Thursday, October 9, 2008

A bit about the Bee Bees...

So, let's move on from my last post to happier subjects--let's talk about my disease!

No, seriously, that's a much happier subject, because things have been going quite well. It occurred to me, though, that I talk about the DaisyBeeBees here without giving much thought as to how much or how little we all know about it, really. And in the forums and blogs that I've started reading since being diagnosed, there are dozens of posts grumbling about how family and friends don't really understand the disease and what it's like to have it and what it means and what they can do and on and on and on....
Well, you all are my friends, my family, and though I don't recall having any trouble from any of you concerning my disease and how I'm managing it, I thought a little education wouldn't hurt, just to be clear. So, yes, here's a bit about the Bee Bees...

Sugar Is Not the Issue

Well, actually, let me rephrase. Because *blood* sugar is the issue. But the sugar I ingest? That's not the problem. Diabetes doesn't mean I can't have sugar, it doesn't mean I'm allergic to sugar, it doesn't mean if you see me eat a piece of cake you should tackle me and pry open my mouth like I do to the dogs when they eat my kleenex. Sugar is a carbohydrate, and diabetics react to all carbohydrates the same way. ALL THE SAME. So, for me, BeeBees-wise, there is no difference between a piece of candy, bread, some pasta, or a slice of cake that all have the same number of carbs. Most diabetics aren't on a no-sugar diet, they are on a lower-carb diet. And, yes, it drives most diabetics crazy to be asked, "Should you be eating that?" I can promise you that no one ever "forgets" they have diabetes. I think about it a million times a day. If I'm eating something, you can bet I know how it will affect my blood glucose, and I'm okay with putting it in my mouth.

The Numbers Game

Once you become diabetic, your entire life becomes about numbers. Type 1 or Type 2? Blood Glucose level? A1C? How many miligrams? How many times a day? How many shots? It's complete number over load.

Type 1 used to be called juvenile diabetes, but since it's not really just a children's disease, we got the number designation. Type 1 diabetics don't produce insulin to help them convert glucose for the body to use as fuel. They have to inject (or pump) insulin into their bodies to help this process. Type 2 diabetics are insulin *resistant*, meaning their bodies are producing insulin, just not able to use it. That is what I have, and currently it's being treated with a few pills twice a day. I do not need to inject insulin now, and may never need to do so, even though the disease will progress.

As far as blood glucose goes, roughly normal range for someone without diabetes is 99mg/dL or less before a meal, and 110 or less after. When I was diagnosed, I had readings before meals ranging from 200 to 286, nearly 3 times the normal range. For diabetics, ideal before meal range is 90 to 130, and after meals less than 180 (above 180 and the extra glucose molecules spill into your urine and begin to damage your kidneys). For anyone my age planning to have kids one day, which Matt and I would eventually like to do, the ideal is 80-120, with the morning pre-meal being around less than 100.

A1C numbers are a representation of your average glucose level over a period of 2 or 3 months. Some glucose becomes permanently attached to the red blood cells, and these cells have a life span of 3 months or so. By measuring how much glucose is permanently attached, you can get a clearer picture of what the average levels have been than what measuring a few times a day can tell you. In non-diabetics, 4-6% is the number. When I was diagnosed, mine was 10.6, which translates to somewhere between 240 and 280mg/dL for a blood sugar reading. LOTS of potential damage there. The ideal diabetic A1C is 7%, and for being healthy enough to have kids, most OB/GYN's want an A1C of 6%. This translates to an average blood sugar of 120.

The medicines I take are Metformin (which helps my body use the insulin I produce) and Glimepiride (which keeps my liver from over-producing glucose overnight while I sleep). I take two Metformin in the morning with breakfast, and two in the evening with dinner. I take the Glimepride in the evenings also. There are other drugs I could take, even combinations of these in single pill forms, but these two are safe to use during pregnancy, so we wanted to start with those so that when I decide to have kids I don't have to switch anything up. If I were to have gotten pregnant before getting the glucose numbers under control, I would have immediately been put on insulin shots. This is much better, and there's no rush ;)

So What (and How) Am *I* Doing?

The short answer is "great" (and "everything I can").

My doctors and I discussed things pretty thoroughly, and we all feel that, since I do want to have kids one day, those are the numbers that should be my goal. But, we also know that I didn't become diabetic overnight, and it might take time to get there.

When I started treatment, my average blood sugar numbers were still on the high side, 160's to 180s typically. Since then, I've modified my diet some--you all know that I was straight up miserable at first. But I've really been able to figure out what works for me and what doesn't, and believe me, I no longer deprive myself. I keep Snickers in the freezer still--but they're minis, and I only eat one every now and then. Replacing all the sugar in my baking with Splenda was a nightmare--I don't care what anyone else says, I could TASTE it, and it tasted like metallic chemical death to me. So, instead, I use Splenda baking blend (and brown sugar blend), which is half Splenda and half real sugar. And it totally works, and no more metal taste. I don't eat white potatoes, and I don't miss them, sweet potatoes taste better anyway. But I almost never eat fries, and I DO miss them, so when I can't stand it, I go get the $1 small fry at McD's, and I'm as happy as can be. I count my carbs (roughly, very roughly) during the day and try not to eat more than 30 at a meal. We almost never eat pasta anymore, but when I have to have spaghetti or Mac&Cheese, the whole wheat stuff works fine and I work very hard to control the portions. I try to limit bread, but trust me, I still eat plenty of it. I'm just AWARE now, and the results? AMAZING, you guys. It's totally working. Thanks to my awareness and meds and the evening walks, THESE are my new #'s:

I average 95 or so in the mornings.
In the evenings, before a meal, around 80 (though a big lunch will give me a 115).
Walking drops my glucose nearly 20 points typically.
My weekly average is about 93, 2 week is 95, and 30 day is 99 (these are almost all pre-meal #'s, so my actual average is probably higher, but definitely in a good range).
My A1C went from 10.6 in July, to 8.8 in August, to 7.6 in September. I won't get that tested again until December, but since an A1C of 6% is about a 120 average, I think I should at least see that. All these translate to my ideal levels, already. Just 3 months into treatment.

So, you see, all is well with the Bee Bees. My health is good, my attitude is great, and my numbers are in a wonderful range. And I'm not making myself miserable over food, I'm eating what I want and when I want, but MANAGING it well.

And that, as they say, has made all the difference...


amy said...

hi...i confess, i stalk your blog:)
i am Shanna's dad has type 2 diabetes, and isn't handling it well. I sent him a portion of this post b/c you explain it so well, and thats what he needs. Congrats to you for handling it so well, and thanks for writing such a concise explanation.
I'll be reading!!

CortneyTree said...

Hi Amy! I stalk as well (I think we all do!), so I've been keeping up with your lovely family also :)

I'm so glad you commented and that what I wrote might be helpful to your dad. Tell him I'm rooting for him to take control and be the Boss of his disease! He won't regret it!

Hannah said...

Thanks for the education! I didn't realize how much I didn't know about diabetes. I thought it was a sugar thing all along but now I know its carbs. I think it is awesome that you have such a great attitude about it. I don't know if I could handle a lifestyle change as well, especially when you didn't choose the change. I feel inspired to change my cranky attitude today into a more hopeful one :):)

CortneyTree said...

Aww, Han, you're adorable. And hopeful is always good ;)