The Thrifty Gene: Diabetes Was Once a Survival Advantage

Thrifty-GeneToday, I was reviewing a book on childhood obesity for work, and I came across an interesting passage on the “thrifty gene.” It sounded familiar, probably something I learned about back in high school biology, but for some reason, the idea was new for me. Geneticist James Neel proposed the hypothesis in 1962 in his attempts to understand how diabetes survived natural selection.

I agreed. How did Type 1 diabetes, an autoimmune disorder with obvious negative and previously fatal effects, often inflicting children pre-reproductive stage, survive? Neel proposed it was once a survival advantage to be able to fatten quickly and survive seasons of food scarcity. We’re talking hunter-gatherer societies. And because it was such a survival advantage, it continues to be passed down generation after generation.

The only difference is now we don’t have to worry about famines. We keep eating and eating, but our bodies never have to endure hunger and depend on the survival mechanism of diabetes to eat away at our stored fat without our blood sugar dropping and keep us alive. No, our blood sugar keeps rising and rising until our bodies drop dead or malfunction.  Continue reading

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I Swing Alone: A Diabetic’s Confession

Photo credit: Sandy Hunt

Photo credit: Sandy Hunt

I swing alone. My feet now touch the ground. The figure eight chains are rusted. The black u-shaped seat is worn at the edges. I wonder for how long it will hold my weight. I am much bigger now, but I still love the feeling of when my feet leave the ground. For a fleeting moment, I wonder if they will ever return, and then gravity brings me back to reality. I swing alone. I do not belong here anymore, but I also do not want to leave.

The red and brown leaves fly across my shadow in the direction of the setting sun. I envy their journey, but I do not envy their withered state. They are at the end of their lives. I should be beginning mine, but ever since I turned twenty-two, I feel lost within this body. I feel like it’s slowly giving up on me. From a pancreas that doesn’t work to a series of infections to chronic pain to now an IT band that won’t let me run, I feel like it’s shutting down on me. It’s at the end of this journey, and although I know I have years left, I don’t know what quality that will be.

It will let me enjoy one last swing, but it will not let me enjoy the simple pleasures in life – the simple luxuries our physical beings allow. I cannot eat what I want; I cannot exercise how I want, and I cannot have a long-lasting sexual relationship. My mental state has never succumbed to my body – it’s only succumbed to itself, but how much more can my mind take? Can a mind be free with a useless body? Can a mind truly enjoy life with a body that’s slowly withering away? Continue reading

Happy Anniversary Sugarcoated!

According to my LinkedIn account, this month marks the one-year anniversary of this blog. I’m impressed I kept it going one month, much less a year. But here we are, more than a year since my short book of essays, Sugarcoated, was published, since I graduated with an MFA in writing and publishing, and now a year sharing my trials and tribulations online with you.

It seems fitting to focus on the numbers. I leave their meaning up to you.

of three million Type 1 diabetics (T1D) in the U.S.

times per week that I plan to spend writing for this blog

seizures as a result of hypoglycemia or low blood sugar

times per week I think my body may be curing itself, and I no longer have to live with T1D

17 times I change my continuous glucose monitoring (CGM) system site per year (this does not count the number of times I re-tape the transmitter so the wire stays beneath my skin)

20 units of insulin I use every day Continue reading

Blood Sugar Woes

“Is everything okay?” my former colleague and friend asked the young woman standing across from me, a rack of beach towels and bathing suits between us.

It was my first visit to Ocean City. My friend, who I hardly saw anymore since I left the restaurant business, had invited me along with her roommate on this girls’ weekend, fourth of July beach trip. We had just arrived when the roommate realized she didn’t bring a beach towel.

“Yeah, yeah,” she said. “I just need to eat; my blood sugar is low.” I looked up from the myriad of snow globes clustered on one shelf. I particularly liked the juxtaposition of Disney characters in bathing suits basking in the snow.

“I feel like I’m going to pass out,” she added and then discards the wave towel she was looking at.

“Really? Do you want some juice?” I asked. She shook her head.

“I have some glucose tablets, too. If you’re blood sugar is really low, you should get it up quickly.” My friend and I exchange mocking looks. The roommate declined again, and I sighed. I held my tongue because I knew in bringing up the glucose tablets, I had embarrassed her. After all, I knew the full repercussions of a low blood sugar as a Type 1 diabetic.

But I didn’t mention the two seizures or attempt to unmask the real reason behind her irritability. It’s very likely she did need to eat, but unlike my body, her body knew when enough insulin was enough. It may drop to a certain point (unless she was hypoglycemic), but as long as she ate, it would self-manage.

Mine wouldn’t. If my blood sugar was dropping, I had to take care of it right away, less I risk having another seizure or going into a coma because my body couldn’t stabilize itself without external help.

As we left the store, still beach towel-less (due to the prices), and stopped at the nearest food depot and I watched the roommate’s mood improve significantly with food, I realized I was once just like her. Even before I was diagnosed with Type 1 diabetes, I, too, became irritable and moody when I was hungry. Just like my mom, sometimes I would feel shaky if I hadn’t eaten in awhile.

Continue reading

Show Me Your Pump

I’ve been a Type 1 diabetic for five years and an insulin pump wearer for two, but I still struggle with putting “Gizmo” out there. Recently, Sierra Sandison’s #showmeyourpump campaign has been trending on Twitter and among diabetes communities. I have to admit I am in awe. For one, I don’t usually wear my insulin pump with my bathing suit because it’s not waterproof, and two, I don’t want the stares and questions.

But now that I have Cosmo, my continuous glucose monitoring system, I’ve had to reconsider. This is something I can’t unplug at a moment’s notice (although as often as the tape stops adhering to my skin, I almost want to). Yesterday, I decided to “be brave,” so to speak, and wear my insulin pump on the outside of my pencil skirt. Not only did it make for easier access, but it reminded my coworkers and myself that yes, diabetes is a part of me, but it doesn’t control me.

In the end, no one commented on it. Maybe they stared, but I didn’t notice. Or maybe they’ve just gotten used to me being a vibrating machine because between Gizmo and Cosmo and my phone, even my boyfriend never knows which medical device is calling me.

‘The Fault In Our Stars’: Diabetes Edition

Diabetes is hard, but I won’t die from it. At least, not right away. I believe that I will eventually die of a heart attack. With the constant ups and downs of my blood sugar levels, I am sure even if I was given a decent heart, it would not be able to last years with this kind of stress. But at least it didn’t have to endure it for the first 22 years of my life.

It’s possible I may die from something else entirely, unrelated to my health, like a car accident, an injury sustained from rock climbing, food poisoning, etc. Okay, I’m being dramatic, but it doesn’t make sense to spend my days thinking about death, something I learned while reading The Fault In Our Stars by John Green. I love the title, by the way, but when I saw previews for the movie, it looked kind of cheesy and unrealistic, one of those “feel-good cancer movies,” if there can even be such a thing.

Then I read a review of the book and thought I might like it. After all, even though I’ve only been to one funeral in my life, I think about death a lot. I used to worry about receiving a call in the middle of the day that one of my grandparents or siblings had passed. I used to worry my friends would be one of those statistics for teenagers killed by drunk driving. When I wrote stories, one of my characters always, inevitably died (many times the main character because I’m that author). Continue reading

Writing Blog Tour

Thanks to Danielle Ariano for inviting me to be a part of this writing blog tour. What does writing mean to me? Why do I write? Here are the cliff notes:

What am I working on?

This blog. I know, seems silly, but this blog actually keeps me writing. Even if they aren’t Pulitzer Prize-winning pieces, I’m still writing, experimenting with voice and style, and all in the hopes that one day I’ll have enough material to write another book.

So that’s the second thing. I originally set out this spring to publish an ebook of my recent book, Sugarcoated, only to discover I had so much more material to cover. I didn’t think I could do Sugarcoated justice by repurposing it for the Kindle and Nook so I decided to expand on its premise of my diagnosis with Type 1 diabetes and write a more fulfilling manuscript. But first, I have some personal growth to do, and maybe when I land on my feet again, I’ll have a frame for my story. We’ll see.

How does my work differ from others of its genre?

I like to think I have a very unique, witty, and sarcastic voice that draws readers from every walk of life and only adds to my popularity and respect as a profound writer. And I like to think no one has ever written about diabetes before (minus the numerous blogs and social media followings out there).

But in the end, I am a writer like anyone else. I read a lot. I learn from observation. I’m a sucker for bittersweet endings and raw character development. I’m currently pursuing the “creative nonfiction” avenue because I like telling true stories, and I never like writing about myself so I see this as a challenge.

Maybe that’s my contribution? In my mind, I live in other worlds, often imaginary and unrealistic, but I am grounded on Earth. I attempt to interesect the two, if only to make sense of random chaos. I am not a believer in “everything happens for a reason,” but I love ironies and coincidences. Continue reading

Diabetes Coverage: The Never Ending Battle

Just when I think I’ve overcome one hurdle (in this case, the elimination of the pre-existing condition clause with the Affordable Care Act), 10 more appear. I don’t know if I would have experienced the health insurance hang-ups that make me want to bite my nails off and tuck my head underneath my desk at the end of the day, had I not been diagnosed with diabetes at 22.

But in those five years, fighting for diabetes coverage, even something as benign as a 90-day supply for supplies I use every day, has only added to my mental and emotional stress, and in a sense, depleted my overall health and quality of life. I’ve won battles and lost others. But at the end of the day, I still feel beaten.

No matter what I say, no matter how hard I push, no one will see my condition the way I do. They see me as a price tag – an expensive one at that. It doesn’t matter that these supplies or that amount of insulin or that sensor help me live. What matters is that in their predetermined rulebook, it says they do not cover it, and that’s that. Continue reading

Lying to My Endocrinologist

This week, I’m responding to a blog post on lying to your endocrinologist from Kerri Sparling at Six Until Me. Sadly, the truth is I almost always lie to my endocrinologist. Every few months, I cringe when the nurse brings in the downloaded blood sugar readings from my glucometer (even more so now that I have a CGM and cannot pretend to hide those unexplained highs or lows). But every few months, my doctor looks at my readings and says, “These look good.”

I’m surprised, relieved, and jumping up for joy on the inside. I succeeded! I DID NOT FAIL in the eyes of my doctor! But then, I feel immediately guilty because I know I’m not telling her the whole truth. I don’t tell her about the late-night peanut butter ice cream binges or the fact that I haven’t regularly exercised in the past five months (mostly due to my commute and the awful winter weather we had this year, which made me want to crawl under my bed sheets and hibernate until spring). Instead, I say, “Well, that’s good,” with a slight smile. Play it casual, like I’ve got it under control.

But as Sparling pointed out in her blog post, my doctor knows it’s not me that’s “noncompliant.” It’s my pancreas that doesn’t work like it should, and I’m just trying to deal. But I’m a perfectionist. I admit this much to my doctor. She’s concerned about the lows; she’s always concerned about the lows. But this last visit, she surprised me. She said research now says that regular low blood sugar levels can lead to worse long-term complications than highs. Really?  Continue reading

It’s Just a Piece of Bread

Last night, I went out to dinner with a friend of mine from graduate school. We were walking down Cross Street towards the market when we saw the hoard of college students and post-college wannabes standing along the strip of bars that make up Fed Hill’s night scene.

Even though we had plans to walk through that hoard towards the restaurant, we were both like “Uh, nooo,” and diverted to the right. We settled on an American bistro neither one of us had been to.

The place looked deserted. Apparently the Cinco de Mayo festivities had already trampled through and left. In the back dining area, one of the servers sat us between two other tables, one replete of the 5pm dinner crowd and another of a middle-aged couple.

The woman of the couple kept giving our server dirty looks, while a man behind us kept grumbling because they were out of his favorite wine. Continue reading