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All About Diabetes:  Everything you need to know in Layman's Terms.

First of all, let me tell you some common myths and how they are WRONG!  (I'll try to be nice)

1.  Just because someone has diabetes, doesn't mean they can't have sugar!  This may not be the same for everyone, but for me, one of the worst things you can do is walk up to me and tell me I can't have something, because #1, it raises my ears on my bitchy side, and #2, it makes me want to eat it just to prove you wrong!  :D

2.  I think one of the oldest of them all: diabetes is not catching!  At all.  Not even minutely.

3.  It's not the sugars that count, it's the carbohydrates.  For me, anyways.  Everyone is different.

4.  It is not the end of the world.  It's a complication, but not the end of the world.  That comes much later, if you've spent years not taking care of it.

Type 1, or juvenile diabetes is a autoimmune disorder.  The difference between Type 1 and Type 2 is that Type 2 is termed "Adult onset" diabetes, it is usually brought on much later in life, due to complications like high blood pressure, high cholesterol, overweight, not exercising and a lousy diet.  Type 2 is simply that the person in question has developed what is called insulin resistance.  More about this later.

Insulin is this nifty little drug, more or less, in your body that allows the sugars in your blood stream to pass into your muscles, thus giving you energy.  When I was little and going to diabetes camp about this they used to show us little pictures of an "I" opening a door into the muscle from the bloodstream.  It is produced by the Isles of Langerhans, located on the surface of the pancreas.  When insulin is not around, the sugar builds and builds in the blood stream, and the body throws up it's little hands in despair and says "I don't know what to do with this" and shunts off the extra sugar to the bladder, where you pee it out.  This is called ketones, meaning sugar in the urine.  In the olden days, the way you used to find out you had diabetes is that you would find someone who would taste your urine; if it was sweet, you had diabetes.  Ewww...  could you imagine that?

For Type 2 diabetes, insulin resistance kind of works like this.  It's like when you taste a food you don't really like at first, but it "grows on you":  you develop a liking for it.  Insulin resistance works much the same way, except it's your body getting used to the insulin.  The more resistance you develop, the more insulin it takes to open a door for the sugar.  Normally, type 2 can be treated with pills, and controlled diet and exercise.  Only in extreme cases is insulin needed.  (The only advantage to me having Type 1 is that I can't get Type 2).  However, more and more children have been developing Type 2 Diabetes.

So Type 1 diabetes is partially an opposite of Type 2.  It is either gotten when born, or develops in the early years of childhood.  It's not a resistance to insulin; the Isles don't make any insulin at all.  In fact, if I'm right, the Isles of Langerhans don't exist at all, but don't quote me on that.  Type 1 is an autoimmune disorder, I said that already.  I developed Type 1 at the age of 5, and what happened was my little white blood cells got all confused, saw the insulin-producing cells as invasive or a virus, and ate them all up.  So in order to treat Type 1 Diabetes, you have to actually give the body insulin.  Otherwise, you get one sick little kid who eats and drinks enough to put an elephant to shame, goes to the bathroom every minute, and is losing weight like he's running a 10 mile marathon every day.  In fact, those symptoms are tell-tale signs of diabetes; that's how Mom and the family doctor knew I had it.

Ok so I've got diabetes, so what?  Well...  it means I have to give myself insulin, by syringe.  This is where it gets complicated.  In a normal person that produces its own insulin, the body can usually correctly judge how much insulin to produce.  When you eat, guess what?  It gets changed into sugars which goes to your bloodstream, your brain says "Oh I just ate," your body calculates how much sugars you ate, and produces the correct amount of insulin to compensate.  If it can't produce the correct amount, then it's Type 2.  My body can't do any of that, so I have to do it all manually.  Here's where all the fancy gadgets come in (and trust me, it's amazing how far they've come in the 14 years I've had this).  Because in order to give myself the correct amount of insulin, I have to know how much sugars, or glucose, is in my blood.  Gadget for that, check.

It's called a blood sugar meter, or just a meter for short.  You load up a special strip, prick your finger, and put some blood on the strip.  30 sec later, it tells you how much sugar is in your bloodstream.  My meter is a little round thing with internal strips in a disk, and when I load a strip it sounds like a gun being cocked.  Ok so I've tested my blood sugars, the meter just happens to read 442 at 12pm tonight before I tried to go to bed.  What does that mean?  A normal person's blood sugar runs at an average of 90-100 mg of sugar per dL of blood.  Most meters nowadays read in mg/dL.

So let's talk about blood sugars (or Blood Glucose, also BG).  Like I said, a normal person's blood sugar runs at about an average of 90-100 mg/dL.  So mine is 442, so what?  Well, after we've gotten done running around and screaming because it's so high, think about it a little bit.  In a normal person…  well I'm not completely sure whether this would happen or not, because as soon as the blood sugar starts getting high, the brain says "Oh, my blood sugars are high," and the body gives insulin to compensate.  You guessed it, my body doesn't do that, I have to do it manually.  The doctors have this fancy formula for figuring out what's called a correction factor, it's how much 1 unit of insulin brings down blood sugars in a certain amount of time.  Mine is take the high, subtract 100 (that's the blood sugar I'm aiming for), and divide by 28.  That gives me something in the area of 11 units, so that's how much I give.  Oh and by the way, when you hear diabetics talking about being "high,"  this is what they mean, not high on weed or something like that.   :)
Special things about High BG:  everyone usually has a different range for their BG, mine is something like 70-160, which means that anything over that 160 is considered high, and I need to give a shot to correct.  On the range of 'badness' of a BG: 

200-250 is high, but not that high.  Missed a shot somewhere

250-350 is getting up there,  give more insulin!

350-390 Oh my, we're getting up there…

390-490   400s, red alert!  Give lots of insulin, check ketones, be sedentary so you don't make it worse!

490-600   AHH!!  500s!  red alert +1!  See above

600+   most meters only read to 600, so when testing, this just shows up as HI on the meter.  Check ketones, give insulin, check every half hour afterwards to make sure it's coming down.  If it's not, call the doctor if you haven't already, being this high is scary.

Oh yea, I almost forgot about ketones.  Remember how I talked about them earlier?  It's sugar in the urine, it happens when you go high, don't have enough insulin, and the extra sugar moves to the bladder (which makes you pee a lot when you're high).  When you start to see numbers 300 and up, they start being a problem.  Ketones can make it difficult to bring a BG down.  If you exercise with ketones, your BG might go higher.  I don't know why, the doctors probably told me and I forgot.  You also have to buy special strips to check these.  The other place these come into play is if it has been a long time since you've had insulin, then you can get what's called Diabetic Ketoacidosis.  I don't completely know what it is and I've never had it, I just know it's bad.

**Edit**  I have been corrected.  Ketones come from the body when it burns proteins for energy.  It is a byproduct of the body burning iteslf up to keep the organs fueld, because there is no insulin to let the sugar into the muscles.

Ok so that covers high BG, what about the other end of the spectrum?  According to my range, anything below 70 is a low BG.  For me, lows are the worst.  I don't feel anything when I'm high, but when I'm low, the world shakes.  Ok not the world, but I sure do.  Everyone can have different low BG symptoms, mine just happen to be that I get shaky, disoriented, my mind wanders even more easily, sometimes I get cold sweat.  And tacked on to all that is what is called the "see-food diet."  It means don't take me grocery shopping, because my brain has gone on red alert and is telling my mouth to eat everything in sight.  Not ever a good thing, because then I over-correct the low and go high!  I know that normal people can go low, they just may not recognize it as easily.  Maybe the "see-food diet" is a normal reaction because the body needs food.  But just as there is a correction for a high BG, there is a correction for a low BG, and it comes in the form of glucose tablets.  These are something that probably every diabetic carries around with them, it's a little table of condensed sugar.  For me, 1 of these brings me up by 20mg/dL,  but it's still a good idea to eat something a little more long acting so that you don't go low in the future.  There's also a few other things for low glucose.  One is a liquid glucose that (at least for me) usually tastes like oranges, it's in a little tube with a twist off cap.  The last ditch effort for being low is something called Glucagon.  Most diabetics have a few of these stashed somewhere too.  It's a red kit with a bottle and a syringe in it.  The bottle has a tablet of dried sugar in it, and the syringe has a liquid in it.  You inject the liquid into the bottle, shake it around a bit (I think) and inject it into your diabetic friends arm, or wherever the directions say to inject it.  Trust me, if this has to be used, it's a pretty safe bet that the diabetic in question is either unconscious or close to it.

Why is a low BG a big deal?  Because when you're testing your BG and it reads a low number, it's telling you the amount of glucose in your blood.  If that number reaches zero…  well they all tell me that's when you're dead, it may not be *quite* that drastic.  But in any case, it's still really bad, even worse than being 600+.  Most meters read as far down as 0, so if it's saying LOW and you're still conscious…  get a second opinion on another meter, that one might not be working right.  Here's the range of 'badness' for a low BG, mostly mine:

70-80  Start feeling shaky, "see-food diet" kicks in.  Test and eat glucose tablets if needed.

50-70  about the same as above, maybe a tad bit worse

40-50  visibly shaky, "see-food diet" is in full force.  Test, correct, and be sedentary!

25-40  red alert!  Might want to try some of the liquid glucose, it's faster.

20-28  most people start to get a little loopy here, time for more liquid glucose.  Don't let them wander anywhere.

23  lowest I've ever been, amazingly enough I was still fully conscious and thinking mostly straight, I hadn't even noticed I was low.

0-20 not sure, but it's a pretty safe bet the diabetic is unconscious.

To sum it all up, when I gave shots I gave 10 or more a day.  I had to give a shot every time I was high, I had to give a shot every time I ate, and in the evening I gave my long-acting insulin which was a 24-or-so acting insulin.  Don't be scared, it's different for everyone, and I'm not done yet.  The key to diabetes is control, as close to a normal person as you possibly can.

On the other hand, what happens if you don't control it?  Lots of 'fun' stuff…  there are many complications that can happen if the diabetic in question does not control it, and they're all scary.  You can lose some of the circulation in your extremities, or they can fall asleep permanently, which I think goes hand in hand with diabetic neuropathy.  You can go blind.  Being out of control plays havoc with your body's immune system:  it can't heal as well, or fight off infection.  I know people who have died from complications:  one of them always ate candy and never compensated, never did what she was supposed to.  She lost the circulation in her feet and ended up having to have a toe amputated.  That got infected, so they took the foot, which got infected so they took below the knee, then above the knee…  Bottom line is, keep yourself in control.  Yes it's hard, I'm still struggling with it, and I've had complication scares – when my outside fingers started to go numb and tingly I thought it was neuropathy, but it turned out to be just pinched nerves in my elbows.

Now that I've covered all the dire stuff, here's the cool stuff.  About 6 years ago, I stopped giving myself daily shots because I got put on an insulin pump.  Insulin pumps are COOL!!  It basically acts as an artificial pancreas.  The details of the way a pancreas works is that it gives little amounts of short-acting insulin all the time.  This is called a basal rate.  In an insulin pump, you program how many units of insulin (either humalog or novalog, both short acting insulins) you want it to give per hour, and you can change the amount every hour depending on how your body acts.  That's the background stuff.  When you eat, or if you're high, you just punch in how many units of insulin you want it to give, and viola!  This is the bolus rate.  It gives it through a small cannula that is injected into the body at places you would give insulin, and changed every 2-3 days.  The pump I'm on currently, a Medtronic Minimed pump, has a bolus wizard which I program in my correction factor and my insulin to carb ration for meals, and all I have to do is dial in how high my BG are and how many carbs I ate and it will calculate how much insulin to give me.
Cool, huh?  Trust me, you can still be out of control with an insulin pump.  :)

Some nifty little links to find out more about stuff like this:

Juvenile Diabetes Research Foundation
Medtronic Minimed

Oh yea, there's another type of diabetes called gestational diabetes... but I don't know anything about that one. :)