I think I've talked a bit about my diabetes before, but lets give a quick and dirty timeline. I recognized something was probably wrong while in nursing school. Sure, you learn about a lot of disease processes and recognize many of the symptoms in yourself but you aren't often able to check off ALL the boxes. By the symptoms, it was clear I was diabetic. At the same time, I was dirt poor and far FAR more concerned about my headaches (later to be diagnosed as migraines).
When I finally got a job and insurance (not going to get into this now, but DAMN IT healthcare should just BE and not tied to having a job!) I figured it was time to go see the doctor. I explained my problems and got two diagnoses; Migraines and Diabetes. You measure diabetes with several methods but the most common is blood sugar. There's the instant read blood glucose reading most people are familiar with but its very dependant on what you ate or drank or what exercises you did in the last 8 hours. Its why you generally do it in the morning as a 'fasting' blood glucose. There's also hemoglobin A1c (shortened to A1c) which is more or less a three month average of your A1c. You can't fool the A1c by dieting for a few hours or days.
A1c measures the percentage of your red blood cells that have sugar-coated hemoglobin. A 'normal' A1c is less than 5.7. 5.7 to 6.4 is considered prediabetes. If you're diabetic then that's your goal as you're unlikely to ever get down below 5.7 again. It obviously follows that diabetes is 6.5 or above. The higher, the worse. As a nurse I see many well cared for diabetics in the 6 to 7 range. Those needing extra help, and likely to get suggestions of dietary or exercise help when they see the doc have between 7 and 8. Those that can expect medication tweaks have between 8 and 9. Those above 9 need big changes in their medication.
At the time of diagnosis, my A1c was 9.6. I've seen worse, but its still bad. My doctor put me on a low dose of metformin just to make sure I didn't have a bad reaction to it. 500mg per day. I also started the long arduous process of working on my diet. Cutting carbs, choosing natural carbs over processed, drinking less of my calories. Now, one thing about getting your blood sugar under control is that it HELPS you get your diet under control. One of the effects of diabetes is to make you constantly hungry and thirsty so when its better controlled you want to eat and drink less. That struggle... to eat less, drink less, and eat more healthy has been going on since that first diagnosis in late 2014.
Over the next year, I had to keep upping the metofrmin as it would do me some good but then just stop working as well. My A1c was going up and down. I eventually was at the maximum dose of 850mg three times a day. So we moved on and added Byetta. That's a daily injection. It was later increased in dose and frequence until I'm at the max dose of 10mcg twice a day. Then we added glimepiride. That was the scary one as both metformin and byetta help your body without increasing your body's insulin. You see, ironically, one of the scarier parts of diabetes is the treatment. High blood sugar slowly eats away at your insides. Your blood vessels and nerve endings. You will slowly lose sensation in your feet and hands. You'll slowly go blind. You'll slowly get high blood pressure and move blood around less efficiently. Slowly. All of those affects can kill you but they'll do it over years. The treatment of lowering your blood sugar can kill you. Nearly instantaneously. Glimepiride squeezes more insulin out of your pancreas and that can lower your blood sugar suddenly.
I didn't really need to worry though as it wasn't strong enough. Within a year I went from 2mg to 8mg a day (minimum dose to max dose) with my A1c going UP.
I saw my doc in November of 2019 and my A1c was 6.9. Not great, but it was an improvement for me and it had met the goal of getting under 7% for the first time in a couple years. I was supposed to see my doc again in three months with updated labs but that was the beginning of COVID-19 and I didn't get the labs or get to see my doc until July of 2020. COVID-19 has taken its toll on me via stress, so I figured my A1c would have gone up. If for no other reason than I'm eating like shit. My doc agreed with my idea of staying the course medically while I try to get my diet back under control so long as the A1c wasn't crazy.
It was crazy.
My A1c, six years and seven months after my diagnosis, after major dietary changes, after maxing out three different medications was exactly the same as when I was first diagnosed. 9.6. There would be no holding the course. Diet alone wasn't going to fix this because diet alone didn't do it. At this point in my disease process it can be frustrating because even doing everything right can lead to worse results. That's diabetes. That's what it does. It gets worse.
So now every morning I dose myself with 10 units of a day long lasting insulin. I bought a candy bar to keep in my car and bought some peanut butter and crackers to keep in my desk at work. It's unlikely that this dose will lead to me experiencing low blood sugars, but it CAN so I need to be prepared. If I travel I need to be careful of how much I exercise and walk around because that naturally lowers your blood sugar. I can't skip meals if I want or wait all day to eat... I need to tell those around me that if I start acting loopy to not just write it off, that it might be a deadly drop in my blood sugar.
My morning blood sugars were 300-340 before I saw my doc. I haven't been on the insulin for but a few days but they're already down in the mid 200s. I figure once I report my blood sugars to him he'll up the insulin.
Oh, and he isn't entirely comfortable managing insulin so he got me an appointment with an endocrinologist. I took the first appointment available; January 8th. By that time we should have the daily dose figured out and I'll be coasting.
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