Remember in my last post I mentioned that I was going to write something about living with diabetes? Well, tough luck. I've written something about that, and it came at you faster than my blood sugar rises after eating french fries. And it's a long read, too. That'll help you get to sleep tonight.
I'll start by describing diabetes. It's not about me not eating sugar and *POOF* I'll be fine. That's about as far from the truth as San Diego is from Saturn—maybe farther. Why did I pick on poor old San Diego? Because the word "Die" is in it and that isn't going to happen to me because of my affliction to be discussed here! Why? Because I won't allow it! My intention is to manage my diabetes like it's never been managed before!
Let the lesson begin! Keep in mind that I'm speaking in very general terms. If you need more specific information, ask me in person, call me, text me, send me a message, or do some research of your own. I used to take messages via carrier pigeon, but after getting pooped on by a bird twice within an hour at the zoo, I decided to keep birds at bay.
Simply put, diabetes is a breakdown in the body's ability to process carbohydrates. Sugar is a carbohydrate, but pretty much anything we eat that isn't protein or fat is a type of carbohydrate. During the digestion process, carbohydrates do become glucose, which is a type of sugar. When food is digested, it is broken down into fats, sugars, proteins, and waste products. Some of those things are absorbed by the body and stored. Some of those things get into the bloodstream. Some of those things are tall enough to take the free ride through the intestines and are expelled you know where.
Diabetes is considered an autoimmune disease, one in which your immune system attacks your body. In the case of diabetes, the pancreas and insulin producing cells are killed off for reasons unknown.
There are two types of diabetes, identified with the clever monikers of "Type 1" and "Type 2." Type 1 was originally referred to as "juvenile diabetes" because it showed up primarily in children. Type 2 was originally known as "adult onset diabetes" because it usually wasn't seen in children, only adults. But that's changing. Children are being diagnosed with Type 2 in ever growing numbers, and Type 1 is hitting adults in scary numbers as well.
Type 1 is characterized by the body's inability to produce enough (or any) insulin. Type 1s need to take insulin with meals, at night before going to bed, or whenever their blood sugar level is too high. Watching their diet and getting plenty of exercise help Type 1s to manage blood sugar levels.
Type 2 is characterized by what is called "insulin resistance," meaning that the body produces enough insulin to do the job of processing carbohydrates, but for reasons yet unknown, the body's cells do not absorb the glucose that insulin brings to them in the bloodstream. Being that the cells are starved of the fuel they need, they literally cannibalize the body's fat and, eventually, the muscle for fuel. The result is a sometimes dramatic loss of weight. Managing food intake and getting plenty of exercise help to keep Type 2 under control. Occasionally, though, Type 2s do need to take insulin because their pancreas no longer makes it. (That's why I do.) So in a sense, I have Type 2, but managing and treating it like a Type 1.
Sometimes I think that when a Type 2 who already has the insulin resistance problem loses the function of their pancreas, and thus becomes insulin-dependent, should be labeled as a Type 3 or some other way. This is only my opinion, though, so take it with a grain of salt for the time being. Or a grain of sugar. [wink]
Since our bodies were kind enough to pitch their job of managing blood sugar onto us, we have to step up to the approach and hope that we don't get a gutter ball or else we could be in trouble. We have to learn how to deal with high or low blood sugar levels. Fortunately, since our bodies don't manage our blood sugar levels for us like they're supposed to, at least they're kind enough to let us know when we need to take some kind of action. Remember, this is a general guideline. Not everybody's body reacts exactly the same. I'll tell you about me.
When I get chills and a case of the shakes, I can tell that I'm too low. When my speech is slurred like someone who's had about 18 beers, and I'm clumsy and shaky, it means my blood sugar is likely very low—possibly dangerously low. The best way to deal with that is to get my glucometer (blood glucose meter), and test my blood sugar. A reading of 100 is perfect, but if I'm low, it won't be 100. If it's about 70 or thereabouts, I'm OK. If it's in the 60s, I'm a bit low. If it's somewhere between 40 and 60, I'm definitely low, but not dangerously low. If it's below 40, get me some juice, a non-diet soda, some honey, some chips—anything to get the level back up. If it's lower than 30, be prepared to call 911.
For low blood sugar, there's a procedure that I learned called 15/15. That means if I'm low, give me 15 gm of carbs, wait 15 minutes and check my blood sugar again. If it's still low, lather, rinse, repeat. Keep repeating till I reach a safe level, say, above 70 (80-100 would be better). Even a bit over 100 is OK. Chances are, I'll be conscious while someone is assisting me and I can help verbally. I've done it enough times and Diana's good at it. One time a couple of years ago, I took more insulin in anticipation of eating more than I ended up eating. My blood sugar went too low and some of my actions were a bit bizarre—not to mention that what I said made very little sense. Diana got scared and called her mom (who was at a Kings game) and said that Dad was acting weirder than usual. Mom suggested that Diana check my blood sugar. Sure enough, it was about 34, and Mom told her to give me some honey. That did the trick and I was back to as normal as I get in no time.
Then there's the ever-popular high blood sugar level. Here, you just might have the pleasure of giving me a shot of insulin. Isn't this getting fun? However, before breaking out the syringe, you can try giving me lots of water to drink. And I mean lots! This helps to flush the glucose out of my ailing body. I'll be spending plenty of time in the bathroom, so I hope you brought a book. After a few trips to the bathroom, another check of my blood sugar level will reveal whether the "make him pee all day" treatment has worked. (Use the same 15/15 method described above, except don't give me anything to eat.) If still too high, you know what's next: time for a shot! If I'm coherent and conscious, I can likely give myself the shot and spare you the entertainment. But if I'm drowsy and appear to be slipping into dreamland, then you get to do the honors. It really isn't hard. If you're interested, I'll give you a live demonstration. All it takes is for us to have a meal together. Just don't look if you have a fear of belly fat.
Diabetics need some tools to help manage their blood sugar level. All of us, whether or not we use insulin, need to have a good glucometer. They're available at most good drug stores, and are fairly inexpensive and reliable. When you're under a doctor's care, s/he'll write us a prescription for the test strips that we need to test our blood sugar. Unfortunately, these strips are only used one time and tossed. Someday they'll have a way of extracting a sample of our blood without the use of a strip. If we have to buy strips, they can be expensive. We also need to get lancets so we can prick our finger. If we use insulin, we need syringes to inject the insulin into our favorite stash of body fat. The belly works best. I've given myself an estimated 5000 shots since I started using insulin in 2006. If you're interested in my journey with this fabulous disease, read about that here. Fortunately, many insurance plans cover much of the costs for diabetic supplies. A small co-payment may apply, though. Check with your plan.
Earlier, I mentioned that diabetes is more than "just don't eat sugar and everything will be fine." It is true that our diets should be tailored to our unique condition and meet our dietary needs. But that doesn't mean that we can't indulge a bit once in awhile. Most of you have heard that things like donuts and cookies and cakes and pies and french fries and chips and so forth are off-limits to us. That's...true-ish. Of course we need to limit our carbohydrates. But we are allowed some. This is where we work with our health care provider—doctor, diabetes educator, dietician, et al. My own recommendation is that I eat two to three "carb choices" at each meal. A "carb choice" is 15 gm of carbs. That means I can have between 30 and 45 gm of carbs at each meal. It works for me.
One of the worst things you can do for a friend or relative is to be the Diabetes Police™. It is not your place to monitor or restrict what your diabetic loved one consumes. S/he should know better, of course, but standing guard over them...um, no. I recall the time when my mom and I went to Texas to meet some of her distant relatives and we had dinner with them in their home. During our pre-dinner conversation, I mentioned that I was diabetic and treating it successfully. Dinner was "goulash," which apparently is Texan for macaroni casserole. I recall that dinner was very good—and very loaded with carbs. When it was time for dessert, our hostess served homemade blueberry cobbler. I could not wait to try that! She served everyone at the table except guess who. She remembered that I was diabetic and decided that I shouldn't have something with so much sugar in it.
On a positive note, researchers are saying that a cure for Type 1 diabetes is likely within five years. Once they resolve what causes the body to reject and destroy our pancreas, perhaps they can figure out what causes the body to reject the insulin that our own body produces. I mentioned before that diabetes is an autoimmune disease, so possibly by unlocking the mysteries of diabetes, other autoimmune diseases can be cured.
Well, there you have it. A basic primer on diabetes for your information and pleasure. I am always open to discuss my condition with anyone because the more you know...
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