How I was diagnosed
My type one diabetes (T1D) diagnosis was slightly unconventional. Firstly, I was 20 years old, and most people are diagnosed at a much younger age, peaking at around 14 years of age. Secondly, I was diagnosed at home by my brother. He was diagnosed with type one diabetes years before, at the age of 13 years old.
Type one diabetes is an autoimmune disease that destroys the insulin-producing cells of your pancreas. Insulin regulates your blood glucose levels and without this vital hormone, the glucose in your blood builds up to dangerous levels and your body begins to starve. I lost over 10 kilograms although I was eating more than usual, drank up to 10 litres of water a day and I was absolutely drained of energy and life.
I suspected I had type one but didn’t even want to give into the idea that I could have it. I remember staring at my skeletal body in the mirror, incapable, sick and a shadow of what it once was and deciding I needed answers. Nauseous, head surging and having reached my wits end, I asked my brother to test my blood sugar. I was in diabetic keto-acidosis and my blood sugar was immeasurably high on my brother’s glucose meter- simply as that, I now had type one diabetes.
My first response to my diagnosis was a complex, stream of emotions. I felt a great amount all at once. A strong emotion that poured over me was, paradoxically, relief. I finally understood what was wrong with me. I cannot explain the trauma of losing yourself to such a degree, and not understanding why you are fading away physically, mentally and emotionally. My heart still aches when I think about what I went through. My heart felt an incredible amount all at once when T1D became my reality, it broke for my parents but it sang that my brother and I were now a team.
We decided to correct my blood sugar at home, in quite an uneducated manner, with my brother’s insulin. We brought it down to a normal range overnight, which could have resulted in serious complications such as hypokalaemia and cerebral oedema. I never went to the hospital where hindsight, I should have been admitted. I suffered from terrible oedema (body swelling) for days after my diagnosis, no doubt due to deranged electrolytes and abnormal fluid shifts. We phoned my brother’s endocrinologist the next day. He was away at the time but drove back to Johannesburg to see me. I remember receiving all my injection pens and going out to breakfast, ordering and truly acknowledging my reality as I tested my glucose levels and injected my thigh with insulin in the restaurant. There was a profound moment of gratitude as I knew I would start to feel human again.
Where to start
When you are diagnosed with T1D, you are absolutely thrown into the deep end. Not to mention that your legs and arms are tied and there happens to be a 50kg weight attached firmly to your feet. You are abruptly instructed to consciously take on the role of an organ that many people don’t know exists. Also, this organ is a fine-tuned machine that is phenomenally precise in its functioning that it becomes a mammoth task for the clumsy human. You hardly have a second to absorb the news before you are sent on your way with injections and directions. There is no time to think, to work through your emotions or come to terms with the diagnosis, you dive straight into action and responsibility.
I was blessed to have had some exposure to and insight into T1D as a second-year medical student and living with a T1D brother. I also had the opportunity to phone my doctor at any time with questions and concerns and there was a 24/7 emergency line for support. I am forever grateful that I was self-motivated and I simply hit the ground running, perhaps not seamlessly well, but I ran regardless. I recorded all my blood glucose readings, what I ate and when, the carbohydrate count of each meal, exercise and insulin injected. I set out to learn my insulin and carbohydrate ratio, (how much insulin I need to inject for a certain about of carbohydrates) as well as to develop a system of pattern recognition in learning how my body responds to insulin and exercise.
I was diagnosed mid-October and before I found my routine I promptly welcomed the arrival of the December holidays and its routine disturbing ways. It was on a rollercoaster of sugar readings with abnormal eating and lack of exercise. Indulgence didn’t only correspond to a weight gain thanks to those sneaky holiday kilograms, it now meant injections and the profound effects of high and low glucose. I experienced my first serious low blood sugar, which left me hallucinating and terrified, understanding that my glucose was low but battling to help myself. The weight that I lost before my diagnosis rapidly returned since initiating insulin injections and I started to feel uncomfortable in my own skin, and psychologically the weight gain was demotivating.
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