Now first of all, I am not a medically trained person, nor do I live with the diagnose in question. I'm just someone who's taken the time and effort to read and learn, so that friends with the diagnose in question can feel safe when we hang out, and can come to me for support if they need to. I am a so called Type 3. I am of course talking about diabetes.
Having started to read about it in high school or just before due to having schoolmates and later, friends living with type 1 diabetes, I've had time to learn a fair bit through the years (probably some 15 years by now) about the differences between the various types of diabetes and its management.
It really grinds my gears when I hear someone say "oh, you have the bad diabetes" when someone who's insulin dependent either takes out their syringe, pen or insulin pump to take some insulin to correct a high blood glucose reading or cover for a meal or snack.
Now, there's no such thing as "bad diabetes" or even "bad diabetics" A diabetic taking insulin doesn't mean he or she got the bad diabetes, it merely means that he or she is an insulin dependent diabetic either because of an autoimmune reaction that ruined the insulin producing beta cells in the pancreas, or too little insulin is produced, or the person has some resistance to insulin and need more than the body produces itself.
Type 1 diabetes which is autoimmune, can hit someone at any time in their life though the most common is to be diagnosed in childhood to early adulthood sometime. Type 1 is always insulin dependent since the insulin production has been greatly reduced or completely eliminated due to the autoimmune reaction that attacked the insulin producing cells. Insulin has to be injected in some way as the gastric juices ruins the insulin, these injections can be done either with a single use syringe, a pre-filled or re-usable pen where you just change the needle for each injection and throw away the pre-filled pen when empty or put in a new cartridge of insulin if it's a re-usable pen, or you can use an insulin pump which gives a continuous infusion of insulin at a rate that you program it to and can set different rates per hour for different times of the day if you need to.
The body needs insulin both to function in general, but also to handle anything that you eat. Normally someone using syringes or pens will have two types of insulin, one slow acting which is injected once or twice daily, and one rapid acting to cover for meals, snacks or random high glucose levels. Someone using an insulin pump normally only have rapid acting insulin, and as mentioned above, the pump continuously gives insulin at the rate you've set it to, and for meals, you use the pump to give a dose that you select there and then based on what you're eating, what you're doing, current blood glucose, insulin to carbohydrate ratio, correction factor and sometimes even more factors are involved in determining the dose needed. Taking insulin for meals is the same regardless of delivery method, the only difference is that many new pumps can make the calculations for you, and that you can take a more precise dose compared to pens or syringes.
Whether an individual use a syringe, pen or pump is all about personal preference (and in the case of USA, what you can afford and what the insurance company will cover for you)
Each delivery method has both pro and cons though in general a pump is considered to give more freedom as you can set the delivery rate to fit your daily life more accurately. With a long acting insulin you can't make any changes here and now, nor can you get different doses at different times throughout the day. With a pump you can have for example 0.5 units of insulin per hour during some hours of the day, 0.75 unit per hour another time of the day and maybe you have the so called dawn phenomenon where the liver dumps out glucose to start waking you up in the early hours of the morning, with a pump you can program the pump to give a higher basal dose at the time where the dawn phenomenon occurs.
Wearing a pump doesn't mean someone has bad diabetes, or is a brittle diabetic or anything. It's just a personal preference to push some buttons instead of taking an injection several times per day, along with being able to have a tighter control over the blood glucose. The downside with a pump is that if it malfunctions and you don't catch it on time, you may end up with dangerously high glucose levels as you have no long acting on board to keep you level like you do on injections. Also, some people don't like the idea of being attached to something at all times.
As for type 2 diabetes, it's not autoimmune and may or may not require insulin injections. Normally it is diagnosed in adulthood but it's not unheard of in children and young adults. Genes play a big role in whether you get type 2 diabetes or not, it tends to run rampant in families and even keeping your weight at a good level and living a generally healthy life is not a guarantee to avoid developing type 2 diabetes, even though it's said to help preventing development of type 2 diabetes. Type 2 diabetes can also be associated with some medicines or other health issues, such as PCOS (Poly Cystic Ovary Syndrome) where your weight or lifestyle doesn't play a big role at all. Type 2 is not a fat person disease and no one who is diagnosed with type 2 diabetes has brought it onto themselves! Diabetes doesn't care what size you are!
Type 2 diabetes can be treated with a healthy lifestyle, tablets that lowers blood glucose either by making the pancreas produce more insulin or make the body more sensitive to the insulin produced, insulin through the same delivery methods as for type 1 diabetes, or injections of some fairly new medicines that also makes the body more sensitive to insulin.
Someone with diabetes will have both high and low blood glucose levels, no matter what they eat and how often they test blood glucose levels. The glucose does fluctuate all the time, it does in non diabetics as well, only that the body compensates for it automatically in a non diabetic and the fluctuations are less extreme. Someone with diabetes has to maintain a healthy glucose level by doing the things their body does no longer do on its own.
When someone has a low blood glucose it's very important for the person to eat something that contains carbohydrates, preferably simple carbohydrates like glucose as it enters the bloodstream faster than complex carbohydrates like starches. You do NOT give insulin to someone who has a LOW blood glucose!
In severe cases where the person is unresponsive, call for an ambulance immediately and if the person has a Glucagon kit and you know how to use it, administer glucagon as it will make the liver dump out glucose which will bring the glucose levels up. Eating something is important to not crash again. Severely low blood glucose left untreated may cause coma or even death.
Symptoms of low blood glucose includes but is not limited to: tiredness, shakiness, confusion, hunger, headache, mood swings
When someone has a high blood glucose it's important to get the glucose level down again, this can be done either by taking insulin, exercise some or in some cases, take extra medicine. Drinking fluid (sugar free) can help lower the levels some as well by flushing the system a bit. Nevertheless, it's important to stay hydrated, high blood glucose levels often cause the person to need to pee more which may rapidly lead to dehydration. Just keep in mind that only drinking water may wreck havoc with the electrolyte levels, so make sure to get some salts as well.
In severe cases where the person is unresponsive, call an ambulance. If ketones are present, you need to at least call a doctor unless you know how to handle it. The combination of high blood glucose and ketones may lead to a condition called Diabetic Ketoacidosis or DKA for short and it is a medical emergency. DKA is most common in type 1 diabetes, and is quite frequently seen in persons who are unaware of their diabetes before getting diagnosed.
DKA left untreated may cause coma or even death!
Symptoms of high blood glucose includes but is not limited to: excessive thirst, needing to pee often, tiredness, hunger, mood swings
Ketones is a waste product from the body burning fat for energy instead of glucose. Ketones in the combination with high blood glucose always needs to be taken seriously. It is not the same as having ketones in the bloodstream from eating a very low carbohydrate diet where ketones are desired.
I write this post as the basic knowledge around diabetes is very poor among the general public. Basic knowledge about one of our most common chronic conditions that comes with rapid changes that can quickly become dangerous unless treated correctly. It doesn't take long to learn how to recognize a low blood glucose and how to handle it, and it only takes a second to ask someone "Are you feeling okay?" if you see someone who doesn't look like he or she is feeling well and you recognize the signs. Don't assume that the person is drunk or on drugs!
Again, I'm not a doctor so don't use this post instead of seeking medical attention, nor use it as medical advice. I just wish to show some differences between the most common types and hopefully get rid of some misconceptions about both diabetes and how to help someone with diabetes who's having a rough time with their blood glucose.
It's sadly all too common that people think low blood glucose means needing insulin, when in fact it could be fatal to give insulin when someone has a low blood sugar.
People with diabetes got the condition for often unknown reasons, they did not eat too much sugar in their childhood!
Someone with diabetes can eat whatever they want, as long as it is covered for. But if you have someone over who has diabetes, don't assume that they'll want to have something very loaded with carbohydrates, have some various choices of foods and snacks and let the person choose instead, and don't question them if they have a piece of cake, or say no thanks to the very same cake.
Why I even write a long post like this?
Well, it happened again... A friend of mine who's had type 1 diabetes since long before I was born, had a nurse ask if it was the "bad diabetes" just because the insulin pump beeped! I mean seriously! A NURSE! *sighs*
End of rant and public service announcement. Have a nice day and now I shall continue to listen to music.
