Considering the fact that Thanksgiving is a mere 6 days away, I need to clarify some issues related to diabetes and food.

Type 1 diabetes is what I have. It will not go away without a cure (or a pancreatic transplant) and the only method of treatment is insulin. Type II diabetes is probably what many of our grandparents and parents have. [Another pseudo science lesson…] Over time the pancreas can become fatigued, by weight or old age or weight AND old age, and it decreases its insulin output. At this point one will usually be diagnosed with Type II diabetes and put on a diet, pills, and perhaps insulin. Sometimes Type II can be completely avoided by weight loss and diet, sometimes it cannot.

What I’m trying to say is, be kind to your Grandma this Thanksgiving. If she is Type II, she might be incredibly tempted to eat that sweetened cranberry sauce, a few handfuls of sugar-coated pecans, a piece of pumpkin pie after the meal and a piece of spice cake for a snack. Here’s how you can help… Prepare a recipe using Splenda or Equal. Honor that Type II (and encourage a Type I) by making a sugar-free gelatin/fruit salad, a sugar-free pumpkin pie, or sugar-free cranberry sauce.

As a newly diagnosed diabetic, and as a lifelong sweet tooth, I found my first holiday season to be really tough. (Remember, at that point I was on a strict diet.) One of the most gracious, most loving acts anyone did for me was to bake several batches of sugar-free Christmas cookies. God bless Diane Downing for blessing me that way. Her kindness still brings tears to my eyes.

Quick pseudo-science lesson: In the most simplistic terms, the human body needs sugar to survive. Sugar enters the bloodstream and can only be absorbed into cells when it is accompanied by insulin. If the islet cells in your pancreas are working properly (as they are for all you non-diabetics), then you will always have a perfect level blood sugar level, or glucose. My islet cells, for whatever reason, ceased to function ten years ago and now I have to attempt to do their work. I try to estimate how much sugar is entering my body and then measure the appropriate amount of insulin to match it. Diabetic complications inevitably arise because no one can keep perfect glucose readings all the time. When the bloodstream is thickened by too much sugar, small vessels (in the eyes, kidneys, heart, fingertips and toes) are damaged and sometimes damaged beyond repair. One final point: ALL carbohydrates are broken down into sugar for the body to use as energy.

When I first became a diabetic, I was taught “exchanges.” One starch exchange equals 15 grams of carbohydrates. One fruit exchange equals 15 grams of carbs. One milk exchange equals 12 grams of carbs. I never truly learned meat or veggie exchanges just because they have very little value. Basically, I took a couple shots of insulin, both long-acting and short-acting, that would “cover” my meals. A dietician would work hand-in-hand with my endocrinologist to tell me how many starches, fruits, meats, etc, I could eat per meal, considering my insulin intake. You can imagine how tiresome this process could be. Sometimes I wanted to eat more food, or less food, or food at a different time of day, or sleep in and avoid food all together. But I couldn’t. I was stuck with the rigidity of the exchange system.

Around the time I got married, I learned that I should either begin to use an insulin pump or consider MDI, multiple daily injections. I hated the thought of poking a needle into my flesh more often than I already was, but I also despised the thought of a little insulin computer attached to me 24/7. Circumstances pushed me over the edge of tolerance for the exchange system and I ended up wholeheartedly endorsing the insulin pump.

It was the best endorsement I have ever made. In short, my freedom with food was back. No more set diet. No more set eating times. No more, no more, no more! FREEDOM!

So here is what I do now, merrily all the day long: carb count. Everyone is into counting carbohydrates today thanks to the popular Atkins diet, so I imagine most folks understand something of carb counting. In a perfect world, I’d know the exact number of carbohydrates that enter my mouth every time I eat. Then I could do the calculations, “Nine grams of carbs per one unit of insulin, so this sandwich equals 3.4 units.” And voila, I’d punch in 3.4 units of insulin to be delivered from my pump and the deed would be done. (The pump can deliver a tenth of a unit of insulin, whereas I could never be that precise on shots.) The problem with carb counting is that I’m not always certain how many carbohydrates are in that delicious piece of lasagna, or that enormous cobb salad, or that dutch chocolate/key lime M&M ice cream from Ivanna Cone. So one learns to guesstimate. Perfection has not been yet been found, but a livable lifestyle has been embraced.

Back to Bob’s confusion regarding ice cream as taboo for diabetics… Not meaning to slam you, Bob, but yes, it is an ignorant thought. However, it used to be the truth for diabetics so I’ll give you that. If it was only ten years ago that I was given a rigid diet, you can imagine how strict life was for diabetics 20, 30 and 40 years ago. It was terribly hard to keep glucose readings in line, so sugary foods were a big no-no. The problem today is that most people’s ideas on diabetes are based on old scientific knowledge and techniques. Other than the fact that whole wheat crackers are healthier than a slice of apple pie, it doesn’t matter whether the food I eat is “sugary” or not. It all comes down to “how many carbs are in that?” and “how much insulin should I dose?” My Uncle Tim, also a type 1 diabetic, was in a hospital a few years ago and was given an outdated handout that said something like this: “Diabetics should not eat dessert, soda pop, jams or jellies.” Want to know a sure way to piss off a diabetic? Tell them they shouldn’t eat that piece of chocolate cake being served for dessert! An educated diabetic will know if s/he can eat it or not. The more sugary foods can causes spikes in glucose readings and make it tough to keep glucoses balanced, so I don’t mean to sound like all foods are equal in this regard. But more or less, a carb is a carb is a carb. I eat ’em. I count ’em. I love ’em.

Classic symptoms of type 1 diabetes are:

* Increased thirst
* Increased urination
* Increased eating
* Weight loss
* Fatigue
* Nausea
* Vomiting

If you are experiencing several of these symptoms, get checked out by your physician. A simple urine or blood glucose test should be taken.

Ten years ago I was a sixteen-year-old junior in high school and I was having a really fantastic school year. My choir was planning a trip to New York City as part of the “Lincoln at Lincoln Center” concert. I had just finished performing a major role in our school’s fall play. I was taking AP classes that were both fun and challenging. Life was good.

Yet there were little signs that something was wrong within my body—signs that went unnoticed for some time. For one, I was really tired. REALLY tired. I remember looking at an alcove by a classroom door and thinking the cold, hard linoleum floor actually looked like a nice place to sleep. My quadriceps began to ache dismally and I’d be completely out of breath by the time I climbed the flight of stairs to my locker. Also, in the middle of the night I would get incredible charley-horse cramps in my calves. In the morning I would wonder if the cramp was real or if I had dreamed it: Had I really hopped around my room in pain at 4:30am this morning? I also began drinking like a camel; just couldn’t get enough fluid in my body. I’d drive through Amigos (local fast-food restaurant) on the way to play rehearsals, get a refill on an enormous pitcher of Coke or Mountain Dew, and have the whole thing consumed by the time I had arrived at school, some three miles away. I remember being shocked by how terribly thirsty I was all the time. Sarah (Howard Baker) and I went to Omaha to see Les Miserable one weekend and all I could think about was how to find a drink during intermission. And you know how they serve drinks at intermission? In teensy little plastic cups. Not nearly enough to quench my thirst! And the result of drinking so much was, as you can imagine, I had to go to the bathroom quite frequently. At some point Charity and I were filming a video for some old camp friends out in Pioneers Park and I had to use the restroom SO BADLY. Now for you out-of-towners, Pioneers Park is a bit outside of Lincoln and has nasty rustic bathrooms. We either couldn’t locate a toilet or they were locked, so we drove back into town (me praying I wouldn’t wet my pants) and I hot-footed it into McDonalds. And, oh yes, Charity caught that lovely footage on camera. I remember watching that video later that day and thinking how UGLY I looked in a shot taken in an elevator of the capitol building. My jaw, forehead and cheekbones were so angular—the skin was stretched tight over my facial bones. Little did I know I had lost quite a bit of weight. My dad later noted that he began to wonder if I had developed an eating disorder. He and I had a daddy-daughter date night at TGI Fridays where I just picked at my huge salad (wasn’t hungry at all), drank a ton of soda and went to the bathroom several times. Hmmm…

All these symptoms came to a head one Monday in November. I nearly passed out in choir, went to the nurse, then lied and told her and my mother that I wasn’t at all dizzy and could certainly drive home. When I got home I ate a HUGE piece of fudge and went to bed. Later that day my mom took me to the doctor where a simple urine test revealed diabetes. She immediately began to sob and say “I’m so sorry” and I knew the diagnosis was not good. Not good at all.

There is so much more about my life with diabetes. More to tell in upcoming blog posts and more to teach others in everyday life. For now I’ll end this little story with a few final points… Being diagnosed with diabetes at age 16 was not a happy point in my life. But I went on to have a really wonderful junior year despite it all. I sang in New York City. I was an assistant director for our one-act play. A friend and I won first place at district competition of National History Day, and then second place at state. And so on… Diabetes is a condition to be borne, a challenge to care for, and so far, an incurable disease. My parents, my brothers, my church family, my best friends and my husband have all carried me through these past ten years. With such support as this, there is nothing to do but to rise to the challenge and take good care of myself.

P.S. If it sounds like I’m abruptly ending my story it’s because, well, I am! I have precious few minutes to write while Livia takes her morning naps and I’ve got more to accomplish in this time period today. More to come, more to come…

World Diabetes Day! did you even know there was such a thing? I find it somewhat ironic that I was actually diagnosed with Type 1 Diabetes Mellitus on World Diabetes Day back in 1994. If you can do an iota of math, that means I’ll have been a diabetic for 10 whole years this Sunday.

In honor of my 10 year anniversary, I’ll be filling the blog with tidbits about diabetes for the next few days. The first thing I want to make mention of is a very exciting research project underway with the Lee Iococca Foundation. There has been mention of a possible diabetes cure. Now wouldn’t that be incredible?