There are a few dates in the calendar diabetics round the world ear-mark in the diary with a big red circle surrounding them. These are the dates when the (rather ominous sounding) ‘nine tests’ are carried in order to make sure we can still earn our tax money and don't need carting off to the nackers yard, just yet. These include blood pressure, smoking status, a marker for blood glucose called HbA1c, urinary albuminm serum creatinine, cholesterol, eyes, feet and my personal favourite, weight. The latter usually being pre-empted by a twitchy Anna standing on the scales professing that, 'I just joined a gym and have already lost a couple of pounds.' I am lying, most of the time.
You've no doubt seen these nine tests mentioned in the media recently because figures from the National Diabetes Audit discovered that just over half of all Type 2s and a third of all type 1s are not receiving the full range of tests, meaning people with complications, or at serious risk of them, are falling through the cracks. In the NHS? Surely not.
I am glad to say that I am one of the two thirds of type 1s who do make the effort to get all nine done. But I should probably mention that I also have my consultant on speed dial (he just loves this, I can tell), my nurse on email and have inadvertently added my dietician to my broader social circle, through what can only be described as proof of the existence of the 6 degrees of separation.
But still, it does take effort to get them all done and relies on GPs, consultants and now, ourselves to be paying attention. Until 3 months ago, I didn't even know these were a benchmark for basic care. I just did it year-in, year-out, regardless.
It's part of the deal if you want to stick around.
Well last week was my annual occular lap-dance, when someone shines a light into your eye at a distance which would be considered sexual harassment in any other situation, so they can see into your eyes and check that everything is still as it should be. These had at one point in my life increased to every 3 months, because although my diabetes team did it subtly, due to many years of increased blood glucose (BG) levels my eyes were already beginning to show signs of damage, and I had to be transferred to a specialist lap-dancer who would assess whether or not to laser them.
I always go into these with a level of nervousness now. Although kidney-explosion (they don’t actually explode, that was for when (if) they ever make the film of this post…) is my biggest diabetes fear (if my absurd reaction to 30-second HBa1c test is anything to go by, I will need to be fully sedated for dialysis), a close second is going blind. As much as I want a dog, currently forbidden by my husband and cats, it's an extreme way to get there. Sneaking one in during the night and looking after my eyes is a much better way to go.
Holding my breath (partly due to nerves, partly because I can't remember if I ate garlic last night and the doc is now 1.5 inches from my face), I wait for the results. I search for a clue on his face at every opportunity, convincing myself that each tiny move is a secret 'Well, we kept it at bay but I better tell her,' being spoken through the medium of body language.
Well I am pleased to say that thanks to my leap into the pumping world, finally joining the gym (for real, not just because my annual chubb check) my acceptance that Simvastatin (now Atorvastatin – more on that to follow) and low-carb lifestyle, I am still managing to keep problems at bay. I have got evidence of the death of some blood vessels, but the real risk is when smaller, weaker blood vessels try to grow back in their place. These break, bleed and eventually need to be corrected by laser (not the kind on the TV adverts). This procedure can often leave you without peripheral vision, and your driving license.
For me however, things are still looking good (sorry about the pun). I can rest assured that if I continue to keep going as I am, I won’t be another statistic.
Are you getting the full nine tests?