Richard Coles

I try not to use my blog posts just for small comments on news pieces but I find this story, from the BBC, very upsetting:

I appreciate that most of you will not know who this guy is. He is a one-time pop star who has since become a pastor and something of a UK TV personality. He is witty and hilarious to watch, refreshingly intelligent.

He’s also a guy who has just lost his partner.

Differences Between Type I and Type II Diabetes

I hit my reader yesterday, and it suggested a post I might be interested in. It was from a diabetic guy, talking about his diabetes. The first thing he said was I am Type 1, so I can only really speak for myself. I can’t really speak for Type II diabetes. It’s funny because on my journey, one of my first questions was what’s the difference? I don’t know the full story but here is what I do know:

Diabetes (any type) is high blood sugar. Beyond that, there are several forms of diabetes. Type II is by far the most common, covering 80-90% of cases. Then comes Type I, covering about 10% of cases. There are other forms of diabetes too, but they are rare in comparison to the two biggies. These different types cover not the raised blood sugar itself, but the causes. Once your sugar is raised, you can look forward to the same lovely benefits, whatever type you have.

Type I is where your body attacks itself – it’s an auto-immune thing, resulting in no insulin being produced. Insulin counteracts glucose (sugar). If T1 is detected, it is often detected early, although in some people it can come on as an adult. The tratment is clear – insulin. There is empirical evidence to suggest a familial link, but the causes ultimately are not yet known, although links with lifestyle or weight have been ruled out.

Type II is where you don’t produce enough insulin, or where the insulin you do produce doesn’t work. It usually gets detected when you’re a bit older. In my case, I think of things degrading over time. There are various treatments which do various jobs – reducing sugar directly, or poking various organs to work harder. Ultimately, there is the same treatment as T1, insulin. T2 is often associated with lifestyle, although in my case the familial link is very strong, though the lifestyle link pretty much non-existent.

There is no cure for either T1 or T2, although with T2 things like what we eat and how much we exercise play a part, so some people can go into remission by changing their lifestyle. I didn’t, so this rule does not apply to everybody. I guess one of the reasons that there are more options with T2 than with T1 is research – I suspect that T1’s cause being as yet unknown is largely down to funding.

Either way, your body has an intolerance to carbohydrates. Many T1s will religiously carb-count, for the simple reason that it guides their insulin dose. I don’t carb-count, although possibly I should. My dose instead is guided by the less specific what did I eat (good/bad)?, or how much did I eat (big/small)? If I ate a lot of carbs, say, I take a 10% higher dose, but again this is empirical, not scientific.

Note that I am using the word carb above. Not sugar. Although sugar is a carb, so there is a link. But a bowl of pasta will do as much damage as a packet of candy.

The insulin that I take is pre-mixed. A fast acting insulin plus a slower-acting insulin. I did post about this ages ago here. The pen is marked just in “units”. Exactly what a unit is, I can look up, but the point here is that working out how many millilitres of a particular insulin I am getting requires a couple of calculations, plus the proportions of the two types of insulin are fixed at 3:1, so for every 3 of slower insulin, I am getting 1 of fast insulin. For these reasons, mixes tend not to be prescribed to T1 diabetics. (That one comes from my wife, who is a diabetic nurse.) The guy whose blog I was reading yesterday did, however, take the two types of insulin – they were different brands to what I take, but the same kind of thing – but took them separately, so he could vary the proportions.

As I said at the top of the post, I don’t consider myself an expert here, but this is just knowledge I have picked up along the way. In many ways it is immaterial, because regardless of the cause, we’re faced with the same problems. I chuckle, too, when I hear new stroke survivors talk about whether their stroke was due to a bleed, or due to a clot. Because that’s the language they hear from the staff. Whatever the cause, we’re all still in the same boat. But maybe that’s just me?