What do you really know about diabetes?

I’m sure everyone has seen the commercial with an elderly man or woman talking about the new diet to cure diabetes or heard Dr. Oz talking about the new superfood to prevent diabetes. The problem with this situation is that the word “diabetes” is being used too generally.

There are two main types of diabetes - Type 1 and Type 2. Unfortunately, the world only likes to talk about one of them: Type 2. The commercials you see, the magazines you read, the diets you hear about are all opportunities for people to help control their Type 2 diabetes. However, not one of those things will get rid of or cure Type 1 diabetes. 

As a Type 1 diabetic, I know the difference. I was diagnosed with Type 1 when I was six years old.

The biggest difference between Type 1 and Type 2 diabetes is that Type 1 is an autoimmune disease, like celiac disease or rheumatoid arthritis. In fact, it isn't uncommon for people with Type 1 to develop other autoimmune diseases. Type 1 diabetes occurs when the pancreas stops working.  The pancreas is an organ near the stomach that breaks down sugars and regulates blood sugars. When the pancreas stops working, the body no longer develops insulin, the fluid used for breaking down sugars. Because the pancreas is broken down, there is no amount of exercise or nutrition that can cure it. Nothing will make the pancreas start working again.

 Because Type 1 diabetics cannot produce natural insulin, they need a replacement. For a while, the only way insulin was given was through a shot or syringe. When I was first diagnosed, I received approximately 10 insulin shots per day. Up until 1978 when the first synthetic insulin was created, doctors used insulin from pigs to treat their patients. Now, with more research available, doctors and scientists have created multiple synthetic insulins safer for humans to have.

Technological advancements have helped with the development of the insulin pump, a machine slightly smaller than the average cell phone. I received my insulin pump three months after I was diagnosed. It acts as a pancreas and allows people with Type 1 to eat normally. A cannula is filled with insulin and inserted into the pump, which has a small removable IV site attached to it. The IV is inserted in the skin and delivers the insulin. The IV site is changed every one to three days, decreasing the number of needles from about ten shots per day to about three per week. Now I have to insert an insulin pump site about every two days.

Replacing shots with the insulin pump was a huge breakthrough for Type 1 diabetics, but  researchers weren’t finished. In the mid 2000s, they developed a continuous glucose monitor (CGM). The CGM is inserted like an IV but can stay in much longer than an insulin pump, often up to ten days to two weeks before it needs changed. The CGM constantly reads blood sugars and has alarms to warn of high or low blood sugars. The CGM is compatible with cell phones and has an app to read different graphs and charts with the numbers taken by the monitor. Organizations such as JDRF ( Juvenile Diabetes Research Foundation) have been working hard for many years to spread the word and increase the knowledge of Type 1 diabetes. Their efforts have had significant impact. Type 1 research and technology has come a long way.

The CGM and insulin pump are two different devices that serve different purposes, but attempt to reach the same goal -  to maintain control of blood sugars. A normal pancreas knows exactly how much insulin it needs to release and does it automatically. Type 1 diabetics must figure out how much insulin they need, which requires doing the math. The amount of insulin needed depends on the amount of carb intake. For example an apple and a medium-sized cupcake have about the same number of carbs, so somebody would get the same amount of insulin for a sugary treat as they would for a piece of fruit. This answers “Yes” to the question every Type 1 hears a thousand times: “ Can you eat that?” There really is no diet restriction for a Type 1 with an insulin pump compared to someone else.

The key is to know as much about what you are eating as you can, so the correct amount of insulin is taken, which is easier with an insulin pump.  However, this is where it gets difficult being a Type 1 diabetic. It is impossible to be accurate on carb counting every time. There are times you just don’t know how many carbs are in the food and relative guessing is the only option. This results in giving too much or too little insulin, which is what affects blood sugars.

Not giving enough insulin will cause blood sugars to be high, which can cause stress, thirst, frequent urination, headaches, and nausea. Being in warm water and excessive exercise can lower a blood sugar slightly, but  the only real way to bring a high blood sugar down is through insulin. Treating a high blood sugar with the insulin pump is easy because the insulin pump can do the math for you and tell you how much insulin the body needs to bring the blood sugar down.

 Low blood sugars are a different story because they are dangerous and make a person suffering them feel awful. They cause dizziness, confusion, sweat, extreme hunger, and can make a person pass out if not treated right away. Treating a low blood sugar is more difficult than treating a high one.  Low blood sugars need carbs to come up, but too many carbs can cause the blood sugar to go too high. It can also take a while for a low blood sugar to come up.

Type 1 diabetes is not only a disease that affects millions of people.  It’s also a disease that can’t be cured. It’s a disease that the public knows little about. Type 1 has been thrown into the category of Type 2 forever, and at some point it needs to stop. It’s beyond important to know the difference between the two types. 

I am very thankful for the advancements of the treatment for Type 1 diabetes. But I also feel there needs to be advancement in what the public says and knows. We need to be specific when speaking about the condition. Diabetes has two names for a reason. While there are some things both types have in common, like long-term effects on the body, most things are not the same. The treatments and causes are different. We should challenge each other to make sure we use the correct term.

Most Type 1’s long to be understood. They are tired of the jokes, tired of being told what they can eat by commercials and, most of all, tired of people thinking they understand, when all they know is a word called “diabetes.”