Let’s Talk About… Diabetes

Type 1 diabetes is an incurable autoimmune disease, occurring when the body attacks part of the pancreas and its insulin-producing cells. Insulin regulates the amount of sugar in the blood, so if these cells are destroyed, the body can no longer produce insulin. This results in a dangerously high sugar level, which, if left untreated, leads to a life-threatening complication called diabetic ketoacidosis (or DKA). Because I have type 1 diabetes, my pancreas produces absolutely no insulin, so I must administer my own through daily injections.

The story of my diabetes is scarily similar to many other people’s. Type 1 diabetes is also called juvenile diabetes because it’s usually diagnosed in children. I was nine when I stopped eating and began peeing every few minutes, and I have memories of drinking the shower water, eating snow, stealing milk from people’s front porches on the way home from school, and drinking my sister’s cider to try to satiate my thirst. This was the case for around three months, and during that time, I went from being a healthy, cheery kid to a little pale skeleton who’d shed almost half her weight. I was rushed to hospital shortly after my tenth birthday where I was diagnosed immediately. The doctors told my parents that I also had DKA, meaning that my body was unable to use glucose for energy and had to resort to using my body fat for its source of fuel. Unfortunately, this complication recurred during parts of my teenage years, and battling high blood sugar remains a daily struggle. I often think of the people who’ve lost their fight with DKA, such as Kycie Terry, who was five when she was taken to hospital with the same symptoms as me. She woke up paralysed, and after months of battling, passed away. She is one of the thousands of children who die as a result of being undiagnosed; and her parents are now on a prolific and noble mission to ensure that people know the symptoms.   

Obviously, more needs to be done to raise awareness of the condition. I am going to contribute to this by taking you through a typical day in my life as a diabetic.

I wake up at eight, and the first thing I do is test my sugar by pricking my finger, and then putting the blood on a test strip. I feel unwell so I assume it’s high – it usually is at this time because I have something called the dawn phenomenon, where my sugar is high in the morning for no apparent reason. This morning it was 25.6 millimoles per litre, higher than a non-diabetic by around twenty millimoles. This makes it dangerous to eat breakfast, so I inject myself to bring it down, do a blood test for ketones too, and get ready for uni in considerable discomfort. Just before I leave I take the first background injection of the day, which is different from the one I take when I eat.

I test my sugar level again at eleven o’clock and it’s down to 11.6 – still high, but not immediately dangerous. I give myself an injection to bring it down further and head to my next lecture.

An hour later it’s lunchtime, so the first thing I do is check my sugar again, and it’s come down nicely to 5.2.  My classmates ask if I want to go for lunch but I decline because I’m worried that they won’t provide the carbohydrate content with the meal (carbohydrate counting with everything I eat is the safest way to find out how much insulin to take). I take my injection with my regular meal, annoyed that I had to miss out because of the fear of becoming ill.

Two hours after lunch I check my sugar again. It’s up to 15.6 even though I counted my carbs accurately. This is because I was sitting down for too long in the library, so I probably didn’t burn off enough sugar. I consider going for a swim to bring it down naturally.

I go to the pool and swim forty lengths before I begin to feel shaky, scared, and disorientated. My coordination is skewed, and I worry that I might collapse before I can get to my supplies. I test my glucose and it’s 2.6 – a hypo – meaning that my sugar is dangerously low. I eat my dextrose tablets and drink my lucozade. My swimming session has to be cut short, so once I check that my sugar is raised I go home. I’m just glad that it didn’t go lower, because when that happens I act outrageously and people often refuse to help me, or they laugh at me because they think I’m drunk.

It’s come up to 8.9 by the time I’m home. I’m happy that the dinner my flatmate has made is one we eat a lot because it means I already know the carbohydrate content. I take my teatime injection. After dinner I do some reading before taking the second part of my injection that releases insulin slowly.

At around eleven o’clock my flatmate makes some toast and jam, and as we all know, it’s hard to refuse toast once you’ve smelt it. I take a piece, and do my ninth blood test and eighth injection of the day, brush my teeth, and go to bed. I hope my glucose stays stable through the night, because I’m no stranger to seizures in my sleep due to hypos. I wake up the next day to the same routine, void of any spontaneity.

The nature of type 1 diabetes means that it is often difficult to get through daily life, and sometimes people make it even harder. I’ve been asked if I used to be obese, or if I should really be eating that, and at school, I’ve had my lucozade confiscated and have been kept in detention while pleading to leave because I had DKA. The latter incident sent me to hospital for four days with no repercussions for those involved.  

I’ve focused on type 1 diabetes so far because that’s the one I have, but type 2 diabetes is an equally important condition that deserves equal attention. I get angry when people assume that I used to be obese but only because it highlights people’s ignorance and the negative attitude they have towards type 2 diabetics, assuming they inflicted the condition upon themselves for being too overweight. I don’t know what it’s like to live with type 2 diabetes, but I do know that nobody asks for an illness, and there is no such thing as the ‘good’ diabetes and the ‘bad’ one. Type 2 diabetes can occur for many reasons but none of them warrant the excuse to shame someone for having it. The best thing a non-diabetic can do is to listen and ask how they can help, which is also true for any other health condition, physical or mental.  

Despite the struggles, diabetes has made me realise many things. I’ve been self-injecting since my diagnosis so I have gained a special kind of responsibility. No matter how repetitive it gets, I never skip an injection, and I’m proud of that. My efforts mean that my HbA1c – a way of measuring how much glucose is being carried by the red blood cells in the body – is at an excellent level, so I am much less at risk of complications such as DKA, heart and kidney failure, foot amputation, blindness, and premature death. I am currently in the process of acquiring an insulin pump, a device that will administer insulin via a small machine attached to the body as opposed to through injections. I’ve also been shown overwhelming support from my care team, from friends, family, university staff, and from colleagues. People are slowly becoming more aware of the symptoms thanks to the vast spread of information through platforms such as Facebook, and treatment is gradually becoming more available. It’s unbearable at times but it has taught me resilience: type 1 diabetes is a constant reminder of my indisputable badassery.

[Sarinah O’Donoghue]

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