Sometimes, you don’t even realise that you’re burning out from diabetes until you’re at the tail end of it. You do what you need to get by the day, rinse and repeat. The biggest question is: how did I not realise that I was going through a diabetes burnout? And how long has this been going on? I failed to see the little things I was doing to cut corners with my diabetes management. Continue reading “Burnout Be Gone!”
Day 3 – Share your most memorable diabetes day.
I remember the initial panic of sitting in my endo’s office and being told that the tablets weren’t working. We needed to move onto injections. I was really upset because I had been working extremely hard while being on the tablets and being told that I needed to go on insulin made me feel defeated. I think this is something that most people with type 2 diabetes experience when they start on insulin. That feeling of guilt and anger at yourself for not doing enough.
Yet there was a part of me that knew, subconsciously, that I had done everything I could. I woke up at the crack of dawn every weekday to head to the gym to do either a spin or bodypump class. They were all intensive classes that left me sweating like a mushrooms that haven’t been stored in a paper bag (possibly the worst analogy ever?). I was obsessive over what I ate and reduced my portion sizes dramatically. I felt like I was starving myself at one point. I knew this wasn’t a lifestyle I could sustain. But was there more I could have done to prevent going on insulin, or even diabetes altogether?
We hear it everywhere – that type 2 diabetes can be prevented with a healthy lifestyle with healthy eating. We’ve grown up with it – that it’s our fault we have type 2 diabetes because we haven’t looked after myself. But I never expected to be diagnosed with type 2 diabetes at 19. When I’ve been physically active and eat fairly well. I did a pretty damned good job of looking after my health at that age, when most of my friends were out partying, clubbing and drinking. I couldn’t comprehend why or how this was happening. Sometimes, genetics just sucks!
I guessed how I felt came through because my endo reassured that I was doing an amazing job on my part but my body is just stubborn. The insulin will just help make things easier for me and manage my sugars much better too. There was no point in working myself to the ground just to manage my sugars and let diabetes dictate my life. And I agreed. I was given the choice between starting on a Mixtard twice a day or Basal/Bolus four times a day. And what happened next felt like a major turning point for me. Instead of having my endo determine what regime I was going to do, I sat up a bit straighter and said confidently ‘Let’s try having it twice a day and if it the numbers still don’t budge, we can do four times a day.’
Did I just have a say in my diabetes management? Did I just choose to go insulin? This endo is so sneaky! He immediately sat back, smiled and said alright let’s do it.
It’s been three and a half years since I started on insulin and I’m now on the basal/bolus regime and I haven’t looked back since. My Hba1c took a dramatic dive from the high 9s to 6s since starting insulin and I’m much more relaxed with the things I eat. It has taken me a long time to stop feeling the guilt and anger of my diagnosis and accept the fact that I do have diabetes (whatever the type may be). I can’t do much about it but to move on, manage it the best I can now and live my life to the fullest! To diabetes dictating lives, Ashley says no! (Cringe factor of a 100 for that corny statement!)
I probably have ranted on this topic enough for it to be common knowledge that my diagnosis has always been a confusing one. I don’t have the typical characteristics of a type 2 diabetic but neither do I fit neatly into a type 1 category. The decision to progress me onto insulin was a fairly easy one, considering that the oral tablets typically prescribed to those with type 2 did little for me. It was only after opting to go for multiple daily injections with the basal bolus regime that my HbA1c took a drastic dive and has been sitting between the 5-6% range ever since.
What I haven’t realised before discovering the Diabetes Online Community and talking to other diabetics is that my eating flexibility and freedom has been somewhat of an illusion. My previous diabetes healthcare team told me how much insulin to take with each meal and away I go with it. I typically only eat three meals a day and was anxious to eat between meals because I wasn’t given doses to cover the extra food I was eating. It was rare that I would have a carbohydrate (CHO) loaded snack in between meals anyway, but if I did, I struggled to calculate how much insulin I needed to cover it. More often than not it would be too much work for me to do all the calculations from scratch and I’d just give up. Maths was never my strong point.
It didn’t take me very long to find out about Oz DAFNE (Dose Adjustment for Normal Eating). Maybe now I will finally learn how to count my CHOs properly. So rather than eating to my insulin doses, I can adjust my insulin doses to my meals! How amazing would that be?! I was very excited. Until I was told that the course was only offered to people living with type 1 diabetes and of course at the time my diagnosis was a solid type 2. Why are there so many restrictions within the diabetes community for people living with type 2 diabetes? I could go on about the discrimination that goes on between people living type 1 and type 2 diabetes but that’s a rant for another time. Needless to say, I was shattered and felt very disappointed by the system. Instead, my dietitian gave me a formula to help me count CHOs. Have I mentioned that Maths was never my strong point? Well, there goes that alternative.
However, all this changed when I decided to see a private endocrinologist. My endo understood my quest to be lumped in with type 1 family because of all the restrictions I had been facing. For the moment, it is believed that I may have type 1B diabetes – a non-autoimmune form of insulin deficiency that is common among individuals of Asian descent. Because there’s no autoimmunity associated with it, there will never be any antibodies found. Despite that, it was made very clear in all our appointments that my diagnosis could still fluctuate if new research and diagnostic tools came out in the future. At my last appointment, we talked about going on the pump andmy endo commented that it could possibly be overkill considering how my control is excellent. I agreed but persisted with the fact that when I am looking to start a family I would definitely want to be on the pump, no second thoughts. I was also hesitant due to the thought of having something attached to me 24-7. I’ll just have to learn to be more graceful and less clumsy. (Yea right, like that’s going to ever happen).
The best thing about my new endo was that my view was respected, taken aboard and fully agreed with. I had been so used to dealing with rebuttals from healthcare professionals that I was thrown aback when it wasn’t dished out this time. Instead I had my endo’s full support. In fact, I was told that even if my diagnosis changed back to type 2, my endo would do everything to help me get the pump with subsidised consumables. At this point I’m pretty sure I pinched myself, thinking that I’m dreaming.
Following from that, my next step would be to learn to carb count properly. Since I am now able to access these programs, I have just booked into the DAFNE course. In the meantime, I’m also hoping to get my hands on either the InsuLinx or the Aviva Expert, which are blood glucose meters that helps calculate insulin doses to the CHOs you are eating. It’s basically like a pump but for multiple daily injections. Baby steps for me, but at least I feel like I’m progressing towards better diabetes management!