Can making notes help you master diabetes?

There can be a lot to take on board when learning to live well with type 1 diabetes. Everything from how to use a glucose meter, administer insulin, calculate the carbohydrate content of the cheese scone you’re about to devour, to navigating the health system and understanding the multitude of things that can affect your blood sugar levels such as stress, travel, exercise and the temperature – just to name a few.

It’s not surprising that at times it can feel overwhelming. What if I told you that kicking it old school, breaking out pen and paper and making notes could help minimise this feeling. Ensuring the plethora of information thrown at you sticks! “You’re dreaming mate!” I hear you say. I kid you not.

When wading through vast amounts of information trying to grasp it all, making notes helps reduce the information into manageable and memorable chunks which are more likely to stick. For people living with type 1 diabetes our lives depend on it. I wish I was being dramatic.

When I was first diagnosed with type 1 diabetes, we made notes (okay it was my parents at this stage. I was 14). We could quickly recall the optimum blood sugar we were striving for was between 4-8 mmol/L (72 – 144 mg/dL). What we hadn’t included in our notes, and it would take me years to understand this, was that blood sugar levels out of range didn’t make you a ‘bad diabetic’. These results simply confirm you are a diabetic #weneedacure and provide an opportunity to identify why it had happened. Perhaps I’d just eaten, miscalculated the carb content or insulin required or needed to look closely at my insulin pump or glucose meter for errors and faults.

Did you know on average our attention span ranges from 30 seconds to 6 minutes at the most? Scribbling down notes keeps you involved and therefore increases how long you are actively learning and concentrating on the task or obstacle at hand. And it’s proven that if you are concentrating, you’re more likely to understand.

Taking notes also allows you to pay special attention to the points that are important or difficult to understand. For example when learning about Diabetic Ketoacidosis (DKA), a life threatening complication of diabetes that occurs when your body produces high levels of acids called ketones in the blood, it was crucial I knew and remembered the warning signs and what action to take. Making notes reinforces the information.

DKA Warning signs:

• • Needing to pee more than usual
  • Feeling very thirsty
  • Being sick
  • Tummy pain
  • Breath that smells fruity
  • Deep or fast breathing
  • Feeling very tired or sleepy
  • Confusion
  • Passing out
  • High blood sugar
  • High levels of ketones in blood

Blood testing for ketones and action to take:
**This was the advice given to me by the HVDHB Diabetes Service November 2013. Please refer to your diabetes team to confirm the best way to manage your diabetes and ketones.**

0.6 mmol/L or less – drink plenty of water and recheck blood ketone levels in two hours.
0.6 – 1.5 mmol/L – contact my diabetes teams. (They will normally recommend you take 5-10% of your total daily dose of insulin as an extra dose every 3-4 hours).
1.5 mmol/L or more – contact my diabetes team urgently. (They will normally recommend you take 10-20% of your total daily dose of insulin as an extra dose. Check ketones every hour.)
2 mmol/L or more – get someone to take you to the nearest hospital. If you are feeling unwell this trip should be in an ambulance. Take 20% of your total daily dose of insulin as an extra dose.

There are so many variables when it comes to managing type 1 diabetes and it can be unrealistic to be able to recite every piece of useful T1D information you’ve received since diagnosis. However being able to quickly refer back to notes you’ve made can help you feel calm and confident navigating whatever diabetes throws at you or changes to your routine. It may even save your life! No need to wade through streams of information to find what you are after.
Every time I travel overseas I always refer back to my notes about how to get through airport security when wearing an insulin pump because it’s not something I do every day. (NZMS state there’s no need to disconnect the Animas Vibe insulin pump unless going through a walk through xray. “DO NOT expose to security checkpoint x-rays by putting through conveyor belt x-ray or walk through xray.”)

Next time you find yourself trying to make sense of either a complicated subject or vast amounts of information, I challenge you to make notes. You have nothing to lose and you can’t get it wrong. There is no right way to take notes, simply do what works best for you. Whether you choose to write down key quotes, summarise information including references, mind map or draw pictures to support your findings and confirm your understanding, you’re one step closer to mastering diabetes!