Thursday 19 April 2012

The Other Diabetes

Recently in the DOC (particularly CWD) it seems like there has been a lot of talk about type 2 diabetes and type 1 diabetes. I've read a lot of posts before about people with type 1 who want a different name for their condition, because of the constant confusion and misconceptions around diabetes. I've seen TV shows (mostly on Channel 4, UK, although they actually seem to have improved a lot recently) which blatantly confuse the two illnesses, which have different causes, some different symptoms and different treatments.

I think that the level of confusion between the two types of diabetes is irritating, to say the least. Type 2 diabetes can often be treated (especially in its earlier stages) with diet and exercise, and even when this is ineffective, pills are often used rather than injections. From what I've read about type 2, it seems that BG levels are often more stable than what people with type 1 experience, and fewer BG checks per day are necessary. Honestly it bugs me to have to say to people "no, I will NEVER be able to control this with diet and exercise" because the media are careless and don't distinguish between two very different conditions.

However, some of the comments I have read are just plain cruel about the people with type 2 diabetes. I get irritated with the ignorance surrounding the types, I get irritated with people who spout crap when they don't have a clue, I particularly get irritated with the media, but I have never really thought to get irritated at the people with type 2. It just doesn't really make sense to me. If you have type 2, hi! We have two different conditions, which overlap in some ways. The similarities are that we both feel like crap when our BGs are high, and we are both prone to complications, particularly if we have many high BG levels. There are even more similarities if you consider somebody with type 2 diabetes who uses insulin, because we both have to face scary lows, and the challenges of injecting multiple times per day or wearing an insulin pump.

I have empathy for anyone who has woken up in the middle of the night with a pounding in their head and a mouth like the Sahara because their BG is high. I have empathy for anyone who has felt the whirring around their ears and the spinning in their head; the absolute confusion and desperation to eat from a low BG. I can empathise with anyone who has ever looked at the meter and felt angry because it gave them a number they really didn't want. I can empathise with anyone who has decided to pass on the cake or cookie because their BG is above the target range.

Some people feel irritated at people with type 2 because they 'brought it upon themselves'. After some googling, I have read that 80% of people with type 2 are obese, so there is certainly a strong weight related risk factor. However, here are some issues I want to highlight:

1) Only 80% of people with type 2 diabetes are obese. That is 1 in 5 people with type 2 diabetes who cannot in any sense be blamed for their condition, even if you want to blame obese people for developing diabetes.

2) Only 25% of obese people develop type 2 diabetes. If you want to blame people only for factors within their control, why blame those with diabetes in particular, when for every obese person with diabetes there are 3 more who may have had exactly the same lifestyle and just been lucky enough not to develop diabetes. There is absolutely no reason to discriminate against the diabetic obese rather than the non-diabetic obese.

3) People do not want to be obese. There are still studies into what makes some people become obese rather than others, and obesity is definitely often caused by mental illnesses such as depression or dysthemia, or even just a traumatic life event. In that sense, even if a person's obesity is caused by overeating, can you necessarily blame them if the overeating is in some way out of their control?

4) The risk factor for certain types of cancer is also hugely increased by obesity. Would you blame people with cancer in the same way as you blame people with diabetes?

I'm sick of people directing their anger and irritation in the wrong direction. If you're pissed off at the ignorance and misinformation, email and telephone and campaign against misinformation in the media, and correct people who present misinformation to you. But why direct your anger at people who have a particular illness(with a few similarities to that of you or your child)?

Tuesday 17 April 2012

Sweatbetes Week 5

Today was the start of my fifth week of running. And I ran 2.5 miles in 25 minutes - that's further than I've ever managed before! I'm really happy about it because at the start I could barely manage a mile, I got so out of breath so quickly after MONTHS of barely exercising.

I've lost about 1.5lbs, which is fine - my weight was normal to start with, weight loss is not my gain. But I think I'm getting more muscles (yay!!) because my legs are looking a bit more toned. That could be my imagination, of course.

I can't wait until I hit the 5K mark, and it doesn't feel too far off now. Once I can do that I hope I will feel like I'm running 'real' distances rather than just jogging around the block!

I also can't wait for the day that I am faster than my 40something mum, who has been in training for a little longer than me. (Also she's underweight - about 2 stone lighter than my perfect 22.5 BMI self, and I swear that must make it easier - she's got very little to actually carry around!) Yes. I'm bitter about my mum being better than me. It's a bit demoralising.

I'm really loving using to track my runs. So far I've run 34 miles and apparently burned off 36 donuts!

I really hope I manage to keep up running after next week, when I go back to university, have to run on different roads and won't have a running partner anymore.

Sunday 15 April 2012


Control is a big word. Although I know I can't get my diabetes under complete control, I try to try the best that I can. Recently, for whatever reason, my BGs have been slipping and the last few a1Cs I've had have been higher than I would have liked. I do a hell of a lot (temp basals, bolusing for all food, making adjustments frequently, testing BG 10-12 times per day) but there are a couple of areas that I'm looking at for improvement.

Firstly, I'm starting to log my BGs. That's something I haven't done for a long time - I tend to rely on my memory for pattern spotting.

Secondly, I'm going to start weighing my food. I'm going to order a scale to have at university so that I will keep it up. I'm not going to weigh everything, just the tough to guage foods like cereal, pasta, rice, etc. Although I'm pretty darn good at SWAGing, I want to see whether more precise measurements could help me with unpredictable meal spikes.

And if neither of those things help, I'm going to think about adding a shot of Lantus to my regimen, since people have suggested that could help with stability. My last resort is going low-carb, but I'm not so keen on that because I'm not sure how well it would fit with my pesco-vegetarian diet.

So, here's a nice screen shot of the first few hours of my crazy new log. I'm not testing my BG as frequently as it would suggest - some of those are CGM numbers. And there were some BG tests in between. I had to treat 3 BGs last night (although the numbers weren't below 4 I count them as lows because I had to treat them to stop them getting that way).

Wish me luck on the crazy logging! I've never been that good at it, so I'm really hoping I can manage to do it for longer than a few days.

P.S. Yes, 12AM until 12PM does count as "night" for me. Not only do I sleep long hours, but I was awake for quite a while at 6AM. Whatever, I'm a student on vacation. No judgement please!

Friday 13 April 2012

Looking Back

Sometimes it's important to look back, to see where we've come from, what has changed for the better and what has changed for the worse. Since I wrote this piece for English class almost four years ago, I have been using the pump and CGMS. Diabetes has become harder to manage, and I've tried my best to rise to the challenge. I still have the same undercurrent of fear that I can feel when I read this essay, but I think it has become less strong. I have been forced to face up to the clinical depression which has been present in my life for a long time but which recently became more severe. I have been weakened, and I have grown stronger. I have tested my blood glucose tens of thousands more times. I have changed hundreds of pump sites. I have been faced with serious lows and highs which made my head sticky and my mouth feel like the Sahara. I have tried hard, I have struggled, I have won, I have lost and I am still fighting.

A Silent Attack
Four thousand two hundred blood sugar tests; one thousand seven hundred and fifty insulin injections; one thousand and fifty high blood sugar levels and seven hundred low blood sugar levels. Four hospital appointments; six blood tests and three days in the paediatric hospital ward with an intravenous insulin drip.

On Friday July 6th 2007 my life was changed forever.

On June 27th my Grandma came over for dinner. When she arrived, she hugged me, and drew back, surprised. She was shocked that she could feel my ribs through my clothing. I hadn't been feeling too good for a while; it had been harder than usual to focus at school, and I was sleeping a good 12 hours a night.

On July 6th, I went to my doctor. She tested my blood sugar levels, and acknowledged the result with a short, hesitant gasp - the drawing of breath that I knew even then was going to change my life forever. As if I were someone else, watching from far away, I saw disbelief on my mother's face; she never thought this would happen to her daughter, who was still, at fourteen, her little girl.

"I have a girl here who needs to be admitted to the children's ward. Blood monitor reads off the scale, ketones positive times 5. Some symptoms of ketoacidosis, but her blood acids haven't been tested. Only weighs 40 kilograms." These foreign words broke through the fog of my mind, bringing to life my situation and sending me down to earth with a bang.

My hospital stay was a flurry of "don't worry, this won't hurt"s and "you'll just feel a little prick"s, none of them true for me. I was shocked, even then, by the extent of the pain of a chronic illness. Everybody said it would get better with time, but I didn't believe them - why would I have done? I had just been thrown into my worst nightmare.

Once I'd had my first shot of insulin, my blood sugar level plummeted back into the 'normal range,' which shocked my body, which was used to elevated levels, used to being off the scale. That shaking, the fog, which seemed to seep through every passage of my brain, that feeling of losing control, was my first of many experiences of what hypoglycaemia felt like.

"Now, don't worry, Emma, you'll still be able to have children. They will have a 3-4% chance of developing type one diabetes, but as long as you keep your blood sugar in good control throughout the pregnancy, there shouldn't be any complications." These words stunned me - not because I'd thought I wouldn't be able to have children, quite the opposite, but because nothing like that had ever crossed my mind. I hadn't had time to think, at that point, that somehow this disease was going to infect every aspect of my life, to somehow become a part of me.

It was when the nurse handed me the insulin pen that I broke down, for the first time. The needle was only small, but what it symbolised was much greater. A new lifetime dedication was being forced upon me, a condition which I had never asked for and certainly did not want.

The first night was the worst; my head was still spinning from flashbacks of the doctor's face when she had gasped... When she had phoned the hospital... When the letters "HI" had appeared on the blood glucose meter. The hospital contained everything I didn't want to face; the smell of the food and the hallways jolted my mind back to just one month before, when I'd seen my granddad for the last time in that same hospital.

Type One Diabetes is a chronic condition, which results when the body develops antibodies towards the insulin producing beta cells in the pancreas. An auto-immune attack results, which eventually entirely destroys that part of the pancreas, leaving it incapable of producing insulin. The function of insulin in the body is to lower the level of glucose in the blood, by allowing it to pass into cells in the body and be used to provide energy. When there is no insulin, therefore, the blood sugar level just keeps rising, until, in a worst case scenario, the person could go into a coma or even die.

I learnt all this during my time in hospital. At first it seemed a foreign language to me, the words meant nothing, but now each of those words registers clearly in my brain, and I know what it means almost too well. I now know the carbohydrate contents of most common foods (I have to count carbohydrates in order to balance them out with insulin); I know my acceptable blood glucose levels for all times of day, every day; I know how I feel when my sugar level is high; I know how I start to act when it gets too low.

In the beginning, to treat my diabetes, I was put on a treatment of two insulin injections a day. Whilst taking this, I had to eat a set quantity of carbohydrate every two hours in order to keep my blood glucose levels steady. This treatment did not work for me; my blood sugars stayed high and would not come down, no matter how little I ate, or how much insulin I took.

I have now moved onto a more effective treatment - injecting insulin every day in the evening, as well as whenever my blood sugar is high, and whenever I eat something containing carbohydrate. This generally totals to around six injections a day, but can be as little as four or as many as eleven or twelve. Sometimes I still become frustrated - it is a heavy burden for anybody to carry, every second, every minute, of every day. And sometimes it still feels that I live for my health - everything must be weighed, factored and counted, nothing can be spontaneous anymore. A simple cold or flu, or sickness, can turn into something serious, possibly requiring hospitalisation. However, a life like this becomes normal, and most of the time I don't even think about it anymore.

Soon, I will be tied - quite literally - even closer to my health. An insulin pump is another method, uncommonly used in the UK, to gain tighter control on blood glucose levels than it is possible to do on injections. Using this treatment, insulin continuously infuses into the fat below the skin using a tube from the 'pump' (an object around the size of a mobile phone, which contains insulin) which is connected to a cannula, a flexible plastic tube which must be inserted into the fat on the abdomen, thigh or arm every two days. I will still have to test my blood sugar levels, program my doses into the pump, and count my carbohydrates, but new technology provides better accuracy and precision, and less room for error.

I am not condemned to die young, or to suffer greatly in the preceding years. But when uncontrolled, diabetes is a silent killer, causing the diabetic to battle with the prospect of kidney failure, blindness, stroke, heart attack, and many other potential complications.

People with diabetes have an average life expectancy less than those without, but I will not become another statistic. With everlasting vigilance, and the best control I can hope for, I will live as long as I can, and achieve everything in my life that it is possible to achieve.

Tuesday 10 April 2012

Sweatbetes Week 4

Just a quick post. I feel that a sweatbetes post every Tuesday is necessary!

I'm feeling a bit demotivated with running, and I guess that could be what's causing my depression symptoms to worsen again. I have shin splints and nasty cramping in my lower legs, which is sometimes making me stop running.

The plan for now is to stop increasing my running distance, and stay at around 2 miles per run. I'm going to cross-train on top of that, because it is not so high impact and will put less pressure on my shins.

I'm frustrated! I hope that the pain will get less soon so that I can start increasing my distances again and hopefully start feeling better. I don't like cross-training so much because I'd prefer to get out in the fresh air. But you know, I'll stick with it, and hopefully my legs will be doing better soon.

Monday 9 April 2012

Custard and Quicksand

If life is like swimming, the water I was swimming through started to get thicker and thicker a long time ago. For a while I guess it was like fighting through custard. Sometimes it got thicker and it became harder and harder to swim. Sometimes it let up and got easier again for a while, but I haven’t been swimming in water for a long time.

Eventually I was swimming in quicksand, and being pulled under, so quickly. It felt so out of my control.

Somebody is playing a cruel trick on me. They replaced the quicksand with custard again, just for a few days. The custard felt so much easier to swim through. Now I’m just alternating between custard and quicksand. Just when I remember how much easier it is to swim through custard, the quicksand is back. When it’s easier to fight, I forget how hard the hard bit can be. When the hard bit comes back, I don’t believe that swimming will ever get easier again.

I don’t know if this is what recovery is supposed to feel like.

I’ve never recovered from swimming in quicksand before.

I don’t know if it is worth fighting through the custard just to be pulled under the quicksand again, or whether this means that I need to try something else.

I don’t know why some people believe antidepressants are a fucking lifeboat, a ‘happy pill’. They have stopped me from drowning in quicksand, but that’s all they have done. I’m not better. I’m not okay. I wish the custard bits would last for longer. And I can’t even imagine how it would feel if the plain old water came back.


This blog might be temporary. I just needed to get my thoughts of recent days out somewhere.

Tuesday 3 April 2012

Sweatbetes Week 3

I've had some injury issues this week, which is a shame, but I'm trying my best to both work through it and not push my body harder than it can deal with. "Shin splints" seem to be the name for multiple different problems, and basically a catch-all for pain in the shins, which is what I have, but mine is not so bad. When it happens, if I stop for a second and do some stretches it gets less intense and I'm able to keep going.

My mum and I ran almost 3 miles today, which is pretty cool. I could always do a few miles on the treadmill, but when it came to running in real life (hills and all!) I couldn't even do a mile to start with! I used to be able to run quite far until I got out of shape with depression etc., but I'm only just over 2 weeks in so this is a really huge improvement.

I even went shopping this week for some new trainers, I now have Nike Air Pegasus 28 trainers, which really beat the 9 year old Skechers I had been wearing (note to anyone reading: learning to run in shoes which were never intended for running and now barely even have soles is... interesting. But I didn't want to invest in new shoes if I didn't feel I was going to stick at it).

So I've now logged 20 miles overall (as you can see in the cool orange thing under my profile on the side of the blog), I'm feeling good and I'm ready for more!

Diabetes wise, it's not as hard as it was. I don't need to consume as much sugar beforehand and I'm not getting crazy overnight drops now I've adjusted. It's going well. Now I just need to find a decent belt for running which is comfy and doesn't jiggle about or rub, because that would drive me crazy.