By: Bill Poe
Dismal Predictions – In 1949, at the age of 13, I was diagnosed with diabetes. I was told that I would have to take shots for life and that my life would probably last only 25 years longer. Furthermore, I could eat no candy, and all my children would be diabetic.
Only the prediction about requiring insulin for life was correct. But for a 13-year-old, the barrage of misinformation was shocking news. That initial lecture was, I suppose, responsible for my decision to remain single.
The entire state of knowledge was primitive at the time. I boiled urine in Benedict’s solution and observed the color change to learn my glucose level. I sterilized my glass syringes by boiling them in the hard water of the rural Mississippi Delta, and injections were difficult.
I went to college and did all the reckless things that students do, but I was still young enough to survive a few years of bad management. Ultimately I received two degrees from Mississippi State University, where I spent the next thirty years as a chemist/nutritionist.
Low Sugar Dramas
My diabetic life has been much more good than bad, but the worst of the bad has had to do with low blood sugars. When blood glucose levels fall below 20mg/dl, death is a real possibility. I have been in the low 20’s several times, usually when alone.
A part of my brain can remember in detail the things I do when my blood sugar is low. Some of these events have a humorous side, while others seem part of a horror story for me.
While having low blood sugar, I have:
- Rearranged my bedroom furniture in the middle of the night, ripping pictures off the wall while trying to climb out.
- Listened to an alarm clock ring for four hours.
- Had a head-on-collision in my auto; fortunately, both vehicles were traveling slowly, so no injuries occurred. I ended up in jail.
- Collapsed in a restaurant and been taken to an emergency room in a tow truck.
- Crawled to the street from my house, seeking help.
- Sat in my car in a WalMart parking lot for two hours, convinced that the world was ending and that people were coming in for one last purchase.
- Turned my 4-wheeler over while speeding on a solitary hunting trip.
- Sat in my car in the carport at night, hiding from gangsters.
- Gotten my legs tangled in a ladder, climbing in my tree stand while hunting.
- Been trapped in an imaginary coffin while on the floor looking up into a coffee table bottom. This is as close to being in hell as I have ever been.
- Been lifted from the bedroom, carried to the kitchen, and placed in front of a jar of honey. Imagination? Maybe.
My life has been good because of some awesome friends and a loving family, all of whom understand the embarrassment I often feel after a low. Without these assets, I wouldn’t be here today.
Advice to Newbies
To new diabetics, I would give the following advice:
- Get a doctor with diabetic training, preferably an endocrinologist. They are the first to tell you that you are your own manager, so be your own doctor.
- Absorb every bit of information you can on diabetes. Computers and diabetes magazines are loaded with more data than you need. Knowledge is your best weapon.
- Let others know you are diabetic, especially co-workers and friends. Purchase car tags and driver’s licenses indicating diabetes. Many states have them. Wear personal alert items, such as necklaces or bracelets.
- Strongly consider the pump. I should have purchased one sooner.
- Don’t get depressed if things don’t happen the way you anticipated. Depression itself changes blood sugar.
- Be aware that blood sugar levels are changed by exercise, moods, and grief, as well as foods. I once misdiagnosed myself with cancer and consequently produced enough adrenaline to increase my blood sugar. I no longer self-diagnose.
- Be aware that genes are responsible for only about a third of your longevity; two thirds is due to lifestyle. Develop healthy eating habits, which should include daily fruits and vegetables. Eat fast food sparingly.
- Exercise! Unless you are self-disciplined, the easiest way to exercise regularly is to join a health club. Exercise and diet improve your compromised immune system and control your weight. I weigh within 10 pounds of what I did 40 years ago.
- Do not smoke! If you are young and feel invincible, you will be tempted. I was and I did for 20 years. I just hope this bad habit doesn’t come back to haunt me.
- Develop outside interests. Do not let diabetes control your life. My love of nature has taken me hiking in the Rockies, boating in the Amazon and Nile Rivers, and canoeing in the Georgia Okefenokee Swamp. I have seen glow-worms in a cave in New Zealand, visited Machu Picchu in Peru, and ridden in a hot air balloon in Australia. I plan to go on a camera safari in Africa’s Serengeti next year. As you can see, diabetes has not robbed me of my dreams.
- If you drink alcohol, do so in extreme moderation. I found out the hard way in college about the blood-sugar-lowering effect of alcohol. Today, I limit myself to one drink per day.
Technology Finally Comes Through
Last year, I started using the pump. I thought it would tie me down, but I was completely wrong. Management is much easier, especially when traveling. The closer I come to correctly estimating the carbohydrates in a food, the more accurately I can program the amount of insulin to bolus.
In September 2006, I received another wonderful device: the Medtronic Continuous Glucose Monitoring System. The monitor senses glucose levels in interstitial fluid and then sends signals to the pump, which records an average blood sugar reading every five minutes. Some of the disposable sensors have an accuracy rate of +/- 10 blood glucose units, which is very good when compared to glucose meter readings. (I use the sensor for six days instead of the recommended three because they work fine, and who can afford $35 every three days?)
The monitor has an alarm system for highs and lows, a feature which has freed me from my fear of a fatal night-time low. Living alone, I used to check my blood glucose in the middle of every night. Now, with the monitor set to alarm when my blood glucose is either below 70 or above 180, my worry over early morning lows has evaporated. I have had numerous alarms in the last six months, and if the alarm hasn’t wakened me, the back-up vibration has.
With the three-hour pump window showing a plot of the changes in BG values, it is easy to understand the effect that food has on my blood glucose. My last A1c was in the non-diabetic range. Meal times are much more flexible, and travel is much easier. I am soon to begin a safari trip to Africa, and I think the continuous monitor will be worth its weight in gold on the trip.
The Future Is Now
I never thought I’d be around long enough to enjoy life without living “on the edge.” But with this pump and continuous glucose monitor, it seems that my 58-year-long roller coaster of highs and lows is a thing of the past. Every cell in my body is smiling. I feel like I’m coming around third base and headed for home plate. When the pump computer can instruct its motor to inject the correct amount of insulin—an artificial pancreas—that’ll be home.
In the mid-1970’s, researchers were always predicting a major breakthrough within the next five years. Similar “within the next five years” stories have appeared countless times since then. Well, finally, the next five years is now.