Living with Type 1 Diabetes

 

Living with Type 1 Diabetes

I JUST turned 60 (what??!!) and I was diagnosed with type 1 insulin dependent diabetes when I was eleven years old. Yup, back in the early 70’s. Nearly 50 years ago!  

We didn’t have the technology that we have today. Home blood sugar testing wasn’t even thought of! Urine testing was the only way to guess what your glucose levels were. Think about that. By the time your body processes the food and excretes it as urine, it’s at least 3-4 or more hours old! Talk about inaccurate.  I used pork or beef insulin which always ran the risk of rejection or allergic reaction (luckily, I didn’t have that problem). I started out taking one shot a day in the morning before breakfast. At age eleven it felt like torture.

Today I take 5 shots a day; One long-acting (basal) of Lantus insulin in the morning. One fast-acting (Humalog) before each meal and one intermediate acting of Novolin or Humulin before bed to carry me through the night. Today’s formulations are often human recombinant DNA (no longer beef or pork). I could wear a pump, but I’ll admit I’m too vain and don’t want to deal with it. My A1c (long-term blood sugar test) is rarely higher than 7 (normal is around 5).  I figure if it ain’t broke, don’t fix it.

Type 1 diabetes can be very inconvenient and at times downright scary. It requires constant monitoring, constant planning, and no spontaneity. You become like a boy scout; always prepared!  It’s also very expensive, but we’ll talk about that in another entry.

My typical day starts with a blood sugar test. Up until recently I would prick my finger with a small lancet, place a drop of blood on a test strip inserted into a meter, and get the reading in a few seconds. Today I’m wearing a CGM (Continuous Glucose Monitor). It took me a long time to agree to that. I didn’t want to be a “cyborg” always attached to something, but technology has advanced to the point where it’s just a tiny device, about the size of a quarter, inserted by a tiny flexible filament into the back of my arm. I have to change it every two weeks and it’s a pretty easy process that I can do myself. We’ll go into my life with a CGM in another entry.

Once I see the blood sugar (glucose) result, I can determine how much insulin to take and what I should eat. Every diabetic has a different ratio (no two patients are alike!) between insulin and glucose levels. For example, 1 unit of insulin lowers my blood glucose by 20 points. There’s also a different ratio between insulin and grams of carbohydrate. It’s a lot of math just to eat a meal!

I administer my insulin injection using a “pen” device, which is basically a syringe encased in plastic with a small dial that measures the dose. I suppose for some people it’s less intimidating than an actual syringe. I prefer the bottle/syringe combo, but the drug makers are no longer offering them in every formulation. That’s another thing. You’re very happy with your insulin regimen, and then your health insurance decides, whoop! No, they’re not going to “cover” that brand any longer. What??!! It’s annoying and I always get my doctor’s approval before switching, but I’ve noticed that most brands of the same formulation have little difference.

Every single thing affects your blood glucose. Sick? Minor infection? Your blood sugar goes crazy. Too much exercise? Too many carbs? Again, you’ve got to adjust your insulin dose. Even stress can send my readings off the chart! When I suffered a heart attack in May 2021, my glucose was over 400!! Normal is between 80-120 points. Talk about stress. It’s a constant tightrope that type 1 diabetics walk every second of every day. I compare it to a pyramid. There are 3 “keys” to good control: diet, exercise, and medication. If any one of those is off the entire pyramid collapses. Throw in stress or illness and it’s a free-for-all.

In addition to having a high blood sugar which can lead to coma and even death if left untreated, you can also have a low blood sugar – what I call a “crash”. This needs to be dealt with much more immediately as it can lead to losing consciousness. Generally, a high carbohydrate snack will do the trick. When I’m crashing it’s non-negotiable. I NEED to eat NOW. I can’t wait for the movie to end, or until we see a rest stop.  I always carry a granola bar, even some jellybeans (they don’t melt!), in my purse for emergencies. What’s a diabetic’s motto? “Always be prepared!”

I hope by now you’re getting an idea of how intense and complicated a Type One’s life can be. Testing your glucose level, watching your diet, staying aware of how much you exercise, and keeping stress as low as possible. Not to mention the multiple daily injections (or a pump infusion device). A word of advice; we tend to be very moody. When my blood glucose drops too low, I can get very short-tempered and focused on one thing; finding a snack to bring it back up. When my glucose is too high, I get drowsy, and not quite “with it”. Many people just don’t understand or realize it’s not my personality but my glucose level!

There are also numerous long-term side effects that I’m always aware of in the back of my mind as well. As I mentioned previously, I suffered a heart attack a few months ago. My blood pressure and cholesterol were low. Always have been. I exercised regularly. The cardiologist said it was the long-term effect of having type 1 diabetes. The arteries become brittle.

I’ve also suffered from retinopathy. This is a proliferation of blood vessels in the retina of the eye. If left untreated you can go blind. I went through several years of monthly eye injections and laser surgeries. This also turned out to be a very expensive process. I am extremely grateful to my friends and family who helped via a GoFundMe page. My eye surgeon said at my last visit that my eyes looked great and were healing well. No surgery expected for at least a year!

Considering I’ve been diabetic for nearly 50 years I’m blessed to have suffered only those two medical issues. I’m constantly worried about having a stroke or losing my sight. Diabetics are plagued by circulation issues. If you think about it, the sugar in our blood stream is too high. We’re “fermenting”.

The best thing I can do is take care of myself; keep my blood sugar in good control, watch my diet, have regular visits with my endocrinologist and other doctors, and stay informed. I know many Type One’s who have become bodybuilders, marathon runners, triathletes, rock stars, movie and TV stars and more. It’s all a matter of being AWARE, being PREPARED, and PLANNING.