Diabetes Awareness Month

November is ‘diabetes awareness month’, so as a fairly recently diagnosed diabetic, I thought I’d give you some info about this disease.

People with diabetes cannot control the amount of glucose (sugar) in the blood.  We require glucose for energy, and a hormone called insulin allows the glucose to enter from the blood into the cells in our bodies.  Our bodies have some fantastic mechanisms, and one of them is blood sugar regulation.

We get glucose from the carbohydrates we eat.  In a non-diabetic, two hormones; insulin and glycogen work to stabilise the amount of glucose in the blood.  Normal values are between 5 and 7 mmol of glucose per litre of blood.

Insulin is produced by the pancreas, and acts like a key, letting the glucose in the blood gain entry into cells to be used for energy.  When blood glucose rises, eg after eating carbohydrates, the pancreas produces more insulin and the excess glucose goes into the cells.  If the blood sugar drops, there is another hormone called glycogen, that causes the liver to release some of its stored glucose.

In type 2 diabetes, the receptors on the cells do not work properly – they do not recognise the insulin, so glucose cannot enter the cells.  The pancreas works harder to create more insulin and eventually 'tires' and stops producing insulin all together.

In type 1 diabetes, the cells in the pancreas that produce insulin (beta cells) are attacked by the immune system, and there is no insulin produced. Type 1 diabetics always have to inject insulin.

There are over 3 million people with diabetes in the UK (29million in the USA).  By far the majority – 90% are type 2. 

I am a type 1 diabetic, so not producing insulin.  I have to inject insulin 3 or 4 times per day.  Insulin comes in 2 forms:

Basal insulin.  One injection per day of long acting insulin, a kind of background insulin that counteracts the liver’s own production of glucose.

Bolus Insulin.  Injected at each meal depending on amount of carbohydrate consumed.

I use this ‘Multiple Dose Insulin’ regime, but some people have a pump, permanently attached which drip feeds small amounts of insulin constantly, more like the pancreas in a normal person.

There is always the possibility of the blood sugar going outside the ‘normal’ range, especially as other factors can affect the blood sugar too, such as activity levels, illness, stress and alcohol.

Hypoglycaemia.  When the blood sugar goes below 4mmol/l, it is called a ‘hypo’.  Hypos can be a bit scary, as you can feel quite unwell, sweaty, dizzy, jittery, nauseous, confused.  (A bit like when you’ve had too much coffee)  You need to treat the hypo as soon as possible by consuming fast acting carbohydrate such as fizzy sugary drink, jelly babies, dextrose tablets etc.  If not treated, it can become a medical emergency as you can slip into a coma and die.

Hyperglycaemia.  When the blood sugar goes high, ie above 7mmol/l, it is a ‘hyper’.  If blood sugar is constantly above 7, the risk of complications gets much higher.  There is also the risk of DKA (diabetic ketoacidosis), a nasty condition where the blood gets acidic and you can become very unwell very quickly and require hospital treatment.

Consequently, I have to check my blood sugar at least 5 times per day, by pricking my finger and using a drop of blood on the test strip that goes in the meter.

I always carry a blood sugar meter and hypo treatments.  Right now my choice is jelly babies!

The risk of complications such as blindness, heart attack, stroke, nerve damage leading to amputation and dementia increases the longer the blood sugar is above normal range. 

Many diabetics are finding that a low-carbohydrate diet helps, and some type 2 diabetics have been able to reverse their disease with this diet plus exercise.  I have been trying to eat low-carb, but it is difficult!  At the moment, I am eating some carbs, as I am still trying to stabilise my blood sugar, as I have not been using MDI for long. 

It is an emotional rollercoaster.  From shock at first diagnosis that I have a life long medical condition, to fear about the future and the complications, to sheer desperation that I can’t seem to get my blood sugar levels right, and depression for the sheer slog of having to think about it all the time.

But… there are worse diseases to have!  I can continue my life reasonably normally, I still exercise, I still drive, I can still do all my crafts.  I am grateful for that, and that Insulin was discovered and it keeps me alive. I am grateful too that I became diabetic in my 50s and haven’t had it all my life.  It must be really hard if you have a small child with type 1 diabetes.

Do please let me know in the comments if you have any questions and I’ll try to answer them.  I don’t claim to be an expert, but it’s amazing how much I do know about the disease now!