A Day in the Life of Sweety, a T1D
Hello. My name is Sweety and I am a Type 1 diabetic for 6 years now (yes, I get the irony of my name!) Today, I would like to take you through a day in my life — which is representative of what most Type 1s go through. Through this piece, I would like to demystify some of the myths that are associated with this condition.
I wake up at 6am and the first thing I do is test my sugar. I have a glucometer at home with which I can test my sugar levels and I get the result in a matter of seconds. It’s a very essential part of any diabetic’s supply kit. It includes a meter, some test strips and a pricking (lancing) device. I place one of the strips in the meter, prick my finger with the device and place a drop of blood on the test strip. After 5 seconds, I get the result on the meter. Looks like it’s on the higher side today — 190 (normal fasting blood sugar range is 80–100). So I take a shot of insulin to correct this (bring it down to the normal range).
I then go for a morning jog. I make it a point to do some form of exercise at least 5 days a week. Exercise is a very important component of successful blood sugar management. It is not just good for the sake of fitness, but also increases insulin sensitivity.
Once back from the jog, I get ready for the first day at my new job. During my bath, I inspect my feet for any injuries and also make sure to clean them well. You see, foot care is really important to all diabetics. High blood sugars over a long period of time can affect the nerves in the feet, which can cause them to lose sensation. That’s not the case with me of course, but it is a good practice to check…prevention being better than cure!
I have eggs and almond milk for breakfast. I like keeping my breakfast low carb so that I can have good sugar levels throughout the day. Contrary to popular knowledge, it’s not just simple sugars that would raise blood sugar levels, simple carbohydrates would do the same. So, I avoid consuming these and opt for low carb foods, which do not raise sugar levels drastically.
I then pack my lunch for office. I take vegetables, a salad and curd. I weigh my food and calculate the carbs in each of them. Through this carb-counting, I will know how much insulin to take before lunch. If done correctly, my sugar levels will remain in the normal range. I make a note of the food I am eating in my blood sugar management app, so that I have a record of it when I meet my doctor next.
I’m finally ready to leave for work. I check my bag once more to ensure I have carried the essentials — my Glucovita tabs (these are glucose tablets and are essential weapons in my fight against hypoglycaemia episodes); I carry my insulin pens in my Frio case, so that the insulin in them remains at a cool temperature, otherwise it may become ineffective at high temperatures. Just in case one of the needles breaks, I also carry some extra needles for my insulin pens.
I reach office on time. It being my first day here, I am introduced to all my colleagues and seniors. A little after I start working, it is time to test my post-breakfast sugar levels. This time, I test it on my Libre Pro sensor. This is a coin-shaped Flash Glucose Monitor that I have affixed on my upper arm. This convenient device allows me to scan the sensor with the help of my phone and I get the blood sugar level on my phone with the help of an app. This sure beats pricking my fingers multiple times a day!
Just before lunch time, I remember that I need to make an appointment with my path lab to book my HbA1C test. This blood test gives me an average of the last 3 months’ blood sugar levels and is helpful to know if I have been a good girl (in terms of blood sugar levels!). I get this test done every 3 months at my lab.
We are going to have a meeting at 2pm, so I need to have an early lunch today. As I have already calculated the carbs in the lunch that I packed, I just need to check my blood sugar level before eating and take insulin according to my carbs and present blood sugar level. I test my sugar level on my sensor again — it is in the normal range! So, I just inject my insulin. As I need it to start its action fast, I inject it on my stomach. Rate of insulin absorption differs depending on where you inject it. It is the fastest on the stomach, slower on the thighs, upper arms and buttocks.
While I am injecting myself, I get ‘caught in the act’ by an older colleague! She looks shocked. She blurts out in a tensed way, “Are you taking drugs?!”
I explain to her, “No ma’am, I am taking insulin, as I am a diabetic. I need to take insulin every time I eat something.”
“But how can you be a diabetic? You are so young!” she asks.
“I have Type 1 diabetes…this is different from the diabetes that happens to older adults. Type 1 diabetes normally happens to children and adolescents (although it can occur at any age). It was detected when I was 15 years old.”
“I see. But why can’t you take tablets to control it? That will be safer. Won’t you get addicted to this drug?!” she asks me, incredulously.
“Type 1 diabetics need to inject insulin because their bodies can’t make any of their own. We have to take it externally, unlike Type 2 diabetics. There is no chance of getting ‘addicted’ to it, as it is a natural hormone, which a non-diabetic body produces. Since my body does not, I need to take it externally, simple.”
She continues, “But my aunt manages very well with ayurveda tablets. She also has methi (fenugreek) seeds every morning, soaking them overnight. That helps her a lot. She also does yoga. I will get you in touch with her…she will help you overcome this disease!”
“Ma’am, thank you so much for your concern. However, as I told you, my diabetes is different from the one your aunt would have. She has Type 2 diabetes. Type 1 diabetes is ONLY manageable by taking insulin externally, as our body produces NO insulin. In your aunt’s case, her body is producing a little insulin, so these other methods of controlling it may work for her. They cannot work for me.”
“Okay. You must have eaten a lot of sweets when you were young, and that’s why you got this, right?”
“Not at all! In fact, I never liked sweets and chocolates. Type 1 diabetes is an autoimmune disease, not a lifestyle disease. It is caused when the body’s own immune system attacks the insulin-producing beta cells of the pancreas. So, it is not caused by being obese, exercising less or eating too many sweets!”
“What about marriage and kids? How will that happen now?” she asks me.
“Ma’am, right now that is not a priority for me, I need to concentrate on building my career first. When the time comes for marriage and kids, I am sure there won’t be any problem. I know several Type 1 diabetic women who are happily married and have kids too. We just need to make sure to keep our sugar levels in a tight control during pregnancy. Then there would be no problems.”
“That’s good. So tell me this, do you have high sugar levels all the time?”
“No ma’am. Sugar levels vary throughout the day, and are dependent on multiple factors like food eaten, exercise done, insulin taken, whether you are sick or not, if you are stressed, the amount of sleep you have had, and many other factors! Sugar levels can fluctuate greatly within a single day too. In fact, type 1 diabetics face a real threat of low blood sugar levels, or Hypoglycaemia.”
“Hmmm. Don’t you miss eating things like rice, potato chips and chocolates?” “I don’t really like sweet things anyway. As for rice and potato chips, I still have them sometimes, however, within limits. As long as I take the appropriate amount of insulin for these, I do not have a problem!”
“All this is fine. However, how will you handle a tough job like this? Will you be able to work hard? Won’t you be tired all the time?”
“No ma’am. If I keep my sugar levels in range most of the time, i.e. between 70–160, I will have no problems doing any task. There are many successful Type 1 diabetics in the world. To name a few, Theresa May, Nick Jonas, Wasim Akram and Gaurav Kapoor. There is no limitation to what we can achieve, if we follow a disciplined lifestyle.”
“Thank you for clarifying so many of my misconceptions! I have understood many things clearly now.”
“You are most welcome!”
After that fruitful conversation, I have my lunch. Then I attend the client meeting. I make sure to check my sugar level 2 hours after lunch, during the meeting. It is normal. However, the meeting goes on for another 2 long hours, during which I start feeling uneasy. I start sweating more than usual, start feeling disoriented and my hands start shaking. I understand that my sugar level is going low (hypoglycaemia). When I test my sugar level on my sensor, it shows a level of 55. I quickly take 2 Glucovita tabs from my purse and have them. When I check my sugar level after 15 minutes, it has come up to 80. My hypo symptoms settle down and I feel better. This was a mild episode of hypoglycaemia. Had I not corrected it in time, it would have worsened, and I could have lost consciousness too (worst case scenario!). Hypoglycaemia can happen due to various reasons, like eating lesser than normal, eating late, miscalculating insulin doses, excessive exercise or long gaps between meals. My hypo today happened as there was a long gap after lunch, and I had not eaten anything for a long time.
Finally, I’m done for the day. I have an evening snack before I leave for home. I do a check on my sensor again before I leave for the day, just to make sure that nothing untoward happens on the way home. I reach home soon. A few minutes later, I get a message about a newly detected Type 1 girl in my city. Her family is having a tough time and need someone to talk to. I call her up immediately. She’s just 11 and is finding it hard to accept her new-found ‘situation’. She seems overwhelmed with a lot of new information about her condition. She almost breaks down on the call when she asks me this, “Why me?”
I calm her down first. Then I tell her that she is not alone in this situation — there are thousands of Type 1 diabetics the world over. I tell her that I was in the same shoes as her 6 years ago. It is difficult in the beginning, but it gets easier later on. The important thing is to learn as much as you can about the condition and to join a community. I tell her that I would get her added to the support group that I am a part of, where we all help each other out in different ways, to help manage the condition better. She is happy to hear that. I also tell her to take one day at a time, so as not to get overwhelmed. She can set daily goals and then the larger goal would be easier to achieve. I promise to visit her over the weekend and speak with her and her parents personally. She thanks me for my help.
Speaking to her makes me reminisce about my diagnosis. I had all the typical symptoms — excessive thirst & urination throughout the day, I had lost a lot of weight and felt very weak all the time. These are the common symptoms of diabetes, irrespective of the type. I had been admitted to hospital after a blood sugar report of more than 500! I have come a long way since that day, when I was confused, scared and depressed over this diagnosis.
I test my sugar level again before having dinner. Other than the hypo episode in the afternoon, my sugar levels have been pretty well-behaved throughout the day! I have dinner, watch some TV and turn in for the day. Just before sleeping, I can’t help but think of the day gone by. It was not extraordinary, but was not ordinary either! I guess that’s the ‘thrill’ (for want of a better word!) of being a Type 1 diabetic — a VERY eventful life! Think about it — 95% of our decisions and moods throughout the day are based on our sugar levels at the time. Something as simple as going for a walk needs a series of steps to be taken before it! And the term ‘travel light’ does not exist in a Type 1’s dictionary…coz our ‘diabetes kit’ itself can fill a mini-bag! There’s a glucometer, with its strips, cotton swabs, sensors and the reader, insulin pens, extra needles for the pen, insulin pouches to keep it cool and of course, insulin — our saviour! For Type 1s who use an insulin pump (as opposed to insulin pens or syringes), they need to carry a serter, patches and reservoirs as well!
I shut my eyes with these thoughts in my mind. I need to get a good 8 hours of sleep…after all, even less sleep can cause my sugar levels to go out of whack! Tomorrow will be a fresh day, with a fresh load of challenges! That’s the thing with us — there’s never a dull moment in our lives…and I have made my peace with that!
- Many thanks to Mihil Ramaiya for his help with this piece
