Northerner
Admin (Retired)
- Relationship to Diabetes
- Type 1
This is a relatively short book of 114 pages, and as such I expected to provide a concise and useful guide to the salient facts of (as the title suggests) living with Type 1 diabetes. As part of the Sheldon Press series of ‘Overcoming Common Problems’ books, of which I have read several, I looked forward to a well-written and clear account of Type 1 diabetes that would inform without overwhelming – as has been my general reaction to previous books.
It is now nearly three years since I was diagnosed with Type 1, and in that time I have learned a great deal about the subject, both personally and from many hundreds of accounts of fellow sufferers. As such, I tried to read this book from the point of view of someone newly-diagnosed, whilst at the same time looking for any points that may have eluded me and may prove beneficial to managing my diabetes well. However, having commenced reading in a positive frame of mind, I quickly found myself alarmed at some of the statements being made, that immediately made me question whether this would indeed be a suitable recommendation for newly-diagnosed patients or carers.
The book begins with a short introduction and history of diabetes, followed by a number of case histories which illustrate the diversity of reasons why a person might develop diabetes, both in childhood and adulthood, and a brief but not very edifying explanation of how terminology has changed over the years to describe the different types. We then move on to a chapter about the effects of uncontrolled diabetes, resulting in hyper- or hypoglycaemia, a description of ketoacidosis, and the effects and possible consequences of hypos or hypers, such as diabetic coma. It is here in particular that I began to lose faith a little in the book, as despite acknowledging that insulin dose requirements vary considerably and are very personal to each patient, Dr Smith then recommends injecting 4 units of insulin an hour to overcome a high blood sugar level. For many, this may be far too much, and for others too little, so why give a number? Next, Dr Smith states that a hypo (low blood sugar) is when the blood glucose measurement falls below 3 mmol/l, which is in fact dangerously low – the correct figure is 4 mmol/l. This error is repeated later in the book.
Moving on, the chapters on eating and on different insulin regimes fail to mention the prevalent method of good diabetes management used today, by matching doses of fast-acting insulin to the amount of carbohydrate consumed, known as ‘carb-counting’. Instead, the impression is that doses are relatively fixed and meals must be eaten to match – the precise opposite of current practice. I began to question whether the book was a poorly updated edition of a former work, but it was written in 2009, published 2010. This feeling was compounded by the discussion of the use of insulin syringes with only a short paragraph allocated to pens which are surely the dominant tool used to deliver insulin now, and for several years.
Oh dear! In the passage about testing of blood glucose levels, Dr Smith says that a Type 1 diabetic should test at least once a day – again, best practice (especially with a basal/bolus regime – a phrase never even mentioned, b the way) is to test a minimum of four times a day, and often this will be many more times depending on circumstances.
I am afraid I couldn’t recommend this book to anyone wishing to learn more about Type 1 diabetes and its management. I found a lot of its messages either confusing, incorrect or potentially dangerous. I’m sorry Dr Smith, but I feel you need to spend some time bringing your knowledge up to date so it is more in line with what today’s Type 1 diabetic can expect. For a much better book about living with Type 1, go for Ragnar Hanas' Type 1 Diabetes in Children, Adolescents and Young Adults
Living with Type 1 Diabetes
It is now nearly three years since I was diagnosed with Type 1, and in that time I have learned a great deal about the subject, both personally and from many hundreds of accounts of fellow sufferers. As such, I tried to read this book from the point of view of someone newly-diagnosed, whilst at the same time looking for any points that may have eluded me and may prove beneficial to managing my diabetes well. However, having commenced reading in a positive frame of mind, I quickly found myself alarmed at some of the statements being made, that immediately made me question whether this would indeed be a suitable recommendation for newly-diagnosed patients or carers.
The book begins with a short introduction and history of diabetes, followed by a number of case histories which illustrate the diversity of reasons why a person might develop diabetes, both in childhood and adulthood, and a brief but not very edifying explanation of how terminology has changed over the years to describe the different types. We then move on to a chapter about the effects of uncontrolled diabetes, resulting in hyper- or hypoglycaemia, a description of ketoacidosis, and the effects and possible consequences of hypos or hypers, such as diabetic coma. It is here in particular that I began to lose faith a little in the book, as despite acknowledging that insulin dose requirements vary considerably and are very personal to each patient, Dr Smith then recommends injecting 4 units of insulin an hour to overcome a high blood sugar level. For many, this may be far too much, and for others too little, so why give a number? Next, Dr Smith states that a hypo (low blood sugar) is when the blood glucose measurement falls below 3 mmol/l, which is in fact dangerously low – the correct figure is 4 mmol/l. This error is repeated later in the book.
Moving on, the chapters on eating and on different insulin regimes fail to mention the prevalent method of good diabetes management used today, by matching doses of fast-acting insulin to the amount of carbohydrate consumed, known as ‘carb-counting’. Instead, the impression is that doses are relatively fixed and meals must be eaten to match – the precise opposite of current practice. I began to question whether the book was a poorly updated edition of a former work, but it was written in 2009, published 2010. This feeling was compounded by the discussion of the use of insulin syringes with only a short paragraph allocated to pens which are surely the dominant tool used to deliver insulin now, and for several years.
Oh dear! In the passage about testing of blood glucose levels, Dr Smith says that a Type 1 diabetic should test at least once a day – again, best practice (especially with a basal/bolus regime – a phrase never even mentioned, b the way) is to test a minimum of four times a day, and often this will be many more times depending on circumstances.
I am afraid I couldn’t recommend this book to anyone wishing to learn more about Type 1 diabetes and its management. I found a lot of its messages either confusing, incorrect or potentially dangerous. I’m sorry Dr Smith, but I feel you need to spend some time bringing your knowledge up to date so it is more in line with what today’s Type 1 diabetic can expect. For a much better book about living with Type 1, go for Ragnar Hanas' Type 1 Diabetes in Children, Adolescents and Young Adults
Living with Type 1 Diabetes
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