For Deb it was a vicious circle. She was diagnosed with type 1 diabetes 33 years ago at age 20. It was four weeks before her marriage. You can imagine the stress she endured at that time. “I have lived on a diabetes rollercoaster ever since, until about eight months ago,” she says.
Deb started on the standard insulin regimens, Regular and NPH, but she was never educated about her condition. She knew insulin was a hormone that decreased her blood glucose, but she knew nothing about the onset of action, peak times or how to balance her meals and activity level with her insulin. She exercised regularly, weight training three times a week and using the treadmill daily.
“I understood the relationship of tight blood sugar control and prevention of complications. I tried to keep my blood sugars as close to normal as possible. The closer to normal I’d try, the more lows I’d have, so the more I ate to bring my blood sugar up. I gained weight. Then I’d get too high and have to take more insulin to bring my blood sugars down, which also caused me to gain weight. This ride took me to close to 200 pounds, with a BMI of 29.5. I wanted to lose weight, but how could I?”
Deb’s increased weight and erratic numbers caused her to develop complications. Her blood pressure and her cholesterol levels were also on the rise. She acquired diabetic retinopathy and has had several laser treatments to prevent further eye damage. “I wanted to protect my heart, my vision, my kidneys and my legs, so I tried for even tighter control, but with that came more lows, and for me, that meant more weight gain.”
Deb’s turning point came last spring when she had a low during her sleep. “I bit my tongue so hard during a reaction, I almost needed stitches. I demanded more help from my doctor.” Her doctor referred Deb to me for diabetes education.
I taught Deb how different insulins work. We discussed the new types of insulins and how to balance them with her food intake and activity level. I recommended she start using an insulin pump. We continued with education and adjustments to her regimen in the weeks we waited for her pump.
“I learned about carb counting and that as I decreased my carb intake and changed my types of insulin, I didn’t need nearly as much insulin as I had been taking. I learned that I could much better balance my insulin, food and activity. My numbers improved—all of them.”
Deb started insulin pump therapy seven months ago. She has lost a total of 45 pounds and has a healthy BMI of 22.9. She went from a size 14 to a size 6. Her blood pressure is 100/70, her total cholesterol is 120, and her most recent A1C was 6.3%. “My new lifestyle and way of eating has made me a happier and healthier woman. I thank God for this.”
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Deb lacked the knowledge she needed to make healthier choices and to lose weight.
Deb wanted to be healthier. Deb started experiencing complications of diabetes.
What was in Deb’s way?
A lack of education about her condition and her treatment options. Deb was willing to change, but she needed to know what to do.
Deb demanded more from her doctor. She met with a diabetes educator who taught her about counting carbohydrates and lower-carb options and how to balance her meals and activity level with insulin using an insulin pump.