Diabetes Details 9: The Diagnosis
Previous diabetes posts are available by clicking the diabetes tag.
I was diagnosed with type 1 diabetes on October 31, 1998. That’s right, the day I learned my pancreas was a lazy quitter and I’d have to monitor my carb intake for the rest of my life, I got to make my way through a hospital packed full of Halloween candy for the other patients.
My father was diagnosed with the same thing when he was 24 and a half, midway through grad school, so I was familiar with the disease. In October of ’98, I was exactly 24 and a half years old, and was just starting my second year of grad school. (My son is not allowed to go to grad school until he’s 25.)
The symptoms had started a few months earlier. I started feeling a lot thirstier, and drinking much more. Milk, water, orange juice … I even tried a few wine coolers. (This brief period is the only time in my life I drank anything with alcohol.)
The trouble, though I didn’t know it, was diabetic ketoacidosis. As my pancreas cut down to part time work and prepared for retirement, my blood sugar rose steadily higher, throwing my body’s pH out of whack and causing any number of nasty side effects. My body kept trying to flush the crap out of my system, and to do that, it needed fluids.
Of course, the fluids I was drinking had a lot of carbs … which means my blood sugar just kept on climbing. And all that fluid had to go somewhere, meaning I was constantly running to the bathroom, day and night.
In addition to the drink-n-pee cycle, my mood went downhill. I was teaching freshman English at Eastern Michigan, and I remember ripping into one of my students I thought was disrespecting me. When my roommate left his dirty dishes in the sink, I did them … swearing and slamming things around hard enough I’m surprised I didn’t break ’em all.
Mom talks about my father going through the same thing. She says she was relieved when he was diagnosed, because if he had continued acting that way, she wasn’t sure how much longer she would have put up with him.
I also lost weight. A lot of weight. No matter how much I ate, my pancreas wasn’t producing enough insulin to use that food. I dropped from over 150 pounds down to about 130. (For comparison, I was about 160 pounds in this picture. 130 on me is not healthy.)
When I finally figured out something wasn’t right, I headed home. I went out to dinner with my family, then used my father’s glucose meter to check my blood. Normal blood sugar is about 80-120. The meter’s range went up to 600. Mine was too high to read.
Dad said he had already figured out I was diabetic from the amount I drank that night, and how often I went to the bathroom.
The nice thing is that after I went to the hospital, I felt better within a day or two. Insulin is amazing stuff. I had no idea just how bad I had been feeling until I was better.
I’ve kept the disease under pretty good control for 12 years now, in no small part because I remember how miserable I was back then, and I have no desire to go through that again.
I’m very comfortable talking about the disease, so questions and comments are more than welcome. (With the understanding that I’m not a doctor, and I can only talk about my personal experiences.)
For those who are interested, the American Diabetes Association has a list of diabetes warning signs.
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Insulin/syringe photo by starrynight.
Andrew Betts
September 29, 2010 @ 9:49 am
It’s a crazy disease. After my diagnosis 5 years ago I just went willy-nilly not particularly caring until March this year when the doctor said “We need to put you on insulin, your A1C was 11.1%” then I started getting a lot more serious and as of my last check up about a month ago my A1C was down to 6.1%. Now I’ve hit a very troublesome point in that the couple times I’ve missed my shot my blood sugar was actually better in the morning than one would expect. I’ve been averaging 130-140 fasting and the doctor said with my A1C where it was she was fine with that. I’ve tried talking to her about reworking my dose because if me getting none looks better than me getting the 60 units a day something isn’t right there. I’ve been slowly working my way down little by little to see how it goes. It seems to be going steady and I’m hoping that by the three month mark I’ll be down to half my dose of insulin and have more level glucose readings.
Note: I’m on a slow release insulin so I only take it once a day and the doctor’s I’ve seen have never said anything about if I should ever adjust my dose if things start changing. Sometimes I think I’d do better with fast acting insulin, but I don’t think I could handle more than one shot in a day.
Note 2: Sorry about the long comment.
Jim C. Hines
September 29, 2010 @ 9:53 am
Hi Andrew,
6.1 is awesome for a diabetic. Go you!
Okay, for the rest of this, I AM NOT A DOCTOR. I could be talking out of my ass here, so please check with a doctor or specialist before taking me seriously.
With type 2, your pancreas is still producing insulin. One factor *might* be that by decreasing your shot, you’re putting more of the burden on your pancreas to make up for that defecit.
The pancreas is smart, and manages blood sugar better than anything we can do. But I wonder if part of the reason they gave you the higher dose was to try to let the pancreas take it easy, so as to prolong partial function.
Again, I don’t know, and could be totally off base. But it’s a question I’d ask if it were me.
“I don’t think I could handle more than one shot in a day.”
This is why I really like my insulin pump 🙂
Andrew Betts
September 29, 2010 @ 10:03 am
Yeah I don’t think my insurance would ever cover an insulin pump, they hardly seem to cover anything that’s not my doctors visits or prescriptions.
We’ve (the doctor and I) that I can’t recall the name, but its where your body will actually produce sugar if it feels you’ve gone too low and usually happens at night. The problem is I don’t wake up when I bottom out like that (in fact I usually sleep harder) so we’ve been unable to get the concrete data that that is indeed the problem.
In all honesty the biggest reason I want to get my insulin down is cost … I’ve been unemployed for going on two years and while my insurance covers some of the insulin cost between all my meds I’m around $70-100 out of pocket a month which is still pretty pricey … the long term goal is getting down about 70lbs and hoping that works on other things, but genetics is not my friend for parts … C’est La Vie
Jim C. Hines
September 29, 2010 @ 10:14 am
That makes perfect sense. Your sugar drops, so your body dumps some from the liver, which spikes the sugar.
Insurance/cost is such a problem, and I get the sense it can be an even bigger issue with type 2, where the insurance companies don’t seem to believe you need as much care or treatment.
In an ideal world, I’d suggest slapping a CGM (continual glucose monitor) on you for a few days to confirm that nighttime low/dump issue, but of course, that’s another test that requires more money…
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Steve Buchheit
September 29, 2010 @ 1:03 pm
For me, with Metabolic Syndrome (aka Insulin Resistance), it was the weight I put on throwing me into jeopardy. My body makes plenty of insulin. In fact, it makes too much of it because it wasn’t working well (for those who don’t know, your body needs all sorts of good food to eat to supply macromolecules of important stuff, but the only thing it uses to make the energy that drives everything else is Glucose, Insulin is needed for cells to properly uptake Glucose). So I was continually over eating and drinking pop (btw, high-fructose corn syrup and it’s close cousin evaporated cane product/syrup – worst things ever for you to consume, okay, there are worse, like arsenic, but they’re pretty bad). I needed extra sugar and needed it bad. Which lead to more weight. Which lead to the insulin not being able to do its job even more (insulin is weight dependent, ain’t that a kicker). Which lead to me being even more hungry… wash rinse repeat.
Until I 1) went “sprung!” and my body changed and I felt it and cut back on the pops and 2) mentioned it to my doctor who then ran the tests and whoa doggy, look at all that insulin and triglycerides in the blood.
So he put me on Metformin (a common drug used to treat Type II Diabetes), and I lost 50lbs in just over a year without changing much (just not drinking nearly as much pop). I’m fighting for the rest of it (300lbs seems to be my nemesis).
Right now I’m hopeful that I’ll avoid DM, as long as I can lose another 50-100lbs.
Steve Buchheit
September 29, 2010 @ 1:17 pm
Your liver can produce glucose from other products (glycogen and fats, which is why they are the energy storage products of the body). However it has side effects (like killing your liver). Especially if that is the only way you are getting your processable glucose, which lead to your ketoacidosis (ketones are one of the by produces of your liver converting glycogen and adipose/fat to glucose). A little is okay. A lot drives your pH into the area that your body throws in the towel (buffers are amazing things, but they suck when they reach saturation).
This is actually the process that many of the current diet fads count on (South Beach and what’shisname). When you start it’s all proteins and fats, no carbs (sugars). It drives water out and burns up the adipose and glycogen stores. However, if you stay on “just protein” for too long (notice in the diets after a few weeks you start adding carbs back in), you can get ketoacidotic. My own doctor recommended what he called “Adkins on Steroids” (basically just protein with some fats to process the fat soluible vitamins for months on end). With that diet I would have blood drawn every week to make sure I my pH wasn’t taking a dive (also note, that kind of diet should only be done under doctor supervision, see notes about possible death occurring).
Also, not a doctor myself. If you’re having problems, go see one (and not having insurance sucks, been there this year). It’s better than collapsing and (if you’re lucky) getting to an emergency room.
mattw
September 29, 2010 @ 4:08 pm
So far no diabetes for me, but my dad got diagnosed with Type I on or right around his 40th birthday. My father-in-law has had type I since he was a kid and it’s done all sorts of nasty things to his health, the most devistating of which is making him blind.
My father almost died when he lied to me about being sick while my mom was out of town and then refused to go to the hospital until she got home. But that’s a rant for another time. My father-in-law has had a number of close calls.
My wife’s ok so far too, but we’re really on the lookout for the kids. It’s scary.
Jim C. Hines
September 29, 2010 @ 6:08 pm
I’m glad you’ve dodged that bullet so far, but sorry to hear about your father. It can be such a nasty disease.
The one thing I’m holding on to, regarding the kids, is that I’ve seen how much better the technology and treatment have gotten in the past 30 years. The things we have today are a quantum leap ahead of what my Dad was using 30 years ago. So I’m hoping and believing that if my children eventually come down with it, the treatment options will be that much better for them.
Dawn K.
October 4, 2010 @ 3:41 pm
I was diagnosed at 18 months old, so I’ve been Type 1 for roundabout 34 years (this month!) without any large complications (early-state retinopathy). And I’m with you, I love my pump!
“In an ideal world, I’d suggest slapping a CGM (continual glucose monitor) on you for a few days to confirm that nighttime low/dump issue, but of course, that’s another test that requires more money…”
Actually, most doctor’s offices will do this without cost. Mine regularly “makes” me wear a CGM for a few days, about twice a year or so to take a look at the “Dawn Phenomena” (not named after me.. rats).
Also, and I’m sorry I don’t remember the name either, of when your body “saves” itself, but the life-saver produced is called glucagon. It’s nasty, it makes you feel terrible for about three days, but it saves your life. I’ve had it save mine more times than I care to think.
DM is definitely more terrifying than Roudette on a bad day (ha!). However, we can treat it. I see that as a big bonus. 🙂