Friday, January 28, 2011

the one where i answer your questions (and it takes you 2 hours to read)

this week, i asked my facebook friends what their questions are about diabetes. some are serious, some are funny, some are funny to PWD but people probably seriously want to know the answer ... and i will answer them all. and if this post makes you think of others, please, write them in the comments and i'll answer those too!! there are no dumb questions. if you want to know, ASK, don't ASSUME. educate yourself and others! 

abbreviation key
PWD: person/people with diabetes
BG: blood glucose (same as blood sugar)
DOC: diabetes online community 

this is an answer to 2 similar questions: i think a thorough explanation on HOW you get diabetes would be great ... did you get diabetes because you ate too much sugar as a kid? first, i was diagnosed when i was 17. the name 'juvenile diabetes' has transitioned to 'type 1 diabetes' because not everyone is diagnosed as a child. i have type 1 diabetes, people usually get it when they have some sort of other sickness (for me it was probably the repeated sinus infections, or strep, or pink eye) and the body's defense system attacks some of its own cells and the pancreas starts failing. type 2 diabetes is more 'environmental', it can be caused from unhealthy diet and lack of exercise. every PWD has a different story and i don't think i've ever met two people with the exact same story/issues/etc. as far as how i found out i was diabetic, go here.

if you stopped eating candy would your diabetes go away? no. refer to the last question. my pancreas produces little to no insulin, which has nothing to do with what i eat. a diabetic can eat/should eat what a 'healthy' person's diet should be. a normal, balanced diet. do i always eat that way? no. am i perfect? no. sometimes i want candy, or sweets or pasta. i have learned to count carbohydrates and calculate the amount of insulin i need based on the amount of carbs i am eating. this calculation is different for all PWD, meaning that not everyone takes the same amount of insulin per carb. one person may take 1 unit of insulin for every 5 carbs they eat, another may take 1 unit for every 10 they eat. it's different for all of us.

can I get high off of your insulin? i had seriously never heard anyone ask me this! i personally don't know/don't think so/don't want to find out, and no i will not let you try. thanks for playing.
 
did you get diabetes because your parents have it? did you inherit diabetes from one of your parents? while i have heard before that diabetes is hereditary, no one in my family has it. i guess it has to start somewhere. lucky me! :)

do you have the bad kind? because you have to take insulin? i would never say that one kind of diabetes is worse than another. they are all equally sucky. diabetes is an equal opportunity employer. it doesn't care if you are rich or poor, black or white, tall or short, girl or boy. just because i take insulin does not mean my diabetes is 'worse' than someone else who has it. some people also think i 'have it bad' because i wear an insulin pump. no, actually the insulin pump makes my life so much easier because i don't have to carry around different vials of insulin, syringes and other things. it helps with calculating insulin dose amounts and i have a constant 'flow' of insulin all day long from my pump as opposed to taking 'long lasting' insulin as well as 'fast acting' when i eat food. however, the choice to have a pump is mine. it's not for everyone, some people prefer giving themselves injections. how one cares for their diabetes is their decision.

how is the disease pronounced? is it diabetus? clearly this is one of the silly questions, but it is NOT di-a-bee-tus. wilford brimley. it is not di-a-bee-tis. it is di-a-bee-tees. thanks.

here's my question: wwwbd? haha, not everyone will understand this so let me explain ... my JDRF walk team was named by my friend in 2010, and it was 'what would wilford brimley do?' (wwwbd) as for the answer, he would check his blood sugar. and check it often. and eat oatmeal.
 the 2010 walk at churchill downs


bragging for my team: we won a Bronze Achievement Award! our team total was $2,478.38!

bragging for myself: i won a Golden Sneaker Award for Excellence in Fundraising! (i raised $1118)

what affects does exercise have on diabetes? does it mean more insulin/carbohydrates will be needed? again, it's one of those things that is different for every PWD. some people have to reduce the amount of insulin they take before they exercise, some don't. for some people, it depends on what kind of exercise they are doing. i know that some PWD's blood sugar drops 2 hours after they exercise. some people it could a few more hours for it to drop, or it might not drop at all. exercising can help with maintaining healthy BGs. sometimes people do need to eat more carbs before or after they exercise to prevent the BG drops, but again, it is different with everyone. from my experience, exercise can help maintain healthier levels which means using less insulin because there are less instances of having high BG that would need a correction bolus. (which basically means giving myself an extra amount of insulin to bring the BG back down to normal range) also, if my blood sugar is over 250, i'm not supposed to do physical activity because it could backfire and make my BG go up higher.  

why does my dad (also diabetic) smell metallic sometimes when his sugar is high? i have never heard of a 'metallic' smell, but i have heard of a 'fruity' smell. i searched for more information because i was also curious, and a few things i found said that it could be a sign of ketoacidosis or it could be from BG that is too high ... we all know we shouldn't believe everything we read on the internet. is your dad aware of the smell? if it is a sign that his BG is high, it might be a clue for him to check it. i have had doctors ask me in the past if i still 'feel' my lows and highs, so that leads me to believe that it might get to a point where a PWD may not be able to 'feel' it and need to check. also, clearly i am not a doctor so a medical professional opinion might be best for this one since i have never experienced it. 

do refined sugars affect you differently than naturally occurring sugars? or is it all based on amounts? for me, refined sugars can affect me because it takes longer for the insulin to 'do it's job', meaning if it raises my BG it will take it longer to come down, or my BG might stay higher for a while, as raw sugars (like natural sugars from fruit) don't do that as much. again - it's one of those things that can be different for many PWD. 

i understand where you wear your insulin pump with your clothes, but can you explain how it works?
i have an animas ping insulin pump. there are many different types, all pump users make different choices based on what is best for them.
the pump is attached to me through an infusion set. there are different types of these ... mine is a small circle - and animas has color options, my infusion sets are pink.
the site that is attached to my skin has a small thin tube (called a cannula) that goes into my skin, the insulin is delivered through that (there is a needle when i insert the set, but i take the needle out).
i can detach the tubing/pump from the site on my skin if i need to, but for the most part i wear it 24/7, and have for the past 10 years.
insulin is inside the pump in a reservoir. the pump is programed with a basal rite that was determined by my endorinologist. the basal rate is a small amount of insulin that is delivered all day long. that means: every few minutes, the pump delivers me a tiny drop of insulin. this happens all day long. the pump is my pancreas. basal rates for PWD are all different, we don't all get the exact same amount at the same time every day.
when i eat, i take a bolus. this is an extra 'shot' of insulin, based on the amount of carbs i enter into the pump. i have a ratio that helps me figure out how much insulin i need, and it delivers that insulin to me over a period of time when i am eating. 
i change the site where my pump goes every 3 days, and i rotate sites around the middle of my body (around my stomach and lower back). 
here are a couple images i searched for, and you can find more information here if you are curious.



this is what my infusion set looks like. image from valuemedical.com

  this shows how small the cannula is that stays in my skin. image from flickr search

how does stress affect your diabetes? it makes my BG go up for sure. i could let 'all of it' get to me every day, but i have to learn how to deal with the daily stresses of diabetes so it doesn't affect me. when i was diagnosed, i remember people being sad for me, and upset, and feeling bad for me... and i didn't really get why. i was like, um, this happened and now i learn to live with it. the end. but when life gets stressful, yes, it makes my BG higher. which makes me bitchier. and moodier. and just is all around a crappy feeling.

I'd like to know why the DOC is so spread out? hehe. diabetes doesn't care where we live. it's an equal opportunity disease. luckily, we can travel so we can have DOC meet-ups. :)

what do you miss most that you've had to give up? i haven't had to give up anything. diabetes doesn't control my life, i control my diabetes. food-wise, i can have anything, i just have to use common sense and moderation with some things. activity-wise, i can do anything i want, i swim with my pump, i can exercise, run, zumba, dance, camp, fish, anything i want to do! i just use my diabetes education to know how to deal with each individual situation.

what are some of the most common warning signs? hunger, thirst, frequent urination, tiredness, weight loss. yes, i had all of them.

how often do you check your sugar daily? i check my BG before meals and 2 hours after meals, and at bedtime. the reality is, that there are some times that not all those checks happen. usually i check before i eat in the morning, then if i feel low or high i will check 2 hours after, but most of the time i just check before lunch. then i check 2 hours after lunch, before dinner, and 2 hours after dinner or before bedtime. when i am sick, i check more often. when i do lots of physical activity, i check more often. if i feel 'low' or 'high', i check. lots of BG checking :) gotta stay in check. (more 'check' puns??)

have you ever been hospitalized because of diabetes complications? nope. well, this could be argued. last year over superbowl weekend i was admitted to the hospital ... i went (was taken/forced to go) to the hospital because my blood sugar was low (in the 50s) and would NOT come up. i was having a really upset stomach and i couldn't keep food down, which in turn made me not want to eat to help my BG come up. in the ER i was given fluids because i was dehydrated from vomiting, etc, and my heart rate was elevated. i was admitted for 2 days because they wanted to monitor my heart, and come to find out upon discharge that i had a stomach virus and my heart rate was elevated from dehydration. it was not a fun weekend that i do not want to relive. i got extensive heart tests done that i hope i never have to do again (and my heart is healthy!).


why do diabetics have issues with their feet? diabetes complications can occur and one area it can affect is the nervous system. the way it was explained to me was that the feet are the farthest extremity you have. that's a long distance of nerves/nerve endings. peripheral neuropathy is a loss of nerve function in the legs and feet and peripheral vascular disease is impaired circulation in the legs and feet (yes i googled the 'real' names). those complications can lead to loss of feeling in the feet, burning, tingling, that pins & needles feeling, feet falling asleep, etc. PWD can also have dry skin on the feet, and if they get a cut on their feet it takes longer to heal. this is why i feel that pedicures should be doctor prescribed and i should get them monthly. paid for by insurance. haha! until then, i pay for my own :) it's a nice treat that is good for me! If PWD keep their diabetes under control, they can very easily live their entire lives without having any issues with their feet. I plan to be one of them.

when I was pregnant, I found a lot of my other health issues were chalked up to the pregnancy. it actually annoyed me because I really felt some of them were because of something else. i've often wondered if people with chronic conditions go through the same thing? or are all those things really because of diabetes? it depends on what the 'things' are. and what else is going on in their life. for example, my feet are dry, more so in the winter - that is from diabetes but also because in the winter people have drier skin than in the summer. so, it's related and it isn't. if i have a migraine, it could be from my blood sugar being totally wonky and going from really high to really low in a short period of time, but it might have been caused by something else. i don't like to 'blame' everything going on in my body on diabetes, but sometimes, it is the cause. it depends on what the health issue might be.


what is the lowest/highest your blood sugar has been? my lowest has been in the 30s (i don't remember exactly, maybe 36?) and my highest was when i was diagnosed, it was 467.

is diabetes contagious? will you always have it? it is NOT contagious. although my family and some friends have a running joke that they can't share a drink or food with me because they'll get diabetes. ;) it's all in good fun, friends. i will have diabetes until i have a cure. until then, you'll find me sporting an insulin pump - until they come up with the next great thing.


what does it feel like if you are high/low? when my BG is low, i feel different things. some things i don't always feel, some i feel every time ... shaky, hot, sweaty, dizzy, confused, sensitive, tired, weak, hungry. when my blood sugar is high, i feel moody, very thirsty, it's hard for me to focus, and sometimes frequent urination goes along with it.


what happens if you aren't low but you eat a lot of sugar? i either have to take insulin or my blood sugar will keep rising and that can be very dangerous. it could lead to
ketoacidosis which is very scary and could lead to hospitalization. 

do you have to get up in the middle of the night to check your blood sugar or take a shot? when i was first diagnosed i had to do this for a few weeks i think, my mom might remember better (right after i found out i had diabetes, i spent a lot of time sleeping, i was exhausted from all the time i was spending at the endocrinologist learning and my body was trying to get 'back to normal' which took a lot out of me, so there are some things i don't remember). There are some occasions when I might have to check in the middle of the night, like if my endocrinologist thinks we might need to change the amounts of insulin i am getting at different times of the day, he might have me check my BG every few hours for a few days. in those cases, i do check in the middle of the night.


What if you forget to take a shot? i don't personally take shots, but if i forget to take a bolus of insulin  with my food, my blood sugar will likely rise and it will be high, which will lead to me feeling bad and having to take a correction bolus later (which is where i take an extra amount of insulin to bring my BG back down into a desired range).


Where does insulin come from? today, it is man made. ya know, in a fancy lab somewhere i guess. PWD used to use bovine (from cows) insulin back in the day.
whenever i donate blood, the questionnaire you get before your donation asks if you've ever used bovine insulin. i have not.

4 comments:

  1. Okay,to help with the answer of
    "did you get diabetes because your parents have it? did you inherit diabetes from one of your parents? while i have heard before that diabetes is hereditary, no one in my family has it. i guess it has to start somewhere. lucky me! :)"

    Studies show that it doesn't neccessarily have to be Type 1 diabetes that runs in the family but Autoimmune diseases... Rheumatoid Arthritis(Sp?) is the biggy in my family, but it can also be MS, parkinson's, etc. People often think if Type2 runs in the family then type1 must have come from that but that is not the case.
    Sorry, just thought I'd help a little bit with that one! Great responses/questions! I love reading your blog, Meredith!

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  2. Great Blog Meredith...Ross H.

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  3. This is fantastic! Really nice job!

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  4. This is an awesome post. Really. If I ever need to refer someone, I'm keeping this post in mind- you really did a great (and comprehensive) job!

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