Posts Tagged 'insulin'

One thing I have in common with new British Prime Minister Theresa May

She’s a woman, we’re about the same age, and we’re both survivors. The most significant thing I have in common with Theresa May, though? It’s actually one thing we both would rather do without: the new British Prime Minister and I have Type 1 diabetes.

Theresa May, the UK's new Prime Minister.

Theresa May, the UK’s new Prime Minister.

Millions of people have diabetes. Only a small fraction of us have Type 1, though. That’s the one that is also known as juvenile diabetes. I was diagnosed with Type 1 at age seven. Prime Minister May was diagnosed in 2013. This BBC story about her last Tuesday demonstrates just how complicated it can be to fully understand the chronic disease:

She has rarely opened up about her private life although she revealed in 2013 that she had been diagnosed with Type 1 diabetes and would require insulin injections twice a day for the rest of her life — something she says she had come to terms with and which would not affect her career.

I looked up an interview where she mentioned her diagnosis. “I’m on an insulin regime so I’m injecting insulin four times a day,” she said (the emphasis on the number four is mine). In the interview She also explained that she takes additional injections when she eats extra carbs or her blood sugar tests run high.

Okay, I hear you. It’s just a number. What’s the difference between two, and say, four? Or more? Trust me, it’s a tremendous difference when you’re the one taking all those injections. Not to mention the blood test you need to take throughout the day to determine if you got the amount of insulin right the last time you took a shot. Or whether you still need to take more

Type 1 diabetes — the kind Theresa and I have — comprises only 5 percent to 10 percent of diabetes cases. Type I diabetics have to inject insulin –pills won’t work. In Type 1, the immune system destroys the cells in the pancreas that make insulin. Researchers have not yet been able to figure out why that happens, but they do know it has nothing to do with the person’s behavior.

Ninety to ninety-five per cent of the people who have diabetes have Type II, and in those cases doctors often prescribe exercise and weight reduction. A number of people I know have been “cured” of Type 2 by exercising and losing weight. Type 1 is a whole different story. Prime Minister May and I could run, jump, swim, skip rope, lift weights and do cartwheels from sun-up to sundown (okay, truth is, I could never do a cartwheel, even when I was a kid, but you get the picture) and we could shrink down to a size 3 dress, but we’d still need to inject insulin. That’s because, no matter how much we weigh, those of us with Type 1 produce no insulin. None. Nada.

And so, Theresa and I — along with millions around the world who have juvenile diabetes — take insulin every time we eat. We test our blood several times a day to make sure glucose levels are within range. We balance meals, snacks, exercise and medication to prevent diabetes complications, which can include kidney failure, amputations, and … blindness.

Fast-acting insulins, insulin pumps and home blood monitors were not available 50 years ago when I was diagnosed. I took shots, avoided sugar, and tested my urine at home from time to time to get a guess at what my sugar levels were. I was advised not to have children, warned of the likelihood of complications and told I likely wouldn’t live past age thirty.

No surprise that throughout my childhood I saw my juvenile diabetes as a weakness. In early adulthood, though, I decided to fight back. I studied the disease, bought one of those new-fangled home glucose monitoring machines, and with my husband Mike’s help and support we started testing my blood regularly. I became more vigilant about exercise, walking everywhere and swimming every other day and closely monitoring how much that exercise brought my blood sugars down. I figured out how much my favorite foods brought my blood sugars up, too, and now I inject that new fast-acting insulin six, seven sometimes eight times a day to balance the meals and snacks I like to eat.

A new blood monitor at home talks — it calls my numbers out loud, so Mike doesn’t have to be around every time I want to check my sugar levels. Controlling my blood sugar keeps my weight at a steady level and gives me good overall health. Best of all: It makes me feel good.

Today’s appointment of Theresa May as UK’s new Prime Minister makes me feel good, too. Her appointment gives me even more reason to think that our Type I diabetes is not a weakness after all. It’s a strength. Living well with the disease teaches us perseverance, self-control, discipline and resourcefulness. Coordinating meals with insulin injections forces us to think ahead and make good decisions. Here in America we’ll be making a decision soon about a new leader. I hope we choose one with characteristics like those of my fellow Type I diabetic. Prime Minister May shows good judgment and is careful about her personal management. Maybe it’s just me, but it sure seems having control of yourself is a good place to start when it comes to taking control of a country.

Our beloved worlds

Blind justiceDid you catch John Stewart interviewing Supreme Court Justice Sonia Sotomayor on the Daily Show? Hear her interviewed on NPR’s Morning Edition? Latino USA? Her memoir was published a few weeks ago, and I think the only day she’s had away from the book tour since then was Monday, January 21: that’s the morning she swore Vice President Biden in for his second term.

The reviews I’ve read of My Beloved World mention young Sonia growing up in a tiny Bronx apartment with her Puerto Rico-born parents, her father’s early death, her mother’s hard work, her beloved grandmother, and her appreciation for affirmative action. One reason she gave for writing the memoir was that so many people identify with different pieces of her story. She thought perhaps writing about her path to the Supreme Court might give them hope.

But, alas, very little of her story that I identify with most was mentioned during her book tour. You may not know this, but Supreme Court Justice Sonia Sotomayor was diagnosed with Type 1 diabetes when she was eight. I was diagnosed with Type 1 at age seven. With all the press coverage she’s had the past couple of weeks, the only thing I found that dealt with ways Sotomayor’s early diabetes diagnosis may have influenced some of her life decisions was in an article in the Charlotte Observer. The paper revealed that the chronic disease nearly killed her, and that one of the reasons Sotomayor never had children was that she was afraid she wouldn’t be around to raise them. I know what she means. Here’s an excerpt about my high school years From my own memoir, Long Time, No See:

In 1972, at the beginning of freshman year, I was admitted to the hospital twice, both times via the emergency room, both times close to coma. In the first episode, I could still talk when we arrived there, but the second time, Flo found me in a heap on the basement floor and dragged me, a hundred pounds of dead weight, up the stairs and out the back door and into the car. During that second hospitalization, my doctor, exercising his version of bedside manner, declared that I wouldn’t live past age thirty.

I was 14 years old when that happened, and my doctor then couldn’t have known about the diabetic advances around the corner. Fast-acting insulin, diabetic educators and home blood monitoring methods came along too late to save my eyesight, but those advances, along with my husband Mike’s willingness to learn about the disease and motivate me to stay well, have kept me happy and healthy far longer than my Nostradamus pediatrician and I could have expected.

The Charlotte Observer article reported that monitoring her health has become second nature to Sotomayor now, and that she gives herself insulin injections five or six times a day. Me, too! Justice Sotomayor told the reporter that she no longer worries she will die young. “When I reached 50, I was able to let go of that demon,” she said. “But not without recognizing its benefits. It drove me in a way that perhaps nothing else might have to accomplish as much as I could as early as possible.” I know what she means. Justice Sotomayor’s memoir ends when she is named to the Supreme Court; mine ends when we move to Chicago. And hey, with more advances in diabetes around the corner, watch out, world. Sonia and I are just getting started.

The only thing I have in common with Jay Cutler

I’ve always liked Bears quarterback Jay Cutler. “That’s because you can’t see his face!” my football-loving friends at Hackney’s (our local tavern) tell me. “You can’t tell what a whiner he is.” Ever since Cutler broke his thumb in last Sunday’s game, though, it seems like it’s those Bears fans doing the whining, not my Jay.

Confession: I don’t really follow NFL football much. The reason I follow Jay Cutler? He has Type I diabetes. I have Type I diabetes, too – that’s the disease that caused my blindness.

Two very different conditions are referred to as “diabetes” – Type I, formerly known as juvenile diabetes, and Type II, the kind that is often brought on by obesity or poor nutrition. Type II involves a breakdown in the body’s ability to process the insulin it makes. So with Type II, if you watch your diet and exercise, you have a fair chance of improving the condition. With Type II, you can even reduce or even eliminate the need for insulin injections.

Type I, the kind of diabetes Jay Cutler and I have, is an autoimmune disease. With Type I, the body attacks and destroys its insulin-making cells. No matter what we do (exercise, diet, whatever) our bodies are unable to make insulin. We either have to take multiple injections of insulin throughout the day, or wear an insulin pump. There is no behavior that causes Type I. Doctors believe it is a genetic condition often triggered by an environmental stress. A virus, for example.

Type I is usually diagnosed in childhood (I was diagnosed when I was seven years old) but in recent years it has become increasingly common for people Cutler’s age or older to be diagnosed with Type I. We test our blood sugar levels regularly to know how much insulin to take. The more we test our sugar levels, the easier it is to walk the tightrope between high and low blood sugars. It’s never a walk in the park, though, and I cannot imagine what it must be like to walk that tightrope with a football in one hand while the other hand is fending off 300+-pound gorillas rushing to knock me down. It wasn’t easy to find details on how Jay Cutler handles his Type I diabetes on the football field, but finally I found an interview in Diabetes Forecast magazine where Cutler was asked how he uses a blood glucose monitor to check his blood sugar level on game days. His answer:

I check my blood sugar about four or five times before the game—try to stay around 150 to 160 [mg/dl] before kickoff. Most of the time, I prick my finger every time we come off the field, especially in the first half. There are definitely dangers out there—we try to avoid them at all costs. That’s why we check as many times as we do. I think the worst thing imaginable would be to get really low and pass out in the middle of a play, or in the huddle. That would scare a lot of people. I try to avoid it as much as possible, but it’s still a reality that could happen.

The interviewer also asked Cutler if he worried whether his teammates, the media, or fans might blame his Type I diabetes as a reason for poor performance. His answer:

I hope not. I don’t want sympathy—I want to be judged like every other quarterback. But living with diabetes in the public eye does make it harder. If I go out and my numbers are off and I have a bad game, I know I’ll be criticized for it. I just try not to worry about it and go out and play my game.

I dunno. This guy just doesn’t sound like a whiner to me. I sure wish the diabetic magazine had asked him about that Packers game last year, though. You know, the one where so many Bears fans accused Cutler of not being a “team player.” Who knows? Maybe he needed a blood test.

And Now, for Sports

That’s me, hanging at Hackneys with bartender Billy Balducci. Let’s hope we’re still friends after tonight’s Final Four game.

That's Billy (and me). Let's hope we're still friends after Monday night.

Four years ago I won an award for a White Sox story I did for Chicago Public Radio. Ever since, I’ve been telling people that I am the only blind woman in America to win an award for sports broadcasting. I don’t know if that’s true, exactly, but so far no one has told me differently. It is in that spirit that I am sharing news of three momentous events from this week in sports that could change our lives.

1. I picked Michigan State in the NCAA pool at our local tavern, and for the first time ever, in my entire March madness life, I am still alive going into the final four. Not only that, but I have a chance, although remote, of winning the jackpot. My stiffest competition comes from beloved bartender Billy Balducci. He has North Carolina beating UConn in the final, I have Michigan State beating UNC in the final. In order to get to that final, though, Michigan State has to beat UConn tonight. Mike, Hanni and I will be watching the game from Hackney’s – Billy is bartending, which means he’ll be waiting on us hand and foot as we enjoy a Michigan State victory. Go Spartans!

2. Yesterday NFL quarterback Jay Cutler was traded to the Chicago Bears by the Denver Broncos. Normally I don’t follow football, but this trade is noteworthy to me because Cutler was diagnosed with Type I diabetes a year ago. I have Type I diabetes, too – that’s the disease that caused my blindness. Yahoo Sports had a sportswriter whose own son was diagnosed with Type I a few years ago write a piece about Cutler. The description of Type I in the article is one of the best I’ve ever read. The writer points out that two very different conditions are referred to as “diabetes” – Type I, formerly known as juvenile diabetes, and Type II.

Type II diabetes, often brought on by obesity or poor nutrition, involves a breakdown in the body’s ability to process the insulin it makes. For that reason, improved diet and exercise can often improve the condition and lead to the reduction or elimination of the need for insulin injections. Type I is an autoimmune disease in which the body attacks itself and destroys its insulin-making cells. There is no behavior that “causes” it; doctors believe it is a genetic condition often triggered by an environmental stress, such as a virus. It is more typically diagnosed in childhood but in recent years it has become increasingly common for people Cutler’s age or older to become symptomatic. Those who suffer from Type I are completely insulin dependent, and there is nothing that can be done to change that fact.

The writer explains how Type I diabetics balance food, exercise and insulin to walk a tightrope between high and low blood sugars, and how we use blood glucose monitors to check our blood sugar levels regularly (mine has audio output that calls my results out loud).

Yet control not only requires hyper-vigilance, but it also correlates to a risk in the regular occurrence of hypoglycemic episodes, or “lows” – the scariest day-to-day element of diabetes management.

To control blood sugars, most people use one of those finger-stick kits like the one Cutler carries to check their blood-glucose reading on a frequent basis, certainly before meals and often as much as 15 times a day. When that number is higher than the intended target range, additional insulin can be given through shots or via a battery-powered pump that is threaded into the body (the plastic insertion devices typically must be removed, reloaded and relocated every two or three days). When the number is low, fast-acting carbohydrates – usually juice or glucose tablets – must be ingested. It is also important that a person accurately computes the amount of carbohydrates he/she consumes, ideally by reading labels and measuring or weighing portions. Insulin is then dispensed according to a preset ratio (which also needs to be tweaked based on frequent testing).

Sounds pretty complicated. That’s because managing Type I diabetes is complicated. but the writer goes on to say that Cutler isn’t the only pro athlete who has Type I, and that plenty of people with Type I diabetes manage to live happy, fulfilling and healthy lives.

For now Cutler – like Charlotte Bobcats forward Adam Morrison, Seattle Mariners pitcher Brandon Morrow, golfers Scott Verplank, Michelle McGann and Kelli Kuehne, swimmer Gary Hall Jr. and other pro athletes with Type I – can help the cause simply by conspicuously continuing to perform at a high level, despite the daily challenges he faces. And if seeing him suck down a juice on the sideline or prick his finger during a timeout helps some observers gain a better understanding of the rigors of Type I management, that’s not a bad thing.

Amen.

3. Thanks to Hanni, Mike and I managed to get tickets to Monday’s White Sox home opener – the game is sold out, but since she needs room to lie down we qualified for seats in the handicapped section. Rumors are flying, pardon the pun, about Barack Obama throwing out the first pitch. Our president is a big White Sox fan, you know, and he does have experience — Obama threw out the first pitch during the 2005 playoffs, and the 2005 World Champion White Sox won 8 straight games afterwards. I can’t imagine President Obama returning from the G20 Summit overseas in time for Monday’s 1 pm start, and once he sees the weather forecast I doubt he’ll make the White Sox game a priority –it’s supposed to snow.

OMG, it’s 4:37 already. Time to head to Hackney’s. Go, go Spartans!


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