When 22-year-old Mikka started feeling sick, she assumed it was the flu. She felt nauseated and was drinking water all the time. It wasn’t until her best friend commented on her weight that she became concerned. “You’re looking kind of thin,” she told Mikka. Mikka looked at her legs and could see that she had lost weight and thought, Oh no. She knew right away that something was wrong.
She went to the emergency room and within an hour was told that her blood glucose was reading 30 (an ideal range is between 4 and 7). She was also told that the ketones in her urine indicated that she was in a state of diabetic ketoacidosis (DKA). DKA is a life-threatening condition in which the blood essentially turns acidic. It was likely, the doctor said, that Mikka had type 1 diabetes.
What is type 1 diabetes?
Diabetes mellitus type 1, often called type 1 diabetes, is an autoimmune disease caused when antibodies destroy the beta cells of the pancreas. The pancreas is responsible for the production of a hormone called insulin. Insulin regulates the metabolism of fats, proteins and carbohydrates. When the beta cells of the pancreas are destroyed, insulin is no longer produced and the body is incapable of regulating blood sugar. Without insulin, the body will die.
For Mikka, who received a diagnosis of type 1 diabetes after further antibody testing, the disease is the biggest thing on her mind. She said, “I was used to going for runs in the morning. The first time I went for a run, after diagnosis, a neighbour had to call 9-1-1 because my blood glucose level dropped so quick.”
Lifestyle changes are often tremendously difficult for people with type 1 diabetes. Typically, aerobic exercise causes glucose levels to drop, while resistance exercises cause glucose levels to rise. As carbohydrate intake/insulin ratio must be considered when exercising, physical activity needs to be planned. For people like Mikka, who are used to spontaneous activities, the mental preparation needed for planning exercise may be overwhelming.
Choosing what foods to consume and when to eat them is another difficult task. Everything that is eaten needs to be gauged according to its carbohydrate, fat and protein content. The challenge lies in calculating insulin dosage, a scenario commonly called “insulin math.” Though the general rule is total grams of carbohydrates divided by the grams of carbohydrates disposed by one insulin unit, this can vary wildly based on the type of day one is having with stress, exercise and sleep considerations. Further, the correction dose that follows is the difference between actual glucose and target glucose, divided by the correction factor. If it sounds complicated and time-consuming, that is because it is.
Sleeping can be a challenge
A person with type 1 diabetes may have to wake up several times a night to treat a drop in blood glucose levels. Mikka was having such a hard time with this aspect that she ended up having to leave her full-time job. She was simply exhausted from waking up multiple times every night.
Going out and about is increasingly hard
Mikka recalled her last trip to Vancouver as a “nightmare.” First, airport security wouldn’t let her apple juice through with her. As anyone with type 1 diabetes knows, prevention of a low is paramount, and having juice nearby is not only a convenience, it is a survival tool. Second, the concert venue wouldn’t let her take her small backpack into the show, even though it contained her insulin and her necessary sugar-laden snacks. Third, she has been refused participation in events because helping her avoid hypoglycemia is “beyond the event organizer’s capacity.” Fourth, Mikka is worn down by people asking her what is wrong with her as she pokes her finger or injects insulin. She identifies bathrooms and bathroom stalls as her “lifeline to peace,” a place where she can avoid the stares and questions of others.
The future and finding peace
Above all else, Mikka says that the weight on her soul is knowing what the future holds. She tries to find peace in knowing that she is doing the best that she can, but she also knows what the data presents: many people with type 1 diabetes face a future with health complications, including diabetic retinopathy, peripheral neuropathy, heart disease and stroke. As she nears the five-year anniversary of her diagnosis, she is reminded that, at year 5, the blood vessels of the eye may start showing signs of damage.
“What can I do?” Mikka asks. “Every day, I just do the best I can. That is all any of us can do. Wake up, put your feet on the floor, and move forward with your day.”
Mikka and others with type 1 diabetes are sharing their stories at the event My Failed Pancreas: Life with Type 1 Diabetes, taking place on September 7, 7–9 p.m. at Baked Café.
By Marney Paradis. Marney Paradis is the chair of the Yukon Type 1 Diabetes Support Network.