Day 20 – My type (diabetes that is…)

20 01 2010

Day 20 sounds good! A nice milestone… and a lower-key exercise day with a chilly dog walk and Classical Stretch with Miranda on a lovely golf course (“to improve hip flexibility AND your golf game!” she said).

20 days ago, I thought this blog would be mostly about diabetes and exercise. But I haven’t addressed that much yet. Each time I start to type something about that part of my life, it seems too complicated to get across in 300 words.

At a basic level, Type 1 diabetes occurs when a body’s immune system attacks the pancreas/insulin-producing cells. So my body doesn’t produce any insulin at all. You can’t turn food into energy for your cells without insulin. So the “sugar” or glucose remains in your bloodstream (causing high blood sugar). With too much insulin on board and not enough food, you get low blood sugar – no “fuel” for your body.

To stay in the middle in great control, I have an insulin pump that I refill every 3-4 days. It needs human interaction to know how much insulin to deliver based on my current blood glucose (BG) level and how many carbohydrates I’m eating. I have to factor in how much I’ve exercised and when – and this is a huge variable.

I check my BG level 8-10 times each day and night with a finger stick, and adjust my pump according to how low or high my blood sugar is. Every bite I take – in addition to physical activity, stress levels and sleep – impacts my blood sugar and insulin requirements.

After 28 years, I am used to these daily science experiments and I stay in very good control overall (my A1C is usually around 6), but I don’t talk about it much with those around me. I’ve always tried to appear “normal” and not make a big deal about my diabetes – even though it consumes so much of my time and mental energy behind the scenes.

Most people are much more familiar with Type 2 diabetes, which is a huge problem in the U.S. and growing at astronomical rates. The American Diabetes Assoc. says the total number of people with diabetes is projected to rise from 171 million in 2000 to 366 million in 2030. (Only 5-10% of diabetics have Type 1). Type 2 is quite different and makes up more of the growing epidemic. The body typically still produces insulin, but cells resist it. Often you can control Type 2 with diet/weight and exercise improvements or other medications. Type 1 will never go away and will always require external insulin to control it.

For me and other Type 1s, exercise has great long-term benefits, but it can cause short-term problems. Blood sugar levels can drop drastically during and after exercise. And I can’t exercise if my BG level is too low or too high.

The point of sharing all of this (yes, I’m now well over 300 words!) is to explain why exercise complicates my life, even though it improves my health just like everyone else’s. For diabetics, it is so much easier to not exercise than to ride the blood sugar roller coaster it can cause.

If you want to read more, I found a great explanation of the exercise’s benefits/effects for diabetics in this New York Times article that’s worth reading for Type 1 and 2.

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