Happy World Diabetes Day (no, really)!
If there’s a silver lining to a diabetes diagnosis, it’s the people.
People like Matthew Brown, diagnosed at 2 years old in 1959. He’s receiving an award tomorrow for living with Type 1 for 50+ years, and he graciously agreed to let me post his account of life with Type 1 and why T1 has turned out to be a very good thing. His quick, cheerful emails about how his mom taught him to love life and how wonderful it has been (if nothing else, read his “Summary” below) had me blinking back tears of relief.
Happy World Diabetes Day! And Matthew – thank you (and your mom :)).
Having Type 1 Diabetes 50+ Years
I have a fairly long viewpoint of living with diabetes since the age of 2 starting in 1959. As many of you may have heard we used re-usable, large gauge needles (something akin to using an 8 penny nail) and glass syringes that were boiled each day to sterilize. Blood sugars were checked two ways; one by “how you felt” and two, urine “test stripes” with 4 colors; there was no real way to check accurate blood sugars. Other than knowing to eat healthy and exercise regularly, the routine was fundamentally to do the best you could based a lot on gut or how you felt physically.
Though the above tools for monitoring diabetes were not sophisticated, it did not prohibit my living in any shape or form; quit the contrary. My parents put me into situations and opened more doors than perhaps I might not have experienced WITHOUT having diabetes, so in an odd way this event in my life turned out to be a very good thing. I became confident of myself early in life by learning to cope and manage each day. We all have “stories” on things that have happened to us, particularly with ultra low blood sugars that I will not bore you with here. In a twist of fate diabetes opened new horizons to me that may not have existed. To this day, my extensive work overseas in Africa and particularly Asia has a lot to do with the sense of adventure my parents and family encouraged me to go after. Life has always been a very full glass for me regardless of the circumstances. So this is all of our story isn’t it ? Not what we have but how we deal with it.
Another bright note for me that diabetes caused was an “additional” layer or insight into the sensitivities of others. Meaning, my senses were heightened by other’s ordeals; be they physical, mental or emotional. It wired me into becoming a more caring person knowing the day to day, hour by hour living I went through. This too became useful to me in my living as I thought little or nothing of my situation, and it keyed me into others I might be able to help in life in some capacity. While cliché, it’s true, your attitude determines that do not see yourself as a victim but as strong survivor and “opportunist”. Or as some of the top type 1 world athletes tell us they actually have an “advantage” over others as your subconscious goes into overdrive and we seem to leap tall buildings or compete in ways perhaps we would not if we were not presented with this living “opportunity”.
Today as most of you type 1’s know, diabetes has evolved immensely on multiple levels. Insulin I once used from pigs and cows is now available in recombinant DNA born out of human cell growth development. Syringes that were once HUGE in gauge are now very small in gauge (around) and in length, along with machining and lubrication that make taking shots a breeze. Further, we now have very sophisticated insulin pumps, one which I switched to a year ago following 50 years of using syringes with Regular and Lente, then Humalog and Lantus, and now use J&J, Animas One Touch Ping with Humalog. Point is, the options are many for health management.
Tricks of Trade & Experimentation for Living
If I had to pick one “thing” that has worked for me it is this; it comes down to trying different approaches that work very specifically for YOU ! One size does not fit all like it use to in the “old” days of having diabetes (there were LOTS of “NO’s” back then; now it’s about what WORKS for YOU !). Men, women, young, old and literally hundreds of factors including your own gene pool and chemistry make your body into a min-lab. We can definitely learn techniques for good health from doctors, nurses, books, seminars, events and so on; most if not all which I still pursue and use, however in the end it comes down to you figuring out what foods, use of insulin and exercise work for you. I would like to share a couple ideas that have worked for me.
First, I start with my day, whether it is more stagnant or I am going to the gym (which I do daily) or I’ll be biking, hiking or skiing all day. Each is uniquely different for obvious reasons and adjustment to each through increased/decreased insulin use and same with food to accommodate the above is the primary driver. I start with my activity level and work “back” toward then doing number two, figuring out roughly how much food I want to consume.
Second, I generally eat more carbs during the day such as fruit, sandwich bread, yogurt and so on (also with protein in morning and at lunch), and move toward more veggies and protein at night. The result is I get the proper “brain food” via carbs I need for work and energy and can adjust my insulin to get me to my targeted blood sugar (average A1C’s run around 6.5) and reduced variability (keeping “swings” from low to high more stable – these swings as most of you know if kept down overall help prevent the long-term negative affects to kidney, eyes, etc). Then at night, I bulk up on food that fills me with veggies and protein (still eat carbs like non-fat milk, carrot juice, salads etc, but less processed carbs like cereal, rice, pasta which tend to kick in sugars 4 to 8 hours later and impact nighttime BG’s). So day time is more carbs for energy/brain food; nighttime more protein/veggies for BG stability so when I wake up my BG’s are close to the 100 mark. It’s much easier than you think if you have not tried it. Course overall the key is BALANCE of food for good health. And, focusing on healthy foods vs. lots of fried, fatty animal meats, sugar based is really no different at all from a non-diabetic individual.
Third, then put in whatever amount of insulin matches the above two; first activity then food to get me to my target BG followed by insulin “matching”.
I would say beyond the above “routine” of activity, food then insulin matching, the next component is to TRY many varied approaches. We are not necessarily talking about doing reckless things here; we are discussing trying different food options that work for your unique body. For me, some foods have been great such as cottage cheese, my “leveler” food, and others like fig Newton’s that I can count on repeatedly for fairly exacting BG outcomes if desired for a snack. Each of you has your favorites that work for you.
Food exploration is one means, but so is insulin use. In some cases I will use my temporary lowering of basal rates on major biking, skiing and hiking days, and others I’ll load up far more on carbs; and in some cases combine and tweak both for ultimate outcome. I discovered that while I do tend to eat a lot of carbs hiking, after going in for a VO2 testing (oxygen body use) I was still far too low, so I’ve added an additional 60G of carbs per hour with excellent results. I also worked up my own custom basal/bolus split at lunch (I will not give mine here as I cannot recommend using my formula for you); the outcome is my post lunch BG’s 90 minutes to 2 hours are always hovering around 100 vs. the spike around say 200 with eventual drop to normal BG level. It took me a while to do this, but it’s amazing what you can do if you want.
I’ve turned my body into a lab most of my life; I also mentally make it a game or some challenge, goal or whatever vs. something I “have” to do. It’s all in the mindset. And, I throw in a big dose of humor and give myself grief when I really blow it “jeez you goof Matthew…..next time…” which takes all the seriousness out of it and life. Lastly, I tend to isolate the above variables one by one to not confuse my analysis and progress; minor adjustments are easier to track, though you can try more stacked approaches if you have a good grasp which change is affecting your final goal. Becoming adept at seeing more variable changes at once takes some time and practice, but again, it’s about moving forward and trying new things.
As strange as this is going to sound I have BENEFITTED from having type 1 diabetes. It has made me a strong, confident person who cares deeply about others via the subconscious impact this situation has brought about. Course, this all comes from how we choose to live with this situation – victim or survivor, looser or beneficiary, challenged or gifted, an embarrassment or a role model, defeated or hope to others in this world ? What is your choice ?
Once that one simple but important choice is made, the rest is “mechanics”. During my entire life I have never felt bad having or living with diabetes; I had no time for thinking about it, there was too much life to live ! Once, when I was around 12 years old, I lay in bed and asked the question “why” not in like “why me” self pity question, but just “why” and the answer that came back to me was “why not”. That simple little platitude put things to rest very quickly. “Water under the bridge” so to speak is really that simple; it just IS !
The opportunity for living an incredible life as a type 1 is now quit amazing. The knowledge and tools at our disposal are immense. All we need is some curiosity, willingness to learn, a desire to live a wonderful life and moving forward. The rest honestly is nothing more than modifications or adjustments. The JDRF, ADA and now this organization, ConnecT1D, provide unlimited avenues for education, motivation and endless forums for making our lives that much more spectacular to celebrate.