Friday, November 15, 2013

A Day in the Life...and a Diabetes Primer

What exactly is a day in the life of a diabetic? I considered live Tweeting a day of diabetes. But that's a little boring, I think. Instead I'll give a basic outline. I have a feeling this post is going to be a long one. On a typical day...

Like most people, the first thing I do in the morning is wake up. Instead of rolling out of bed and heading into the kitchen, I roll over and grab the meter on my bedside table. This is the first number I see in the day, and sometimes if it's high it will put me in a grumpy mood for the rest of the day. I hate to say that, but it's true. Next, I go and eat breakfast. I try to avoid super sugary things for breakfast because they will make my blood sugar spike no matter how I bolus (give insulin) for it. I like things with peanut butter in general, so I usually eat a PB sandwich if I'm on the go. Maybe an apple and PB. Sometimes I eat Chex cereal with soy milk and add Splenda if I want it to be really sweet.

Now I'm good to go. I try to do a mid-morning blood test to see what's going on after breakfast. I especially try to do this if my blood sugar was high at breakfast. When lunch rolls around, I do another blood test. Eat food. Mid afternoon I do another blood test. If I know that dinner is going to be at a late hour, I will probably do another sometime before I start cooking. Before dinner I test again, and then again before bed.

Here are some diabetes basics:

How does Type 1 Diabetes work?

Type 1 diabetes happens when the immune system makes a mistake and thinks the beta cells in the pancreas are foreign invaders. Your immune system is supposed to attack invaders, so it attacks the pancreatic beta cells. Beta cells are, among other things, responsible for producing insulin.

Insulin's role in life is to allow sugar into the body's cells so they can use it for energy. It's kind of like the key that opens the cell's doors and lets the sugar inside. In the absence of insulin, sugar can't get into the cells so it builds up in the blood, raising the blood sugar. Trying to get rid of the sugar, the body starts spilling it into the urine. The diabetic person will be thirsty and will start drinking and urinating more. I've been there and done that. It's not fun.

Blood Sugar
The goal is to have my blood sugar between 70 and 130. If it falls below 70, I have to eat about 15 carbohydrates' worth of fast-acting, sugary substance. It can be candy, juice, or these large things that look like half-dollar sized pills. They're called glucose tabs, and I have a key chain that holds four of them, which will get me through one low blood sugar episode. Honestly, I prefer candy to glucose tabs.

If my blood sugar is high, I need to take insulin. If it's only a little bit out of range, I correct it using my insulin pump. Punch some buttons, and I'm good. I give the insulin some time to do its thing, and I check my blood sugar again. If my blood sugar is way out of range, I assume something is going on with my pump (I'll get there in a minute) and I go into manual mode. I go all old-school and pull out the syringe and insulin vial. Then I give it time, and test my blood sugar.

Insulin and my Pump
Instead of using syringes or insulin pens, I use an insulin pump. Before we get there, let's talk about insulin. There are two basic types: long-acting and short-acting. Long-acting (basal) insulin lasts 12-24 hours. It makes sure there is always some insulin working in the body. Why? Because that's what a normal pancreas would do! The liver is always secreting sugar, so there always needs to be insulin there to save the day and keep blood sugar levels in line. The short-acting insulin (bolus) is given whenever carbs are consumed or when blood sugar is too high.

Instead of giving myself all of this insulin with a syringe or pen, I have an insulin pump. Instead of injecting myself multiple times per day, I need to change the infusion set (the part in my body) every three days. It only holds short-acting insulin, so if something goes wrong with my pump, my blood sugar can go pretty high fairly quickly. It gives me a set amount of insulin per hour instead of using long-acting insulin. I can program it to give me different amounts/hour at different times of the day. I give bursts of short-acting insulin when I eat or if my blood sugar is high.

My pump saves me from having to do too much math. My blood sugar reading is sent straight from my meter into the pump. I tell it how many carbs I'm going to eat, and it combines the insulin I need for food with the insulin I will need for food and tells me how much insulin to take. Then I tap a few buttons and bam! Insulin. My pump's name is Henry, and he is pretty smart.

So What Affects Blood Sugar?

Carbohydrates, exercise, stress, the wind speed... anything, really. That's what is so frustrating. I can be doing everything just so, following all the rules, and then my diabetes just does something stupid. Sometimes I eat the same thing for breakfast every day all week and one day my blood sugar will do something different than it does on the other days. This is when it bothers me the most because I really tried, but it happens anyway.

Stress is the worst. It makes my blood sugar  go high, which makes me feel disgusting and unproductive. So if I have a major project coming up and I'm stressed, my blood sugar will rise and I won't work as efficiently as I should, which causes me to stress. It's a big, terrible loop.

Highs and Lows

Nobody without diabetes can really understand how terrible high blood sugar feels. Have you ever been outside on a hot day, really wanting a drink when there's nothing available? Oh, and imagine you've been running around. That scratches the surface of what extreme high blood sugar can feel like. You're hot, very uncomfortable, your heart is racing, and you would make a human sacrifice for a bottle of water. You're super thirsty, but the more you drink, the more nauseated you feel. You have to pee, and after you do, you have to pee again, right after another glass of water.

On the other end of the scale, low blood sugar makes me feel just as terrible, but in a different way. I might look drunk when my blood sugar is low. I feel weak, almost hollow. I'm shaky and unstable,and cold. Very cold. My words don't make a whole lot of sense, and they might be slurred (I'm not exactly sure, but they sound funny to me). My body just doesn't have enough energy to do much. I also get a little panicky because I'm basically like a phone with a low battery alert. I don't want to run out of juice.


Emotionally, it blows. There are times when diabetes does its own thing and defies logic. Sometimes I'm just really tired of having diabetes. I'm tired of poking and prodding myself all the time. It's hard work pretending to be a pancreas. Most times it just feels like part of a normal routine. But sometimes I let numbers get to me. I take them personally. I question everything. Did I count those carbs correctly? Did I forget to bolus for lunch? I internalize the numbers and it usually makes me feel terrible. Sometimes it hits me in the face that I have diabetes and I probably will have it forever. I'm going to have to keep checking my blood sugar, counting carbs, and poking myself for life. FOR LIFE. It's a lot to take in, and occasionally it gets to me.

What do I do to keep myself from jumping off of a bridge because of diabetes? I laugh at it. It hurts a lot less when you can laugh at it. I make a lot of bad jokes. I post them on the internet. I have an entire Twitter account for my bad diabetes humor. On this account I follow other diabetes accounts. I feel a lot less alone when there a bunch of people out there who know what I'm going through.

If you've made it this far, thanks for reading. If I left anything out, or you still have questions, ask away! I'll be around.

1 comment:

  1. I think you covered it all, at least until something different happens tomorrow!

    When I first started following you on Twitter, it took me the longest time to figure out your name. I couldn't pronounce it in my head. And then once I saw how cleverly you had combined the two words, it was "Duh".