some cool new stuff. Hopefully he'll be back in the UK again sometime next year.

Greetings from the Islets of Langahans - a beginner's guide to LADA

Most people are aware of two types of diabetes, conveniently named Type 1 and Type 2. Type 1's are typically thought of as people who are insulin dependent and Type 2's as non-insulin dependent. Type 1's develop the illness in childhood while Type 2's develop it in later life and are often overweight. This is all true up to a point, but the difference between the two is better defined as Type 1 being insulin deficient and Type 2 being insulin resistant. That is to say that in Type 1 the pancreas doesn't produce enough insulin to control blood sugar levels and in Type 2 the insulin is produced but something stops it getting to where it needs to go in order to control the blood sugar. That's why people with Type 1 need to take insulin but people with Type 2 often control their diabetes with medication which helps their own insulin perform better.

Still with me? Good. So, which type am I? Well, because Type 1 normally appears in childhood, people who develop symptoms in their adult years tend to get automatically classified as Type 2 and put on to medication such as metformin. In my case, the doctors were, like me, a little puzzled as to why I had developed diabetes - I didn't exactly fit the Type 2 profile. I cycle every day, swim a couple of times a week and don't eat any meat. I'm not overweight (one doctor even described me as 'lean', which I was rather sadly quite proud of!) and although several members of my family are Type 2, they didn't develop it until they were in their sixties. Anyway, the doctors decided to give me a chance to see if I could control my blood sugar by changing my diet, cutting out all the sweet stuff basically, and that seemed to do the trick. In the meantime a lipid clinic doctor decided to screen me for something called GAD antibodies and bingo, it turned out I was positive.

My somewhat rudimentary understanding of what this means is that GAD antibodies are nasty little bastards which fool the immune sytem into attacking the beta cells that produce insulin in a part of the pancreas called the Islets of Langahans (beautiful name - sounds like there should be a whisky distillery there). This is what happens to us LADA's - typically after the age of 40 (I was a month shy of my 41st birthday when I got diagnosed). Nobody knows why this happens or whether it's genetic or not. In fact it's only fairly recently been recognised as a discrete type of diabetes. Anyway, although developing diabetes in adulthood ticks the Type 2 box, I'm more of a Type 1 because I'm not producing as much insulin as I should - my last test measured it at about 15% of that of a healthy pancreas. However, I don't quite fit the Type 1 profile because on this 15% I'm still just about able to control my blood sugar without injecting insulin - so I'm insulin deficient but not insulin dependent...yet.

So that's how LADA's are different - we're about 10% of the total diabetic population apparently. Like most people in the same boat, the main questions I would like answered are 'why did I develop diabetes?' and 'how long can I carry on without injecting insulin?' So far, no-one's been able to give me a decent answer to either of these. It seems likely that LADA is genetic but there may well be other factors at work. On my last visit to the diabetes unit at Guy's Hospital, the doctor wanted to put me onto insulin because my average blood sugar level had crept up to about 7.5 (the ideal is around 6). I persuaded him to give me a stay of execution to see if I could get it back down again and he gave me two months - one month later and I'm averaging 6.1. If I'm lucky I'll be able to maintain this for a while, perhaps even years, but it seems likely that at some point I'll need to inject insulin. For the moment though, cycling rather than injecting is my most effective form of control. 30 minutes on my bike can make an impressive difference, so as long as my knees don't give up on me I shall continue to brave the elements, London's lethal bendy buses and the risk of saddle sores in pursuit of a perfect blood sugar level.

Hello...

So I'm a 42 year old lecturer who does a bit of radio and plays in a couple of bands. I own three knackered organs: two of these are Roland VK-09's with dodgy drawbars and outputs, the other is my pancreas.

Last April I was diagnosed with Latent Auto-immune Diabetes in Adults (LADA!) and since than I have been managing to control my blood sugar with diet and exercise. It was quite a shock when I first found out, and I had loads of questions. I discovered that several people I know had diabetes, and it was really useful to compare notes and get reassurance from them. I still don't know any fellow LADA's though, so thought that by blogging I could record my progress for anyone else who's new to the old blood sugar control lark, as well as adding to the never ending mountain of trivial dross occupying the interweb by writing about some of the rest of the stuff that happens in my ker-razy world.

Funnily enough, I did once own a LADA car. It was bloody amazing, built like a tank, steered like a boat and had the most amazing heater but the carburettor went after 6 months and that was that but it only cost £100 so you can't complain really can you?