By now most people who know me (and anyone who stood next to me long enough to listen) has probably heard my pity party. The last time I blogged I was about to head back to the doctor to be diagnosed as diabetic (or pancreatic cancer). The good news... It's not a toomar. The last than peachy news was confirmation that I have diabetes; considering most of my extended family has type 2, I kind of expected it sometime in my future (I was no specimen of fitness after all). The doctor told me that not only did I have diabetes (a diagnosis I gift wrapped for him) but that I was type 1. Bugger.
For anyone who isn't aware, type 1 is when the pancreas, the clever organ responsible for the production and release of insulin has stopped being so clever and decides that it doesn't want to do its job any more. Unfortunately our bodies have no workers compensation scheme for retired or injured organs so the only way I can now get insulin is via injection 4 times a day. Luckily I've had thousands of patients to practice my superlative injection techniques before taking over care of my most important patient: me.
Now, let's clear something up: Type 1 is NOT a disease of lifestyle. It almost certainly had nothing to do with my love of large Quarter Pounder meals with a coke. It is not very well understood who will or wont get type 1. Genetics have some part to play, but there are also (according to most experts) an external triggering factor, be it viral, traumatic, or stress that switches diabetes on. I could not have prevented type 1 diabetes (so no judgey-judgey looks, I feel *language warning* shit enough already). Type 1 is essentially pancreatic failure, insufficient insulin supply to meet the body's demands. In most cases it is autoimmune in nature, where the body goes a bit haywire and destroys the pancreas. Nice. In about 60% of these people, there are antibody markers that indicate this process of self destruction. I have come up negative to these antibodies. What does that mean? Not much, depending on who you ask. I still need exogenous insulin to keep me alive (dramatic pause), luckily we live in an age of easy access to insulin (before 1922 type 1 diabetics died within 2 years of diagnosis from essentially starvation. Type 1 diabetes is a lifelong disease with no cure, however it can be managed and almost all long term complications avoided.
I have had to quickly brush up on endocrinology 101 and everything I had forgot (never bothered studying) from uni. I saw the diabetes educator, dietician, and endocrinologist to receive my programming. According to them (and Diabetes Australia) their aim for me is to have blood glucose levels (BGLs) into a "healthy" diabetic range, essentially 50% higher than the BGLs of a non-diabetic. Normal BGL is considered 3.9-7.8mmol/L (the low ranges before meals and the upper range after meals). Diabetic ranges are 5-10mmol/L. These soft targets would definitely slow down onset of diabetic complications but not stop them. I feel I deserve normal BGLs, and the ability to grow old and cantankerous with good kidney function, both my feet intact, and no higher risk of heart attack or stroke than my already poor genetics already give me.
To achieve normality, I have chose to make some big lifestyle changes in both diet (now) and exercise (baby steps, people). These changes have let my BGLs return over the last few weeks to the normal range, averaging 5.1mmol/L (a non-diabetic average). Even with these changes, I will still need exogenous insulin for the rest of my life (or until a cure is found), just not such massive amounts as if I was back on the Maccas diet. It's not that I can't have certain foods, it's that I CHOOSE not to eat it because although that cheesecake with a side of chips and gravy looks awesome, my long term priorities have shifted. I want to become a Granddad at some point. I want to be a geriatric driver terrorising the streets of Perth. I don't want to be every horrendous diabetic complication that I have ever nursed.
It's not all bad though. I found out that, more or less, whisky has no direct affect on BGLs. I can live with that. Anyone who wants to toast my long life can join me with a fine single malt (straight or on the rocks if you're feeling weak). Diabetes won't get me, but I'll have to watch the number of toast I make or cirrhosis might!
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