We all need glucose to give our cells the energy they require to function so that the brain, heart, and lungs all work perfectly. Our bodies will manufacture enough insulin (produced by the pancreas) so that the blood glucose or blood sugar can get into those cells. But people with Type 1 diabetes (T1D) cannot make that insulin, so they have to inject it to help the body work properly. But it does not always go according to plan. When they have too much glucose or too little, there are serious health consequences.
I remember vividly when we had friends over for lunch on a very hot summer’s day. One of them has Type 1 diabetes and he had just been given a new, cutting edge insulin pump. But the pump was not correctly adjusted. He nearly collapsed on the way home and fortunately, his wife was driving. She later told me that he could have died. The irony is that he is a doctor himself!
Let me explain what an insulin pump does. First, it removes the need to have multiple injections of insulin on a daily basis. Second, it has to work perfectly because in many ways it mimics the pancreas. Otherwise, the diabetes gets out of control and may endanger one’s life, as happened with my friend.
Now, if I told you that people with this type of diabetes have to get through each day by checking and preventing spikes or slides in blood sugar, you would probably raise an eyebrow or two, but not give it much thought. So, here are 5 things that diabetics have to constantly monitor and prevent on an almost 24/7 basis.
1. They have to constantly check their blood sugar
They have a blood glucose meter which tests their levels of glucose. But they have to do this between 4 and 8 times a day! They have to do this when they change medication, exercise or when they have gone through a stressful period. They have to do it very often and it means they must always carry the monitor wherever they go. Just a pinprick. But there are no holidays here. Anytime their routine changes, they have to check.
2. They have to know all about blood sugar levels
They know that when they get a reading of 70 milligrams per decilitre (mg/dL), they may have a dangerously low blood sugar count, aka hypoglycaemia. They may already know because of the alarming symptoms such as shaking, sweating, weakness and palpitations. If their levels skyrocket, they are in danger of going into a diabetic coma.
They know their levels change according to the time of day, before and after eating and, of course, at bedtime. Generally, according to the Mayo Clinic, daytime levels should be in the 80-120 md/dL range while bedtime scores should not go over 140 md/dL.
Just have a look here at the chart which explains the target range for blood sugar levels. It depends on many other factors such as age, weight, sex and general health.
3. They have to be extra vigilant when eating out
If you think that diabetics are fussy eaters, think again! They are just trying to avoid a crisis which may in turn save them from going into a coma or fainting.
Because they are following a regular diet where they are watching out for carbohydrates, sugar and starch in vegetables and fruit, they have to careful when eating out. They have to focus on vegetables that are rich in vitamins and minerals but low in starch. They have to watch out for too many carbs as they turn to sugar in their blood. Typical vegetables that are good for them are tomatoes, spinach, onions, asparagus, peppers, and celery. Generally, they have to eat the right proteins and avoid processed foods.
4. They can exercise but they still have to be careful
They have to do another juggling act here! If they exercise (and it is highly recommended as it prevents other health issues), they have to balance insulin with the snacks they eat and the effect the activity has on their blood sugar levels. It also depends what time of the day they exercise and when they eat. The great thing is that physical activity does help to reduce blood glucose levels and reduces depression.
The inspiring story of Jay Cutler, quarterback with the Chicago Bears, who has T1D, has helped both kids and adults to live a healthy life which includes physical exercise.
5. They are really hopeful about the future
And now the good news! The latest insulin pumps are much more sophisticated than they were a few years ago when my friend had his installed.
There are no wires and it is so small that many people never spot it. It communicates with a tiny computer which controls the insulin input. The machine needs a new pod of insulin every 3 days. It can be worn on the abdomen, leg or underarm. Diabetics can even get an extra dose of fast acting insulin just before mealtimes to take care of any carbs they will be consuming. There is even software in the computer which can calculate the right dose before eating.
It is fascinating to read about the latest research reported on the American Diabetes Association website which is moving towards making life a lot easier for people with T1D.
“I think I can, I think I can… I know I can, I know I can… learn to count the carb content of everything that passes my lips; carry monitor, glucose tabs, insulin pump/pen and needles at all times; learn to inject myself throughout the day; navigate the American healthcare system; and ward off the feeling that I’m somehow being punished. We all can. I’ve learned a ton since my diagnosis in 2003. With diabetes, you really do learn something new every day. “– AmyTenrich, Editor, DiabetesMine
There are 3 million people in America living with T1D, and 80 new cases are diagnosed every day. Myths and legends about diabetics abound. One fact is obvious though – if they neglect any of these checks and balances, they are putting their health at serious risk. They may suffer nerve damage, kidney malfunctioning, high blood pressure, vision deficits, and poor skin health which can lead to tissue death. It is no exaggeration to say they have to be their own nurse, dietician and math wizard to survive!
Featured photo credit: Diabetes test/Victor via flickr.com
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