In the second part of my life, we move into the teenage years and through university. It’s probably not as in depth as the early part as being diagnosed tends to stick out in your memory. Living with Diabetes as a teenager doesn’t so much. It was just a part of my life and I got on with it.
As I had previously mentioned, we had been initiated into Carb counting at an early stage of life. That included checking labels and weighing things, measuring the carb content of foods when making them, etc. and was a great introduction to how to live life.
Going through the teenage years was more tricky though. As I got older, I rebelled a little more. As most of us did, I got fed up with testing my blood glucose levels, and just before a clinic appointment, I’d make up weeks of results. Typically, on the once a day test regime, I’d test once every four or six days, but due to the regimented way of eating and the regularity and routine of it all, there were rarely days where my bg levels deviated too massively.
I went through periods of eating sugar out of the sugar pot and the cake making decorations. I’m sure my mum new about it but didn’t ever mention it. I’d steal biscuits that I knew I shouldn’t be eating. I craved sugar. I’d also use/abuse the tuck shop and sweet shop at school. I knew what i was doing wasn’t good, but I did it in spite of the warnings.
I’d dread the six monthly check-up with consultant, hoping I’d put enough high numbers into the diary to manage what I expected would be a high Hba1C, and then being surprised when it wasn’t anywhere near as bad as I was expecting.
At some point in this period, I was moved on to MDI, using the same Protaphane, and Actrapid. I’m fairly sure this was during my sixth form years.
Now I had a way to eat badly and manage it better. At this time, there wasn’t really a good way of managing this. The consultant guessed at my required dose and we titrated it from there. I don’t recall being asked or told to test pre and post meal to work out what was going on, although I probably was. I was too wrapped up in exams, cricket and school theatre stuff. The one thing I remember about Actrapid was that I needed to inject it half an hour before it was supposed to take effect. It was a long wait for food. These were the days before the 3ml cartridges, when Novopens used the smaller 1.8ml cartridges. I recall the Novopens were also a lot smaller as a result.
Sometime in this period, Protaphane got renamed to Insulatard GE. Funny how you remember little things like that.
It was also during this period that I learned about and started to drink. Only without really doing any testing. at first it would be one or two drinks. And then we hit the proper teenage drinking years, from sixteen onwards. I ended up so drunk one night through drinking shots that I passed out on the downstairs bathroom floor and had “flu” the next day. Throughout all of this, I didn’t really pay attention to what it was doing to my glucose levels. Kebab at the end of the night? Required to stop me going low overnight as a result of drinking. Sugar in beer? I wouldn’t have noticed. If I’m honest, I have no idea what my bg levels were really doing. The main thing was my six monthly and annual reviews weren’t showing a wildly out of control type 1 and I was getting my Hba1Cs in the 7.5% range, which everyone considered good enough.
Throughout my school days I remained under Dr Olczak at Pilgrim Hospital, until I moved to university at the University of Warwick. It made sense for me to change my clinic then, and I started at the Coventry and North Warwickshire Hospital.
For the most part, I had Diabetes and I just got on with it. I took insulin with food, knowing that I needed it, and I relied on Hypo signs if I thought I was going low. I tested my glucose levels, but I wouldn’t say I paid enough attention to what was going on. I relied on the history I had with carb counting in order to maintain my levels to something I could cope with.
I distinctly remember nights where I would go to the Union, and end up not going home. I’d have Actrapid with me, so instead of taking Insulatard, I’d give myself a couple of shots of Actrapid to tide me over and I’d enjoy the night. Testing? Well I didn’t carry the kit with me on nights out, as a rule of thumb, so it was very much luck that I didn’t end up very low and my Hba1C still managed to remain in the realm that it was supposed to be. For a night out, I used to drink wine before I went out as it made the night a lot cheaper (and as I know now, didn’t have an effect on blood glucose levels).
During my time at Uni, I also spent a summer holiday working in France. For the three month period I knew I would be away for, I stocked up on insulin and strips and basically spoke French the entire time. I was lucky in that I didn’t need to buy additional insulin, but when I looked into it, I was shocked at the cost of doing so! Still, it was my first experience of living in a foreign country and having to manage. I came away okay…
If I look back, it surprises me that I didn’t give myself more issues at the time, but I guess I knew what feeling high felt like and how uncomfortable it made me feel. As a result, I generally treated stuff to avoid that happening. I stuck to the rules of taking Actrapid with food and eating glucose in some form when I went low. At no point in this period did I find myself needing assistance for a hypo. That’s a real surprise and suggests I may have run my levels higher than optimal.
On the other hand, I never really had a problem with food and I mostly ate reasonably well and was fairly active throughout the year, playing cricket, doing Tae Kwon-Do and competing in National Championships.
I worked on a best efforts basis. I may have done myself irreparable damage, but given my current state with complications, I seem to have come off okay.
The one time I really overdid it was after I completed my final exams. Instead of having a good day afterwards, I ended up having a terrible one. In bed, I simply didn’t think about long acting insulin or testing my blood glucose levels. I had been ill from a big night out and I just considered that I was still ill. I didn’t want to eat and I stayed in bed. As my breathing became uncomfortable, I ended up calling the site guards and they called me a GP. He tested my blood and it was in the 27 range. I felt dreadful, and was rapidly stuck in an ambulance and whisked to the local hospital, where I was put on a pump containing Actrapid and stabilised. Hungover friends came to visit, and I experienced my one and only DKA session. It was the first and last time. I never wanted to feel it again, and I, in the 18 years since then, haven’t!
As a teenager, I probably didn’t take enough notice or care about what my team were telling me. I guess I rebelled a bit against being told to test and do insulin by my parents. As it happened, unlike many, I didn’t stop taking insulin and still approached that aspect of care in a fairly systematic manner. I just didn’t like and didn’t want to test. As a result, I didn’t. I could probably have taken a lot better care of myself. But as I mentioned, I didn’t have issues with either DKA or Assisted Hypos either. I continued on, getting on with life and while Diabetes took a back seat, it wasn’t like I was ignoring it and deciding I didn’t have it. There were just aspects that I didn’t want to deal with.
I guess I understand well why there are significant numbers of people who struggle to achieve an Hba1C at a sensible level. I somehow managed 7%-7.8% without really trying. I didn’t want to do more and my long term control showed that I was doing okay. Why would I have done something different? Everything worked, nothing was falling off, and I was good, as far as I was concerned. I wonder how my body really felt?