THE DAFNE DIARIES
Consider what you think you know about diabetes. What comes to mind exactly? Is it fat people stuffing their faces with cake? The lolcat with the miserable face and the rotund belly? Or perhaps the diabeetus man warning that your leg is going to be amputated if you sniff even leisurely at a chocolate biscuit? If it is indeed any of these things, then the chances are that you don’t really know anyone with diabetes, or maybe that you rather enjoy memes far too much, and of course for that you can be forgiven. But few people know that there are two types of diabetes; Type 1 and Type 2. If you stuff your face with cake and can’t see your feet, then you more than likely have Type 2. But Type 1 is an autoimmune disorder;
‘It happens when the insulin producing cells (beta cells) in the pancreas gland, can no longer produce enough insulin… A virus or some other trigger may start off this process. The insulin producing cells in the pancreas gland are eventually destroyed and the symptoms of diabetes occur.’
And boom! Even without a cake or large vat of melted, bubbling candyfloss ever having passed your lips, you can develop diabetes. The cause for it is currently unknown, a genetic predisposition however can mean that you are more likely to develop it, and a sudden illness or emergency operation can trigger the diabetes to develop. These types of triggers do not cause the condition, rather they simply cause the condition to emerge when it is likely this would have happened anyway, at some point in life.
And with regards to this it then becomes necessary to manage your condition with blood tests and injections. Once the beta cells have started to fail, insulin is no longer produced (or only very small amounts of it are produced towards the beginning of diagnosis- they fail entirely over several months). Insulin is used in the body to ‘unlock’ cells to allow energy (in the form of glucose) to enter. Without insulin the glucose stays in the bloodstream which then ‘spills’ into the urine as it has nowhere else to go. This is why people with diabetes will urinate more frequently when undiagnosed, and also this will cause them to be more thirsty (due to dehydration). As the cells cannot access the fuel (glucose) for energy, the body will begin to break down the muscle instead which is why Type 1 diabetes can commonly also cause severe weight loss (bet you didn’t know that, eh!). The breakdown of fat eventually produces the by-product of ketones which is a sure-fire sign that you are diabetic- it can cause you to become very ill and can be tested in your urine. If you are producing ketones, this is known as diabetic Ketoacidosis (DKA) and can be treated with insulin. DKA may also occur if you are diabetic and have been for a while, and you become very ill, not just at the beginning of diagnosis.
Where am I going with all of this, I hear you ask? Well, I have been largely away from the blogosphere over the past couple of weeks as I have been preparing for, and in this last week have been attending, the DAFNE Course. ‘DAFNE’ stands for Dosage Adjustment for Normal Eating and is a Diabetes management course which takes place over five days. I have had Type 1 diabetes for over 15 years and in the past few years I have constantly been asked if I wanted to go on this course- I have repeatedly declined for the reasons many of the other participants also raised- I thought it would be patronising, useless, and quite frankly, a waste of time. How much difference could it make exactly? I’d certainly lapsed in my diabetes control over the past few years; I’d miss injections (because doing five a day for the rest of my life was a crippling thought), I’d eat what I wanted and guess at the amount of insulin I needed either because of a lack of time or a constant presence of laziness, and the fact that it was going to be with me for my entire lifetime always made me push resolving my issues to tomorrow (never today).
If you are reading this as a general interest piece or as a diabetic considering attending the course, let me be perfectly clear about the fact that I was so sceptical about the whole process that I previously thought frequently to myself that I would have much rather been at work, as opposed to at the hospital. But then how much difference did it make? Honestly… more than I could have ever expected.
Oh, and you guessed it. This is going to be a long post. I hope you’re sitting comfortably.