Living with Type 1 Diabetes

Living with Type 1 Diabetes

I was diagnosed diabetic in Dec 2012 after having to go in to hospital for a completely different ailment, let’s just say a brain issue. At 38 years old, the diagnosis was for Type 2 Diabetes. I was given a prescription of metformin and sent on my way.

I registered myself with my local GP diabetic clinic and we began to adjust my medication adding more pills such as Gliclazide and Sitaglipten. As time went on and I responded less aand less to the meds, the dosage was increased to a point where I was taking just over 20 pills per day on average. This obviously raised a few alarm bells and my GP put me forward for further testing. The result of these tests was that I had been misdiagnosed a Type 2 and was actually a Type 1 diabetic. (My GP has been completely supportive throughout all of this and I have only praise to give the NHS). So, after just over 2 years of taking medication for type 2, I was then moved on to type 1 medications. I now take 2 insulins. My long acting insulin, of which I am currently at 48 units every night before bed and my short acting insulin which I take roughly 20 minutes before every meal and whenever I need to control anomalous spikes in my blood sugar levels, roughly 6 times a day on average.

All in all, Type 1 diabetes is a 24 hour thought process, continually taking action to anticipate, prevent and recover from my blood sugar going too high and too low. Trying to stay within the heavenly 5mmol - 8mmol level of blood sugar

So, what is the difference between Type 1 and Type 2?

Type 2 diabetics produce either smaller amounts of insulin or their body’s sensitivity to the insulin has diminished.

While people with Type 2 diabetes must also keep their blood sugar within that golden space, it can be dealt with by diet, exercise and / or tablets that cause the body to become more sensitive to the insulin that has been released by their pancreas. Some Type 2’s can even have the need to take insulin and for those who do, Type 2’s are often able to regulate their after meal blood sugars from rising too high and offset severe low blood sugar.

Type 1 diabetes is an autoimmune condition. Your body destroys your pancreas' insulin-producing (beta) cells causing your body to stop producing insulin, or at most, produce a minimal amount. 

There’s still no definitive answer as to what causes Type 1 diabetes. We know that it can be passed genetically, that it can be brought on from a severe viral infection or some form of severe trauma (such as the cause of my type 1 development). The only treatment for Type 1 is to self administer insulin and regulate your own levels through testing, testing, testing and more testing.

Every meal or snack has to be thought about, the carbohydrate total worked out and the amount of insulin units required to regulate the consuming of those carbs against how your body deals with it.  Food raises your blood sugar, insulin lowers it. The amount of carbohydrates in a food is how we work out how much our blood sugar will rise as it is the carbs that your body turns into glucose which you then convert into energy. Without the insulin, my body cannot absorb the glucose causing energy levels to drop and cause potential organ damage. At the moment I take on average 6 injections every day.

When your blood sugar drops below 3.8 mmol/l you become hypoglycemic. Your brain and muscles stop getting enough glucose (sugar) to function properly. You may start to tremble and sweat, have trouble catching your breath and your thoughts, well they are a complete mess, then add dizziness and / or tingly feelings all over and you’ve got a good idea at what diabetics go through.

If your blood sugar goes below 3 mmol/l, you are moderately hypoglycemic. You may slur or appear drunk, become confused and irritable. If your blood sugar falls below 2.2 mmol/l you are severely hypoglycaemic causing you to have convulsions or faint. You may need someone to call an ambulance or at the least have something on you that will give them information about what to do. If swift action isn’t taken at this time you can suffer severe brain damage or die.

Hypoglycemia is the biggest worry for people with Type 1 diabetes. Keeping within your small range (5-8mmol/l) doesn't give you much room for error to avoid a hypoglycemic event.

It has been reported that a person with Type 1 diabetes who is in good control of their blood sugar levels can still experience up to 10 episodes of hypoglycemia a week, and severe disabling hypoglycemia once a year.

Even scarier for some Type 1’s, just under 20% of people with Type 1 diabetes have hypoglycemic unawareness. This means they don't even feel the symptoms of their blood sugar dropping.

The other side to this coin is something called Hyperglycemia. Once you go above 9.9mmol/l (basically into double figures of 10 and up) you are prone to diabetic complications. These complications don’t happen over night however it is highly likely it wall cause severe issues months or even years down the line. Being Hyperglycemic is the result of too much sugar in your blood which causes damage to the small and large blood vessels.

High blood sugar can damage almost every organ and system in your body: nervous and gastric systems, eyes, heart, kidneys, feet, hands, pretty much everything.

8mmol/l is the recommendation of the NHS for Type 1 diabetics however 7.7 is the ultimate goal. The problem I have with hyper and hypoglycaemia is the huge mood swings and bouts of depression that comes with it. The depression (or feeling like I’m depressed) is brought on by me having the mood swings, knowing I’m having the mood swings and not being able to do anything about it. I try my very hardest to hide it however it seems the harder you try, the more it comes out. I know this affects my family, yet they understand and try not to take anything to heart. I often go to a room where I can sit quietly, alone to deal with the feelings as i am very conscious of what I can be like. Work can sometimes be very difficult. The job I currently have is high pressured; fast paced and doesn’t have time for someone who is nearly always pre-occupied with trying to be “in the range” or dealing with impending mood swings.

If you were to meet me, I doubt very much (other than the fact you have read this blog) that you’d even notice I spend most of my time managing this serious chronic illness. I look ok in a healthy way (I’m not particularly narcissistic) and I am generally a very happy, spiritual, optimistic person. I am active and try to walk to most places and have a reasonable healthy diet.

It’s hard for non diabetics to know that half my brain power is taken up by all of this unlike your standard person. Constantly working out the amount of carbohydrates in my meals, then checking my blood sugar to see if I had worked it out properly and if I haven’t, look for something else to eat before a hypo kicks in or give myself another injection to try and avoid the mood swings. And with all this going on I'm prepping my insulin shot, working out the dose and remembering where my last three injections were so I don't inject in the same place which can cause scars and lumps.

I then sit and wait to see if I got it right. 2 hours after I’ve eaten I have to check my blood again and decide whether I need to eat something, or take another shot. And that’s if I even last the 2 hours. If I over estimate the carbs, I’ll definitely over estimate how much insulin I’ll need and then I’ll end up having a hypo causing me to have to eat to raise my blood sugar up, not too much though as I’ll have to give myself a small shot to counter act the carbs I’ve eaten to counteract the hypo I’m having. And so it goes on........

Oh, and don’t forget the time I have spent wiping blood from my fingers, recording my readings, setting up my testing kit ready to use again, checking I have enough of all the items I need to get through one day.

Yet it doesn’t end there! Have I had enough carbs to walk home, have I adjusted my insulin for a morning of manual labour, have I taken in to account the weather (sudden changes in the weather can cause your body to use more energy which ultimately brings on another hypo) can I run for that bus or did I have to eat the emergency chocolate bar I had in my bag? Is that a cold coming on, if so I need to call the doctor, is my flu jab up to date? Colds, flu well actually nearly all “normal” day to day illnesses can cause major problems. Your body naturally increases the glucose level in your blood to convert more of it to energy in order to help fight off the infection. So what do I do? Take more insulin, don’t take more insulin? People with diabetes take longer to recover from illnesses and injuries that are often brushed off by a non diabetic. Every cut or graze has to be monitored for infection as they take longer to heal. This is all down to diabetes. To being unable to help my body heal me quick enough as I only have manual mode. No more auto pilot for me.

Type 1 diabetes is a juggling act all day and night, every day and every night.

I also have to tell you that it is very irritating when we get blamed for causing our illness. Some people believe Diabetes is one illness with varying degrees of severity. This couldn’t be further from the truth. I described the difference between Type 1 and 2 in as simpler way as I could back towards the beginning of this blog. However, there are many different types of diabetes causing many different problems all categorised into 3 categories. There is now a Type 1.5 that seems to be a little of type 1 and a little of type 2. And as for type 2, it isn’t only someone’s diet and weight that can cause you to develop it. Illness plays a much larger part in the onset of type 2 than people like to admit as these days it is easier to blame someone for their dietary choices than to try and understand how or why they have it.

Luckily I don't have to wake up throughout the night to check my blood sugar unlike the  many parents of children with Type 1 diabetes. However, every night before I go to bed, I have to check my blood sugar and ensure I am at a level that gives me the best chance of waking up in the morning. A number of people don’t with death in people with Type 1 diabetes through the night being attributed to hypoglycemia.

We don’t want sympathy at all. What all diabetics want is understanding. A better all round knowledge of what the types are and how each one causes different things. That sometimes, we aren’t angry at anyone or anything, we are just dealing with a spike in blood sugar. That if we forget something, it may be because we have had to deal with a hypo.

Oh and please don’t lecture us on what we can and can’t eat because actually, as a type 1 I could eat everything you do, I just have to adjust my insulin, like your pancreas does, however, I am now very conscious of all food groups, the effects of what different food stuffs has on your body and how I react to everything I eat. In fact, most of us Type 1’s are food experts! Remember the difference between you and me is I am stuck in manual, all day and all night and as far as I know of medical science, forever.