Glucose Intolerance

MD visit 9/23/2010


Glutamic Acid Decarboxylase Antibodies
>250.00 (Elevated)
**These are the auto-antibodies responsible for destroying my beta cells in my pancreas.
http://en.wikipedia.org/wiki/Glutamic_acid_decarboxylase

Islet Cell Antibodies, IGG
<1:4 (Normal)
http://en.wikipedia.org/wiki/Islet_cell

C-Peptide, Serum, ng/mL
0.4 (Low – normal range: 0.5-3.0)
**Once this number reaches 0.0, my beta cells in my pancreas will all be destroyed and my body will no longer produce any insulin at all.
http://en.wikipedia.org/wiki/C-peptide

Insulin, uIU/mL
9.9 (Normal - normal range: 6.0-27.0)
http://en.wikipedia.org/wiki/Insulin

Glucose, mg/dL
334.0 (Elevated - normal range: 65-99)
http://en.wikipedia.org/wiki/Glucose

Hemoglobin A1C, %
9.8 (Elevated - normal range: 4.0-6.0)
235 mg/dL
**A1C is an average glucose over the last three months. I was diagnosed in late September which means I was diabetic in late June. I will never know what pathogen I picked up, or when I picked it up, that initiated my immune system to produce overactive GAD antibodies that began destroying my beta cells. June 2010 is the earliest sign of diabetes for me.
http://en.wikipedia.org/wiki/Hemoglobin_A1C

Autoantibody: http://en.wikipedia.org/wiki/Autoantibody
Beta Cell: http://en.wikipedia.org/wiki/Beta_cell
Pancreas: http://en.wikipedia.org/wiki/Pancreas
Type 1 Diabetes: http://en.wikipedia.org/wiki/Type_1_diabetes

Featuring... Thanksgiving Turkey Hand!!

TuDiabetes featured another drawing, my Thanksgiving Turkey Hand!



Puzzle Pieces

Today I was very frustrated with my numbers… they were high. I didn’t think I ate enough carbs to make me so high and I couldn’t figure out why my numbers were not dropping. I even took a 25 minute walk 15 minutes after eating.

My coworker, who also has diabetes, reminded me that there are MANY factors that raise and lower glucose readings. He showed me that I ate a meal that had protein in it and the protein causes the carbs to digest at a much slower rate than eating carbs without protein, therefore my numbers will stay higher for longer. He also showed me that yes I walked, but I walked outside, in the snow. When the temperature is colder the body digests slower. He also showed me that when I exercise in an extreme manner, my body will release glycogen in order to fuel the muscles for the exercise thus raising my blood sugars.

He listed many more reasons why my sugars would be high, which all reminded me that I’m a walking test tube. I’m my own chemistry lab and I’m the only person who can track the numbers, find correlations, and apply them in my own life. He said doctors only know one piece of the puzzle, nurses only know one piece, nutritionists only know one piece, diabetic educators only know one piece, and it is up to me to connect them all to see the whole picture.

He also reminded me that 90% of the population has Type 2 diabetes from being overweight and sedentary, where a 30 minute walk 30 minutes after eating does a world of wonders for their sugar levels. I am an active, fit youngster and most studies/findings/advice about diabetes does not apply to me. I need to find how diabetes works in MY body by paying lots of attention to me and piecing together my own picture/puzzle. This will most likely take many years before I begin to see patterns in certain scenarios, like seasons, illnesses, menstrual cycles, holidays, etc.

By the end of the talk with my coworker, I felt much better. I’m not as paranoid and worried as I was this morning and the wheels in my head are turning with ideas and excitement.

Happy Thanksgiving

Featuring... Blue Diabetes Ring!

My Blue Diabetes Ring drawing was featured on TuDiabetes - COOL!!



Sugar-Free

Before I became diabetic, I avoided the term SUGAR-FREE at all costs. The words sugar-free meant instead of using good ol’ sugar, we’ve used artificial, man-made chemicals that cause cancer with extreme use. Over the last few weeks I’ve tried some sugar-free candies, fudge bars, and sodas and am torn between eating my sugar-free goodies and not wanting to ingest the artificial sweeteners.

For example, the ingredients listed on my Werther’s Original Sugar-Free Caramel Mint Hard Candies are:

Isomalt

Butter

Cream

Artificial Flavoring

Salt

Emulsifier Soy Lecithin

Anatase

Sweetener Acesulfame-K

Isomalt, Anatase, and Acesulfame-K???

There is also a warning, “Excess consumption may have a laxative effect” – What?!?

I’m going to have to Google these artificial sweeteners to a) learn about each of them and b) determine which are safe and which are not.

I have a feeling I’m going to be doing A LOT of diabetes related research.

Happy Birthday To Me!

Today is a very special day for me ~ today is my birthday. Today I am 29 years old and I am excited to be alive!

Growing up, my mom was told that her mom, grandma, and great grandma all died at age 33. My mom was terrified that she too would die during her 33rd year of life and on her 34th birthday probably breathed her first real breath in one year’s time. She had made it! My mom survived the curse and I know now, more than ever, how she felt and her relief, now that I too, have survived the curse.

After some investigating, we learned that only one of the three women had died at age 33, the other two died in their late twenties. It doesn’t, however, change the fact that illnesses happen and take lives. My grandma (Mary) died at age 33 in a car accident (my mom was four years old). My great grandma Zelpha (Mary’s mom), died at age 28 of pneumococcal meningitis. This started as an ear ache, which turned into pneumonia, which turned into meningitis - all lasting a little over one month before it took her life. My great-great grandma Zora (Zelpha’s mom), died at age 27 of pneumonia. She became ill on a Monday in January 1917 and died the following Friday. If it were not for the discovery of insulin in 1922, merely 88 years ago, I would be listed alongside my grandmas… I would’ve been dead at age 28 from diabetes mellitus.

According to Wikipedia, the term diabetes was coined by Aretaeus of Cappadocia (1st century AD) who attempted to treat diabetes but could not give a good prognosis; Aretaeus commented that "life (with diabetes) is short, disgusting and painful."

I am thankful that I did not have to suffer and die from diabetes in a “short, disgusting, and painful” manner. People diagnosed with diabetes, prior to 1922, died shortly after diagnosis. I am blown away every time I think about this. I have a chronic terminal disease. Diabetes will eventually get me (if nothing else does before then). I vow to do everything in my power to keep it at arm’s length, but I cannot escape the fact that I will most likely die from complications of diabetes. How about we celebrate sixty more birthdays before we let that happen?  ;)

Today is a very special day for me ~ today is my birthday. Today I am 29 years old and I am excited to be alive!! P.S. Today was a GREAT day!

HRM Course Complete!

Woohoo!! I completed my HR Management Certification class today!

The class started Tuesday September 14th and ran every Tuesday evening for four hours. I missed two classes: the Tuesday immediately following the onset of my diabetes and a class in mid October due to a head cold. I had made it through work that day but would not have been able to make it through a four hour class that evening – I needed to go home and sleep!

Diabetes sure did throw my life into a tizzy. I was in the middle of taking my HRM course, getting my master’s degree, and of course, conquering the world. Once I was diagnosed I just couldn’t concentrate and I knew that I needed to take a few steps back and heal. I kept the HRM course going, but dropped the MBA program and decided to let the world rest a bit from my rampage. Of course I will still do it all, it’s just going to take a little more time than I had originally planned – and that’s ok. Now that my HRM course is finished, I can focus on completing my MBA, and then take the PHR exam for my HR certification (Yay!!).

What’s especially exciting, is now that my Tuesday nights are free, I get to start attending my local Diabetes Support Group!

Uh oh, in my excitement to write this blog, I sat here and ate two pieces of cheese pizza and completely forgot to take my insulin. Oops!

Books About Type 1 Diabetes

I’m surprised at the lack of books about Type 1 Diabetes at my local book stores. I’ve only been to two Barnes and Nobles so far, but at both I have only been able to find the following three books that reference T1DM (not including cookbooks):

* Diabetes A to Z: What You Need to Know About Diabetes - Simply Put by the ADA

* The American Diabetes Association Complete Guide to Diabetes by the ADA

* Type 1 Diabetes for Dummies by Alan L. Rubin, MD

All the rest are for Type 2 Diabetes – and there are TWO shelves worth. Seems like there might be a market for books about T1DM… hmmm?

I also noticed that the majority of the T2DM books had “cure” in the title – such as ‘the 30 day diet cure for diabetes’ or ‘exercise – a cure for diabetes’. This is so misleading. There is NO cure for diabetes. Insulin isn’t even a cure; it’s simply a way to manage the disease. With diet and exercise, people with T2DM can put their diabetes into remission, but once they have it, it will never go away.

If anybody out there knows of any good books about Type 1 Diabetes, please let me know!

World Diabetes Day

Today is World Diabetes Day!

Per TuDiabetes.org:

November 14 is World Diabetes Day. On that day, at 14:00 hours (local time), thousands of people with diabetes will test their blood sugar, do 14 minutes of exercise, test again and enter their results on BigBlueTest.org. Afterwards, we invite you to share your results on TuDiabetes, Twitter, or any of the partner diabetes communities listed on Big Blue Test web site.

  

The event is called The Big Blue Test because blue is the color associated with World Diabetes Day. It is based on a test-in activity that took place July 14, where more than a thousand people with diabetes tested their blood sugar at the same time and shared their results online. This time, the activity incorporates 14 minutes of physical activity to reinforce the importance of exercise.
  

Participating in this event to raise diabetes awareness on November 14 is easy:

1. At 2 pm (your local time), test your blood sugar.
2. Run, jog, walk the dog, or do anything you’d normally do as part of your exercise routine for 14 minutes.
3. Test your blood sugar again.

I participated in the Big Blue Test and here are my results:

1. Pre-exercise blood glucose: 278 mg/dL
2. I exercised for 14 minutes on the stationary bike. I averaged 72 RPMs and traveled a little over 3.4 miles.
3. Post-exercise blood glucose: 295 mg/dL

Oops!! My numbers were supposed to decrease. Oh well. I still understand the importance of exercising to help lower blood glucose levels. Only 30 minutes of exercising no later than 30 minutes after eating has the same effect as taking insulin. Now THAT’S some pretty powerful stuff!

Darn Diabetes

Today’s blog is about frustration.  Diabetes is on my mind EVERY day.  I cannot escape thinking about it for one day.  I say insulin, diabetes, sugars, needle, carbs, etc to myself and others EVERY single day, from the moment I wake up to the moment I go to bed.  I’ve come to the realization, after only 50 days of having diabetes, that I hate having it.  I’m in shackles.  I tell myself and others that I can eat whatever I want as long as I counter it with insulin.  But the truth is this way of thinking is very exhausting, physically and mentally.  I’m so new at this game that I do not have an idea yet how one unit of insulin truly affects me or how 30 grams of carbs affects me.  I will know more as time passes, but for now I can only guess.  This guessing game is exhausting.  I go high (a lot) and FEEL the consequences – dry lips, extreme exhaustion, constant worry that my arteries are hardening.  I go low and FEEL the consequences – shaking, sweating, heart pounding, drunk-feeling.  The ups and the downs caused by eating whatever I want and countering with insulin is such a roller coaster ride… and I want off, even if only for a day.  I can avoid carbs in my diet (err… meal planning), but then I am hungry and feel like I never really get full.  My nutritionist limited me to 30-45 grams of carbs per meal. 30 grams is ONE slice of bread.  I miss snacking.  I miss vegging out on the couch with a huge bag of chips.  So gosh darn frustrating. Arg!

Wordless Wednesday

Diabetes - The Good And The Bad

Diabetes - The Good Stuff: 

Dietitian
Insulin Therapy
A1C
Blood Glucose
Employment Rights
Test Strips
Endocrinology
Sugar-free Snacks

Meal Planning
Exercise
Labels (Nutrition Facts)
Lancets
Injection Sites
Type 1
Urine Ketone Tests
Sleep

Diabetes - The Bad Stuff: 

Depression
Impotence
Alcohol
Blood Vessel Damage
Eating Disorders
Triglycerides
End-stage Renal Disease
Stroke

Metabolic Syndrome
Eye Disease
Low Blood Glucose Levels
LDL Cholesterol
Infections in Feet
Terminal Disease
Urinary Tract Infections
Sick Days

Diabetes and Dental Care

I had my semi-annual dental cleaning and exam today. I LOVE my dental appointments. First of all, my dentist is gorgeous – he looks like a young Val Kilmer with awesome blue eyes that I get to gaze into while he cleans my teeth. Secondly, I love that clean feeling after the hygienist brushes my teeth and the yummy crunchies I get to enjoy afterward, mmmmm. However, today’s exam led to the discovery of a small cavity :( So I’ve gotta go back in mid December and have that fixed, but that’s the least of my worries.

Today was different than all of my previous dental visits because today I had the task of telling my dentist I have diabetes. He was shocked, especially when I told him it was type 1. He was under the impression that people were diagnosed with type 1 as kids, and I was an… adult. I explained to him that type 1 is known as juvenile diabetes but also as insulin-dependent diabetes and that my pancreas is going ka-put on me.

He asked me what my symptoms were that indicated to me that I had diabetes and I told him about my weight loss, extreme thirst, dry lips, and dehydration. He told me that saliva is VERY important to maintaining a healthy mouth, just as important as brushing and flossing. Saliva washes away a lot of the sugars and other nasty stuff that builds up in the mouth and on the teeth. As a diabetic, if I do not maintain my diabetes and allow my sugars to stay at a high level, dehydration (a symptom of hyperglycemia) will reduce the amount of saliva in my mouth and I will be at risk for some major dental damage. Yikes! And I thought a cavity was bad.

I’m glad I told my dentist I have diabetes. I learned a lot from the experience today. The importance of maintaining my diabetes for my overall health (teeth included) was reinforced, as well as the importance of staying hydrated, whether you have diabetes or not.

Flexible Spending Account

Today I signed up to participate in my company’s Flexible Spending Account (FSA). The FSA allows me to put aside, each paycheck, an allotted amount of pre-taxed dollars. These dollars can be used throughout the year to buy my prescriptions (two insulin pens, needles, lancets, meters, and strips), miscellaneous over-the-counter items (glucose tablets, glucagon kits), and pay for my quarterly endocrinology and lab visits, as well as my semi-annual dental cleanings and vision exams (including glasses and contacts).

I’m use to spending $50 each year on an annual well woman exam - and that’s it!

The following will give you an idea as to how much diabetes will cost me:

Humalog (insulin) $70 co-pay (3 mon supply) x 4 = $280

Lantus (insulin) $70 co-pay (3 mon supply) x 4 = $280

Needles $70 co-pay (3 mon supply) x 4 = $280

Lancets $34 co-pay (3 mon supply) x 4 = $136

Meter $70 co-pay (3 mon supply) x 4 = $280

Strips $70 co-pay (3 mon supply) x 4 = $280

Endo Office Visits $25 co-pay (every 3 mon) x 4 = $100

Total $1,636

These totals are if I sign up for Mail Order. If I continue to purchase my supplies over-the-counter on a monthly basis then each item will have a $35 co-pay each month which is a total of $2,336 (including the office visits).

The totals are with insurance. I cannot imagine having to purchase all of the above items without insurance (below).

Humalog (insulin) $217.80 x 12 = $2,613.60

Lantus (insulin) $188.19 x 12 = $2,258.28

Needles $35.00 x 12 = $420.00

Lancets $11.30 x 12 = $135.60

Meter $35.00 x 4 = $140.00

Strips $205.19 x 12 = $2,462.28

Endo Office Visits $131.00 x 4 = $524.00

Total $8,553.76 – Yikes!

Hopefully I will be a good candidate for a pump (I have to wait six months from diagnosis to apply). I do not know how much a pump is going to cost me at this time, but I hear they are pretty pricey.

Definition of Diabetes: the siphoning of money through your wallet.

9/23/2010

I've been reading fellow Type 1 Diabetics' blogs and each encourages people with diabetes to blog as a way to advocate. Since November is Diabetes Awareness Month, I've been convinced that a blog might be a great idea. I'm super new to the diabetes world, diagnosed with Type 1 diabetes at age 28 on 9/23/2010 - a day I will never forget. Let me tell you about it.

It all began when I noticed I was losing weight sometime after June-ish. I've consistently been 115 pounds since high school, hardly ever fluctuating in weight. Suddenly I lost a pound, then another pound, then another pound. At first I thought it was pretty neat that I was losing a few pounds without exercising or dieting, and that I might make it down to a nice, slim 110. Then 110 came and went, and I kept losing weight. Not only was I losing weight, but I noticed I was losing muscle mass and my "trouble areas" were becoming bony. I was down to 105ish when I began to feel like I was drying up from the inside out. My lips and skin had been very dry for a few weeks and I was extremely thirsty and hungry. I could not put enough icy cold water in my body to satisfy my thirst. I was also peeing like crazy! The week before I was diagnosed I was up every 2 to 3 hours using the bathroom, which resulted in no sleep and a very tired me. I had no strength to brush my teeth or straighten my hair with a curling iron without having to rest my arms on the counter. My heart would race in the mornings and my vision had become super blurry; I could not see at all at night, even with my glasses on.

With all the above going on, I still managed to get my weekly walk in with my mom that Wednesday night. It felt really good to get out and warm up my aching muscles. As we were walking, I was telling her my symptoms and how I was feeling, and she made me promise that if I woke up the next morning and lost more weight to go to the doctor and get checked. The weekend before, my mom had fed me get-some-fat-on-those-bones meals for three days in a row thinking my weight loss might have been due to eating like a college student (you know, ramen noodles and frozen burritos). When I lost weight following the third day, we knew something was wrong.

The next morning I woke up to find I had lost another pound - the scale reading 102.9 pounds. Off to the doctor I went. I did not have a Primary Care Physician (shame on me, but I never needed to see the doctor except for my annual well woman exam) so I went to the nearest Urgent Care. I told the receptionist I was there for weight loss. I was taken back to my room and waited (for what felt like an eternity). I could suddenly hear the urgent care doctor in the hall saying, "Weight loss, are you kidding me?". She entered my room and immediately began to tell me that this was an urgent care, a step down from an ER, and weight loss was not something you went to the urgent care for. She could probably see the tears in my eyes and my lips quivering, so she assured me she would treat me but to use a PCP for weight loss issues in the future. As she sniffed my elbow pit for traces of drugs, I told her my symptoms and she sent someone in to take blood.

An hour later she came into my room asking me if I wanted to hear the good news or the bad news (I hate when anyone asks me that). I don't remember what she said the good news was... but I remember the bad news, "You have diabetes". I looked at her and said really? She said really. I told her I thought she was joking. I really did think she was joking. I thought she would say, "Just kidding. You’re fine. Now get out of here and stop wasting my time". But she replied with, "No, I'm not joking". She then proceeded to tell me she was sending in some IVs and fluids to get me hydrated.

As the nurse hooked me up she told me to push the button if I had to a) pee or b) when the fluid ran out. I pushed the button three times, each time to tell the nurse my fluids had run out. Three bags of fluids... and I did not have to pee at all. I walked into that UC at 103 pounds and walked out of the UC at 111 pounds - my body held onto every ounce of fluid they put in me, that's how dehydrated I was.

The urgent care doctor made an appointment for me that very day to see an Internist that was right upstairs - who had a 3 month waiting period for new patients. Four hours after entering the urgent care, the doctor who lectured me about abusing the urgent care walked me to the lobby and shook my hand as we parted.

I went upstairs, met my new PCP (awesome lady, by the way), received my Humalog and Lantus pens, learned how to give myself an injection, and went home. My diabetes journey had begun. The next few days I read a lot about diabetes (can't remember a single thing I read during those few days) and slept A LOT.

It’s been a little over one month and here I am. Getting my blood sugars slowly under control, probably annoying everyone around me with my constant talk of insulin and sugars, and becoming an advocate of a disease I thought I’d never have.

If you care to take this journey with me, maybe learn a few new things about diabetes along the way, then read on friend! Here we go!