Diabetes, Failure and Playing the Numbers Game

As a type one diabetic, I have to think like a pancreas. Whereas a normal, 'healthy' person's pancreas releases the amount of insulin it needs to regulate the body's blood glucose levels, mine doesn't. For reasons unknown, my immune system destroyed its insulin-producing beta cells - so I have to inject the insulin myself.
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Diabetes is a numbers game and I've never liked numbers.

My mum has told me how, when I was at first school, I managed to go three weeks without doing any maths work. We were allowed to pick the tables we worked at and I'd kept my head down busying myself at every table except the maths one. When she looked at my maths book, she could see I'd got stuck on a problem - but instead of admitting I was struggling and asking the teacher for help, I just moved on to something I could do.

Because that's another thing I don't like: failure.

I've come to learn this is why I often struggle with my diabetes.

This Diabetes Day, Diabetes UK is encouraging people to 'set the record straight' about living with the condition, so I'll try and explain:

As a type one diabetic, I have to think like a pancreas. Whereas a normal, 'healthy' person's pancreas releases the amount of insulin it needs to regulate the body's blood glucose levels, mine doesn't. For reasons unknown, my immune system destroyed its insulin-producing beta cells - so I have to inject the insulin myself. I count the carbohydrates I eat and then give myself one unit of fast-acting insulin for every 10g.

Admittedly, this should be easy maths. But the mathematics of diabetes is never simple.

I have to factor in what I'm going to be doing over the coming hours. Am I going to be exercising? And by exercise, I don't just mean doing something like going to the gym. Am I going to be walking to a meeting at the other side of campus? Will I be stopping at Meadowhall to go shopping on my way home? Do I want to vacuum my carpets? All of these actions, as minor as they sound, lower my blood sugar.

And then there are the things that can cause my blood sugar to rise: illness, stress, injury. All of these things have to be factored into the equation when calculating how much insulin to inject.

More often than not, I get the sums wrong.

When I give myself more insulin than I need, I can have a hypoglycemic attack - or a 'hypo'. I get clammy, shaky, confused and disorientated. My body burns up and I feel like I have no control. Without treating it by eating something sugary, I could end up in a diabetic coma.

Too far the other way, I could develop diabetic ketoacidosis. This is where your blood sugar becomes so high your body starts burning fat for energy. This produces ketones - a deadly chemical which, essentially, turns your blood to acid. When this happened to me, I ended up in intensive care. It is a condition that can be fatal.

So, it's fair to say, it's important to get the numbers right. But to do this effectively, you have to know what the numbers are in the first place.

This is the thing I have found hardest about living with diabetes.

I should test my blood sugar before every meal and again before bed so I know what the starting point is when trying to calculate how much insulin I should give myself. The key word in that sentence is 'should'.

If I am doing things right, my readings should always be in a target range of 4-7 mmol/l - and I get great satisfaction when my blood glucose tester does its little countdown to reveal a reading of 6.2 or a 5.3. But if I know it's more likely to be a 17.1 or an 18.5? I'd rather not know about it.

I'll confess, there are times I can go a long period of time without testing. Why? Because I'm afraid of the numbers. I'm afraid of failure.

I'll make excuses that I've been too busy to test or that I can tell what my blood sugar is so I don't need to, but really it's because I don't want to admit I've not been good enough.

This is a vicious cycle. The worse the situation gets - the more tired, run down and ill I'm feeling - the less I want to deal with it. There are times I've described myself as a 'functioning diabetic'. I do enough to survive, or give the appearance of surviving, but that is all I have the energy to do. It's no way to live.

It is unsustainable and I know I have to deal with it. Ignoring my diabetes isn't going to make it go away. I need to ask for help - and, recently, I have.

I've always said I would never let my diabetes stop me from doing anything, but I've realised this was misguided. What I need to do is make sure I look after myself properly and am ensuring I am well enough that I can live a full and healthy life with diabetes. These two things are very different.

I'm now seeing a fantastic consultant and getting a lot more support to help me break the cycle. I'm testing my blood sugar more regularly and trying to recognise that it is only through failure - and understanding the numbers - that I can manage my diabetes properly.

So it's back to the maths table for me. But this time, I'll keep working at it.