Lindy: Type 1 Diabetes
VisAbility client Lindy was 22 years old and studying medicine when she received her diagnosis of Type 1 Diabetes.
“Diabetes Type 1 is where the body develops an autoimmune response that attacks the insulin-producing cells in the pancreas, which means my body can’t make insulin,” explains Lindy.
How does Type 1 Diabetes cause blindness?
Diabetics can develop an eye condition called Diabetic Retinopathy, which affects the blood vessels in the retina. Each person can be affected differently.
After 20 years of managing her diabetes, Lindy’s eye health rapidly deteriorated over an 18-month period. She first developed cataracts, followed by Rubeosis Iridis complicated by minor diabetic retinopathy. Bleeding in her irises and increased pressure within the eye impaired her vision and caused glaucoma. This led to persistent scarring of her irises and blocked pupils, which could not be remedied with surgery or laser therapy.
In 2000, Lindy started coming to VisAbility, then the Association for the Blind of WA, to adapt to her rapid vision loss. By 2001, Lindy was completely blind due to diabetes.
Jenny: Type 2 Diabetes
As a child, Jenny had just 5% vision. She has been totally blind since the age of 18 due to glaucoma. In 2005, Jenny was diagnosed with Type 2 Diabetes.
Can vision impairment cause Type 2 Diabetes?
While vision impairment can’t cause diabetes, it does make it challenging to maintain a healthy lifestyle. When you’re vision impaired, you can’t see obstacles in your way – which makes it very difficult to exercise or move at a fast pace. You can’t just join a local sports team (until very recently) or venture out for a bushwalk. Exercising independently can be risky and even lead to serious injury, which is one reason why people who are blind or vision-impaired can become isolated at home.
When you can’t see, it can also be difficult and dangerous to cook. While the variety of healthy pre-made meals has increased in recent years, pre-made meals and fast food can contain high amounts of fats, sugar, and salt. When you’re unable to cook for yourself and can’t view the ingredients, it’s hard to make healthy diet choices.
Jenny lives at home with her husband Trevor, who is also blind and has Type 2 Diabetes.
How does the Low Vision Gym support people with Diabetes?
The Exercise Physiology team are specialists in exercise and movement for the prevention and management of chronic diseases and injuries. Using the VisAbility gym can provide a safe way for clients to:
- Improve blood sugar levels.
- Boost overall fitness.
- Manage weight.
- Lower the risk of heart disease and stroke.
- Improve well-being.
When combined with advice from a dietitian, our healthcare professionals can teach you how to balance your medicine with exercise and diet.
Lindy has been seeing the Exercise Physiology team in the VisAbility gym for around two years. She has noticed a significant difference during that time.
“The improvement in my fitness, essential balance, and flexibility, as well as the social interaction and independence it encourages, have been invaluable,” said Lindy.
Jenny is a long-time VisAbility client and has been coming to the low vision gym for the last five years. She also sees the VisAbility dietician. Jenny explains that since coming to the gym,
“My blood sugar levels have stabilised and I’m fitter than I’ve ever been! With guidance from my doctor, I’ve been able to reduce my diabetes medication. The extra exercise has also done wonders for my mental health.”
What is a gym session like when you have diabetes?
Both Lindy and Jenny must test their blood sugar levels before coming to the gym, on arrival at the gym, and then again, every 30 minutes of their program. The results are kept onsite and can be sent to the client’s doctor or diabetes educator on request.
Regular monitoring ensures the team is aware of any rapid fluctuations in blood sugar that could lead to potential hyper/hypoglycaemic episodes.
The Gym team can also advise you on:
- How the activities you want to do might affect your blood sugar.
- When is the best time of day for you to exercise.
- How the diabetes medicines you take might affect your blood sugar as you become more active. Depending on your treatment, your healthcare professional may tell you to adjust your medicine dose or the food you eat before exercise.
Technology for Diabetics with Vision Loss
Lindy explains that technology advancements to support people with diabetes have come a long way, especially for those with vision loss.
“At first, I had to monitor my blood sugar levels by eating food at the same time every day. I would always eat the same food to make it simpler. Then I would do a urine test – which was the only way you could test glucose levels at the time – and read the results by changes in the colour-sensitive strip.”
This test has since developed into a blood glucose meter. A finger-prick device is used to draw a drop of blood from your finger, which you put on a special stick. The meter reads out the blood sugar level, and the person with Type 1 Diabetes can decide how much insulin to administer. Most people with Type 2 Diabetes can manage their sugar levels with food and exercise.
Once people with Type 2 Diabetes have their blood sugar level under control, they may only need to check it a few times a week. However, people with Type 1 Diabetes must test their glucose levels anywhere between 4-10 times a day – which equals a lot of pin pricks! Add in the complexity of being able to get the blood sample onto the test strip when you can’t see. Both Lindy and Jenny use a Talking Glucometer to read out the results.
Fortunately, Lindy now uses a continuous glucose monitor (CGM) patch on her arm, which monitors blood glucose levels continuously. The CGM is linked to an app on her iPhone and talks to her hearing aid via Bluetooth connection, audibly telling her the blood sugar reading. It will give her a reading on request, noting if it’s falling or rising and alerting if it’s doing either rapidly. Depending on her activity levels and when she last ate, Lindy then uses a smart insulin pen to manually inject the right amount of insulin.
At some stage, Lindy hopes to upgrade to an insulin pump that links to the CGM. This would automatically administer the right amount of insulin in line with the CGM monitor reading. However, currently these pumps are not accessible for people without vision.
Jenny also uses a talking blood pressure monitor and wears an Apple Watch to monitor her heart rate. She finds it empowering to be more aware of the physical changes in her body when exercising.
In Australia, there are a lot of funding options available for people with diabetes. However, as a chronic illness, the ongoing out of pocket costs continue to be a burden for many. The National Diabetes Week 2024 Theme is Unite in the Fight for Tech, which highlights
Who can use the VisAbility Gym?
Access to the VisAbility Gym and Exercise Physiology team is available through fee for service, NDIS funding or other funding options.
“I feel cocooned in the service here. I’m understood and feel fully supported. The sessions with the Dietitians and Exercise Physiology team have empowered us with the knowledge of how to support ourselves,” said Jenny.
We have a varied team of experts who provide specialist therapy support for people with low or no vision. For more information on how to access Exercise Physiology, or any of our other vision services, you can phone: (08) 9311 8202 or email: info@visability.com.au, or click here to visit our website.