Learning the language of diabetes

I thought it might be time to do a little diabetes education here.  You can get all the details on the websites that are listed on the right column of this page, but maybe I can put things in terms that non-sciencey types can understand.

Back in college, I learned there were basically two types of diabetes.  Type 1 diabetes, which used to be called Juvenile Onset Diabetes, is caused by a person’s own antibodies attacking the beta cells of the pancreas and knocking them out so that they can no longer make insulin. (This kind of disease is called “auto-immune” since the cells of body are being attacked as if they were a foreign invader that the antibodies think they need to destroy.)  Insulin is necessary to help transport glucose into the cells of the body so that the cells can use the glucose for energy.  What happens is that once a critical proportion of beta cells are knocked out, the person’s blood glucose (BG) goes up and up and up, because the body’s cells can’t use it – it just keeps accumulating in the blood.  Eventually it is excreted in the urine too.  The high BG levels cause the person to be really thirsty, which in turn makes them need to urinate a LOT. And, because the body can’t use the glucose, the person tends to lose weight fairly quickly, even though they are probably eating as much or even more than they were before. If it isn’t brought under control, it can lead to serious consequences, which I will talk about in a later post.   It used to be thought that this happened only in children and young adults. Type 1 diabetics must take insulin by injection or through a pump.

Next up is Type 2 diabetes, which used to be called Adult Onset Diabetes, for apparent reasons – it is the kind that showed up in adults.  Most type 2 diabetics can still make their own insulin, at least at first.  The problem in type 2 is that the cells of the body are “resistant” to the insulin – in other words, the cells don’t recognize the insulin and so won’t allow the glucose in to the cells even though there is insulin around.  This tends to happen when a person is overweight, but not always. And, it is not caused by eating too much sugar, or too many carbohydrates, or too much of anything else specific. If it is caught early enough, while there is still insulin being produced, blood glucose levels can be controlled with diet, weight loss, exercise and non-insulin medications. Often, a doctor can tell that a person is at risk for Type 2, because the BG levels creep up above normal over time.  It can’t really be called adult onset anymore, because unfortunately it is showing up much more frequently in children.  Eventually most Type 2s will need insulin.

Now I had also learned about Gestational Diabetes, which shows up temporarily in pregnant women, but once the baby has been born, blessedly reverses itself and things get back to normal eventually. During the pregnancy though, the mother with Gestational Diabetes must work to control her BG, because high BG in the mom can have adverse affects on the baby, including a risk that the child is more likely to develop type 2 diabetes.

OK, so now we come to the fun part.  Turns out, there is another kind of diabetes that I was lucky (HA!) enough to develop. It’s called LADA, or Latent Autoimmune Diabetes in Adults. It’s also called Type 1.5 Diabetes.  This is basically Type 1 diabetes that develops long past childhood  – and no fair making faces about how MUCH past childhood I was when I developed LADA!  It can also carry with it some resistance to insulin.  It comes on fairly rapidly compared to Type 2, and some LADAs can go for a while without insulin. That was not true for me – no medication other than insulin would work to bring my BG down to normal. And it developed very suddenly in me – the symptoms came on literally overnight.

So those are the basics.  I think my next post might be about the cool new technology that I have learned about as a result of having diabetes.  Most of you out there have no idea what diabetics, whatever type they might be, have to do in order to maintain some semblance of normal BG.  I’ll also explain why keeping BGs normal is so important.  I hope this has been helpful.  Stay tuned for more information soon!

Blood sugar fairy tale

Apparently the blood sugar fairy – or demon, more likely – attacked last night.  My CGM line looks like a roller coaster.  I went to bed at about 75 (not a good idea), went up and down all night, and I woke up at 165. The only thing I can figure out is that someone was feeding me cookies all night. Darn. Sure wish I had been awake to enjoy them.  Just when I think I have things completely under control, stuff like this happens. And just to confirm it, while grocery shopping this morning, I must have hit about 50 (Dexcom said 70) and got really sweaty and shaky, right in the middle of the cereal aisle.  Jolly Rancher to the rescue!

I read something this week about the fact that we are never in control of our diabetes, we are just in charge. That really makes sense to me.  On days like today, I know very well I’ll never be in control.  So it is encouraging to think that at least I can be in charge.  That means I don’t have to get all upset when my blood sugars go in unexpected directions, as if it were my fault.  Instead, I take charge and do something about it.  Presto, no guilt! Well, almost no guilt.  OK, sometimes no guilt.  It’s hard not to take a BG reading of 250 personally. But I’m working on it.

All of this makes me profoundly grateful that God is in control of my life, not me. This has been a rough week at our church, with the sudden death of a member, and a sudden serious illness of another. This is just made worse by the fact that it seems like we have a lot of folks dealing with serious illnesses already.   At times like this, I am reminded that God is indeed in control, and all of this is in His hands, according to His timing, for His purpose. I don’t understand the whys, but the more I learn about the character of God, the more I am able to trust Him for the answers I don’t have.

This has also put my own struggles with diabetes in perspective. Even on my worst days, life is good, and full of blessings.  I am thankful for the technology that makes the management of this disease so much easier. Even when my Dexcom wakes me several times in the night to warn me I’m low (or high).  I am thankful for Dr. Hazen and for Betty, my diabetes educator, who encourage and coach me through the ins and outs of diabetes, and listen to my whining when I’m feeling sorry for myself. I’m thankful for great insurance that makes it possible for me to get the medication I need. I’m thankful for people in the DOC who can make me laugh about diabetes. Mostly I’m thankful to God for creating me the way He did, diabetes and all, knowing that He has a plan for me, and is providing the help I need to bring Him glory in and through the challenge of diabetes.

Sunday morning blues

For months I have struggled with my blood glucose levels on weekend mornings.  Sunday is a work day for me (since I am a Children’s Director at my church), and I don’t swim on Saturdays or Sundays.  My BG always soars really out of control on Sunday mornings, and even on Saturdays, though not as high.  This has been really frustrating, to say the least. I have not been able to make it through a worship service for over a month now without having to leave because I feel like I’m going to be sick, or fall over, or I just can’t concentrate and participate because my head is so foggy and thick. I was beginning to think my desire to worship had taken a nosedive, and that made me feel even worse. I love worship – the music, singing great hymns and songs, the time of confession, praying for those in our congregation, learning from God’s Word. But mostly I love being in the presence of God and spending an hour and a half  or so with others who love Him thinking about Him, praising Him, praying, and hopefully, honoring Him.  To think that perhaps I was losing the desire to do that has left me feeling really empty.  But this morning, I finally managed to keep my BG under control (more about that later), and worship was wonderful and fresh and full of meaning.  I am so encouraged by that.  It looks like it wasn’t that my desire to worship was impaired, it’s just that when my body is really out of whack, my physical ability to worship suffers. This is a great relief to me.  To lose the love of worshiping God was something I didn’t really want to think about.

So this weekend has seen a real turn-around in my BGs in the mornings.  Honestly, it’s pretty simple.  It just takes more insulin than I had been using.  Wow, brilliant.   I don’t know why I have been so slow to increase my doses for meals, or my basal rates (the continuous small amounts of insulin that the pump delivers all day long) to cover these wild increases.  All it takes is a 20-30% increase in the basal rate to keep things normal on Saturday and Sunday mornings.  Why did it take me so long to figure this out? I think it’s rooted in pride. I don’t really want to admit that I might need more insulin. It’s like admitting some kind of weakness. Well, duh, yeah, there is a weakness! My pancreas doesn’t work!  But my pride wouldn’t let me change my insulin:carbohydrate ratio for meals, or to raise my basals, because I have some strange need to get by on as little insulin as possible.  Once I broke through that barrier, things really evened out – not just on weekends, but all the time.

It has been a good weekend.  “And do not be grieved, for the joy of the LORD is your strength.” (Nehemiah 8:10)  I’m happy to say that the joy of the Lord is indeed my strength, for the days when things go well, and for the days when they don’t.