Brain function in Type 1 Diabetics

Wow, it's hard to believe that the last time I composed a blog was in the summer.  Life has been a roller coaster ride and surprisingly, it has very little to do with diabetes hiccups, but more coping with everyday life and trying to keep plodding away at work to pay the bills.  Aren't we all in the same boat, unless you've lucked in on a win fall!

Also, I've taken a bit of a step back from social media.  Facebook to be exact.  It's too time-consuming and it's not real life.  Real-life is what we do outside of these machines that go bing.  Though I have to admit, Instagram is my fav social media hang out, as it has some great Type 1 diabetics who post not just about diabetes, but their lives outside of it.  It's a much happier place, and I guess I've always liked pictures. Of course, I time myself to how much I spend there!

One of my fav Instagram posters is Melissa Allison from Australia.  One of her children has Type 1 diabetes, and we just happened to click with our posts.  Her pictures are breathtaking showing their life in Australia as well.  You can follow her at ShinyBrightSkies .

Last week, she sent me an interesting study from Standford University that was released back in December 2019 on brain function being irregular in children with Type 1 diabetes wondering what I thought of it.

'  The study, published online Dec. 9 in PLOS Medicine, is the first to evaluate what happens in the brains of children with diabetes during a cognitive task. On functional magnetic resonance imaging scans, when their brains were at work, children with diabetes displayed a set of abnormal brain-activity patterns that have been seen in many other disorders, including a cognitive decline in aging, concussion, attention-deficit hyperactivity disorder, and multiple sclerosis. '

It's nothing really new to myself since insulin plays a big role in brain functionality and I've always known that another outcome of long term diabetes is possibility of dementia.   It's the reason why I try to educate folks with diabetes to keep their blood sugars from going too low or too high.  In my mind, our blood sugar when out of whack is like a car battery leaking acid onto metal.  Need I say more?

This wasn't new to Melissa as well, but she felt that this article was good ammunition when dealing with schools if a child was having problems in the classroom.  Showing that blood sugars can play a role in how our brain works.  I'll be passing this article onto a few of my school teacher mates, especially those who already have diabetics in their classroom, to give them a better understanding.

Another segment of the papers had me reread it a few times, and you'll understand why when you read it below :

'   The study found that, although the children with diabetes performed the task as accurately as those in the control group, their brains were behaving differently. In children with diabetes, the default-mode network, which is the brain’s “idle” system, was not shutting off during the task. To compensate for the abnormal activation of the default-mode network, the brain’s executive control networks, responsible for aspects of self-regulation and concentration, were working harder than normal in the children with diabetes.  '

The "idle" system not shutting off during a task really resonates with me, and I wonder is it because we are always having to think about whether or not we are low or high in the blood sugar area subconsciously in the background?  Other diabetics I've spoken to, have said the same thing, that our brains don't really take a rest, we are always thinking.  About the only time we get to go idle is sleeping.  That's if we aren't dealing with low or high blood sugar, whether or not we have the use of a CGM (continuous glucose monitor).  Our brains just do NOT shut down. 

As someone who been diagnosed well over 50 years, I wonder if that one of the reasons I had problems at school, it was a bloody challenge at times.  Of course my fav subject, writing/arts were my favs, but those don't gain your foot in the door all the time for employment!  I managed to grind through, but I wonder if I'd had the devices like we have today, that keep us more in check if perhaps I'd gone further on in education.

I Wanna Be a Pole Dancer

Yes, I do like to joke about taking up this hobby when I retire in some of the places I post at in the social media world for diabetes, I'm looking as this being one way to be able to afford my diabetes gadgets that help me to stay in control when I am no longer working (retirement is fast looming up after 35 years as a 9-5er).

So come into my dream world, and dance away with me ..... 'cause  "I wanna be yours" ...

Three weeks ago, I had a second go with an MRI scan that had been delayed from a previous visit when I found out ... a Dexcom sensor cannot be worn, even if it's not placed anywhere near where the portion of your body is being scanned (my knee has been acting up over the last 3 years).  The problem was the day before I had only placed a new sensor on my upper body, which usually lasts an average of a month.  No insurance coverage for the CGM (and I'm not alone in paying out of pocket) meant I wasn't about to rip it off.  So my file was left open, and viola, 4 weeks later ... I was back without any piece of metal on/in my body (I didn't know tattoos can react to MRI's as well - and I have one). The things you learn, but in reality, these questions should be given to the patient prior to making an appointment, not on the day you arrive.

So, after the 2nd MRI (I twitched alot even though I tried to be still during the 20 minute scan), I went back home to place a new sensor on.  This time, it wasn't going to be on my regular real estate  portion on my body which is either my stomach, upper back, upper thigh or arms.  I had seen a post from JeVonda Flint who was diagnosed with Type 1 diabetes (T1D) 6 years ago.  She places her sensor on her calf, and finds it works well for her there.  So between myself and another T1D here in Canada, I decided I'd give a try.

Yes, I was abit terrified about placing it into what is abit of a muscular portion of my leg (actually I think there's alot of fat, if I was a chicken or a turkey, I'd feed a family of 4 easily).  The good thing, I felt nothing when inserting it.  If any of you have seen the introducer needle for the Dexcom sensor, it looks abit scary.  I felt nothing at all, and even thought to myself, "did I do it properly - did it go in?".

Two hours later, calibration done (you have to take 2 blood tests to get the CGM going) ... I was all set to see if the sensor would work as well, and as long on my body as the other sites do that I place it in.

Sadly, it didn't ... by Day 3,  I was seeing gaps on the trend line or 1/2 hour here and there, along with a few other warnings (e.g. having to restart sensor due to sensor failed warnings - and I tried twice that day to restart).   I realised it wasn't worth continuing to try to keep it on.

The only three factors that I can come up with:

1. When coming back from a walk as well that day, had my boot cuff (yes, it was still cool here in Canada 3 weeks ago), did I perhaps rub on the sensor too much since it's advised not to have anything bump up against it).
2. The sensor was expired and this time my luck ran out?  The majority of the time 2 out of 3 sensors I use are expired and work fine  (I can only afford to buy new sensors a few times a year due to cost, once in a blue moon I get a lovely package of expired sensors from American diabetics who do have insurance coverage).
3. Is my receiver starting to maybe go (I haven't had any warnings yet that should say it's on going to stop).  It's getting close to being 2 years, again, the receiver was gifted to me, and I really have no idea of how much it was used prior to my receiving it.  I have already replaced the transmitter portion that is inserted into the sensor, and so far, it's gone past the 6 months time frame. So eventually, this will go as well and I'll have to buy a new one.

I'm now approaching into my 3rd week without a sensor, and in the beginning I did miss it, but one thing I didn't was how it affects my sleep at night with alarming (combine that with menopause hot flashes, etc. I don't sleep like a cute little kitty).  The same goes with my insulin pump as well, that I'm still not reattached to since the end of January when I went on my holidays to Cuba.

The one thing with not having the sensor on,  I'm not constantly obsessing about the trend of my blood sugars during this period, and from others I have spoken to who wear this device, they can be checking it alot compared to my once in an hour check up.  Along with comparing it against my blood meter (and with the calf placement I was doing check up alot due to how it was not as close to the real thing from the blood meter).  I'm very fortunate that I can still detect when I'm going low (though I think wearing the CGM has made me abit lazy since I woke up to a few in the 2 mmol/l range ... which I never used to do).  Also, I know for some die hard CGMS wearers,  it can be dangerous due to their not having hypoglycemic unawareness!

So, yes, I will be placing a sensor on again, probably next week, and I will probably not be placing it back on my calf again due to the results I had with first placement.  I'll stick to my usual spots, and know that I will hopefully get my 3-4 weeks out of the sensor.  Maybe if I had coverage, I'd be different with not being so anal about keeping the sensor in place, but when you're not quite a pro a pole dancing, well, a cat girls gotta do what a girls gotta do.

Oh, and the outcome of the MRI, despite my twitching knee during the whole process?  I had been trying for past 3 years in Quebec with no success of seeing a specialist (I tried but kept on being told to call back in 6 months and there might be an opening) and  GP who looked at my MRI in the beginning, said it was my age and  arthritis.   Finally, I've been diagnosed by an orthopaedic surgeon  -  with a torn meniscus  - and am now on waiting list for surgery - whoo! whoo!.  It'll be nice to have a knee that doesn't go wonky on me - but at least I finally got to see someone who knows their stuff (and they're interested in what I do within the DOC as well)!