Under sweet: daily challenges of managing Type 1 Diabetes

Often enough, my typical day begins at 2 a.m. I wake up and feel fatigued. My body shakes with tiny, repetitive tremors. I am simultaneously freezing cold and boiling hot, having too many blankets but simply not enough. My boyfriend softly snores, sometimes uttering an incomprehensible sentence, as I reach over to grab my phone. In the dim light, the software somehow manages to recognize me, although my eyes are crusted over, and a thin stream of drool runs from my bottom lip. I open my glucometer app, scan the sensor on my arm (whether it’s right or left, it depends. I change it every two weeks), and wait for the number. I am met with a big, bright, red screen. There’s an arrow pointing downward, seemingly into Hell, where it feels like my body is. The number is 2.5. I sigh; my Glucose is low again.

The scientific name is ‘Hypoglycaemia,' coming from the Greek term ‘under sweet.' It’s a condition most often associated with Type 1 Diabetes. Diabetes, Type 1 specifically, is an autoimmune disorder where the body causes the pancreas to die. Without a pancreas, you can’t filter Glucose out of your body. If you can’t filter Glucose out of your body, it builds up and begins to poison you. The funny thing is that every single human alive needs Glucose to keep them running. Glucose is the number one source of energy for your cells; it keeps them happy. Most people don’t have to worry about this at all. Your body functions the way it does; you eat whatever you want and don’t really have to pay attention to it. For me, and every other person who is Type 1, we have to do what many people can’t imagine doing. I have no pancreas; I am the pancreas. I am a human being and a sentient organ. 

I’m too exhausted to get up and do anything, so I try to sleep it off. I last about 7 minutes before I stumble into the kitchen and rip open my fridge like a frenzied animal. I pour orange juice into the biggest cup we have (which just so happens to be the Cineplex ‘Morbius: The Living Vampire’ collectors cup). It’s filled to the brim, and I begin chugging. I stop after a second and take a long, drawn-out breath. I’m almost choking, it seems like. I swallow it down and just keep drinking. It’ll take a while for my body to adjust to the giant amount of sugar that just entered in the form of Walmart brand juice, so I’ll have to just wait it out. Unfortunately, that’s the least of my problems. My stomach growls, and I clutch my abdomen in pain. It also feels like I’m starving to death.

The best way to describe a Low is when you're smoking a big fat joint or eating an edible shaped like a Sour Patch Kid, and then you green out. Every sensation is off, and every thought is muddled and fuzzy. Sometimes, you can’t see properly or concentrate. Me? I also get hungry, ravenously hungry. I’ve smoked weed before, and I know what it’s like to get the munchies, to feel so hungry, and have the urge to absentmindedly munch on whatever. Yet, when I’m Low, my brain seems to automatically focus on the most carb-dense food in the pantry. Everyone has their favorite food when they're high, and I have my favorite food when I’m Low: Rice Krispies and milk. There have been times when I’ve eaten four bowls of Rice Krispies, contemplating a fifth, only to wake up later and vomit or have a sore stomach.

The other way your body feels when it's Low is drunk, seriously drunk; I’m talking ‘white girl wasted.' I remember a time I was driving home from the night shift about two years ago. It was winter, and the snow was gently blowing across Highway 9 as I made my way home from work. I must’ve miscalculated the amount of Insulin I needed when I ate my peasant's dinner of an iced tea and potato wedges, staring at the faces of the Weston’s in our break room before making my way back out to my cash register. As I drove, I gripped the wheel tighter; my eyelids weighed a thousand pounds, and my brain was shutting off. Did I mention that it’s illegal in Ontario to drive while your blood sugar is low? If something happens, you can get charged with impaired driving. It’s one of the first things they tell you after you’ve been diagnosed.

I did my best to focus on the road, and yet, I took what seemed like, a long blink. Suddenly, I was at home, my car parked in the driveway. My aunt texted me, ‘Are you coming inside? It’s late. You’ve been out there for 15 minutes'. 

After the orange juice, I’ve had two granola bars, one plain tortilla, and a cup of mixed berry yogurt: the pinnacle of nutrition. I stumble back to bed, flop on my side, and curl up in a little ball. About an hour later, my phone goes off again. I pick it up and read the alert.

Challenge of high glucose

High Glucose makes you pee. It makes you tired and irritable. Diabetic Rage is a real thing; I’ve felt it often. When I was in my first year of university, back when I was undiagnosed, I slept the most I’ve ever slept in my entire life. It also makes you thirsty, so thirsty that it’s like you wandered for forty days and forty nights in the deserts of Arabia. Yet, while it doesn't make you feel as bad as a Low does, it’s still dangerous.

I reach into the nightstand again, grab my fast-acting Humalog, and put in a few units. I stick the needle into my gut, press the button, and it clicks slowly until the Insulin has gone into my system. I have to always inject in different spots since Insulin is a ‘growth hormone,' and putting it in the same place will cause a hard, fatty lump to form under the surface of my skin. I remember when I was first at the Endocrinology clinic at St. Joe’s, and the dietician showed me a plastic piece of skin designed to mimic what it feels like when that happens.

After an hour, my phone will tell me if I’m High again, or if I’m too Low from overcompensating. Then, the whole song and dance repeats again.

A lot of Diabetics get depressed because of how much they take on. I’ve seen episodes of shows where people openly admit to not taking Insulin so they can die outright. Diabetes is one of the only illnesses where you can act like a normal person, eat healthily, and perform moderate exercise, and still manage to die a few months on due to a lack of Insulin. For me, my distress comes from the constant see-sawing of Low to High Glucose. It’s the transition to feeling like death in one way, then feeling fine but knowing you’re still at risk of dying. I don’t want to lose limbs due to cuts I can’t feel when my nerves become fried or my vision becomes blind. I don’t want my liver to fail either or my blood pressure to cause a heart attack. Yet, I also just want to be a normal person. Unfortunately, that’s impossible.

My phone says that my glucose level has become stable. It’s now 4 a.m. I’ll have to wake up in 5 hours to get ready for school, catch the bus, and go to my office hour. Then I’ll have a two-hour lecture and a choral concert I need to usher as part of my job at the theatre. All the while, my phone will beep, saying I’m going Low or going High, and I’ll correct it, as I am the sentient organ, after all. I look at my boyfriend, and while I've been doing all of this, he has simply been asleep. I sigh.

This whole process, the Insulin, the carb counts, the nutrition labels, and the beeping monitors is my every day, and this will be my every day for the rest of my life.

That is usually how my day starts.