A Special Skill

I’ve spent this week studying for a physiology midterm on the cardiovascular system so the heart’s been on my mind, and I remembered this terrific diabetes analogy by George Simmons, who blogs at Ninjabetic.com   

“Imagine having to pump your own heart because it didn’t do it by itself. And when you want to sleep you have to pump it slower. For exercise you would have to speed it up. You would have to know the rate of pumping for every activity. Do you think you could do it? Do you think it would be easy?”

For any non-diabetic reading this, living with an improperly functioning pancreas means diabetics have to manually mimic the functions of the pancreas (matching insulin to carbs to maintain homeostatic blood sugar control).  It’s not easy, and it is often as difficult as manually controlling your heart sounds. (Interestingly, I just completed a lab in which we constructed a manual analog of a heart and then tried to maintain a steady heart rate while we manipulated the system, and I can attest to the fact that it was very difficult to do.)

For any diabetic reading this, take a moment to reflect on the difficulty of living with type 1 diabetes, and congratulate yourself for coping and prospering with the disease.  When I was diagnosed with diabetes as an 11 year old, the nurses told me that I was still just like every other kid, I just had a couple special skills because I knew about carbohydrates and insulin and how the body balances these things.  Of course, the older I got the more other people started to know about these things, but I’d still like to think that type 1 diabetics have a special skill that is, quite simply, living with type 1 diabetes. Maybe we should start listing it on our resumes under accomplishments or skills. Goodness knows it takes skill to achieve good blood sugar control, and having good blood sugars, even for a day, feels like a far greater accomplishment than any artificial award.

A Global Health Perspective of Type 1 Diabetes

Monday marked the 90^th anniversary of the first time insulin was used on a human diabetic patient. Thanks to Frederick Banting (hooray for the Canadian connection!), not only is type 1 diabetes no longer fatal, but technological advances since his discovery of insulin have brought us such conveniences as insulin pumps and continuous blood glucose monitors, allowing type 1 diabetics to live long, healthy lives. 

But from a global health perspective, this is simply not the case.  The number one cause of death in type 1 diabetics worldwide is still lack of access to insulin.  Insulin.  The magic hormone that gives me life, 9 ½ years after my diagnosis.  Yet it is so easy for most of us type 1 diabetics in developed nations to remain thankless for this life-saving hormone, and instead focus on the hardships of living with type 1 diabetes.  It is so easy to be flippant with blood sugar control, to indulge in sweets when blood sugars are high, and overcompensate with insulin.  How many times have I griped about a high blood sugar, or been annoyed by the paperwork that comes with ordering diabetic supplies?  Too many times to count. What are your most common diabetes complaints?

Maybe it is time to take a step back from the luxuries of life in a developed country, and be thankful for the most necessary component of our life: insulin.  What would we do without it? You know the answer, and it isn’t happy.  But it is a reality for thousands of children with type 1 diabetes in developing nations.  For those who have the opportunity to be diagnosed in a hospital, they may have access to insulin, though the access will likely be inconsistent and liable to stop.  But many people are unable to even receive a diagnosis, and pass away without ever having known their condition was type 1 diabetes. Without ever knowing that it is a treatable condition.

I realize that there are many complex political, economic and social issues which underlie this inequality between the life of type 1 diabetics in developing versus developed nations, and I don’t believe we should spend all our time being sad about this dismal reality. But knowing it exists may just be enough to shift our perspective on our own diabetes, and maybe from that shift, we can grow a global solidarity of type 1 diabetics.  Perhaps together we can invoke change.  May we mourn over the deaths caused by type 1 diabetes, but may we also rejoice over the many lives that insulin has saved.    

Today, I was thankful for Banting’s discovery of insulin. Were you?

Any facts listed in this post came from the following International Diabetes Federation's article: http://www.idf.org/global-idfispad-guideline-diabetes-childhood-and-adolescence

For an interesting read about Banting's discovery, check out the following BBC article: http://www.bbc.co.uk/news/health-16657425 

My Diabetes Success Story

This post is written as a response to the International Diabetes Federation's tweet: “We have the power to change. What is YOUR #diabetes success story? Let us know how you intend to carry on the success into 2012”.

My diabetes success story does not begin with success. It takes place 3 years ago, during my first semester of my first year of university, when I was struggling to balance the newness of university academic, extracurricular and social activities with all the usual inconveniences of life with type 1 diabetes. This story may not begin with success, but it does end with it.

Exam season of first year university is a stressful time. Personally, I found myself very stressed about my chemistry exam, as it was the course I found the most difficult, and my mark was consequently not as high as I would have liked, so I really had to ace the exam to get the mark I wanted. After long days of studying, I finally felt prepared for this beast of an exam, and the morning of the exam I ate a big bowl of Mini Wheats cereal (for comic relief, click the link), something I don’t usually have for breakfast because I do not find it very filling.  As a result of this highly sugary breakfast, my blood sugar an hour before the exam was sky high, and I felt terrible and thirsty. In my agitated state, nervous about the exam and feeling groggy from hyperglycemia, I over-bolused.

Flash forward to mid-exam, and the mixture of the sugary cereal carbs, that flashed through my system far faster than they should have, combined with my over-bolusing for a post-meal hyperglycemia, meant my blood sugars were low and dropping fast.  But because this was one of my first university exams ever, and because my mind was unclear due to hypoglycaemia, I didn’t immediately call on one of the invigilators to ask to go to my bag and test my blood sugars.  Instead I sat in my seat, attempting questions that seemed impossible to my sugar-deprived mind, and I believe at some point I must have momentarily blacked out (Note: I have never passed out from hypoglycaemia, although twice in my life, this being one of those times, I have blacked out, while still moving and functioning as normal to those around me, though I simply don’t remember time passing), because next thing I knew there was only an hour left in the three hour exam and I was barely half done.

I finally beckoned the invigilator and got some juice into my system, but by the time my blood sugar was up enough to function properly, I didn’t have enough time to do all the questions on the exam properly and I rushed through quite a few multiple choice questions in the end.

I did poorly on the exam, which was extremely upsetting given the amount of preparation I had done, and the potential I had going in to that exam to succeed, which was all wasted because of my low blood sugar.  I was furious. Furious at myself for allowing my blood sugar control to be so poor, furious at Mini Wheats for being such a terrible breakfast choice, and furious at diabetes for interfering with my life.

But I channelled that anger. I decided that from that day forward, I would not allow poor blood sugars affect an exam.  I strategized. I experimented with different breakfasts (peanut butter toast, oatmeal, eggs, etc.) to see which offered the most stable blood sugar control and minimized the effects of the Dawn Phenomenon (in case you’re wondering, oatmeal was the winning breakfast choice in the end).  I planned.  I made sure I always had juice and crackers in my bag before exams, and made a plan to test multiple times before exams (3 hours before, 2 hours before, 1 hour before, 30min before and 5 mins before) to track my blood sugar pattern.  I prepared for the worst by ingraining in my head that the moment I felt low during an exam, I would immediately summon the invigilator and test my blood sugars, to maximize the time that my blood sugars were normal.    

Now, 23 exams later, I can honestly say that my diabetes has not affected my success on any of my exams since that fateful chemistry exam.  Though this story does not begin with success, I can certainly say it ends with success.  Success that will continue throughout 2012 and that will see me through the rest of my undergrad career, and throughout whichever post-grad opportunities I pursue.    

“Our greatest glory is not in never falling, but in rising every time we fall.” -Confucius