my best friend

I would like to share with you the other loves in my life…simply because they do just that…provide lifethese are just a small portion (not everything we need or use is included) of our daily supplies used to keep Kinzie going…playing the role of the pancreas is not easy job!  Missing in this picture is our ever so loved pump and infusion sets…because they are on my daughter and she is at school (they are never not on her unless we are changing our sets)…because they are her provider of life, they are a part of her.  I have heard in many different forums, phrases, classes, get togethers, books…etc. that insulin is merely life support.  That is true because for type 1 diabetes, there is no cure.  Insulin is simply life support until a cure is found…I am thankful for life support, I am thankful for advances in technology and medicine.

I am no expert on diabetes…and what I do know I know because of what we live on a daily basis.  I do not claim to be the know all, end all of this disease.  What I describe is in my terms, and in no way do I claim everything to be exact.  The following is the easiest way I can describe type 1 diabetes.

Much is unknown about type 1. Type 1 is an autoimmune disease…her body has attacked her insulin making cells in her pancreas.  Insulin is made in the pancreas and used to pull sugar from the blood stream.  Without insulin sugar cannot be pulled from the blood stream and used for energy.  Your body needs energy in order to function.  Type 1 diabetics are often noticeably thinner…because their body, when insulin isn’t available, will ‘eat’ their fat for energy.  The by-product of that is ketones…we hate ketones and do not want them.  Ketones is essentially poison in the body and can be deadly, leading to DKA (diabetic ketoacidosis).  Your pancreas is a very smart organ and knows how much insulin to make/release and when to do it.  Without the pancreas working you cannot live unless you take in insulin and monitor blood glucose multiple times a day and adjust your insulin needs accordingly.

Hyperglycemia is high blood ‘sugar’ glucose.  It means too much sugar not enough insulin.  It can be deadly leading to DKA (build up of ketones). High blood sugars can lead to heart disease, eye problems, amputations, kidney problems, etc.  It affects every organ and can cause great damage.

hypoglycemia is low blood ‘sugar’/glucose.  It means too little sugar and/or too much insulin.  It too, can be deadly.  In order to function, your body has to have sugar and be able to convert that sugar to energy.  Hypoglycemia can lead to seizure, fainting, death etc.

Both hypo/hyper glycemia can affect organs, thinking, sleeping, etc.  And your body’s blood sugars are affected by EVERYTHING!!! The weather, emotions, late nights, hormones, stress, etc.  Taking into account anything that can affect your blood glucose and adjusting accordingly is a magic act.

A type 1 diabetic must have insulin to live…no exceptions despite the myths going around.  If there were any way around that, trust me, we would be taking that avenue and not be spending thousands of dollars a month on supplies/medicine.  Insulin can only be taken via injection.  There is no magic pill.  The acids in your stomach will break down the insulin before you can even use it…hence the reason diabetics have to have multiple injections a day.

Our bodies have natural alga rhythms daily and it varies hour by hour and minute by minute.  Pancreas knows the alga rhythms and knows how to adjust your ever-changing insulin needs.  A type 1 doesn’t have that option.  Instead through calculations, monitoring and sometimes guess-work we find what we call the basal rate.  It is ever-changing and the basal rate varies hour by hour, but it is the baseline amount of insulin the body needs to function regularly.  It is a very important aspect of type 1 therapy.  We are ALWAYS making changes to the basal rate as the needs for the body changes for what ever reason and whatever influences are around.

Then we have to take into account our I:C ratio or insulin to carb ratio (this is how we choose to calculate Kinzie’s insulin need for food).  Sugar free means absolutely NOTHING in this house.  Carbohydrates is what counts…and we literally count every single one she consumes. She eats like every other human being SHOULD eat…a healthy balanced diet.  If she wants something sweet or something not necessairly healthy, we plan for it.  And again, through calculation, guess-work, monitoring, etc we find her unique I:C.  Every time she eats, drinks, etc we administer insulin no matter how little she eats. Not to mention fats, and how fats can interact with spikes in sugar, when to combo bolus, etc….details I will not even get into because there is so much to take into account.  You cannot simply go carb free either, because that too, will build starvation ketones. Remember, your body needs insulin to utilize the sugar in your blood stream.  Sugar essentially from the carbs you take in…if you do not eat them then you cannot cover them and do not have enough insulin to be able to do the job right.

 Over coverage or under coverage with both basal rate and I:C can lead to hypo/hyper glycemia; which can result to damage, coma, passing out, lethargy, death.  Insulin is a very controlled drug and misuse can lead to death.  That is why you should always recheck your dosing.

Diabetes doesn’t rest, go on vacation, have a schedule or is predictable.  I find it vital to do overnight checks to 1. make sure she is within her target range.  2. make sure she is alive.  3. correct highs/lows throughout the night….unnoticed low (hypoglycemia unawareness) can lead to dead in bed syndrome (we won’t go into detail).

This is just a quick synopsis of the disease as I can word it.  Later on I will probably go into detail on parts or in whole.  The disease itself is scary, and the key to being successful is by learning all that you can, monitoring frequently and working in collaboration with your health care team.  So many myths surround Diabetes…ignorance isn’t an excuse.  If you don’t understand, seek answers.  If you have a question, ask.  It isn’t offensive when we see people trying to learn or understand more about this disease.  So I leave you with my all time favorite nursing quote (not sure where I heard it or if I just made it up, can’t remember but it has been with me since nursing school)…  Knowledge is Power, Education is Key.  And may you always find a purpose to be an advocate, reach beyond your comfort zone for the greater good.

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