Turk from Scrubs

I watched this episode some time before I was diagnosed … had no idea what diabetes was at that time … now when I watched this clip back again, it’s hilarious! Have a look:

The Airplane Analogy

I found this great analogy (http://www.hanselman.com/blog/ScottsDiabetesExplanationTheAirplaneAnalogy.aspx) for making people understand the difference between Type I and Type II. I’ve modified it a bit suiting my ‘use case’. Here goes :

You are flying from L.A. to New York. You have to maintain a consistent altitude the whole way.

Note: For this analogy we will focus on a good cruising altitude and pretend that taking off and landings aren’t important.

Food raises blood sugar (altitude.) Insulin lowers it. Non-diabetics don’t have to think about altitude, as you all have a working pancreas (autopilot) and don’t sweat altitude. Diabetics, on the other hand, have to constantly wonder if they are at a safe altitude. Staying at a consistently high altitude (high blood sugar) will eventually make you sick; while a low altitude (low blood sugar) will kill you quickly.

When I prick my finger to check my blood sugar with a glucose test strip, that’s an altitude check. I want to know how I’m doing. Each time I do it, it costs about $1.

Each time I feel I need to lower my blood sugar, I take insulin. I take a manual shot by measuring the insulin and filling the syringe by hand (or I use an Insulin pen). I would typically take about 2 or 3 shots a day (presently).

Here’s where the analogy gets interesting. Remember in the analogy we are flying from L.A. to New York, except we only get to check our altitude seven times. And, we only get to change altitude (take insulin) less than ten times. But, when I check my blood sugar, I’m actually seeing the past. I’m seeing a reading of what my blood sugar was 15 minutes ago. And, when I take insulin, it doesn’t start lowering my blood sugar for at least 30 minutes.

Now, imagine yourself in that plane with an altimeter that shows you the altitude 15 minutes in the past, and a yoke that changes the altitude – but when you press on the yoke, your altitude won’t change for a half-hour. It would be a challenging trip.

Kind of reminds one of the delays in controlling the Mars Rover by remote, eh? This is what Type I diabetes is like. It’s a daily “chasing of one’s tail.” This is why I prefer to eat at Subway when I’m in NYC or SFO. It’s consistent. I can count on it. I know how much insulin to take for a Steak & Cheese. Believe me, I’d love to eat new kinds of food every time I visit a new city, but I’d have to discover how much insulin to take and that’s and exhausting series of calculations and trial & error.


23 and me

15 minutes from now, I’ll be 23 (well, actually I already turned 23 12:30 hours ago, but yeah whatever!). It has been an interesting ride until now – filled with a lot of fun … i’ve had my share of bumps and I am glad I always had family and friends with me all the time! This year, I don’t have a lot of them around on my birthday …. that just means one thing – I am sure gonna get a hell lot of calls tomorrow! well, happy birthday to me!
Update: I had a piece of my favorite chocolate cheesecake on my birthday morning after taking 2 units of insulin. I was scared but the values were perfectly normal 2 hours later! I need more cheesecake now!


I saw my endocrinologist last week. Last time I saw him, he had ordered some labs for me. This time he had all the results. Here are the highlights:

My c-peptide was much better (2.0) than before (0.9) although it was not as good as it should be. Basically it means that my pancreas is still somewhat working. I am currently in something called “honeymoon period“ – the period where most of your islet cells (cells in the pancreas that produce insulin) are dead but some of them are still working their asses off to produce as much juice as possible.

My antibodies labs came out positive – well they were way high! While the normal value is around 1-1.5, mine was somewhere around 13! These antibodies are generated by my own immune systems. They go attack the islet cells in my pancreas and kill them. So, that helps explain how it all happened and confirms my diagnosis to some extent. My insurance although has not been helpful at all with these labs. They marked my antibodies lab as “experimental“ and refused to pay a single penny for that! I had a chat about this with my doctor, and he was really pissed at the insurance guys on hearing this. The test is actually not “experimental“ at all. It is kinda required for the diagnosis. Now, I have to go thru the grueling process of appealing for a claim for this lab but as of now, I need to pay $207 for the freaking test!

On the tratment front, I am on long acting insulin shots currently. I inject 17 units of lantus (a long acting insulin) in my tummy every morning. I was expecting (and half hoping!) that my endocrinologist will start me on short acting insulin as well this time and he did exactly that. So, now I’ll also be taking a few (3-5) units of short acting insulin (Novolog) right before dinner. So, that makes it 2 shots a day. This makes things more inconvenient but the upshot is that I can eat more freely (=more carbs) in one meal of my day. Probably a piece of cheesecake once in a while! Totally worth it!!!

And yeah! I asked him what he thought about the kind of research going on for finding a “CURE” for type I diabetes. He was very hopeful for a cure coming up in the next 10 to 20 years and he believed the most likely cure would be a islet cell transplant. It seems researchers have carried out such transplants recently and so it is possible to do that. The problem that the community faces today is the source of these cells. Right now, they come from cadavers but researchers are looking into various other sources to get these cells from. 10 years, 20 years – it’s definitely a long time but if we are looking at a possible cure, I’ll surely be waiting. Here’s a wonderful video I came across that talks about another possible cure.

PS: I have been telling a lot of people about my doctor’s visits lately. So, I figured it will be best if I write down all of the stuff somewhere, so I don’t miss anything when I am repeating the whole story again and again. This is the reason for the post above.

Revenge of the pissed off pancreas

Back when I was in high school (standard 7th or 8th, i think), I studied about various systems in human body – nervous system, digestive system, excretory system etc. The biology teacher made us draw all sorts of diagrams explaining these systems in detail. My favorite one was the digestive system. I liked drawing the esophagus and the large intestine. They looked like a couple of crumpled pipes lying around inside my tummy! And then, there was the stomach, the liver, the small intestine and so on. Somewhere near the stomach, I used to draw a silly looking organ called pancreas. It seemed like it was trying to hide from me, as if it was guilty of something really bad it was going to do. I never really understood what pancreas was supposed to do and no one cared to explain the function of this insignificant digestive system organ to me. Hell! I didn’t really care. I wasn’t interested in the stupid pancreas and wasn’t planning on becoming a doctor anyways! But, it seems my egotistical pancreas didn’t really appreciate my indifferent attitude and took it upon itself to make me understand its importance (and ofcourse get back on me .. that stupid egomaniac!). So, like a suicidal jehadi, it just blew itslef up and totally stopped working. That’s how it took its revenge on me. It took me a few months to realize this but by the time I became aware of the wrath of my pancreas, I had already lost 22 pounds and was spending a good part of my day drinking water and then immediately giving it back to the mother nature!
Well, now after 3 months of living with type I diabetes, I know a lot about what pancreas is and what role does it play in the diagram with those stupid crumpled pipes. The damn thing made its point very strongly and didn’t really leave a lot of choice for me. All I can do now is just hope that science soon finds out a way to coax our pissed off pancreas into starting functioning again. Lessons learnt – Respect thy pancreas, DO NOT piss it off!

Sugar Challenged

Finally found a blog name that is available! http://sugarchallenged.blogger.com it is!

It’s been 2 and a half month since I was diagnosed with Type I diabetes. It was 9th of Jan, 2008. I was visiting my family in India and had just come back to Delhi from an awesome trip to Hyderabad. My brother (who is an orthopedic surgeon himself) was there to pick me up from the airport. I had gotten some routine tests done before going on the trip. He had their results for last few days but hadn’t told me anything about it. I just knew that my sugar levels were ‘a bit high’. In fact, he chose not to tell me anything when he met me at the airport. He took me straight to an endocrinologist. We had lunch on our way there. Mom had sent some healthy homemade food but I really wanted a McDonald’s burger. I thought I’ll definitely get one as soon as I was done dealing with the doctor. Just before we ate, we got a blood sugar test done in the car (and that was my first prick on the fingertip). It showed some insanely high number but I didn’t care at that time because I had no idea what that number meant. I didn’t know what diabetes was – no idea what blood sugar meant! And even if I had known, I had no idea about what it meant to be diabetic. I could not understand what this fuss was all about. Why did we have to see the doctor right away? But, I thought that my brother probably knew what was best for me. So, we went to see the doctor.

After a few minutes, we pulled into Gangaram hospital – a prestigious medical institution of Delhi. The doctor’s office was a small room with him, me, my brother, and a few other patients sitting and staring at him. He had some basic questions – weight, height, BP etc. Then I told him about my 20 lbs weight loss from a few months ago. After a few minutes of talking and perusing my test results, he casually broke it to me – “Ofcourse, there is no doubt that it is diabetes’. And then, he suddenly started talking about insulin, injections, pen and blood glucose monitoring! At first, I didn’t realize the gravity of the situation. I thought, “hmm, diabetes. Interesting. I have some fancy disease – that’s cool! So, doctor, please tell me how do I get rid of it?” But looking at the doctor’s and my brother’s face and trying to comprehend what they were talking about, the reality started to dawn upon me. And then, the doctor looked at me and said – “As you know, diabetes is a lifelong disease. Your lifestyle is going to change drastically.” Hey, I didn’t know that! and why the hell do you have to assume that I know anything about diabetes? He and my brother talked a bit about the type of diabetes it could be but none of that made any sense to me. He gave me about 10 minutes to digest what had struck me. 10 minutes – that’s all and we were done! We came out of doctor’s cabin and visited the dietitian. She gave me long list of what I should eat and not eat – not giving a single thought to the fact that she was dealing with type 1 diabetes . I couldn’t hear most of it because I wasn’t even listening. “Diabetes … insulin … injections … lifelong … ” – I had my own river of thoughts going on in my brain. So, we finished our business at the hospital, and got into the car. As I sank into my seat, I looked at my brother. He asked me – “So, how do you feel?”. And I just started crying. I couldn’t stop it. Cried like a baby. What seemed like an awesome vacation the same morning had just turned into a nightmare!

I was Sugar Challenged.

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