What Is It Really Like To Live With Type 1 Diabetes?
Diabetes is a daunting word, especially when you are diagnosed with it. That's what I found out first hand when type 1 diabetes was bestowed upon me in 2015. I had symptoms in the prior week but didn't think a lot of it at the time (check out my Symptoms of Type 1 Diabetes blog for more info on common early T1 symptoms). That made the subsequent diagnosis all the more shocking. Being thrown into a whole new world of lifetime diabetes management wasn't something I had ever imagined and certainly wasn't something I knew anything about.
In this blog I want to share my personal experiences of living with type 1 diabetes and what it's really like to manage the disease. It's important to realise type 1 diabetes is very different to type 2 diabetes. Type 1 is an auto-immune disease where the body's immune system mistakenly attacks the beta cells in the pancreas that produce insulin. As a result the body is no longer able to make insulin naturally so exogenous insulin must be administered by the type 1 diabetic for the rest of their life.
Perhaps the biggest part of living with type 1 diabetes is the constant maths puzzles that it involves. For me, this means working out how many units of insulin to take at various times of the day based on a number of factors. Text books sometimes recommend carb counting for type 1 diabetics which means calculating the number of carbohydrates in a meal and administering a corresponding amount of insulin to counter its effect. However I find there are many more variables to consider when formulating this equation.
As far as food is concerned, I try to be as aware as possible of what I've eaten, when I ate it, what I'm going to eat and the nutrient composition of that food. The carb, protein and fat ratios of each meal will alter the amount of rapid insulin I administer. If I've been exercising or will be exercising, then the amount of insulin will differ. The type of exercise I'm doing will also impact this calculation. A high intensity weight lifting workout will require a different amount of insulin than a low intensity cardio session. If I'm particularly stressed then insulin sensitivity will be altered so insulin administration will be altered to counter. If I have a cold or other illness then this can greatly impact blood glucose levels so again, insulin levels need adjusting accordingly.
It's true to say there are a vast number of factors than can affect blood glucose levels of a type 1 diabetic and therefore insulin administration. To be aware of this mixing pot of variables is more of an art than a science but it's important for me to keep on top of them as best as possible in order to optimally control my blood glucose levels. Keeping tabs on this amount of continually changing information may sound like a headache but the habit of remaining aware of the variables becomes somewhat natural over time.
Tied into the maths puzzle of blood glucose levels is the actual insulin injections. First I will test my current blood glucose level with a lancet and blood glucose monitor. Typically I will then take rapid insulin before each meal and slow release basal insulin once per day before bed. Depending on the social setting though, this can be difficult. At a restaurant for example, the nutritional composition of a meal is often not available from the menu so an educated guess may be required. I will also normally excuse myself from the table in order to test my blood glucose level and inject insulin in a more suitable place. In order to prevent lipohypertrophy I rotate injection sites regularly. For more on that fun subject be sure to check out my "Where is the Best Place to Inject Insulin as a Diabetic?" blog.
Of course, in order to monitor blood glucose and administer insulin, equipment is needed. For me, this takes the form of rapid and basal insulin pens, a lancing device, lancets, blood glucose testing strips, ketone strips, a blood glucose monitor and a sharps box. With the NHS in the UK all type diabetics are entitled to free prescriptions which is great. I still need to keenly monitor supplies though to ensure none of the extended list of items runs out.
Keeping blood glucose levels within a low, narrow range throughout the day is ideal but not always possible. Living with type 1 diabetes involves temporary hypos (low blood sugar) and hypers (high blood sugars) and these can occur at any time. If my blood glucose drops low, say below 4 mmol/l, I will usually start sweating, feel weak, hungry and experience brain fog. If my blood glucose goes high, say above 10 mmol/l, then I may feel lethargic or pass urine more frequently. The severeness of these symptoms is linked directly to the extent of the hypo or hyper.
Hypos can even happen when I'm asleep at night which sounds scary. Luckily, as this isn't a frequent trend for me, my body is sensitive to this drop in blood sugar and I'll wake up. At which point I will get up, test my blood glucose level and eat some carbs to counter the low blood sugar. Waking up is definitely a blessing but the interrupted sleep can also be a pain, leaving me tired the next day.
With type 1 diabetes there are also extra to-dos such as a hospital checkups every 6-12 months, a yearly diabetic eye screening, HbA1c blood tests, a yearly flu vaccination and a triennial driving licence renewal in the UK.
Overall, type 1 diabetes has made me more aware of my nutritional intake, reinforced the importance of exercise and left me feeling healthier than before my diagnosis. For type 1 diabetics, the truth is that diabetes is a part of your life but it's certainly not your life.