Lurking in the Shadows
This month people around the nation are walking to support those with diabetes for American Diabetes Month. According to the American Diabetes Association, 25.8 million children and adults in the United States—8.3 percent of population—have diabetes. That’s 18.8 million people who are diagnosed and another 7 million who are not. Worldwide, as many as 371 million people live with diabetes and more than half of them are unaware that they have diabetes according to the International Diabetes Federation. It's a disease that lurks in the shadows, affecting many before they even know of its existence.
So I decided this week to have someone who has lots of experience with diabetes share her story and information about symptoms and how to help those with diabetes. Her name is Carolyn Dailey.
1. How long have you had diabetes?
I have had it for 37 years. In September of 1975, I recognized the symptoms and checked my urine sugar with my Dad's “test kit.” When the result was bright orange in color (high urine sugar), I knew I had diabetes. I couldn't believe my eyes. I was scared, told my Mom, and then cried.
2. How did you life change when you were diagnosed?
I began taking daily insulin injections immediately and had to test my urine every day (blood sugar testing was only done in a laboratory). I followed a strict diabetic diet using a meal plan and the diabetic exchange system. Sugar consumption was reserved for when my blood sugar was low. I had to learn to balance food, exercise, and insulin in order to prevent hyperglycemia (high blood sugar) or hypoglycemia (low blood sugar).
Although I grew up in a home with diabetes (at the time my Dad, 2 brothers, and 2 sisters had Type 1 diabetes) I found out how little I knew. My knowledge was that a diabetic had to take insulin injections, they sometimes had insulin reactions and needed sugar to elevate their blood sugar, but other times sugar was off limits. Wow did I get on the job training quickly. It was a whole new ball game for me. I followed my doctors directions to a tee—followed a strict diet and rode my bike daily for exercise. I think the hardest part was experiencing blood sugar swings and insulin reactions. I had to learn the difference by how I felt because I didn't have the means to check my blood sugar and treat accordingly.
3. What kind do you have and how does it affect you?
I have Type 1, insulin dependent diabetes. My pancreas does not produce insulin. At first it was an adjustment, but after 37 years it is just a way of life. All the advances made through the years (ie. blood glucose monitoring, the insulin pump) have made it easier to control my diabetes. In the beginning years I took up to four insulin injections a day, but I still didn't have good control. I was frustrated and told my endocrinologist that I quit trying. I did everything I was supposed to do and still my blood sugars were out of control. I told him I wasn't diabetic.
He then suggested the insulin infusion pump. I began pump therapy on February 6, 1984. The pump has been a Godsend. I still have highs and lows, but my overall control is very good. My most recent A1C (blood test which indicates your average blood sugar over a 3-month period) was 6.4 (in normal range). I credit the insulin pump and home blood glucose monitoring for giving me the ability to achieve tighter control of my blood sugars, thus rending me free of diabetic complications (ie. retinopathy (eye), neuropathy (nerve), nephropathy (kidney)).
4. What are the best ways for others to help people with diabetes?
Learn about diabetes and be supportive. If you’re the neighbor of someone who has diabetes and lives alone, then check on them in case they don’t wake up in the morning if their blood sugar goes down in the night. Let the person who has diabetes decide what they can or cannot eat. It’s always nice to have an alternative to cake or sweets for birthdays and holidays.
I also used to be a counselor at the diabetic camp in Louisiana for children. They always need volunteers. We would do sailing, sports, and so on with the kids. Dieticians taught about proper nutrition. Doctors, nurses, and medical students helped monitor blood sugars. The camp was to educate kids on diabetes and also to have fun and learn how to monitor blood sugar when being active.
5. What are symptoms of diabetes?
Frequent urination, extreme thirst, unexplained weight loss, extreme fatigue, blurred vision.
6. What do you do to deal with it? Diet, exercise, medication, etc.?
All of the above. I take insulin via the insulin infusion pump. The pump is a small computer that houses a syringe of insulin connected to tubing which is connected to a needle that is inserted subcutaneously into my abdomen. The tubing must be changed every 3 days to prevent infection at the injection site. The pump is programmed to automatically deliver a set amount of units of insulin per hour at various times of the day. This is called a basal rate. I also bolus or take additional units of insulin at mealtimes based on my blood sugar level and the number of carbohydrates I eat. I monitor my blood sugar a minimum of 4 times a day (meal time and bedtime) plus any time I suspect a high or low blood sugar. I also take Metformin which is an oral agent for Type 2 diabetes. It has been found to help Type 1 diabetics with insulin resistance.
I don't follow a specific meal plan at this time, but am careful with what I eat. Whereas sugar used to be taboo it is no longer forbidden so long it is covered with insulin. The downfall is that insulin allows the sugar to enter your cells so can cause weight gain if one overindulges. I don't have a regular exercise regime much to my doctor's chagrin. Exercise does help lower blood sugars so when I do any rigorous exercise such as house cleaning, grocery shopping, mowing the lawn or what have you, I have to decrease my insulin so as to prevent hypoglycemia (low blood sugar). It is really a balancing act—diet, medication, exercise.
7. Is early diagnosis and treatment important? Why?
Yes! Early diagnosis and treatment is very important in Type 1 diabetes to prevent diabetic coma or death. Tight control is important to prevent diabetic complications to your eyes, kidneys, heart, etc. Since the pancreas of a Type 2 diabetic still produces insulin, it takes longer for them to realize they have diabetes so their blood sugars could run higher for longer periods and they could have diabetic complications from delayed diagnosis and treatment.
8. What sources would you recommend to someone who has just been diagnosed with diabetes?
Read and learn everything you can about diabetes. Above all take your medication and monitor your blood sugars. Keep blood sugars in normal range. Develop a good working relationship with your doctor...work together as a team. Ask questions. The American Diabetes Association (ADA) is a great source of information. Visit their website. Membership in the ADA includes a monthly issue to Forecast magazine which contains a wealth of information.
9. What life lessons have you learned from having this disease?
Discipline and self-control.
10. Is there anything that you would like to add?
Because I didn't give up and eventually achieved good diabetes control without complications, I was able to get pregnant and have my first and only baby 10 days before my big 4-0!! My son is now 19 years old and I am still very healthy.