It’s National Diabetes Awareness Day! I cracked my knuckles, pulled out my stalker credentials and hunted up my little sister’s super secret old blog (which I will not link to, because ~~she has access to younger!me blogs that I’d rather leave dead~~ I respect her) for a guide to Type 1 Diabetes she wrote when she was 16.

My sister was a weird 16 year old.

I’ll let younger!her tell you the tale, originally written for our cousin, Brooke, and later shared with the wide world through LiveJournal. I’ve touched it up a little. There is a strange organizational flow to the teen-induced frenzy in the original post that I’ve decided to maintain, but I’ve added a few more headers to make navigation easier.

The abridged version is below for your enlightenment. Enjoy.

Everything You Need To Know About Type 1 Diabetes:

First of all, the difference from type one and type two is that:
Type 1: Is where the body attacks itself and kills/stops the pancreas. It can no longer provide insulin, and so you have to get it through shots, a pump, an inhaler, or any other new thing science comes up with.

Type 2: Is when the blood stops accepting the insulin being made. I don’t know much about type two, but I think how they treat that is with pills that force the body to take the insulin, and it is possible to be cured if you exercise/get healthy.

The pancreas is under the stomach, and next to the kidneys. It makes insulin (duh). Insulin is often looked upon like a key, because when there is energy (sugar) in the blood stream, it has no way to get into a blood cell unless there is insulin there to unlock the door. When there is no insulin, the sugar just floats around in the blood stream. The blood becomes thicker. No energy is getting to the blood cells.

To help, for some reason the body makes you thirsty. So you drink. But this is an unending thirst, and it never goes away as long as your blood glucose is high. (Note: blood glucose is blood sugar. I’m going to call it BG for short, because it’s better than calling it BS. Even though Amy [our oldest sister] calls it BS on purpose just to annoy me. Anyway.) So your BG is high, and you’re drinking a lot, and going to the bathroom a lot.

[The Thirst:]

I used to barely ever drink water, it makes me feel weird. I remember when The Thirst (Dun Dun DUN. ominous.) began, and I drank a glass of water, it wasn’t too bad.

I began to take a glass of water with me every time I went to bed. Then that glass started to not last me through the night, and I would get really thirsty. So at first I would refill it in the bathroom sink. But that was bad, because it was unfiltered and we were in DC. So I would bring two glasses of water with me to bed. Soon that wasn’t enough either. That’s when The Pitcher came into the picture. I would put tons of ice in it, (the water HAD to be cool) and fill it half way. That was fine, but soon THAT wasn’t enough EITHER.

Ok, this is getting long, so in the end when I went to bed I would take: a full pitcher, two glasses of water, and a little ice chest with like… as many water bottles as I could fit in it. I thought that if I could drink water without it making me feel weird, than I should drink as much as I could because it was good for me.

[Mr. Liver:]

I will now tell you about Mr. Liver. I forget why we call him that, but there is something you must know… Mr. Liver… is… EVIL! He controls the fat, see? And fat is energy that can be given to blood cells without the aid of insulin. Mr. Liver can tell that you aren’t getting energy, so he takes fat and gives it to you. Thus the huge loss of weight. And that was all fine and dandy until, YOU ARE LOSING WEIGHT. I lost 14lbs in one week, all the while with mom FORCING food down my throat. (That was the last week before we went to the hospital)

Before we move away from Mr. Liver, I’ll tell you why he’s so evil. Once you know that you’ve got diabetes, and you’re treating yourself all perfectly, like a little diabetic angel, BAM BAM BAM!! YO BLOOD GOIN’ CRAZEE!!! And you spin around like, “What was that?!?!”

Then you spot Mr. Liver over in the park and he’s FEEDING your blood cells like they were PIGEONS. So you run up to him like, “What are you doing!?!” and he’s just like, “DURRR, I’m feeding the blood cells sugar…”

“But my blood’s FINE!”

“DURRR, I downnooow. I guess I’m just stupid…” *feed feed feed*

Then you try and take the sugars away from him, but that’s impossible, so it’s time for… The Shot OF Long Acting Insulin!! (Sweet no more!) And that makes Mr. Liver go to sleep for about 18-23 hours.

The cause of Type 1 diabetes: More in depth.

Autoimmune diseases are from when the body thinks a part of the body doesn’t belong, so it attacks itself. I forget why, but this happens when you get sick. Not every time you get sick…it’s just like you get a cold or something, and your body freaks out and goes all cannibal. There are a lot of different kinds of autoimmune diseases, diabetes is just one of them. Autoimmune stuff runs in families. (YOU COULD BE NEXT.) My aunt has Chrone’s, my mom has thyroid, Alyssa has some thing we don’t know yet [spoiler: I had Rheumatoid Arthritis], &ct. I have diabetes.

[Diabetes Awareness is Important and Ignorance is Rampant:]

I went to the dentist right after I was diagnosed. We told her I was diabetic in case there was any random special way to do things that we were unaware of. There wasn’t. I went back, and as she was cleaning my teeth, she told me that her daughter had diabetes. We talked for a while, and she asked if anyone else in my family had diabetes too. I said no, but that my aunt had Chrone’s disease.

She was like, “Dur, what? That has nothing to do with diabetes.”

I was like, “Uh, yeah it does.”

And then I explained to here what I just said and she WOULDN’T BELIEVE ME! ARG! *Headdesk* That was when I first found out how little everyone knows about diabetes, I mean, her daughter has it, and she doesn’t even know how! I also learned that it’s impossible to argue with a dentist. Even if you’re right, you’ll lose. The dentist always wins, because it’s not like you can even say anything while they’re stabbing out your tongue.

Another example of this is with The Nurse Who Almost Got Me Killed. Where the nurse in the ER literally almost got me killed. I couldn’t sleep at night, I was drinking water like crazy, and I had lost 14lbs in one week on top of the loss of 20lbs before that. Something was obviously very wrong. What did The Nurse Who Almost Got Me Killed do? She diagnosed me as being Anorexic. I could have gone into a coma at any moment, and her solution was to see a councilor.

Mom and me both knew this was complete nonsense, and the choice we made to stay and wait for another doctor probably saved my life. Once I got into the ER, they checked my blood. It was 840 something. Soon all the doctors were running around like headless chickens. Then The Nurse Who Almost Got Me Killed came in and gave me a picture of her ugly fat dog to make me feel better. It really was comforting (Not!), I was like, “Mhmm… I’m so glad my life is worth a scrap of paper to you.” But really, I think we are all too harsh on The Nurse Who Almost Got Me Killed.

[Ketones and Mr. Liver:]

OOH Yeh. When your Mr. Liver gives you energy from fat, some of the fat is left over. That is what’s called ketones. It’s like squeezing out all the sugary juice from an orange, and being left with a bunch of pulp gunk. Only, the ketones turn your blood into acid. Not good. Drinking helps flush the acid out of your system. If your blood is high (say, 250 or over) for a long period of time you should/could/would go into ketoses. (The state where ketones are in your blood) Um, this can also be called DKA, or Diabetic Ketoacidosis, just FYI.

Even though my blood was over 300 for longer then a year, I wasn’t in ketoses when I first went to the hospital. That shocked all the doctors.Speaking of being over 300 for longer than a year. You may wonder how I know that, since I never checked my blood before getting diagnosed.

Well, there’s this thing called an HbA1c, or Glycosylated Hemoglobin. (Yeah, that’s why we call it HbA1c. A1c for even shorter.) Your A1c tells you the average level of your blood sugar over a period of 2-3 months. It should be between 4.3 and 6.2 for a non-diabetic. Diabetics get to settle for less than 7-8. That’s what we aim for anyway. An A1c of 6 means that your blood’s been hanging around 120, 8 means 180, that make sense?

When I was diagnosed, my A1c was 27. That’s something so rare it blew the doctors minds. There was so much loose sugar stuck to my blood cells that they knew it had been there for more then a three-month time.

[Cataracts:]

I think that the oddest case I’ve had, is my cataracts.A cataract is when the lens of your eye becomes cloudy. It’s like when you look through the viewfinder of a camera on a humid day and the lens is all foggy. There are very strong glares around silhouettes.

I remember going to camp right after being diagnosed with diabetes. I was walking to the cafeteria, and some people from my youth group were about walk past me. The sun was so bright I couldn’t recognize them; no matter how hard I squinted. I couldn’t even tell that they were waving at me, until we were right next to each other and they were calling my name.

A lot of things like that happened until we finally went to the eye doctor. She asked me a few questions, and then stood me in front of that big chart with all the letters on it. It was a giant blur.

“What’s the biggest letter?”

“Well, I know it’s an ‘E’… But I can’t see it.”

“…ok then.”

She sat me down and got a light thing to shine in my eye. She looked for about thirty seconds then made a call to another doctor on the phone. She sounded urgent, and that made us nervous. At first the other doctor didn’t believe her (That seems to always be happening to me…). Then she got off the phone and told us we would have to drive to the hospital to see the other doctor. Apparently, the cataract was so thick that you couldn’t see any of my eye past the lens. I didn’t get to see it (though I was looking through it the entire time), but they said that the cataract was so strong that there were patterns/cracks that ‘Looked like the grand canyon’ as my doctor said. Lovely thing to have in your eye.

For the surgery, he said that they would cut a slit on the surface of the eye, and then the lens would be rolled up, pulled through the hole, and replaced by a fake lens. But as it turned out, the cataract was so hard that they had to cut an entire circle around the cornea to remove it. Cataracts happen to people as they get older. I was only 13. The youngest diabetic with cataracts that my doctor had heard of was 17, and that was extremely rare too. During my surgery they took pictures of my eye for textbooks if that helps you imagine how weird an occurrence it was.

BACK TO DIABETES!

My Dead Pancreas:

Unlike Mr. Liver, the (Live) pancreas is SMART. It knows how much insulin it needs to make for any food. A pancreas is so smart that it’s probably smarter than you. It knows if you are going to eat something even before you decide to. If you so much as look at food with the thought of eating it, the pancreas will start to release insulin. Each human has a mini superman pancreas in them, and most people don’t even know what a pancreas is.

A pancreas is a nasty thing to loose. Without it, the brain has to take on the role. (Even though Mr. Liver tries to. *Stupid grumble grumble*.) You have to Think Like a Pancreas (that’s a good book) and are now left alone in the world to find insulin for yourself. Yes, you can steal an animal’s insulin and use it as your own. But, it is far better to…

MAKE IT IN A LAB!!! (Anti-SWEET!!)

Lab insulin works more like human insulin than a cow’s insulin. Animal insulin is slower, and is known to do random acts of craziness. It is very unpredictable.

[Blood sugar levels:]

Oh no, I’m feeling shaky at the moment…you know what that means! It’s time to check my blood sugar! (No really, I am shaky, brb.) Ok, *sits down* as it turns out, my blood is 60, which is LOW. Thus the cosmic brownie in my hand that will make it HIGH. (Have you ever heard the one ‘bout the high diabetic? heh) After that, I’ll take insulin to make it NORMAL.

What does all this mean? I will tell you.

Most foods have sugars that make the blood go up. Insulin makes the blood go down, but sometimes insulin makes the blood go down too much. First I’ll cover…

The Lows! (Hypoglycemia. It’s the most fun. Until you DIE.) Under 70

The brain likes sugar. He is a greedy mush of spaghetti, and he’ll steal all of the body’s sugars before he goes low. That’s one of the reasons why diabetics don’t check their blood sugar in their brains, among other more obvious reasons.

When your blood has too little sugars, you are most likely to notice from your limbs first. If you very softly hold out your hand and relax it. You’ll see it twitching. There is also an indescribable feeling of low blood sugar that I think is too hard to explain to someone who has never felt it.

When you get hypoglycemia, you have two choices:

Eat carbs.
Go into a coma.

That narrows down the choices to one. That means free food with no shot. That equals happy diabetic.

You need to eat a certain amount of carbs and a certain kind of carbs to treat low blood sugars the best. Different kinds of carbs take different amounts of times to get into the blood stream. You’ll want to eat (or drink) something sugary, and not fatty, to bring yourself out of coma stage quickly. Fats and proteins slow down the absorption of carbs, so they are to be avoided when you have hypoglycemia.

Now for the eliminated choice number two. Once you are in a coma, you get to be shot by a special Glucagon Shot as fast as possible. The person giving the shot has to either be taught how to do it, or be able to read Egyptian hieroglyphics, because that’s the language its instructions are written in. After someone else shoots you (you are in a coma), you should be turned on your side because you are most likely to throw up when/if you wake up. Then you should immediately be taken to the hospital.

Now forrrr…The Highs! (Hyperglycemia. Not fun. Nooo not at allll…) Over 200.

Too much sugar, too little insulin.

If you have ever set a lump of jello on a plate, and just watched it sit there, imaging that you were the jello, then [you’re weird] you can imagine how it feels to have high blood sugar.

You just feel like a BLOB, and if you want to feel better you have to take insulin. (Or exercise, but that takes longer for the blood to go down, which isn’t good for you.) When you are high, you have either taken drugs, or need to take drugs (such as insulin).

But I am talking about high blood sugars. Whilst having hyperglycemia, you run the risk of the before mentioned ketoses. AKA, DKA: Diabetic Ketoacidosis.

You also run the risk of a coma with high blood sugar, only this time you DO NOT want to take a Glucagon shot. That would be bad bad bad. Glucagon pretty much means super sugar. If you add super sugar to high sugars, you get super ginormous death blood sugars. So just take insulin, and go to the hospital.

[More of Laura’s Story:]

I stayed at the hospital for three days, and that was Walter Reed hospital, which is really bad. The whole time I was there, the air conditioning was out on my side of the hospital. That was unbearable with my super high blood sugars. Once they started giving me insulin, I got REALLY hungry. When your blood is high, you don’t feel like eating. Even if you do eat, it doesn’t do anything to your body. So by the time I was diagnosed, I was starving. The mean hospital people wouldn’t let me eat for the first day. It was horrible! Then they came around in the morning with breakfast. My person who was sharing the room with me got the most delicious looking donut, and cereal. There was some confusion as to which was mine, and which hers, so they gave it to me. My mouth was watering! And then the doctors came in and took it away! Torture!! When they finally let me go down to get food from the cafeteria, I ate so much food, my blood went back over 400.

When we first went into the room, a roach literally run across the floor, and dad stepped on it. I had a little pull out TV, so one time we turned it on to see what channels it had. A picture of a chocolate protein looking shake in a blender came on. It was just a picture, it didn’t even move! We were like, “uh… ok…” and then we flipped the channel. There it was again! It was the only thing the TV did. We turned up the sound to see if it had any, and it was like a Mexican radio station. Weird.

A Look Back on History!

Ok so, you know how no one knows anything about diabetes? Well that is OLD NEWS. Up until around the 1980’s the doctors were still going, “Here, have some leaches and a chicken head. Ok, now tie the chicken head around your neck and run around the house ten times. Drat! You’re still not cured!”

Up until the 1920’s it was REALLY bad. The only treatment of diabetes was starvation. A diabetic would die a short while after being diagnosed.

“January 1922 Leonard Thompson, 14, a ‘charity patient’ at the Toronto General Hospital, becomes the first person to receive and injection of insulin to treat diabetes. Thompson lives another 13 years before dying of pneumonia at age 27.”

“1944 The standard insulin syringe is introduced so to make diabetes management more uniform.”

“Sept. 14, 1971 Anton Hubert Clemens receives the first patent for a portable blood glucose meter called the Ames Reflectance Meter. Dr. Richard K. Bernstein, an insulin dependent physician with diabetes, uses the meter to monitor his blood glucose at home, and subsequently publishes a report on his experiences.”

Up until the 1980’s people were still on strict no-carb diets. Now we are free to eat almost whatever we want, but there still isn’t a cure. That leads us to…

HOW YOU CAN’T CURE DIABETES.

There are some people in the world who still think that eating no carbs and exercising can cure diabetes. This is WRONG. Insulin does more than just keep your blood steady, and you cannot live a good life without it. It would be like driving a car with no tires. (But with the rims.) You can still move, but…not really. You won’t last long.

Different types of insulin (there are a lot):

There are three types of insulin: short acting, intermediate acting, and long acting. I’ve never had intermediate acting, and they aren’t the newest/best things out there so forget about those. Humalog, NovoLog, Regular, NPH, Lente, Ultrlente, Lantus, and Levemir, are most kinds of insulin.

I take NovoLog and Levemir, so I’m going to only cover those. (I don’t know much about the rest) NovoLog is a short acting insulin (also called a bolus), and Levemir is a long (also called a basal). I take a shot of NovoLog every time I eat, or my BG is high. Bolus acts within 15 minutes, peaks at 1-2 hours, and wears off around 4 hours after injection. This is the same way carbs act in your body, and the bolus is meant to counter that. Basal is the long acting insulin that I mentioned before. The one that makes Mr. Liver go away. Basal lasts from 18-23 hours depending on the kind of insulin.

Different ways to take insulin: we got’s the shot, the pump, the new inhaler.

You can’t treat type 1 diabetes with a pill like with type 2. The acid in your stomach would destroy the insulin.

The Shot: Some people have problems with shots. I don’t. The needles are really short and skinny. You have to get the insulin into the layer of fat under your skin. Muscles make the insulin absorb funny, so they are unreliable. Insulin is a clear liquid that comes in little glass vials. It goes from the bottle, to the syringe, to the fat, to the blood. You take a shot of bolus for every meal/correction, and one every day to make Mr. Liver shut up.

The Pump: I have a pump connected to my stomach right now, that I’m planning on getting rid of as soon as possible. A lot of people like pumps, but I’m not one of them. I prefer shots. The pump has a syringe type tube connected to a long tube that is the exact width of iPod earphones. I know because I get them confused a lot at night when I roll over, I’m like, “Why is my iPod in my bed?” The pump pushes insulin out of the syringe, through the tube, and into your body. You have to wear the pump all the time except when you are bathing or swimming. With the pump there is a tiny constant flow of bolus insulin instead of long acting basal insulin. If the pump has a malfunction, your blood SHOOTS up like crazy due to Mr. Liver being awake all the time. With the pump, you tell it what your BG is, and how many carbs you are going to eat. It then calculates how much insulin it’s going to give.

The Inhaler: This is very new. It’s still being tested for children, but has been approved for adults. That’s all I know about it.