My Guide to Diabetes
For bacony and kingandy
This is a long one!
I've had a lot of people ask me lots of questions about my diabetes, what's wrong with me and when do I need help etc, so I thought I'd put it down on paper to make things easier.
I was diagnosed with Diabetes Mellitus just after my first birthday in 1976. It's very very rare for children under the age of five to develop diabetes this young and at the time, I was one of only 500 children in the whole of the UK diagnosed with the condition. I did my first injection aged 4.
So what is diabetes? Why do some people say theirs isn't as serious as other peoples?
The full name for this condition is Diabetes Mellitus. It is by no means a disease of the modern era; the term “diabetes” was coined by the ancient Greeks and from the Greek meaning excessive urination, which is one of the symptoms first noted. However, it wasn’t until the 17th century that it was noticed that the urine of people suffering from diabetes was actually sweet to taste. Then the term “mellitus” was added - derived from the Latin meaning honey-sweet. It has also been called the wasting disease, because pre-insulin diabetics literally starved to death, even though they consumed large amounts of food.
There is another completely unrelated disease, called diabetes insipidus, which happens to share the hallmark of excessive urination. Here, although we refer to it simply as “diabetes”, you should know that we mean diabetes mellitus.
Diabetes is a chronic disease in which the pancreas does not produce or properly use insulin. Being a chronic disease means that once diagnosed you will never recover and in some cases it can even get worse. Insulin is a hormone that is needed to convert sugar, starches and other food into energy needed for daily life. The cause of diabetes is a mystery, although both genetics and environmental factors such as obesity and lack of exercise appear to play roles.
There are two major types of diabetes:
Type 1 - Type 1 diabetes develops when the insulin-producing cells in the pancreas have been destroyed. Nobody knows for sure why these cells have been damaged but the most likely cause is an abnormal reaction of the body to the cells. This may be triggered by a viral or other infection. This type of diabetes generally affects younger people. Men and women are both affected equally. People with Type 1 diabetes must take daily insulin injections to stay alive. Type 1 diabetes accounts for 5 to 10 percent of diabetics.
Type 2 - Type 2 diabetes used to be called 'maturity onset' diabetes because it usually appears in middle-aged or elderly people, although it does occasionally appear in younger people. The main causes are that the body no longer responds normally to its own insulin, and/or that the body does not produce enough insulin. This can be controlled by diet alone (when the pancreas still works a bit), by taking tablets (which stimulate insulin production) or by insulin injections.
People who are overweight are particularly likely to develop Type 2 diabetes. It tends to run in families and is more common in Asian and African-Caribbean communities.
The people most at risk of developing type 2 diabetes are:
· people with a family history of diabetes
· people aged between 40 and 75
· people of Asian or African-Caribbean origin
· people who are very overweight, and
· women who have had a baby weighing more than 4kg (8lb 8oz)
Type 2 diabetes accounts for 90 to 95 percent of diabetics.
About 1.4 million people in the UK are known to have diabetes (that’s about 3 in every 100 people). There are an estimated 1 million people in the UK who have diabetes but don't know it. Over three-quarters of people with diabetes have Type 2 diabetes. Around 5% of total NHS resources and up to 10% of hospital in-patient resources are used for the care of people with diabetes. The frequency of diabetes in England is higher in men than women. However, women with diabetes are at relatively greater risk of dying than men. This may be because gender compounds other aspects of inequality.
Some people wrongly describe Type 2 diabetes as 'mild' diabetes. There is no such thing as mild diabetes. All diabetes should be taken seriously and treated properly. Everyone who has diabetes is at severe risk from developing complications which could result in blindness, amputation, kidney failure, complications in pregnancy, periodontal disease and nerve damage. Diabetics also have poor immune systems so are likely so suffer more from colds and bugs and can have a shorter life expectancy.
I thought diabetics couldn't eat any sugar or had to eat lots of sugar - I'm confused!
A diabetic's diet is NO DIFFERENT to the diet that any healthy person should be eating, but diabetics MUST eat carbohydrate regularly and try to avoid sugar. Carbohydrate is basically the sort of things that fill you up but are pretty bland - potatoes, rice, pasta, bread, bananas, milk.
In a diabetic the body has little or no ability to move sugar (glucose) from the bloodstream into cells. This means that the body’s cells cannot get hold of their primary fuel source - glucose - and the blood glucose level rises. In a 'normal' person, the blood glucose levels are usually controlled by the hormone insulin. Insulin helps cells to take glucose out of the bloodstream and use it for energy. I have to give myself insulin injections and make my leg, arm, bum, etc pretend to be my pancreas.
I change how much insulin I give myself according to the reading on my blood monitor and what I'm eating. Different foods contain different amounts of carbohydrate and these are usually listed as starch on food labels. However, there are a number of other things that I have to think about too - stress, severe heat or cold, lots of exercise and illness all affect my blood sugar levels.
So why do I see you eating 4 Kit Kat Chunkies in one go?
This is because I am suffering a hypo. I make mistakes. If I'm very busy, concentrating hard or very tired, I might forget to eat, or forget how long ago it was that I last ate. Everyone's done it, but with me it's that much more serious. My normal blood glucose reading should be between 6-8. A hypo can start occurring when the blood glucose reading drops below 4. It's like an early warning system, but the lower I let it drop, the more obvious the signs are. The first signs are very hard to notice, even by me, but most people will know something’s up if I keep on ignoring them. Hypo signs are (in kind of the order they occur):
· Hunger - am I just hungry or is it more serious?
· tiredness - I haven't slept, I’m tired!
· quietness - you all know I'm not, so when I'm unusually quiet this could be a hypo
· paleness
· sweating
· confusion
· memory loss
· pins and needles in lips and fingers - I might say I've got fizzy lips - a definite sign
· crying - generally a good sign something’s up - usually accompanies:
· acting like a five year old - I get very shy, I pull up my skirt and hang on nervously, I pull the bottom of my jumper sleeves, I hide behind people, I don't understand jokes - this is very noticeable and PLEASE feed me chocolate!
At this point it starts to get serious. If I was on my own and had no food there would be a really serious threat of me passing out and falling unconscious. If this happened and no-one found me, in the absolute worse case scenario I *could* die or become brain damaged whilst in a diabetic coma. This is very very unlikely, but it's not unheard of. It has NEVER happened to me in 20 odd years.
What can I do?
The best way to bring me out of a hypo is chocolate. It's not ideal, but because I don't eat very much it's kind of the bright side to the whole situation. You can also give me sugary drinks like Lilt, Tango, Dr Pepper, and if necessary add a couple of spoons of sugar. All of these MUST be followed up by some carbohydrate - biscuits or a bread roll.
I'll usually tell you that you can stop with the sugar. Listen to me - I am fairly helpful *sometimes* :o) Most of my good friends have seen me being silly at some stage and kind of know what to do. It's quite scary, but once you've seen one you know when I'm coming back to normal. Move me into the warm, but not in front of everyone.
What shouldn't I do?
NEVER EVER inject a diabetic EVER. You don't know what their dosage is and if they're having a hypo, it will rapidly make them unconscious. Don't give me Coke - I won't drink it because it's too sweet and I'll throw up. Don't let me go to sleep EVER - this is about the worst thing you can do but I am very persuasive. Thing is I might not wake up. Don't fuss - I'll get cross. Don't give me alcohol - I'll come on to that in a bit. Oh and don't fuss! It's bad enough that I've regressed 20 years, but to have everyone looking at me is the last thing I want.
I thought diabetics couldn't drink alcohol
This isn't true. I used to drink like a trooper, but I have to be careful. When I go to bed I take a different type of insulin that works a lot slower and mops up all the remaining sugar from the day. I take the same amount of this insulin every day. Sometimes I'll have a night hypo - not really all that more serious than a day hypo as I'll be very restless and can't sleep so will get food. Alcohol stops this restlessness and so I'll sleep through it and then either be very groggy in the morning or not wake up at all. The best thing to do to counter-act this is either to avoid alcohol or to make sure I have something to eat before going to bed. The other problem with alcohol is that quite often the sugar content is quite high, so I'll feel OK, but actually need something to eat.
So what do I do if you don't wake up?
I have some stuff called Hypostop. This is pure glucose solution and because it's gloopy I won't choke on it if I'm either unconscious or semi-conscious. You may need to feed me 3 or 4 of these before I can talk to you. If this doesn't work CALL AN AMBULANCE.
So can I catch it from you?
People sometimes misunderstand what it is that causes diabetes, so here is a short list of some things that do not cause diabetes:
· eating sweets or the wrong kind of food does not cause diabetes
· stress does not cause diabetes, although it may make the symptoms worse in people who already have the condition
· you cannot catch diabetes from someone, nor can you give it to anyone
How would I know if I became diabetic?
You would be constantly thirsty and pee all the time. You would think nothing of drinking a couple of litres of water in one go and STILL be thirsty. You would lose a lot of weight and be constantly tired.
So what can I do to help?
If you want to help just make sure I eat regularly, but please don’t force me to eat if I say I don’t need to - too much food is bad for me too.
You might have switched off on page 1, but there is an awful lot to take in. I’m more than happy to talk about it with people and answer any questions and I hope this has helped.
Sarah
This is a long one!
I've had a lot of people ask me lots of questions about my diabetes, what's wrong with me and when do I need help etc, so I thought I'd put it down on paper to make things easier.
I was diagnosed with Diabetes Mellitus just after my first birthday in 1976. It's very very rare for children under the age of five to develop diabetes this young and at the time, I was one of only 500 children in the whole of the UK diagnosed with the condition. I did my first injection aged 4.
So what is diabetes? Why do some people say theirs isn't as serious as other peoples?
The full name for this condition is Diabetes Mellitus. It is by no means a disease of the modern era; the term “diabetes” was coined by the ancient Greeks and from the Greek meaning excessive urination, which is one of the symptoms first noted. However, it wasn’t until the 17th century that it was noticed that the urine of people suffering from diabetes was actually sweet to taste. Then the term “mellitus” was added - derived from the Latin meaning honey-sweet. It has also been called the wasting disease, because pre-insulin diabetics literally starved to death, even though they consumed large amounts of food.
There is another completely unrelated disease, called diabetes insipidus, which happens to share the hallmark of excessive urination. Here, although we refer to it simply as “diabetes”, you should know that we mean diabetes mellitus.
Diabetes is a chronic disease in which the pancreas does not produce or properly use insulin. Being a chronic disease means that once diagnosed you will never recover and in some cases it can even get worse. Insulin is a hormone that is needed to convert sugar, starches and other food into energy needed for daily life. The cause of diabetes is a mystery, although both genetics and environmental factors such as obesity and lack of exercise appear to play roles.
There are two major types of diabetes:
Type 1 - Type 1 diabetes develops when the insulin-producing cells in the pancreas have been destroyed. Nobody knows for sure why these cells have been damaged but the most likely cause is an abnormal reaction of the body to the cells. This may be triggered by a viral or other infection. This type of diabetes generally affects younger people. Men and women are both affected equally. People with Type 1 diabetes must take daily insulin injections to stay alive. Type 1 diabetes accounts for 5 to 10 percent of diabetics.
Type 2 - Type 2 diabetes used to be called 'maturity onset' diabetes because it usually appears in middle-aged or elderly people, although it does occasionally appear in younger people. The main causes are that the body no longer responds normally to its own insulin, and/or that the body does not produce enough insulin. This can be controlled by diet alone (when the pancreas still works a bit), by taking tablets (which stimulate insulin production) or by insulin injections.
People who are overweight are particularly likely to develop Type 2 diabetes. It tends to run in families and is more common in Asian and African-Caribbean communities.
The people most at risk of developing type 2 diabetes are:
· people with a family history of diabetes
· people aged between 40 and 75
· people of Asian or African-Caribbean origin
· people who are very overweight, and
· women who have had a baby weighing more than 4kg (8lb 8oz)
Type 2 diabetes accounts for 90 to 95 percent of diabetics.
About 1.4 million people in the UK are known to have diabetes (that’s about 3 in every 100 people). There are an estimated 1 million people in the UK who have diabetes but don't know it. Over three-quarters of people with diabetes have Type 2 diabetes. Around 5% of total NHS resources and up to 10% of hospital in-patient resources are used for the care of people with diabetes. The frequency of diabetes in England is higher in men than women. However, women with diabetes are at relatively greater risk of dying than men. This may be because gender compounds other aspects of inequality.
Some people wrongly describe Type 2 diabetes as 'mild' diabetes. There is no such thing as mild diabetes. All diabetes should be taken seriously and treated properly. Everyone who has diabetes is at severe risk from developing complications which could result in blindness, amputation, kidney failure, complications in pregnancy, periodontal disease and nerve damage. Diabetics also have poor immune systems so are likely so suffer more from colds and bugs and can have a shorter life expectancy.
I thought diabetics couldn't eat any sugar or had to eat lots of sugar - I'm confused!
A diabetic's diet is NO DIFFERENT to the diet that any healthy person should be eating, but diabetics MUST eat carbohydrate regularly and try to avoid sugar. Carbohydrate is basically the sort of things that fill you up but are pretty bland - potatoes, rice, pasta, bread, bananas, milk.
In a diabetic the body has little or no ability to move sugar (glucose) from the bloodstream into cells. This means that the body’s cells cannot get hold of their primary fuel source - glucose - and the blood glucose level rises. In a 'normal' person, the blood glucose levels are usually controlled by the hormone insulin. Insulin helps cells to take glucose out of the bloodstream and use it for energy. I have to give myself insulin injections and make my leg, arm, bum, etc pretend to be my pancreas.
I change how much insulin I give myself according to the reading on my blood monitor and what I'm eating. Different foods contain different amounts of carbohydrate and these are usually listed as starch on food labels. However, there are a number of other things that I have to think about too - stress, severe heat or cold, lots of exercise and illness all affect my blood sugar levels.
So why do I see you eating 4 Kit Kat Chunkies in one go?
This is because I am suffering a hypo. I make mistakes. If I'm very busy, concentrating hard or very tired, I might forget to eat, or forget how long ago it was that I last ate. Everyone's done it, but with me it's that much more serious. My normal blood glucose reading should be between 6-8. A hypo can start occurring when the blood glucose reading drops below 4. It's like an early warning system, but the lower I let it drop, the more obvious the signs are. The first signs are very hard to notice, even by me, but most people will know something’s up if I keep on ignoring them. Hypo signs are (in kind of the order they occur):
· Hunger - am I just hungry or is it more serious?
· tiredness - I haven't slept, I’m tired!
· quietness - you all know I'm not, so when I'm unusually quiet this could be a hypo
· paleness
· sweating
· confusion
· memory loss
· pins and needles in lips and fingers - I might say I've got fizzy lips - a definite sign
· crying - generally a good sign something’s up - usually accompanies:
· acting like a five year old - I get very shy, I pull up my skirt and hang on nervously, I pull the bottom of my jumper sleeves, I hide behind people, I don't understand jokes - this is very noticeable and PLEASE feed me chocolate!
At this point it starts to get serious. If I was on my own and had no food there would be a really serious threat of me passing out and falling unconscious. If this happened and no-one found me, in the absolute worse case scenario I *could* die or become brain damaged whilst in a diabetic coma. This is very very unlikely, but it's not unheard of. It has NEVER happened to me in 20 odd years.
What can I do?
The best way to bring me out of a hypo is chocolate. It's not ideal, but because I don't eat very much it's kind of the bright side to the whole situation. You can also give me sugary drinks like Lilt, Tango, Dr Pepper, and if necessary add a couple of spoons of sugar. All of these MUST be followed up by some carbohydrate - biscuits or a bread roll.
I'll usually tell you that you can stop with the sugar. Listen to me - I am fairly helpful *sometimes* :o) Most of my good friends have seen me being silly at some stage and kind of know what to do. It's quite scary, but once you've seen one you know when I'm coming back to normal. Move me into the warm, but not in front of everyone.
What shouldn't I do?
NEVER EVER inject a diabetic EVER. You don't know what their dosage is and if they're having a hypo, it will rapidly make them unconscious. Don't give me Coke - I won't drink it because it's too sweet and I'll throw up. Don't let me go to sleep EVER - this is about the worst thing you can do but I am very persuasive. Thing is I might not wake up. Don't fuss - I'll get cross. Don't give me alcohol - I'll come on to that in a bit. Oh and don't fuss! It's bad enough that I've regressed 20 years, but to have everyone looking at me is the last thing I want.
I thought diabetics couldn't drink alcohol
This isn't true. I used to drink like a trooper, but I have to be careful. When I go to bed I take a different type of insulin that works a lot slower and mops up all the remaining sugar from the day. I take the same amount of this insulin every day. Sometimes I'll have a night hypo - not really all that more serious than a day hypo as I'll be very restless and can't sleep so will get food. Alcohol stops this restlessness and so I'll sleep through it and then either be very groggy in the morning or not wake up at all. The best thing to do to counter-act this is either to avoid alcohol or to make sure I have something to eat before going to bed. The other problem with alcohol is that quite often the sugar content is quite high, so I'll feel OK, but actually need something to eat.
So what do I do if you don't wake up?
I have some stuff called Hypostop. This is pure glucose solution and because it's gloopy I won't choke on it if I'm either unconscious or semi-conscious. You may need to feed me 3 or 4 of these before I can talk to you. If this doesn't work CALL AN AMBULANCE.
So can I catch it from you?
People sometimes misunderstand what it is that causes diabetes, so here is a short list of some things that do not cause diabetes:
· eating sweets or the wrong kind of food does not cause diabetes
· stress does not cause diabetes, although it may make the symptoms worse in people who already have the condition
· you cannot catch diabetes from someone, nor can you give it to anyone
How would I know if I became diabetic?
You would be constantly thirsty and pee all the time. You would think nothing of drinking a couple of litres of water in one go and STILL be thirsty. You would lose a lot of weight and be constantly tired.
So what can I do to help?
If you want to help just make sure I eat regularly, but please don’t force me to eat if I say I don’t need to - too much food is bad for me too.
You might have switched off on page 1, but there is an awful lot to take in. I’m more than happy to talk about it with people and answer any questions and I hope this has helped.
Sarah