SHARED EXPERIENCE: Mildura’s Jane Smith and daughter-in-law Aimee Smith both live with Type 1 diabetes.

By JOHN DOOLEY

National Diabetes Week runs from this Sunday to July 18 and will focus on supporting the emotional and mental health of people living with diabetes.

It has been revealed diabetics are required to make up to 180 extra decisions each day, including every thing from food to medication, and from exercise and more just to stay well and healthy.

Research shows that managing the daily challenges of diabetes can lead to anxiety, distress and depression for one in three people living with the condition. 

However, that’s not always the case. For Mildura’s Jane Smith and her daughter-in-law Aimee Smith, both of whom have Type 1 diabetes, the daily ritual of dealing with their disease, is one that they strive take in their stride in order to lead a normal, happy life.

Jane, who is a palliative care nurse working with the Far West Health Centre at Dareton, was diagnosed in 1980 when she was 12 years old.

Living a full life

Being diagnosed with Type 1 diabetes, and the knowledge that you are going to have to inject yourself everyday for the rest of your life can be a daunting thought, but Jane said it was something she has learned to live with and she has never let her diabetes restrict her life.

“Never ever let it stop you doing anything,” she said. 

“Mum always said: ‘Don’t you ever let this rule you’ – and it never has. I have played sport, I’ve travelled overseas, and so all you have to do is be aware of it and look after yourself.

“It was something that happened quite suddenly, although it was sometime before the diagnosis was made. I had developed an indes-
cribable thirst. It was a thirst that you couldn’t quench.

“I remember we were away on a holiday, and I would be constantly looking for water to have a drink, even taking water from a fountain in a park.

“Then one day my mother realised how much weight I was losing and how skinny I had become.”

Jane said then the investigation into what was wrong with her got under way with a series of tests.

“It was quite a process. I was going to the doctor, then having blood tests, then back to the doctor and doing another test – there were a series of tests leading up to the diagnosis,” she said.

“Eventually, I went to the paediatrician and that same day I was admitted to the children’s ward at the Mildura Base Hospital.” 

Once diagnosed Jane went on to insulin treatment immediately.

She was in her first year of high school, and the burden of having to test her glucose levels regularly went to school with her. 

“There weren’t any glucometers when I was diagnosed and so I had to take test tubes to school, and at morning tea time and lunchtime, I had to test my urine by putting a tablet in it and checking the colour and then trying to match colour code to see what my blood glucose levels were,” she said.

“Eventually I got my first glucometer which was the size of a lunch box and it had a dial that showed the blood glucose level.”

Testing technology

Today the testing devices are extremely compact and an accurate reading is digitally displayed within a few seconds of the blood making contact with the testing strip.

For both Type 1 and Type 2 diabetics, controlling blood glucose levels is very important in order to avoid the long-term side effects which, at the extreme, can include kidney disease, loss of eyesight and even the amputation of limbs.

Jane’s control is good, which she says is thanks to the insulin pump she wears now, which has meant she doesn’t need to inject herself anymore. 

“The advent of the pump has been revolutionary,” she said.

“I can tell the machine what my glucose level is and how many carbohydrates I’m going to consume and then the pump works out a dose. It is continuously giving me a little bit of insulin and then I also give it a ‘bolus’.

For a person with diabetes, a bolus is a dose of insulin taken through the insulin pump to handle a rise in blood glucose (a type of sugar), effectively like the one that results from eating. 

Jane said an issue for diabetics over the age of 21 who are employed and don’t have any health card benefits is that they have to pay for the continuous glucose monitor. 

“The only unfortunate thing is that because I am over 21 and work, I don’t qualify for the continuous glucose monitor,” Jane said. 

Continuous Glucose Monitoring (CGM) is a means of measuring glucose levels continuously in order to gain insight into patterns and trends in glucose levels throughout the day and night.

A CGM System sensor is worn separately to the pump, inserted under the skin, and measures the level of glucose in the interstitial fluid (fluid in the tissue). The sensor is disposable and changed reg-
ularly.

The cost of CGM, including consumables (sensors), is around $5000 per year.

Aimee, 29, is in the same situation, and given her busy life as a mum of two active little boys and her hairdressing job, keeping track of her sugar levels is important. 

“When I was diagnosed at 11 years of age, it was quite serious, not a lot of kids had it and I felt a bit left out at school,” she said.

“I always left class five minutes early to go and test my sugar levels and do my insulin and then I’d go back to eat lunch with my friends. No one really knew what it was. 

“While I was at high school, I think one other boy I knew also had diabetes. He didn’t know I had it until we bumped into each other when I was doing my test and he came in to do his and we both realised then.”

Like Jane, Aimee said that she hasn’t let diabetes stand in the way of leading a normal life.

“You can’t let it take over and control your life. I definitely rebelled as a teenager, she said. 

“I just couldn’t be bothered looking after my levels. It was so much of an effort to stop your day and test your sugar.”

Aimee explained how she needs to alter her insulin dosage on work days to compensate for the extra stress that she is under.

“I use an insulin pen now, but initially I was injecting with a syringe,” she said.

“My insulin doses change on work days, I have less and also reduce it the night before.

“If I don’t adjust that I may have a ‘hypo’. To offset the risk of having a hypo I will eat some lollies which keeps my glucose level up.

“At work I’m constantly eating things to keep myself going.”

A hypoglycaemic episode is commonly known as a hypo and for people with diabetes, hypoglycaemia typically happens when blood sugar levels drop below the normal level, leading to a variety of side effects from dizziness, confusion and if not dealt with the person can lapse into a diabetic coma.

There are three main types of diabetes – Type 1, Type 2 and Gestational.

• Type 1 diabetes can develop at any age, but occurs most frequently in children and adolescents. When you have type 1 diabetes, daily insulin injections are required to maintain controlled blood glucose levels 

• Type 2 diabetes is more common in adults and accounts for almost 90 per cent of all diabetes cases.When The cornerstone of type 2 diabetes treatment is healthy lifestyle, including increased physical activity and healthy diet. However, over time most people with Type 2 diabetes will require oral drugs and/or insulin to keep their blood glucose levels under control. Learn more.

• Gestational diabetes (GDM) is a type of diabetes that consists of high blood glucose during pregnancy and is associated with complications to both mother and child. GDM usually disappears after pregnancy, but women affected and their children are at increased risk of developing Type 2 diabetes later in life.