Management of diabetes, especially Type 1 is always going through changes. Just when you think you have it figured out something changes and therefore so does the treatment. Some changes are good. Others not so much. This time around I am only going to talk about the good changes that have happened in my diabetes journey.
I recently had a 3 month stint working in the Division of Corrections as a Discharge Planner Nurse. I provided discharge planning services for inmates in 7 correctional facilities in the region. Think about this for a second: When you arrive at work, how far do you have to walk from your car/transportation to the place you clock in? (If you don’t have to clock in then I am jealous but still love you!) When I was hired I never thought to ask, nor did they mention how far I would have to travel to clock in. Even after I was hired I was not informed until I met my work colleague, with whom I shared the position. Hope you are sitting down. From the parking lot and through multiple buildings it is ¼ of a mile. Now in and of itself that isn’t too bad…the rest of the medical staff do it everyday. But, and this is a big but, once they clock in they are there. After I clocked in I had to turn around and return to my vehicle to drive to my office. Just to clock in and clock out for the day, everyday, I had to walk ½ mile for each trip. My last job I did for 6 years. I had a 2 minute commute and I went to work in my pajamas. The downside of that was I was hovering around 300 pounds, had severe insulin resistance and exercise intolerance. Now my fat, out of shape body was hiking ½ mile, twice a day, minimum – depending on what other institutions I had business in that week.
I had no choice. I had to make what I called my “forced march” after my Nigerian Hug (every-time I entered the facility I had to go through security and be scanned and patted-down) and at first it took me a good 15 minutes with multiple breaks to make the hike in and a little less out. When I started, the temperature was 90-100°F with 90%+ humidity every day. By the time I got through the first building I was drenched. That was just going to be the norm. In and out then off to the office to start the day.
So you are probably wondering what these changes are? The first one was the introduction of exercise. I have always known that the component I was missing in my therapy was exercise. I didn’t have a choice. Walking is the only method of transportation through a correctional facility. So walking I did. The first few weeks I had multiple hypoglycemic reactions a day. Yes, a day. I started to titrate my Tujeo down. Eventually I got my Tujeo dose from 87 units to my current dose of 40 units.
The second change, and this is the contributing factor to the above change and the next, when I started, as I said, I was hovering around 300 pounds. Actually my highest weight was 315. After a few weeks I started to need to tighten my belt more to keep my pants from falling down while traversing the campus. This became a regular exercise, no pun intended. My belt has 4 new holes in it.
On the 16th I went to see my endocrinologist for my routine 3 month follow up. My weight was 259.2 pounds! My last two visits he had been trying to convince me to consider bariatric surgery. When he walked into the exam room he looked at me and smiled. He never smiles. He isn’t grumpy or unpleasant. He just doesn’t smile during an exam. He told me he didn’t recognize me because my body had changed shape after losing 40 pounds. I had a good visit. We reviewed my meds and new insulin doses. Then he put his head in the computer and did some calculations. Because I had lost so much weight my insulin sensitivity had increased and my resistance was decreasing. My insulin to carb ratio went from 2u:3G/CHO to 2un:6G/CHO. That night I had dinner and took 2 units to cover the CHO in my meal. I have not taken 2 units of insulin since I was diagnosed all those years ago. Better yet, it covered it! (I will admit I was a bit skeptical about this new sensitivity ratio as I have been taking “massive” amounts of insulin for so long.)
I know I said I was only going to mention positive changes but this one is more neutral. I have always had the same symptoms of a hypo for the entire time i have been a T1. Well now that I have had these changes I have a new symptom of a low. I get hungry. I never get the feeling of hunger even when I haven’t eaten for 6 hours. Now, I get hungry when my blood sugar is dropping!
Those are my positive changes. Maybe I inspired you to get up and get moving. I am no longer working the prison job for other health reasons but I recognized the impact that walk had on my present health and the future of my diabetes management. I used Google Maps’ measure tool to measure the distance in and out of the facility, then I opened a map of my neighborhood and measured that distance from my front door. Now, after I eat breakfast, I put my shoes on and make that “forced march”, minus the Nigerian Hug. Do I like taking the walk? No, but I like the effect it has had on my health. Next week I will add a new leg to it as I think I am ready to go further. I would really like to get to 225. I would be happy there. I will let you know how I am progressing.
Tomorrow is Thanksgiving Day here in the United States. I just want to say how thankful I am to have the Diabetes Online Community in which to participate. It is nice to have a group of people who need no explanation and understand immediately what I am talking about. I am thankful for the advances over the last 10 years. This last decade we have seen major strides in allowing better management for this condition. I only hope that this means we are that much closer to a cure.
Happy Thanksgiving to all of you around the Blue world!
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If you don’t like what I wrote then let me know in a comment or email. Maybe I am wrong. Maybe I just wasn’t clear. Again, I really am interested in what you think.
Please share my blog with your friends PWD or not. Sadly, at the rate of diagnosis around the world, especially Type 2, you will either be personally impacted by diabetes or know someone who is recently diagnosed. Be informed and aware.
Tim, a.k.a DiabetesDude