Tuesday, November 30, 2010

A Little More About Me

Today is the last day of November, recognized as Diabetes Awareness Month. Whoever knew this raise your hand. Anyone? Anyone?

See, it's ludicrous that the only people who actually know about Diabetes Awareness Month are people who are already aware of diabetes. Those of us with it, who live with it every day, minute by minute, are all too well aware. And those who aren't affected... have no idea.

I know lots of people with diabetes who have been posting this month, but their blogs are mostly read by other diabetics, or parents of diabetics. You, dear readers, are mostly (and thankfully) not diabetic. So this is my chance to spread awareness.

Also, it's been almost exactly eight years since I was diagnosed. It was Christmas season, and I remember this because I am a huge fan of baking Christmas cookies, and that year I baked hundreds of cookies and ate not one. For the first and only time in my life, I didn't feel at all like cookies. Or pies or cakes or anything sweet. All I wanted was grapefruit and water. And more water.

As the weeks in December trickled on, I became addicted to water in a way that became obsessive. I felt constantly like I'd walked through the Sahara. My mouth was like sandpaper, my throat like a dried sponge. I needed water in a way I'd never known.

I couldn't leave the house without it, at first just keeping a bottle or two in the car, but eventually having to carry it with me. I had to get up in the middle of church service because I'd run out and needed to refill it from the water fountain as though my life depended on it. I woke in the night to drink.

I lost weight. In less than three weeks I lost 10 pounds. I figured it was the combination of water and grapefruit.... sounded like some diet I'd heard of years ago, and here I was just craving it. I'd given up most other foods, so of course I'd be losing weight.

I suppose I was tired. Then again, I had three children under the age of five, one of whom was only seven months old. What mother of kids that age isn't tired? To top it off, with the last child I'd become very anemic and bled out during delivery and had to get several blood transfusions and have never really recovered. I'm sure if I noticed I was particularly tired, I attributed it to that.

It was my mom, my mom who'd seen my sister go through the very same thing nearly twenty years before, who suggested on Christmas day that I go to the doctor. Just to make sure.

That doctor appointment was brief... I glibbly told my symptoms, sure it was nothing but still concerned because the water thing was getting out of hand and downright disabling. He nodded, said I probably had diabetes, pricked my finger for some blood, tested it and in two minutes my life had changed.

So in a nutshell, this is what I've learned over the past years:

There is an organ in your body called a pancreas. Like the heart, stomach and lungs, it has a specific purpose. That purpose is to produce hormones that control the amount of glucose in the blood stream. When you eat, almost anything you eat, has something in it that can be turned into glucose for your body to use as energy. Sugar is the obvious one, but anything that is considered a carbohydrate - like bread, or corn, or peas, fruit or milk - is high in glucose, but even meats and wine has glucose. The pancreas produces two hormones that regulate the delicate balance between too much and too little glucose in the body. Glucagon increases blood sugar when it falls too low. Insulin stores it when it gets too high.

Diabetes is when there's a problem with the insulin.

There are two types of diabetes. It's surprising to me how many people don't know this, but since 95% of people with diabetes have the Type 2, it's easy for the type 1 to get misunderstood, even though they are really very different diseases.

Type 2, the more common type of diabetes, is when the body can't use the insulin that's being produced. A lot of times an excess of insulin is pumped out by the pancreas, but the cells can't use it to store the glucose, and as a result, there's lots of extra sugar floating around in the bloodstream, damaging all the other organs it passes through like a poison. Sometimes, even though the pancreas is making the insulin, there is a higher need for it and it just can't keep up.

Type 1, which is what I have, is when the pancreas just gives up altogether. Type 1s make no insulin at all, which is why one of the first symptoms is severe fatigue. If the cells aren't getting any glucose at all, there is nothing to use as energy. So it uses its stored fat as energy, hence the rapid weight loss. And water is needed to flush all that extra, poisonous glucose out of the blood stream, hence the extreme thirst.

Despite sharing the same name, the two forms of the disease are hardly the same. Causes are different. Treatment is different. Type 2 might be caused by weight gain, stress, genes, poor diet, lack of exercise, high blood pressure and certain drugs. A type 2 can often take pills that help them to use the insulin their body is already making. With certain lifestyle changes ( which are by no means easy!), sometimes the disease can be put into reverse.

Type 1 is an autoimmune disease that may be caused by a virus that sets off a genetic predisposition. The whole pancreas-dying-thing isn't really the root of the problem. The problem is that the immune system sees the pancreas as foreign and harmful and attacks it. This is why pancreatic transplants haven't been successful in curing diabetes. You can replace the defunct pancreas, but the immune system is going to attack the new one as well, and pretty soon you end up back where you started: insulinless. You can't take pills. There are no insulin pills as insulin can't be processed by the stomach. Pills only help a person's natural insulin to be more effective, and as the type 1 doesn't produce any insulin, the pills are useless.

The only way for a type 1 to control their blood sugar is by taking shots of insulin. Every day. All day. When I first was diagnosed I was taking two shots a day just to stay alive, and then another shot for everything I put in my mouth. Thankfully, I've since gotten a pump that I wear all the time. The pump has a needle that I shoot into my stomach once every three days, and then just stays there, dripping insulin into me all day, more the way my pancreas might. (That photo isn't me, but my pump looks just like that)

Still, it's not a pancreas. It doesn't know what I'm eating, or how stressed I am, or how hard I'm exercising, or what infection I might be getting... all of which increase my blood sugar. All the pump knows is what I tell it. So I prick my fingers ten times a day to test how much blood sugar is floating around, and then I either give myself more insulin if there's too much, or I have to eat something if there isn't enough.

Being my own pancreas is hard work. And tiring. And frustrating. I know sometimes why my pancreas just gave up. It seems like I am always off by something.... there's too much glucose and I'm tired and thirsty and not seeing very well and slowly killing off my nerve and kidney cells, or there's not enough glucose to make my brain function well and I'm fuzzy-headed, dizzy, sweaty, confused, volatile, and headed towards a coma. If I pump in too much insulin, I die. If I pump in not enough, I die. I'm not melodramatic about it. That's just the way it is. It's a tightrope to walk.

But I'm thankful that I've become much more aware of my health since I've been diagnosed. I exercise more faithfully, I eat better, I get medical tests every few months and know that my cholesterol and blood pressure are outstanding, that I'm still anemic and vitamin D deficient (who knew??) and now I can take vitamins for that.  I'm thankful for the advances that have been made in the past twenty years that allow me to live a normal life, with the prognosis being long.

This is a long post, but I wanted to somehow recognize this month, and all the people that I know with diabetes who struggle daily, minute by minute with it. And so that you... if you or someone you knows, starts drinking a lot, going to the bathroom a lot, sleeping a lot, losing a lot of weigh fast... you will know. And you can be the one to save their life. Or your own.


  1. Thanks for this informative post Heidi. Awareness is the key to help monies finance research to find a cure. Islet transplant is known in my area as Dr. James Shapiro heads the research in Edmonton. But I am still nieve when it comes to diabetes. And that needs to change.

  2. Wow. Great post. That all sounds so tiresome. I think you said it best when you said you had to be your own pancreas.


  3. Great post. Since diabetes is so prevalent in my family, I always need to be aware of it.

  4. Great post, Heidi! Although medically and scientifically sound, your post is accessible to the uninitiated, and should be required reading. I especially liked your idea that you are acting as, and fulfilling the functions of your own pancreas. Thanks for your contribution to a better understanding the distinction between Type 1 and Type 2 diabetes.

  5. Wow, even after reading Some Kind of Normal, it was still enlightening to read this.

  6. Thank you for sharing. Diabetes type II is something that is WAY to common. I seemed to see it with every other patient in the hospital. (Okay, maybe not every other...but close. I was a cardiac nurse, but I think I knew more about diabetes in the end.)

    You prick your fingers ten times a day? Don't they already go through enough with all the typing you do?

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  8. I hate it when I post twice on accident, then delete my extra post, but it still says "this post has been deleted by the author" like I've said something scandalous or rash then changed my mind.

  9. Thank you for an informative post for those, like me, who have just learned that they really need to know more about this topic! Great blogs!