It's a place of shock, bewilderment, desperation, sadness, fear, or sometimes, misplaced relief or joy.
It's a diabetes diagnosis.
Sometimes, it might come at us in a tactful way, but more often than not, it gets thrown at us like a volleyball in a game of tag. "You're it! It's your turn now, to go, and get it figured out!"
A diabetes diagnosis may be paralizing for a patient, especially, when little is known about the disease, or when the diagnosis was not expected. However, few medical professionals seem to realize this, nor the need for essential information right from the start to communicate not just the seriousness of the disease, but to ease feelings of helplessness or resignation that a patient might experience. Insurance hurdles, often limiting helpful actions a medical professional might take, usually end up making matters worse.
So, what can we do? Where can we start? How do we help ease the fogginess of confusion?
Well, if Bob's crazy journey in the movie "What About Bob?
" taught us anything... the answer begins with "Baby Steps."
Bob is right: "All I have to do... is take... one little step at a time... and I can do anything..." Truer words were never spoken by a "crazy" man.
See, Bob isn't really "crazy." He's just soooo overwhelmed by looking at the big picture of life, and everything, all at the same time -- that he's distracted from the little baby steps, and the things that matter. His psychiatrist, just wanting to get rid of him, unwittingly gives him the answers.
Type 2 Diabetes is much like this; a baby steps adventure. Yes, it's an adventure! Just as Bob goes on, exploring a brave, new, and often frightening world... so must we, also, discover that we can do this, and much, much more.
Just what do baby steps look like? Well, I find that learning what the problem IS before I even start, can help signifficantly. So, let's begin. Just what exactly IS diabetes? (THIS is the real problem. The equation to solve.)
Diabetes is a condition in which the body does not use glucose adequately.
- What in the world is glucose? Is this sugar? Well, yes, and no. Glucose is definitely a type of sugar, but it's not 'table sugar,' and it's not exclusively derived from any sweets, or treats, you might like to eat. Glucose is the fuel your body uses to power itself so that it can do tasks, perform bodily functions, exercise, etc. In short, it's the gasoline that powers your vehicle. Your body will take ALL the food you eat (from one degree to another), and turn it into glucose so that it can power itself. Most of that power will come from carbohydrates (around 98% of them will get turned into glucose), some from protein (around 58%), and a little bit from fats (around 10%.)
- What does it mean to not use glucose adequately? Well, it usually means that your body's red blood cells, and muscle tissues, etc. cannot allow glucose to enter them because: a.) they are not communicating well with insulin (insulin is like a door man, allowing glucose to enter cells when it's present), b.) there is not enough insulin present in the body to even try to communicate with glucose, OR c.) both a & b.
When insulin cannot communicate effectively with red blood cells, and tissues, etc., we call this "insulin resistance."
When there is not enough insulin to simply help glucose enter cells, at all, we call this "insulin deficiency."
Both insulin resistance, and insulin deficiency, can vary. Some insulin resistance is very advanced (meaning, the pancreas has failed again and again to produce insulin that can communicate effectively with tissues), and some insulin deficiency is absolute (meaning, there is no insulin production left, in any real signifficant levels.) If you have insulin resistance,
your pancreas will try to continuously make insulin until it can process that extra glucose in your blood stream, allowing it to enter your body's cells and tissues, etc.
This means that if you have pre-diabetes, your pancreas has to work a little harder to process that glucose because it is struggling to keep up with the demands. It might take a few cycles of insulin production for it to get that extra glucose into your cells and tissues, but it can still get the job done.
If you have Type 2 Diabetes, your pancreas can no longer meet these insulin production demands adequately, and your blood stream will start to carry unsafe levels of blood glucose long past digestion. Any extra insulin your pancreas might produce is not communicating adequately, or quickly enough, with your cells and tissues to allow glucose to enter them effectively. Sometimes, the level insulin resistance is so great, that a person may need to supplement with oral medications, or even insulin, to help overcome it. If you are insulin deficient
, this means that the beta cells -- the little cells within the Islets of Langerhans, inside your Pancreas, which are responsible for insulin production -- have become exhausted from the constant insulin production cycle, and have "pooped out." A good amount of them have died, if not nearly all of them. Your pancreas can no longer make a safe level of insulin to help keep you healthy, and processing glucose, so that you don't starve. (Yes, our body's cells, and organs, will starve without glucose!) Patients with insulin deficiency, must supplement with insulin therapy, or risk fatal consequences.
Some insulin deficiency is absolute, and it is brought on by the body's own immune system suddenly attacking these beta cells, for currently unknown reasons, until there are none or virtually none, left. This is called Type 1(a) (or Type 1) Diabetes, and though it is often seen in children, it can present at any age. The fact that it is brought on by an autoimmune attack, makes it distinctly different than Type 2 Diabetes, and it is the main reason why Type 2 Diabetics do NOT turn into Type 1 Diabetics if they become insulin deficient. Knowledge is Power
And this is our FIRST baby step. Now that we are armed with at least, some of the most basic concepts of Diabetes, and the problems and hurdles it may present, we can live with a little less fear. Do you see the light yet? A little bit?
Is it too much? Read it... just a little paragraph at a time. Try to visualize it.
Next blog post, we will discuss what we can do... with ALL this power. :) Stay tuned.