I wish it would hurry up and die.
I’ve been a type 1 diabetic for almost three years (diagnosed in the end of October 2007), but apparently my pancreas is still going. It’s really rather noble, struggling and surviving as the boiling wrath of my immune system is poured out upon it. While inspiring, this epic struggle causes a lot of problems for me. As with any battle, ground is constantly being lost and regained. For this particular phenomenon (commonly referred to as honeymooning), my enduring pancreas sometimes manages to make a decent amount of insulin and sometimes it makes little or no insulin. Usually this natural insulin level stops changing within a year of being diagnosed but, in my case, it’s still wreaking havoc on my diabetes management almost three years later.
A few months ago I went in to see my endocrinologist (“diabetes doctor”, among other things). After looking at my (high) numbers, he adjusted the rates on my subcutaneous beeper insulin pump to generally give me more insulin throughout 
the day. That means more insulin on a constant drip (basal) and more insulin per gram of carbohydrate (bolus). Great! I enjoyed excellent numbers for a month or two. Since May, however, the islet war has gotten more interesting. My pancreas gained ground and its economy spiked: exports of insulin were at a high and, as a result, my blood sugar was very often low. I began giving myself less than the recommended amount of insulin to compensate. Unfortunately, when the battle turned and natural insulin became scarce, my new habits caused a good bout of wince-inducing high blood sugars. Once more, I adjusted. Now the tide has again turned and I wake up almost every morning feeling shaky and sweaty due to a low, despite giving myself less insulin than recommended the night before.
Perhaps a “battle” isn’t even the issue; it could be that subtle lifestyle changes over the last few months have been causing the variations, but I have been unable to pinpoint them. There have certainly been a good number of lifestyle changes, don’t get me wrong, but I’m having a hard time determining which ones would have such a dramatic effect on my numbers and how. Tomorrow I have an appointment with diabetes doctor and I’m confident he’ll be able to help out, once again. I’ll be asking for advice on how to effectively deal with these ups and downs in between appointments (usually every three months).
Finally, I realize it’s rather mean of me to cheer against one of my own organs like this. Don’t get me wrong, if my pancreas was to win the battle and make more insulin consistently that would be great! Insurance woes mean that I’ll likely be paying for each vial of insulin* for the near future and the less I use, the better. Unfortunately, it’s far more common for natural insulin levels to diminish over time and eventually level out at a low rather than a high production rate. I just selfishly want the process to speed up so that managing my disease becomes easier.
*Fear not, I’ve found ways to get it cheaply. Any tips are still very welcome, particularly on how to get Minimed pump supplies inexpensively. Randomly, thanks to iheartguts.com for the excellent illustration.
Nathan
Cleveland, Detroit, Jim Joyce, Galarraga, Bud Selig, and anyone else who has seen the replay knows it was a perfect game the moment Galarraga stepped on the bag at first. Personally, I hope Selig overturns the call and lends a hand to the credibility of the record books. I also hope this acts as a catalyst for more extensive use of instant replay in baseball. David Martin raises and dashes the obvious objections to overturning the call on 
