Diabetic necessities: From top clockwise: Novopen, used to administer insulin injections. Cartridges of insulin that are injected using the pen. The machine used to check blood sugar levels. Test strips that are inserted into machine that checks blood sugar levels.
You might have an idea of what Diabetes is, you might not. For those of you that don’t know, let me explain: put simply, Diabetes (or Diabetes Mellitus to use its official name) is a metabolic disorder in which a person cannot properly process the sugars (carbohydrates), our bodies need to give us energy to do things. This is due to a lack of a hormone (a protein that controls bodily functions) called insulin. Insulin allows sugars to travel from the blood after digestion and into the cells thus providing us with the energy we need to undertake our regular everyday activities. Diabetics have to inject artificially produced insulin to control their blood sugars, and the amount of insulin we inject depends on what we eat. It can be challenging to work out how much insulin to inject if you don’t know the carb value of a food – inject too much and your blood sugar will drop too low leading to hypoglycaemia, a ‘hypo’, inject too little and your blood sugar goes high (hyperglycaemia) which can make you really grumpy and is generally bad for your health. You can treat a hypo by eating something sugary (usually jelly babies!) and you treat high blood sugar by injecting more insulin. Monitoring your blood sugar takes time and effort. You can see why as a geoscientist, particularly one who does a lot of activity in the field, such as digging up fossils, this might be a concern. In this blog post we (Drs Susan Beardmore and David Legg) discuss having diabetes and managing this in our lives as geoscientists.
Dr. Susan Beardmore (National Museums Scotland)
I was diagnosed as a Type 1 diabetic in 1988. I spent 10 days in hospital over Christmas, which as an 8-year-old I didn’t mind too much as it meant I got extra presents! I have achieved so much since this diagnosis – an undergraduate degree, Master and Ph.D level qualifications, and a career in museums – in spite of the difficulties managing what can sometimes feel like a second job (my diabetes). I have never let my ‘condition' stop me from doing what I want with an attitude quite the opposite, of taking on some fairly extreme activities regardless. One such extreme is my palaeontological fieldwork in the Grand Staircase-Escalante National Monument of southern Utah.
I had already done the hard part: the 11-hour, trans-Atlantic flight, with the hit and miss airplane food that left my blood sugars high if the mashed potato was real, or hypoglycaemic if it turned out to be inedible after I had done my insulin. I recovered in Salt Lake City, Utah, over the two days it took for the staff and grad students to finally finish packing, by which time my body had shifted time zone.
Next was a six-hour drive heading south across Utah, through scenic fault-bounded valleys lined with high, glacially-eroded mountain peaks. The last hour was a painful crawl along a bumpy dirt road and we were all relieved to finally stop. We were at the remote Horse Mountain Camp, on a ridge top with flat ground among trees ideal for a camp and a steep cliff to one side with stunning views across the wide, desert valley. At that moment, the oranges and yellows of a sunset were streaming across the sky.
It was great being back in the camp where I had stayed for several weeks the two years previously. In near dark I grabbed a torch and began searching for the best spot to pitch my tent, in competition with the 6-8 other participants. Suitably located and my belongings piled in, I grabbed the roll of toilet paper for my rucksack and a stash of biscuits in case I needed food overnight – I never fancied going into the kitchen tent in the dark as it quickly became home to pack rats and mice with a habit of launching themselves at you. The only difference to my routine was packing my insulin and injection pens in a waterproof, snap top container and placing it in the cooler stacked with ice blocks and perishable groceries. Insulin needs to be kept cool, otherwise it will denature and stop working, and asking for the container to be kept off the ice, so it didn’t get too cold, was the only time I ever really drew attention to the fact I was diabetic. It was difficult to get out of camp if we needed any supplies of food or equipment, let alone to find anything medical; non-working insulin would not be ideal.
Considering where we were, meals were always good and enough to sustain the physical aspect of the work. We had a barbecue grill used to cook a decent breakfast of pancakes (I avoided the jam or syrup toppings), egg sandwiches or quesadillas with the extras packed for an equally substantial lunch with cookies and fruit while they lasted. For a type 1 diabetic it was a little unpredictable and there were inevitable high glucose readings, although use of corrections (the extra few units of insulin to bring levels down) was complicated by the physically demanding work we undertook each day. If I took too much extra I went hypoglycaemic while I was hiking the long, uneven routes to quarries, which tended to happen anyway.
Over my several years volunteering in the field camps I learnt to actually drop my background Levemir and fast-acting Novorapid insulin doses, by a lot – I would burn off most of the carbohydrates I ate. (N.B. Every diabetic is different; this is what works for me, but you should always check with your diabetic nurse before making any changes to your insulin routine!) Things like carrying the heavy tools to excavate bones from rock and at least 3 litres of water in my rucksack each day, picking and shovelling dirt in quarries or just a full day of wandering round looking for new sites. On some days we would need to carry out extra water and bags of plaster to jacket what we were finding, the walk home on these days meant heavier-still backpacks as we brought the finished work back to camp. At the end of the day we would have a bigger meal of rice, chips or pasta as a side to some form of meat cooked on the grill.
Images from top left clockwise:
On the steep path to fossils
"Kaiparowits Standoff" a reconstruction of the Kaiparowits Formation by Batavotyrannus on Deviantart
Exposed bones and plaster jackets in a small dinosaur quarry
Shovelling dirt to get down to the bone layer – one of the strenuous daily activities
Getting ready for a jacket ‘pull’ from quarry to vehicle
The hills were steep and several long, which wasn’t too bad going down. Up at the end of the day was another matter!
I also had to carry at least my Novorapid insulin with me and finding somewhere cool and that stayed cool was difficult. I brought various cool bags, adding a small bottle of water left in the cooler overnight and, ironically, a Hershey’s chocolate bar that I used as a measure of how hot the cool bag was getting – if the bar melted my insulin was getting warm. The chocolate bar was also a nice end of trip treat, when all other luxury items (fizzy drinks, donuts and fruit snacks) were long gone.
Each year, I left the field, Salt Lake City and America knowing I had achieved something extreme and incredible in terms of my palaeontology career, my diabetes just being something I needed to be aware of and dealt with at the time.
Dr. David Legg (University of Manchester)
As long as I can remember I have wanted to be a palaeontologist, and nothing was going to stop me. My mum informs me that as far back as 1992 I told her “one day I’m going to work in the Natural History Museum (in London)”. Flash forward many years and I would eventually be doing my PhD there, and I still make lots of return visits to see friends (and the amazing fossils of course).
Like Sue, I was diagnosed with diabetes at a very young. I was just 2 months shy of turning ten when I was admitted to the John Apply ward of the Royal United Hospital in Bath, back in February 1995. Diabetes management was a lot different back then and the treatment was a bit different from today. For starters we were generally advised to eat to match our insulin, rather than injecting for what we ate. This was because the insulin was a mix of long and short acting and therefore injected just once or twice a day. With this regime exercise often took a lot more planning and a day long activity, such a digging up fossils, would usually be out of the question without a lot of extra carbohydrates.
I will confess that as a teenager I often neglected my health, which ultimately led to prolonged periods of high blood sugar and a very bad mood. Anyone with diabetes will tell you that one of the last things you want to do with high blood sugar is to be active (as contradictory as that might sound). I did an A level in Geology, and hated fieldwork. Mostly because of the bad blood sugar control. However, I still had my heart on being a palaeontologist and thought… “well, if digging up the fossils is too much hassle then maybe I’ll just look at the ones already in the museum”. This changed when I started my undergraduate degree.
In 2005 I started studying “Palaeobiology and Evolution” at the University of Portsmouth and had never felt more motivated in my life. I started to realise that if I wanted to keep going as a palaeontologist I would have to start taking my health a lot more seriously. My attitude towards fieldwork began to change and I started to love the idea of going to new places and especially eating new things. By this time, I was on a different insulin regime – injecting long acting insulin at night and topping up with short acting when I ate – and this gave me so much more freedom to travel, and to eat. My energy levels were finally increasing. In fact, by the end of my undergraduate I was heading to the Isle of Wight most weekends and walking over 10 km along the beach and back to collect samples for my undergraduate dissertation. I used to love the feeling of being outdoors and especially the thrill of finding a new lobster fossil (the focus of my dissertation).
Images from top left clockwise:
Searching for fossils in China (Image curtesy of John Patterson, 2017)
David and his colleagues sit on type section of the Chenjiang Formation, China (Image curtesy of John Patterson, 2017)
A reconstruction of Sanctacaris (meaning, Santa's shrimp), a 505 million year old ancestor of modern arachnids
A meal served during one of David's visits to China - how do you count the carbs for that?!
David eating scorpions on the same trip
David with the fossil of Sanctacaris
Nowadays I rarely get out in the field. At least not every weekend like when I was an undergraduate. Instead, about once a year I go to China. For a long time, I had wanted to go to China. Some of the fossils coming from there are indescribable… in fact the stuff I work on is over half a billion years old and we literally have no idea what kind of animals they were! I was first invited out there in 2016 and have been invited back many times since. The weather is usually very hot, and this can cause blood sugar levels to fluctuate quite a bit. I make sure to test my blood sugar levels very regularly, both because of the weather and because it is often unclear how many carbohydrates are in the food (not to put anyone off going to China, the regular food is amazing and nothing too scary, but at one meal we got to eat bees! My carbs and cals app – which I use to work out carbohydrate levels -unsurprisingly doesn’t have an entry for that!). I took dextrose and other sweets with me everywhere just in case I over injected, and regularly took correction doses of insulin. With a lot of patience and vigilance I rarely, if ever, had any problems with blood sugar regulation. Also, because I was staying in hotels I rarely had to go to the lengths Sue did to keep her insulin cold.
Now it may seem that Sue and I have got things sorted when it comes to our diabetes, but as every diabetic knows – sometimes things just go wrong. I still have days when I struggle to get things under control and have personally found it best to let those around me know when my blood sugars are not on the level. This is even useful in non-fieldwork situations as I know I tend to have mood swings when my blood sugar is high, and I’ve found people are a lot more forgiving if they know it is just the chocolate bar talking! Not that I have ever needed intervention on fieldwork, but I know I feel safer if someone else knows I have diabetes, and what to do if the extreme ever happens. I understand a lot of people don’t like to acknowledge their diabetes too much around other people as they worry people will treat them differently. I have honestly never found this to be the case, although I did worry a lot about this when I was younger. In fact, many people have even forgotten I have diabetes until they see me inject. I think as long as an effort is made to keep our blood sugars controlled then there is nothing we can’t do, and I only wish I had tried harder when I was younger so I could have had a better time during those early fieldwork attempts.
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