Oranges and 30 Other Things about Type 1 Diabetes

What do oranges have to do with Type 1 diabetes, you ask? The juice proves helpful when treating a low, but bear with me—oranges play another role in this story of my mine. Let me tell you about them and 30 other things.

1. First, an explanation. I’ve have had Type 1 diabetes for 31 years. It seems fitting to memorialize the occasion with 31 anecdotes and facts related to the condition.
2. The diagnosis. I was two years old when the doctor told my parents I had Type 1 diabetes.
3. The oranges. When I was first diagnosed, the diabetes educator trained my mom using an orange. It apparently claims a texture similar to a toddler’s skin. (I remain unconvinced. My skin is not and never was the consistency of an orange.) In any case, pumping an orange full of insulin helped my mom transition to pumping me full of insulin.
4. Runs in the family. I don’t know that Type 1 is considered a hereditary disease anymore, but it was the dominant thought when I was little. It runs in my family. My grandpa had it and experienced all the complications that come with not managing it well. My brothers also were tested for the disease when they were young; they don’t have it, fortunately.
5. Examples to follow, examples not to. If I manage my diabetes well, it may have something to do with my grandpa. I witnessed the price exacted by choosing to eat whatever one wanted: he went blind and lost circulation in some of his limbs. I refuse to let that be my story.
6. Faith. I think becoming diabetic at such a young age made me more open to Jesus and believing in him. These days, I think God uses the disease to keep me from pride and to allow me to enter into other people’s suffering.
7. Diabetes is all about control, which becomes a scary, scary thing as a person who battles perfectionism. It also runs counter to faith. I experience a daily tension between trust and control, spiritually, mentally, emotionally, and physically.
8. Diabetes is normal for me. I think I have my mom to thank for the perspective. She always treated me like I was a normal kid. Sure, I owned a dysfunctional pancreas and had to take some precautions, but so what? She also had little patience for whining, a quality I share with her. No pity parties allowed!
9. Pity parties. Okay, so some days are hard. I get upset. I cry and yell. (Especially after dealing with insurance. Don’t get me started on that subject.)
10. Highs and lows. Diabetics talk about rollercoasters. We don’t mean the kind found at an amusement park. The word refers to the rebound effect that sometimes occurs when treating a low.
11. Low symptoms. If my blood sugar reaches a certain threshold, usually below 40, I can pass out. I find the experience entirely Twilight Zone-ish. I think, “I’m going to pass out,” and wake to find myself crumpled on the floor. It rarely happens these days; my last episode happened three years ago. Other symptoms include shakiness, sweating, and irritability. I take the third a step further; I become incredibly stubborn.
12. The floor. I hate going extremely low. I feel like a huge bother and a waste of space to people. That, more than anything, leads to an emotional breakdown. A part of me worries, too, about asking another person to share the burden with me—see #27 for a related reference point.
13. High symptoms. I tend to feel highs in my eyes. Weird, right? I also get stomachaches and feel all-around yucky.
14. Infinity in 15 minutes. The rule for treating a low is 15/15. You consume 15 grams of carbohydrates and wait 15 minutes to check your blood sugar. Those 15 minutes literally reveal how one could hold eternity in an hour.
15. Finger pricks. Most diabetics check their blood sugars between four and six times a day. I’m no exception. I check my glucose level at least that many times, if not more.
16. Constant glucose monitor. If you hear a diabetic say “CGM,” they’re referring to a continuous glucose monitor. It shows trends and patterns that can be used to better manage blood sugar levels.
17. Insulin pump. Several companies provide insulin pumps, including Medtronic and Tandem. I’ve used both and prefer Tandem’s. It gives me better control over my diabetes. Before the pump, I used pens and syringes.
18. Quantified self. Diabetics were some of the first people to embrace the “quantified self”—long before it became trendy and hip. Every day involves looking at data from my pump, CGM, and meter.
19. Doctor visits. My doctor and I review the data at doctor visits, too. I usually see him every three months unless I’m doing so well that he graduates me to four or six months.
20. Lab work. Every doctor visit requires lab work. The usual panels look at my A1C, which calculates average blood glucose levels over a three-month period. Once a year, my panels get more involved. My doctor and I look at test results for my thyroid and kidneys.
21. Optometrist visits. In addition to seeing my endocrinologist regularly, I see an eye doctor once a year. I get a little competitive about my eye health; I’m running on the same contact prescription for almost three years straight. I’d like to keep the record going for as long as I can.
22. Big purses. I prefer smallish purses, but they can’t carry all my essentials. When I go out, I almost always have my meter. I also carry glucagon tablets and, if necessary, all the supplies needed to change out a reservoir on my pump.
23. Glucagon tablets. I guess the tablets deserve some elucidation. Glucagon tablets are fast-acting carbohydrates. I use them when my blood sugar goes low.
24. Reservoir. I suppose the word “reservoir” needs clarification, too, since I’m not speaking about a body of water. My reservoir carries insulin, usually enough for three days.
25. Three days. Why three days? It’s a best practice with insulin pumps. I need to change my insertion site — no magical delivery of insulin via the air, I’m afraid — every three days to prevent infections and developing scar tissue.
26. Scars and lumps. Scar tissue is a big deal because it impedes the delivery of insulin. It also builds up over time, leading to lumps and bumps underneath the skin. Not pretty.
27. Body image. The whole pretty thing comes up a lot with diabetics, maybe more so with females. A fear exists that no one will want us or think us beautiful because of all the scars and all the devices connected to our bodies.
28. Food issues. In addition to challenges with body image, many diabetics suffer a love-hate relationship with food. I include myself in the group. I struggled with anorexia as a teenager.
29. Pizza and cupcakes. I can have pizza and cupcakes, but it’s hard to get the carb count right. I sometimes refuse the foods because of the potential rollercoaster. The fallout just isn’t worth the temporary and oh-so-fleeting flavor.
30. Same routine, different results. One of the most frustrating aspects about diabetes is that I can follow the same routine and get completely different results from day to day. Perhaps I learn to be flexible and resilient through that.
31. I make cyborg and android jokes all the time, hence why I term my insulin pump “Erin version 1.6.” (Soon to be 1.7—I’m on the list for an upgrade.) The versioning goes as follows: no diabetes, syringes, pens, Medtronic, and Tandem. I’m on my second Tandem and will graduate to a third in the near future.

So ends my tale of 31 things about Type 1 diabetes. If you’d like more information about the disease and what it looks like in daily life, check out the Juvenile Diabetes Research Foundation and the American Diabetes Association.