You would think that after 37 years of life with type 1 diabetes, I would have it all sorted. It is something you get, learn about and manage, right? (cue injecting into oranges here). In some ways that is true. Once you get the basics of managing diabetes, once you understand how it works, what it does to your life (screws it up quite a lot), and how to manage it (prepare for a lifelong full time position with the beta cell firm), you can get on with life.
But this is where the statement – “it is all sorted” starts and stops.
The issue with diabetes is that it is not a static condition. You don’t get it, pop a pill and be on your way. Your body is constantly changing and all of the systems in your body, interact and respond to the hormones running around inside of you. Diabetes is basically determined by hormones – it is in fact a hormone itself and likes to hang out with its hormoney friends.
Prepare for an endocrinology lesson here…
Insulin (the hormone in question) has a job to do – it helps maintain your blood glucose levels. All of the cells in your body require glucose for energy. This is where insulin comes into the starring role – its job is to unlock the doors to all those cells and allow the glucose to enter where it is needed. Once you have something to eat, your blood glucose levels rise in your blood stream and the beta cells in your pancreas signal the release of insulin into your bloodstream. Voila you have energy for every part of your body to work, most importantly your brain, which requires replenishment every day with glucose.
Now if you are pancreatically challenged, your beta cells are flakes, worn out, dusty, tired, not up to the job, gone missing in action. This means those doors are either very slow to open (in type 2 diabetes this is insulin resistance – pushhh pushhh little beta cells), or totally closed. If you have type 1 diabetes and therefore no insulin, the glucose just builds up and up until, well without diagnosis and some pretty fast getting onto the insulin train, you are a goner.
Now in an average day, hang on there is the first issue – THERE IS NO AVERAGE DAY- (as you were), your body goes through a squillion things. The first are the waking up hormones, the ones that allow a person with a functioning pancreas to wake up with that perfectly perky little blood glucose level, that means they can mindlessly eat whatever the hell they want for breakfast, or not…and get on with their day. On that, then there is the eating, the thing people without diabetes just do. Do you know how annoying it is to watch people stuff their face with whatever they want, without even THINKING? Then there is exercise, and let’s not even go into that in this post. Excitement, stress, that time of month, pregnancy, working, caring for your kids, walking backwards (I just added that for drama), you get the picture. And don’t even get me started on sick days, grief, anxiety, dealing with trolls or bullies, study loads, all night parties..the list goes on.
Let’s just summarise it in a word –
Yup diabetes is one delicate little sucker and is affected by and affects your entire LIFE.
That said life is good. But there are those nights like I had last night where my blood glucose sat on 5 mmol for the entire night no matter what I ate and then as predicted shot up high overnight. I tricked it with 3 alarms overnight to wake up and take bolus insulin twice, followed by glucose – to wake up with a 5 mmol reading – so take that diabetes – but just don’t look at my eyes today (yeah hanging out of my head). In fact I have created the poor person’s CGM (continuous glucose monitor) – I wake up at least 1 – 2 times every night with an alarm and check my blood glucose and deal with it. Not pretty, maybe not streamlined yet but very effective.
I have said it once and I will say it again – having diabetes is a bit like a duck, it may look like you are gliding across the water on the surface, but there is a hell of a lot of paddling going on underneath!
Let’s quack together!