I've been lucky so far. For the past ten years my diabetes has been well controlled using diet and exercise. No pills, no injections, no six-times-a-day blood testing (just every so often). Even when I was pregnant with T, I only had to have injections once or twice daily, and I have never suffered a hypo (short for hypoglycaemia, or low blood sugars).
Normally, people who get type 2 diabetes fit a certain type: they are over 45, often overweight, and sometimes have other conditions such as heart disease or high blood pressure. I was 21, in a healthy weight range, and had no other medical conditions. What I did have, though, was a pretty scary diabetic family history.
My Mum was diagnosed as a type 1 diabetic at the age of thirteen. I grew up in a house where the distinct smell of insulin preceded every meal, and when Mum didn't look well the first thing you offered her was not a cup of tea, but a jellybean.
About a year ago, my blood pressure skyrocketed, and I started taking medication to bring it back to normal non-heart-popping levels. I hadn't been checking my blood glucose levels much during this time, preferring instead to concentrate on getting my blood pressure back down. And so it was during a routine visit with my GP a few months ago that they checked my blood glucose for the first time in over a year. Blood sugars should normally be within about 5-7 mmol/l (that's 90-126mg/dl for the Americans amongst us). On this occasion they were 20.0 mmol/l. That stupefied my doctor, anyway, "Are you feeling OK?" she asked. I was, so I just closed my eyes and tried to make the number go away.
I started afresh on the diabetes mill-wheel. It was like being diagnosed all over again. You get sent to the diabetes educator to be re-edumacated, the endocrinologist, the podiatrist, the nutritionist, the opthamologist. I began taking oral medication: small doses of Metformin to begin with, then adding Januvia a little while later. My day now consists of 14 tablets in five doses during the day, between blood pressure meds, diabetes meds, and the oral contraceptive pill. Suddenly, I'm becoming quite well-known at the chemist, and the pharmacist now addresses me personally by name whenever I'm in. It's nice to be loved.
It was during an endocrinologist (diabetes specialist) appointment that I had an extremely interesting conversation. My doctor had commented that I had only put on about 5kg since I'd first seen him, and there had been nearly 10 years and a baby in the middle of all that. He congratulated me, I said thanks. I'd worked hard to get and keep the extra weight off, dieting when diabetic is not all it's cracked up to be. Then we started to discuss my mother's diabetes. Mum sees the same endocrinologist as me, and he pointed out how few complications Mum has experienced, despite being diabetic for nearly forty years. And then we got back to my weight, my diagnosis, my lack of risk factors for contracting diabetes at such a young age ... my frightening family history...
It was like a light-bulb went on in his head. He asked if I'd heard of LADA diabetes (sometimes referred to as type 1.5). Thanks to the TuDiabetes community, I had, and had even been told by people in that community that perhaps I had it. I disagreed with them on the forum, and began to disagree with my doctor too. I did not have LADA, and I could back it up with facts. Even the 'type 1.5' name was silly, and had led to much joking around in this house.
My specialist interrupted me. He had studied LADA for his PhD, apparently, and agreed that I did not have it. Well, that was a start. "But I want to test you for it anyway".
"Oh man, why?" I whined.
"To rule it out."
I put my confused face on.
Turns out he thinks I have another "other" form of diabetes, but it's practically impossible (and very expensive) to test for it. By testing for LADA, he's hoping to get one step closer to confirming a diagnosis of Maturity Onset Diabetes of Youth (MODY), a very poorly named and fairly rare variety of genetic diabetes. He thinks my Mum has been MODY all this time too, as it is often mis-diagnosed as type 1. It probably also means T will have it when she gets older. Probably before the age of 25.
So, Lana. You know how all that time you thought you were going great guns and that diabetes was a bit of a doddle? Turns out it ain't, Sunshine. Not for you, not for your Mum, and not for your daughter either.
Happy birthday!
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