Diabetes Details 6: The Basics

• Book signing tonight at 7:00 at Nicola’s Books in Ann Arbor.  I’m sacrificing a tribble to the weather gods for a blizzard-free signing this time!

• This is why I shouldn’t be allowed to play with Photoshop.  I end up making LJ icons and escalating the plotbunny wars.  (Help yourself to the icon, if you’re interested.)


I realized that after five diabetes posts, I had yet to talk about the basics of the disease.  Remember I’m not a doctor — everything that follows is based on my personal experiences and understanding.

For you non-diabetics out there, it works like so.  You eat food.  Your body breaks the food down into, among other things, glucose in your blood.  Your pancreas secretes a hormone called insulin that allows you to use that glucose for energy and keeps the glucose in your blood at a normal, healthy level (around 100 mg/dl).

There are two types of diabetes (three if you include gestational).  Type two is the most common.  Your body makes too little insulin, or else your cells aren’t able to use it efficiently.  A lower-carb diet can help, as do exercise and weight loss (your body might not produce enough insulin for 250 pounds, but could have enough for 175). There are meds that improve insulin absorption.   In some cases, you also inject insulin to supplement what your body makes.

I’ve got type one diabetes, which means my pancreas is a lazy bastard that quit producing insulin altogether.  Stupid pancreas.  For me, the treatment is black and white: I either take insulin or else my blood sugar rises until I go into a coma and die.  Type one is known as juvenile diabetes, giving folks the false impression that I got it as a child.  (I was 24 when I was diagnosed. My blood sugar was over 600 mg/dl.)

I started with injections, taking a long-acting insulin shot to manage my baseline needs and short-acting insulin at meals.  Because of the way I eat and live, I was taking 6 or 7 shots a day to keep things under control.  So I switched to an insulin pump, which gives me a baseline insulin rate throughout the day and allows me to give myself more at the press of a button.

When I eat, I guesstimate the amount of glucose I’ll be getting from that meal and take insulin to match.  I check my blood sugar levels about two hours after each meal.  Too high, I take more insulin.  Too low, I snack.  (If you see me acting drunk and confused, shove some carbs my way.)

What this means, among other things, is I can eat whatever the heck I want, as long as I take the insulin to cover it. I get cranky when people tell me what I can and can’t eat.  Yes, I had a donut yesterday.  I also took more insulin and checked my blood sugar an extra time.

I do adjust my diet somewhat to keep things manageable.  For example, I switched to diet pop because diet has zero carbs, meaning I can drink it without worrying about taking insulin.  On the other hand, when I was first diagnosed, I did extensive “research” to figure out exactly how much insulin I needed to cover a hot fudge sundae (2.5 to 3 units of regular insulin plus 1 unit of long-acting). So when you ask what I’m allowed to eat, the answer is anything I want, so long as I’m keeping the disease under control.

I was going to get into the consequences when the disease gets out of control, but this is getting long, so I think I’ll save that for next time.

I’m very open about all this, so feel free to ask questions.  You can also click the “diabetes” tag if you want to read any of my earlier posts about the disease.