November signals a lot of things – whether it be bonfire night, mo-vember, or the beginning of the festive season. But less obviously, it is Diabetes Awareness Month. Growing up I was constantly aware of diabetes, as both my sisters and my dad have type 1 diabetes. That being said, it is safe to say that I am far from clued up on the issue.
I decided to speak to my older sister to get an unfiltered and a not so ‘NHS-approved’ account of having diabetes, as well as getting a low-down on the science-side to know what it actually is. A couple of questions in, I soon realised that what I witnessed daily only scratched the surface and I wanted to award her a medal for being her own doctor, nutritionist, personal trainer and mathematician.
A brief biology interval: A key distinction between type 1 and type 2 diabetes is that type 1 cannot be prevented as it is genetic. My family has type 1 which is when the body immune system attacks itself and destroys the cells that produce insulin. This calls for one long-lasting insulin injection which provides a background insulin to stabilise glucose levels between meals and overnight.
A fast acting injection of insulin is also required to reduce the rise of blood glucose levels caused by consumption of food or drink with carbohydrates. The amount of insulin needed is determined by doing a sugar check and calculating the amount of carbs. Type 2 is far more common in the UK – this is where the body does not produce sufficient amounts of insulin, or the body cells do not react to insulin. For this type, patients are typically offered a medicine called metformin. If this no longer works, then you will have to also administer insulin. For more details, such as what happens when your blood glucose drops or spikes, I recommend the Diabetes UK website.
Looking back on all the times we ate out as a family, I easily forget that the ritualistic ‘sugar-check and inject’ was not normal for everyone. I can vividly picture the confused or even fascinated faces of other diners as my mum whipped out her ‘weapon’ and injected my younger sister. It seems strange that whenever we ate with guests who had no knowledge of diabetes or that my siblings had it, the whole check and inject became a classified secret. Sometimes they would mysteriously escape to the toilet in an MI5 fashion to ensure that the injection remains confidential – even though there is nothing obviously taboo about being diabetic. I asked my sister for some insight into the restrictions and potential burdens of going out.
She began by explaining the process of carb-counting, which is accurately calculating how many grams of carbs there are in her meals. This is because the amount of carbohydrates has the greatest effect on her blood glucose level, much more so than say proteins or fat. The phrase immediately triggers my memory to a thick A5 fact-file that delineates the nutritional information of all food to you could possibly conceive of which sat on our computer table for several years.
Other than referring to this bible, she would either google it or simply rely on her instincts if the food was similar to something she had eaten before. Perhaps the heaviest load of being diabetic is that it is life-long, and determines several, if not all, social decisions. You couldn’t simply disengage with what you are consuming. On a more practical note, you can’t leave the house without your sugar-check machine and insulin.
I immediately think of how I pat down my pockets to check for my phone and wallet before I leave, and how my sisters would have to triple check for their insulin as well. Not only are the trendy tiny bum-bags ruled out as they simply wouldn’t fit what she needs, but drinking has become a particular ordeal.
Cocktails seem to be an established criterion for any successful girls’ night and your drink of choice is somehow an extension of your personality/motive of the night. However, given the sugar content of syrups, juices, wine and so on, it becomes tricky to monitor the effect they will have on your blood glucose. As the night progresses, you are prone to forgetting about checking in with your glucose-levels so going out-out is mastered by bargaining between having a good time and not compromising your health.
She compares the feeling of a hypo (when your sugar-levels dangerously drop below 4 mmol/l) to being drunk – which also poses the obvious threat of not being able to distinguish between the two. It comes to confession time in our discussion, and she admits to lying to a piercing shop to avoid the drag of filling out a medical form – which may make her appear ‘hard-core’, but really is an understandable decision. She sheds a light on how talking to other diabetics on the (compulsory) course reminded her that she was not the only one who slipped off the carb-counting wagon, tackled with the constant monitoring and generally found it all a hassle.
I often take a humorous approach to it all, like laughing at the fact she gets a diabetes magazine or even that she could technically park in the disabled spots. However, I am quick to forget that I can order as many martinis as I like without any serious risk of bodily harm. We end on the forward-looking note of how new technology is rapidly developing to allow diabetics to live with fewer restrictions and of their own accord.
Diabetes is a serious, life-threatening illness – as many as 3.7 million people in the UK are currently diagnosed with the condition. New technology – such as wearable glucose monitors – are now available on the NHS, and are beginning to be rolled out to thousands of more patients. With these rapid and amazing advances in science, diabetes is not the death sentence it used to be – before insulin administration, diabetics had a two-year life expectancy after diagnosis – but it is still a dangerous and under-reported illness. So, this diabetes month, spare those 3.7 million people with diabetes a thought as you sip on your martini – because diabetes is most definitely not easy.
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