There. I said it. Diabetes. Twenty years ago, I was diagnosed with diabetes. I have almost said it in a couple of blog posts, but never quite got up the nerve. I alluded to it in my posts on Healthy Eating and Orthorexia because I am always on a diet. Sometimes, a diabetic diet. Right now, both a diabetic and weight loss diet. Since I know many people can relate to this story, here goes.
When I was diagnosed with diabetes 20 years ago, I weighed 110 pounds. There is a misconception, I think, that you have to be overweight to develop diabetes. That is not true. I have diabetes on both sides of my family. Most of my aunts and uncles have diabetes and some of my cousins. The genetic cards were stacked against me. I remember coming home after the doctor gave me this news and announcing that diabetes was not going to change my life. I think back to that now and laugh. Maybe grimace is a better word.
I tried to control my blood sugar, at first, with diet and exercise. That is usually how doctors like to proceed. It very quickly became obvious that I needed more than diet and exercise. My elliptical and a strict diet just weren’t working. Diet for a diabetic, back then, meant no sweets and perhaps the old diabetic exchange system. Not much more. I went back to the doctor.
Next, we tried diet, exercise, and the drug metformin. The maximum dose. Metformin is a drug with a number of uses, but at this time, it was used primarily for lowering blood sugar in Type II diabetics. The beauty of metformin is that it also helps prevent negative cardiovascular events from occurring in Type II diabetics. We are at risk for heart events just by virtue of the fact we have Type II diabetes. Again, I stuck to my diet, rode the elliptical like a fiend, and took my metformin. My blood sugar did not come down. I felt like I would have to exercise on the elliptical for two hours after meals to make even a dent in my blood sugar.
Again, I returned to my primary care doctor. He decided that my particular case of diabetes was beyond his expertise and sent me to an endocrinologist. Endocrinologists specialize in diseases of the metabolic system such as diabetes and thyroid disorders. The endocrinologist was suspicious that maybe I did not have Type II diabetes after all. Maybe I had adult-onset juvenile diabetes or Type I diabetes. He did some tests for antibodies that indicate the presence of Type I diabetes, but they were negative. I had Type II diabetes, but I had very hard to control, brittle diabetes. The fear was that my high blood sugar was going to start causing damage to organs in my body so there was nothing to do but start on insulin, along with metformin and, of course, diet and exercise. By this time, most doctors were at least having their diabetic patients visit a dietician but except add “portion control” to the no sweets advice, not much had changed.
Type I diabetes occurs when the pancreas does not produce insulin and occurs primarily in children. It requires immediate insulin therapy. Type II diabetes is often seen in people who have insulin resistance. Their pancreas still produces insulin but, for whatever reason, their body cannot use it. In my case, I had been diagnosed as a Type II diabetic, which was the correct diagnosis, but I produced almost no insulin. It took several years before this was recognized by my doctors. When a Type II diabetic has to begin using insulin, they are then classified as a Type I diabetic.
Back in those days, insulin was still administered with a syringe and a vial of the drug. Those shots weren’t fun, but they did start to bring down my high blood sugar. My doctor specified the dose and it was very hard to get it right. Sometimes, the insulin was too little and my blood sugar would still go too high. The scarier times were nights, when my blood sugar went too low and I would wake in the middle of the night shaking, sweating, and have to stumble to the refrigerator to get a quick glass of orange juice to bring my blood sugar up. It often went too low at night.
I was still working during all those years. In fact, I worked for 15 more years as a college professor after I was diagnosed with diabetes. There were days when I felt good, like myself. There were other days where the fatigue, a side effect of diabetes, made going to the office almost more than I could do. I’m sure I would have taught longer had diabetes not struck. I am still working now as a writer, but I am retired from teaching.
Life got a little better regarding diabetes when the insulin delivery system changed from the traditional needle to a punch needle system. About the same time, carbohydrate counting became an option for controlling blood sugar and it seemed to suit my needs. You simply count the carbs you eat at each meal and take the appropriate amount of insulin for that amount of carbs, based on a formula supplied by your doctor. I was able to control my blood sugar better than ever as indicated by my A1c readings, around 7.0, along with my home monitor readings. Doctors were finally recognizing that “sweets” were just one carbohydrate and that all carbohydrates raised blood sugar. My endocrinologist was pleased.
Taking insulin is a mixed blessing. It saves a diabetic’s life. But, it makes you hungry. Diabetics have to watch what they eat, and how much, very carefully. Insulin, and the resulting hunger, cause weight gain and I gained some weight which caused poor blood sugar control once again. Taking insulin is a vicious circle. At this point in my life with diabetes, I was taking up to 90 units of Novolog insulin during the day and 60 units of Lantus insulin at night, along with a fairly new drug called Janumet. As any diabetic or doctor who is reading this knows, that is a lot of insulin. Janumet is a combination of metformin and sitagliptin. Sitagliptin is a bit more dangerous than metformin. It is more likely to cause low blood sugar and other side effects. It increases the amount of insulin a diabetic produces and decreases the amount of sugar produced by the liver. I knew I had to do something. I just wasn’t sure what and neither was my doctor. All that I knew was that I wanted to have a life. A normal, active life.
By this time, low carbohydrate diets had become popular. I did a lot of my own research, talked to my doctor, and decided to go on a low-carb diet to see if I could lose the extra weight I had gained and, as a result, lower my insulin requirements. That’s where you find this writer today. I am happy to report that it seems that a low-carb diet is working for me. My blood sugar control is the best it has been in 20 years. My weight is dropping and I am optimistic I can get to my goal. It isn’t far away now! I don’t even crave carbohydrate-rich foods any more. I live on lean protein and salad. I feel the best I have felt in many years and can, once again, have a normal life. When I reach my goal weight, I will allow myself some carbohydrates here and there, but not many. I have worked too hard for the success I’m enjoying. I’m not able to exercise much yet. Insulin makes that difficult, but since I take much less than I used to, I hope exercise is in my future.
The change in my insulin dose is remarkable. Most days, I take no daytime insulin at all. I don’t need it anymore. I still take 55 units of Lantus insulin at night. Since I don’t produce insulin myself, I will always need a maintenance dose at night. I also still take Janumet though that could change.
It wasn’t particularly easy to write this account of my struggle with diabetes. It’s very personal. I thought it would be cathartic for me and perhaps helpful to some of you. Helpful because you will know you aren’t alone. Helpful because maybe it gives you a place to start. But, don’t start anywhere until you talk to your doctor. Your mileage may vary though I would encourage you to do research on your own. Don’t be a victim of this terrible disease. Take charge of your diabetes. Don’t let it take charge of you. It works silently and will damage your heart, eyes, nerves, kidneys, blood vessels, and much more. Work with your doctor and find out what works for you. You will feel so much better and be able to live a long, happy life!
A great blog on Type II diabetes is Diabesity
I’ll keep you posted.
*Image by Stuart Miles FreeDigitalPhotos.net