Stuttering

Apparently when I was very young, four or five, I used to stutter. I don't remember doing it at all, but in the last year or so it's come back.

When I'm tired, or stressed, or need to eat I start to feel this chattery teeth sensation. Then I'm forcing myself to slow down to get words out. It's really disconcerting, because I can be one of those mile-a-minute talkers. Not being able to get words out, or not being able to get past repeating a single word or syllable is another is scary scary.

Of course the big part of the fear is that I'm once again out of control. So far I haven't been unable to get words out at work, but today I wasn't feeling well and I had to slow my speaking down to keep talking.

I've tried looking up any tie between diabetes and stuttering, and come up empty. I'm guessing that it's just co-incidence that it's come back so soon after my diagnosis and medication. It's definitely one of the strangest and scariest changes I've had in the last couple of years.

Insulin Envy .. and Admiration

I'll admit to feeling a twinge sometimes, when I hear an insulin dependent type comment on eating something especially sweet or having bread and potatoes AND dessert for dinner, or otherwise exceeding the 20 carbs at a time limit I try to stick to. 100 or 150 carbs in a single meal? I just can't do that. I wish I had the ability to 'cover it' with insulin, and have that freedom of diet, or simply having a way to make those numbers go down instead of "don't eat it" and "wait it out" techniques I have access to.

Of course, insulin is not that easy. Sure, you can take insulin to cover what you eat, but it's not like you have a choice in it. And it's not like it's always predictable, or figuring out how much and when is straightforward. No insulin, and you're in bad territory. Too much insulin, same deal. I can't image waking up with the shakes of a low or struggling to get numbers down when you're dealing with a bad batch of insulin, or having to insert pump needles every few days.

I don't think I'd be willing to trade that uncertainty for the ability to counteract the effects of a big chunk of cheesecake. It's reading all those blog entries about the realities of being insulin dependent that keep me motivated to avoid progressing to that stage. My image of the insulin dependent lifestyle has changed from a simple 'lots of shots' idea to a complex, challenging system of checks and balances you can't take a break from.

It's amazing and admirable to me to know of all the people who make it work, and find the strength to deal with it every day.

Brownies & Bad Moods

Alright, brownies are on the 'eat less of' list, but it's been a while, and they looked delicious.

I was careful. I only ate half my multigrain burger bun at lunch. I waited a couple hours to let it digest.

Then I had a small brownie. Not tiny, but within what I can usually handle for a brownie. I was quick to regret it. It was small, but sweet, and very lacking in that chocolate fudge flavor that was the entire point of eating it.

Then I started feeling that sugar rush. The fatigue, the swirling stomach, the fuzzy head and lack of focus. It always makes me just want to curl up somewhere until it passes - not really possible at work. I have no idea how much sugar that baker used but it has to be considerably more than the average brownie to get that reaction.

For some reason, the sugar rush never seems quite reflected in my sugar levels - I tested at 7.7 (139), which is high for me - I try to stay under 6.5 (117), but it's not hugely over.

Fries, I will note, can easily raise me to 9 (162) with no adverse reaction. It takes sugar to screw me up.

Usually I figure once the sugar rush is past, the worst is over. But I'm very slowly starting to clue in to a secondary reaction: the sudden bad mood, five or six hours later. There's such a huge time frame between the sugar rush and the bad mood it's taken me a long time to connect that they're related.

Especially since, once again, it's not reflected by my blood sugars. I'm holding at a stubborn 6.0 (108), even though aside from some roast beef I've barely eaten in 5 hours. Not a bad number, but it means I have to be careful what I eat if I don't want to get past 6.5 again today.

I still haven't figured out how accurately judge what's going to give me a sugar rush. I'm glad I've figured out that sugar rush means an oncoming bad mood later - and my husband will certainly appreciate the warning - but I feel foolish for taking so long to clue in. I need to remember that even if my meter isn't showing crazy numbers, what I eat can be affecting me in a lot of other ways.

Explaining Insulin with Pizza

I've been trying to come up with a good metaphor for describing some of the ins and outs of diabetes. One I've come up with for insulin is a Pizza Delivery Comparison, as illustrated below:

I like this one for a couple of reasons: Pizza's a pretty understood concept. I don't think many people in the western world haven't had pizza delivered at least once. Sugar's easy enough to equate to other food too. Insulin triggers the opening of cell doors to let in food, so that's a pretty straightforward comparison too.

It makes explaining insulin resistance really easy too. If you've got insulin resistance, as Type 2 Diabetics, Pre Diabetics and some Type 1 diabetics do, then some of your 'doorbells' are broken. So you're wondering if that 30 minutes or it's free delivery deal is still good, and outside the pizza guy is wondering if anyone is home.

I'm not sure how to create a good image with this metaphor to describe a lot of other aspects of diabetes - lack of insulin production (Type 1, Insulin Dependant Type 2) is easy enough to talk about, but an image of a pizza guy with no hands doesn't work for me. Beta cells and insulin factories don't really work with hands either.

Still, it's a start.

Diabetics on TV

The TV world we watch rarely seems to include diabetes. I can't remember ever watching a show with a diabetic on it. Part of me objects to this - there's a huge number of diabetics in the world, and you'd think we'd be mainstream enough to include. The other part is a little glad, because diabetes could so easily get sensationalized for dramatic effect. I wouldn't want to see a diabetic on TV if it was all seizures and comas and the like.

But I do wish there would come a show that'd show it in an intelligent way. After all, the day to days of diabetes, the blood testing, the shots/pills/pump, the carb counting, the rest of it, is pretty boring. A character that was all about diabetes would be really boring and one dimensional.

But one that was diabetic as just a character trait, not a character focus, would be worth watching.

I wouldn't object to the occasional diabetes-specific shows. Say one for an upcoming A1C, or having a meter break, or a bad batch of insulin. Things that are handled in a realistic fashion, not an 'OMG DIABETES EMERGENCY' one.

But the gold would be in the tiny details. I can picture little vignettes.

A bunch of teenagers sit down to eat, and one of them pulls out a meter and tests.

A college student accidentally hands in a term paper with a test strip attached.

A young woman hurries to make an appointment on time after having to reset her pump insertion.

Someone gets snarky in a conversation, and is asked if they've checked their blood sugar.

At a restaurant, one person at the table cuts their potato in half and sets it aside, or removes the third slice of bread from their whole wheat club sandwich.

How awesome would it be to see these little slices of diabetes life in the "mainstream"?

Diabetes History

Today's all about awareness in the Diabetes Online Community. We've all got our own personal histories with the disease, and it's amazing how far we've come in some ways, and how much we have left to travel in others.

I thought I'd link to a diabetes timeline. It's got some interesting tidbits.

There have been some interesting miss-steps - apparently in the late 1850s, patients were prescribed sugar. Between 1900-1915, they were trying carb heavy diets based on milk, rice, oats and potatoes. Elliot P. Joslin, a leading diabetes researcher in the early 1900s proclaimed diabetes as one of the best of the chronic diseases, for being, among other things, 'seldom unsightly'.

Of course, there are some important advances too. Insulin, oral drugs, blood meters, awareness and education campaigns. We're in the middle of so many potential advances. Hopefully in the next few decades, we'll see the disease itself become history.

Diabetic "Sucess"?

I know what I consider being successful at this disease. Reaching say, 80 or 90 without getting any of those nasty complications will definitely be a success. That's my ultimate goal.

The problem with this goal is that the only signs of success are the lack of signs of failure. I know my A1C's have been good, so I assume that I'm on the right track. So far I'm able to keep my sugars in control with the combination of diet and exercise and medication I'm on now. I don't have any diabetic complications.

But I wish I could go in to the doctors and find out that I've sustained the same amount of beta cells, or that my nerves are free of damage or see my level of insulin resistance go down. I'd like some way to guarantee that I'm holding my own.

I come out of each A1C feeling like I've gotten a report card: really good at measuring past performance, but still no guarantee of the future. Just because I have an A this term doesn't mean I'm not going to flunk out next year.

I wonder if I'm going to go to the doctors one day, and they'll do some tests on my eyes or nerves and give me bad news. Even if I feel like I'm more or less doing everything right, there's always that push to try and do better, just in case some silent damage going on in the background. Something that I won't know about until it's too late to reverse it.

I know there are no guarantees of the future, but that blindfolded feeling is one of the things that scares me the most.