Diabetes, Type 1.5

Did you read my last diabetes post? No one responded so maybe it was missed. It was characterized by a sense of peace. It ended with these two sentences, "And if, in the near or far future, you know I am sinking into the depths about this disease, that for me defies all the stats and won't behave as it should, remind me relentlessly about who is in control. Because I know. I know." I think I need those reminders now.

I thought I might have a bit more time. That the acceptance might last longer. I wouldn't say it has disappeared, but a new emotional battle is rising and falling within me. I still have joy, but my emotions are fighting against my faith.

I went to my doctor on Friday. It was a good visit--one where my research and knowledge paid off, where the doctor listened to me. She even said it was a pleasure to talk to someone who actually reads about her condition (what a sad statement about her usual patients). She called my case special (Finally, someone noticed). Prior to the visit I had already diagnosed myself. I think I have LADA (Latent Autoimmune Diabetes in Adults). Sometimes it is called diabetes type 1.5 because its characteristics fall between Type 1 (no insulin production, diagnosed usually before 25), and type 2 (insulin resistance, weight issues, diagnosed usually after age 40). Those with LADA are usually in their 30's, have a small bmi (body mass index), and no family history of diabetes. So for me that would be check, check, and check. Generally, LADA patients have some insulin production in the beginning and some success controlling their sugar numbers with medicine. Usually within five years or less of diagnosis, the LADA patients will need insulin. Most of them become type I diabetics.

My doctor was going to increase my meds. I pointed out to her that even when a med helps, usually within a month I need increased dosage or another med. I asked to go on insulin. Turns out, insulin is her med of choice, but most patients are sacred of it. It has no side effects because you are injecting human insulin, but I think its the word inject that scares people. I can give myself shots. I learned how when I was pregnant. So sometime soon, I will go through diabetic education again. This time, as a patient requiring insulin. I believe this is the best choice for me. I need a way to respond to my ever-changing insulin needs. And in the last two years, my pancreas has decreased insulin production (sounds like an economic figure). I can't remember the measurement unit, but a normal body (or a non-Type 1) produces between 0.9-4.4 units of insulin. In 2007, I was producing 2.9 units. Now I produce at the very bottom of the scale, 0.9 units.

I am excited in most senses to go on insulin. I am relieved to know that eating better or exercising more would not have stopped the progression of this disease. I have an autoimmune disease, like lupus, celiac, and rheumatoid arthritis. And the doctor said, "Autoimmune means we don't know why."

Here's the rub. Being a potential type I, or even a type 1.5, means that every meal, every snack is a thought process, a carb counting process. For a while, I thought we had found some medicines that would control this, that would allow me to be steady, to only prick my finger a few times a week. And for the rest of my life there is that machine recording my body's victories and its failures. And there is the possibility in the future of a pump, which brings health but also difficulties. I've read too much. I know the pitfalls. I'm not sure why this good treatment plan set me back emotionally so much. I'm not sure why I have returned to a place where I can't speak of this diseaes without tears. Diabetes is a generally a controllable disease. There are a few people who have lived with it for 80 yrs. "Don't let diabetes control you, don't let it set you back," they write. Ok, I won't. I will get to where you are dear 86-year-old type I woman. Diabetes isn't in control, food will not control my family. But today, dear friends, remind me of what I know. Who is in control? Today, I need to hear it.