Why I put a photo of my butt on the internet
It’s not everyday I post a picture of my butt on the internet, but things don’t always go as planned.
It was meant to be a pic of my tummy, but the good news was that I have “too much muscle” there (#T1DProblems), so the bad news was that this little device had to be inserted into the fat of my butt.
Anyway, as a recovering scientist, I find it hard to make decisions without data. So in the interest of data-driven health, I had this sensor fitted to my butt for a week so that I could see what happens to my blood sugar when I’m feeling adventurous and irresponsible, doing crazy things like eating pizza after 6pm or going for a run just one hour after lunch.
The results were disappointing, but not unexpected: I should avoid the crazy behaviours that most people consider quite normal. I’m not most people, because I have Type 1 Diabetes (T1D), a rare condition that has little to do with the more common Type 2 Diabetes.
T1D in a nutshell: My own immune system turned against me to destroy the part of my body that’s meant to produce insulin. Insulin is something you need if you want to eat food and not die.
There are plenty worse and better diseases to have, but this is the one I have, so that’s why I’m writing about it.
It’s not even half bad most days, as long as I remember that I can’t forget about it: I have to inject myself with insulin every time I eat anything, using something in between a thumbsuck and an educated guess to decide how many units of insulin would cover the carbs in the meal. I also have to test my blood sugar up to 8 times a day using a finger-prick test, and not eat pizza after 6pm, and not run/sleep/work/drive/shop/have sex without an emergency sugar supply nearby.
So here’s a snapshot, thanks to the butt sensor, of a week in the life of a type 1 diabetic:
It rather closely resembles a roller coaster, wouldn’t you say?
Imagine you wanted to film an actual roller coaster ride to see people’s reactions during all the twists and turns and ups and downs, but instead of filming you only take a photo at the beginning and at the end. Your “movie” would have just two similar looking frames and you would’ve missed all the action in between. Instead of having just 8 glucose readings a day from a finger prick test as usual, the continuous glucose monitor on my butt measured my blood sugar 288 times a day for a week so that I could see all the action in between.
Now, a normal blood sugar value is between 4 and 8 mmol/l — that’s the grey area in the middle of that graph above. You can see that I had some *very* high highs that I wouldn’t have known about without the sensor — spikes that happened straight after eating. My average readings are also quite high, as high as a non-diabetic’s reading would only ever be 15 mins after drinking a (gross!) coke or a fruit juice.
Those highs most often happen because of my own negligence: having huge meals, drinking alcohol, indulging in a chocolate croissant. It’s not that I can’t consume those things ever, it’s just that it becomes much more of a thumbsuck when deciding how much insulin to inject. And big, fatty meals take longer to digest, so I can’t be sure that all the sugar in the pizza will enter my bloodstream in exactly the time it takes for all the insulin to travel from the injection site into my bloodstream.
So what happens when I’m high? Well, I can tell ya it’s not as fun as other highs — I get grumpy and emotional, thirsty and irritable. And of course my kidneys have to work overtime to turn the syrupy blood back into normal runny blood.
You might also imagine that syrup does not travel as easily through the tiny blood vessels in my eyes and extremities. This is why poorly-managed diabetes leads to blindness, amputation and kidney failure. Highs are bad in the long-term, and the way to correct a high is to take a little bit more insulin immediately. Exercise helps avoid highs, because it makes the body more sensitive to insulin. It’s like a reward system: if I run I get to eat more for the same amount of insulin! Being very high for an extended period of time can be more dangerous in the short term as well.
And when I’m low? I start behaving like a drunk teenager, slurring, and needing support to stay upright (this is very difficult to explain when actually drunk). Lows usually happen when I get the thumbsuck estimate wrong and inject too much insulin.
If I don’t get simple sugars in the form of juice or glucose syrup or even (gross!) coca cola into my body straight away, there is a real risk of losing consciousness within minutes, and possibly dying. So lows are bad, even deadly, in the short-term.
I don’t want to bore you with the details of dealing with T1D, but I do want you to know that it takes a lot of planning, and the lows often get in the way of life, especially spontaneity and fun. It is always on my mind. But that also means T1D keeps me on my toes, so I’m healthier now than I’ve ever been.
Why should you care about this? Well, maybe you know someone living with Type 1 Diabetes, but you don’t really know what a roller coaster ride it can be. The chart I have shared with you reflects that of a well-controlled T1D patient, according to my doctor. Many other T1D patients, especially children, are not as well-controlled, so just imagine what a roller coaster they must be riding between feeling grumpy and drunk on a daily basis. And go further — imagine all the T1D patients who don’t have access to healthcare, knowledge and support — they’re not strapped in for the ride.
Or maybe you’re reading this because you are, or you know someone, at risk of Type 2 Diabetes — a likely scenario, thanks to the modern high-carb, low activity lifestyle. Although the two diseases are different in many ways, the result of managing it poorly is the same.
If you take one thing away from this story, take this: cut out desserts, fruit juice and sugary drinks, and go for a 30 min walk every day. Especially if you’re a Type 1 Diabetic, pre-diabetic, Type 2 Diabetic, worried about your health, or a human being alive today.
Not worried? Maybe you should be: