Everyone knows what diabetes is. Or rather, everyone thinks they know what diabetes is.
All everyone actually knows are some loosely related words and connotations – insulin, blood sugar, and the most harmful one: being overweight. It’s true to a small extent, Type 2 diabetes is most commonly caused by obesity, but not everyone with Type 2 is overweight, and not everyone overweight has Type 2.
November is National Diabetes Month in the UK, and it aims to spread awareness on the conditions and raise support for those living with it. The 14th of November is World Diabetes Day, in celebration of the birthday of Frederick Banting, whose research led to the discovery of insulin 100 years ago.
But what is Diabetes?
Diabetes is a lifelong condition that causes a person’s blood sugar level to become too high.Definition taken from NHS website
Blood sugar, also known as glucose, is vitally important to all animals. The amount is controlled by the hormone insulin, produced from the pancreas. As we digest food, insulin is used in the process to produce energy from our glucose. This is how it works for people without diabetes.
There are two main types of diabetes, Type 1 and Type 2.
Type 2 diabetes is what most people recognise, and is linked to poor diet, inactivity and old age and can be managed through eating healthily, exercising and some medication. The body becomes insulin-resistant.
Type 1 diabetes is the lesser understood condition, and has nothing to do with diet or exercise. It’s caused by a loss of function in the pancreas regarding insulin, and the body’s immune system begins to attack the cells responsible for producing insulin. As the cells are destroyed, the pancreas can no longer keep blood sugar levels down, which begins the symptoms of diabetes: feeling very tired, thirsty, urinating more often, and so on. For more symptoms and signs, visit the NHS website.
Interview with a blogger
Joining me for this article is a very special guest and type 1 diabetic blogger, Angel (@type1dinobetic on Instagram), who has very kindly offered to answer some questions on her experiences here.
Q. Hi Angel, thank you for joining me today. I suppose what we should start with is, how did you find out you had type 1 diabetes?
A. “I found out I had type 1 in April of 2019. I was extremely tired, thirsty, and needed to pee a lot more regularly. My throat was a bit sore too, so I was told I had laryngitis at first, but when I came home from the doctor’s appointment I began to throw up this kind of green substance. I assumed it was just a stomach bug and went to sleep it off. Around midnight, my parents woke me up after hearing me struggling to breathe. I didn’t even realise I couldn’t breathe at the time, I was barely coherent and it’s a bit of a blur from there. They called 111, and they instructed them that the ambulance wouldn’t make it in time and I had to get a cab, telling my mum I had about an hour before worst case scenario. I fell into a coma just as I got to A&E, and woke up two days later. I was experiencing ‘Diabetic Ketoacidosis’, and was told I had Type 1 in intensive care.”
Q. What is it like on a day-to-day basis living with the condition?
A. “Honestly it’s tough. There’s no breaks from it, and it’s the first thing I deal with when I wake up and the last thing I deal with before I go to sleep. I’ve had to adjust my whole life around it, because absolutely everything can impact it, from the weather to stress or activities. There’s so much more involved than people think; it’s not just giving myself insulin at meal times – it’s counting carbohydrates for everything I ingest, it’s calculating how much insulin to give myself, administering that insulin, testing blood sugar levels, adjusting dosages based on all of the variables, hypos, hypers, poor sleep, the mental impact of all of the needles and stress, the bruising, bleeding, slow healing, the knowledge of all the complications that could happen. It’s a lot.”
Q. What kind of equipment and tools are there to help manage diabetes?
A. “When you’re first diagnosed, you’re typically given two insulin pens, short and long acting, and a glucose meter to test your blood sugars, also known as finger pricking. I’m currently using a tubeless pump called the omnipod and a Libre sensor that reads my blood sugars. There are other pumps, and the Dexcom is another continuous glucose monitor, but some of these are difficult for people to obtain, even on the NHS. They are very expensive in countries like the USA, and even on the NHS you have to meet a specific criteria. It’s still important to keep the pens and meter in case of emergencies, tech isn’t always reliable.”
Q. Is type 1 the main thing you have to worry about? What else are you at risk of? What else do you have to manage alongside it?
A. “There’s a lot of risks involved with type 1. We heal slower than the average person so we are more prone to infections and things like that. Infections, colds, and any kind of virus including COVID-19 can be extremely dangerous. They make our blood glucose rise almost uncontrollably, and put us at very high risk of DKA. Then there’s the risks of other conditions/complications just from having diabetes – diabetic retinopathy, diabetic neuropathy, lipohypertrophy, the list is endless. I personally have one complication from having Type 1, which is quite rare – insulin-induced lipoatrophy. From repeated injections, my fat tissue has disappeared from certain parts of my body, leaving craters where it’s missing. This is primarily on my stomach and I can no longer use these areas to give myself insulin, which limits my injection sites significantly.
Alongside Type 1, I manage a heart condition called Postural Orthostatic Tachycardia syndrome. It’s difficult to juggle the two, because what my diabetes might need one day, my POTS will react negatively to, or vice versa.”
Q. Does diabetes interfere with your hobbies, seeing friends and spending time doing what you want to?
A. “It can do, yes. I will always advocate for not letting diabetes stop you from doing what you want to do, but sometimes it does get in the way. You can’t do a lot mid-hypoglycaemia (low blood sugar), you feel awful when your glucose is high, and sometimes you need to recover from those symptoms. Tech can also fail and this makes things difficult too – going out with friends etc causes a lot of health anxiety too. ‘Is anyone watching what I’m doing’, ‘are they going to comment on what I’m doing’, ‘if something happens do friends know what to do’, that kind of thing. In no way should someone have to hide their diabetes to feel comfortable, but strangers can get the wrong idea when they see people injecting, or make comments like “I don’t want to see that, do it in the bathroom”. It happens more than you think. Bathrooms are unsanitary for injections, yet sometimes we feel we have to do that. It can all get a bit overwhelming.”
Q. What’s it like to know that you have hundreds of people that follow your social media and look up to you as a role model, to know that you inspire so many people with the same condition and that you could be the motivation that keeps them going?
A. “Honestly that wasn’t my intention at all when I started my account. I needed an outlet to deal with the stress of my diabetes and the way my treatment was transitioning from pens to pump etc. I wasn’t having a good time and I needed someone to talk to, but without a face. I had no idea about the online diabetic community before I made that account, and it was such a pleasant surprise – I wound up making friends that could understand me, and I learnt things about the condition I didn’t know yet. I’m not sure I inspire anyone per se, but if I am responsible for keeping anyone going or teaching them something, I’m glad for it. If I teach anyone anything, I’m happy – a friend from high school follows my account and they told me about how they recognised a piece of diabetic equipment from my account and they were able to return it to the owner and help them out – that warmed my heart. I was so thankful that I could have that impact.”
Q. Finally, if you had one thing that you wanted everyone to understand about diabetes, one thing to take away from this, what would it be?
A. “That it doesn’t happen because of sugar!! It’s a joke that’s gone too far. We can eat what we want, when we want, because we know how to do so safely. And it’s a lot harder than it looks – so let us have a doughnut if we want one! We deserve it!”
What can we do to help?
While diabetes is a lifelong condition, there are ways to help those who live with it.
- Being understanding and supportive can really make a difference in their lives. When they’re struggling to take care of themselves, when they feel depressed and anxious, being there for them and listening to what they need to say is vital. Whether they’re a loved one, a friend or family member, everyone needs the support of those they care about.
- Help them. Even if they say they can manage alone, be there to make sure they’re safe. It’s important not to patronise them, they know their bodies and their condition better than anyone, but make them feel comfortable that they can trust you if they need your help.
- Don’t contribute to harmful stereotypes. Diabetes isn’t a joke, it’s not all about being obese, it’s not all about eating too much sugar. These are real people with real issues, and what may seem like a joke to you could be what ends up tipping someone who is struggling over the edge.
- Do your research. There’s a lot to know about diabetes, and it can be daunting with so much information to take in. Take your time to learn the issues and what to do in an emergency, you never know when someone might need it.
- Donate to charity. This is a list of charities around the world that support diabetes research and those who live with diabetes.