Thinking About T1DM

I admit I have come a long way since Nov 23, 1991, when I was diagnosed with type 1 diabetes (T1DM) on my birthday. From sneaking mint chocolate chip ice cream into the living room and eating mouth-fulls with a spoon, to now dedicating my career as a dietitian to helping others understand, manage (with diet and lifestyle) and enjoy this disease. Yes, enjoy. 

When I talk about T1DM, which is only 5% of the population of people with diabetes, connect with someone with T1DM, who therefore becomes an instant great friend, and do work on this condition, I find myself in a state of flow where time doesn’t matter. It’s magic.

Type 1 diabetes doesn’t just mean 1 devastating diagnosis, it means 4-8x the risk for heart disease, 4x the risk for cancer, 3.5x the risk for kidney disease, 80% of vision impairment, increased risk for cognitive decline and a life cut short by a decade. 

But you know what? No one is promised tomorrow.

This disease has pushed me to find all the tricks and trades of health. I eat really clean (maybe sometimes too much), but I am aware of what I am eating, as I have to match insulin to my food every time I take a bite. It also pushes me to be active. In fact, I aim to be active every other day, if not more, to keep my insulin resistance low, and my sensitivity high (makes keeping blood sugars stable easier). I try (repeat try) to get enough sleep. If I sleep less than 6 hours, I have to think about increasing my insulin the next day by 10-30%. If I am stressed; I need to babysit my meter and dose insulin like a hawk. But sometimes, stress will make my blood sugar drop. It’s unpredictable, so I have grown (continue to grow) to be flexible. I find the best supplements to fill the gaps and repair that moving blood sugars cause. I seek out every new study, and old, and fine-tune how to feel my best. Don’t worry, this often includes red wine and it certainly includes a community (shoutout #JDRFCentralOH; proud board member!) of others on the T1DM journey. 

Type 1 teaches us to count our blessings. There are many hard days and night, but the good ones are really good. I’ve grown from believing I was all alone with my diabetes to feeling confident. I’ve gone from burnout to being empowered (although nursing burnout is an ongoing thing). I feel scared, but more often brave. I hope to change the percentage of people with type 1 diabetes to have beautiful labs in the non-diabetic ranges and I want to inspire you that it’s possible.

In closing, my main advice for anyone with type 1 diabetes, as a diabetic and dietitian, is to drop the carbs (even if you are still growing, if you are active, if you are pregnant, etc). And drop them low. The fewer the carbs, the less insulin we need, and less variability of having a blood sugar spike high, or drop too low/seizure. With the transition, start with breakfast. Eating a fat and protein dominant meal in the morning (like an omelet with 3 eggs and vegetables) can set you up for successful blood sugars for the day. 

I can’t help but mention 1 more thing – no matter what you are dealing with in your health, give yourself grace. Be proud of who are, what you are accomplishing and embrace the chapter you are in. I’ve come a long way, but we can’t compare someone’s chapter 10, to another’s chapter one. Take a few deep breaths every day, drink enough water, and socialize.