Natalie, 64
First off, I'm 64 years old, NOT a teenager any more. And I've been struggling with this for a long time, but have just come to the point where I can admit it. The important part of the story for now is that I binge, and when I'm focused in on bingeing, all I can think of is the food I'm so desperate to binge on, and the thought of bolusing for it doesn't even cross my mind. Every time I do it, I swear I won't do it again, but then something sets me off, and there I go again.
Maybe I need to tell you the whole story (hope it's not too long), with no gaps and no omissions, because perhaps the first step is simply confronting the truth. Which I have been denying for as long as I could even think about it. This IS very painful to me, and the last thing I need is judgment. Which I fear, because I'm different. OK, start with history. My grandmother had diabetes, which she developed in the late 1920's. She was in her early 40's. I have one picture of her before she developed diabetes (don't know how long), and she was overweight, but I also have pictures of her from not too long after she developed diabetes, and she was definitely normal weight, verging on thin. But contrary to received knowledge, the diabetes never went away or improved in any way. Of her 5 children, 3 developed diabetes. My uncle was always thin; one aunt was overweight to start, but got thin, and the other aunt was normal weight, but gained weight. So I don't think weight has anything to do with diabetes in my family. My mother never ever showed any signs of diabetes or metabolic syndrome. She died at age 80 of COPD. However, my family was terrified of diabetes, and I was raised being told "Natalie, don't eat that, you'll get diabetes!" And to make things worse, my father was a dentist and my mother an RN, and they resolved that sugar should never pass our lips, due to their concern for our health, I'm sure, but those two pressures were a great setup for an eating disorder. I remember being in elementary school, longing for the white bread sandwiches and Twinkies that my classmates were eating. When we reached jr. high, my mother started giving us allowances, partly to buy lunch and partly for recreational spending money. I remember the 3 of us going to Sav-on and buying a dollar's worth of candy bars -- at 5c a bar, that was 20 bars each (and they were larger in those days), and sneaking them home, and eating them all in one sitting and then sneaking the wrappers out to the trash bin. In retrospect, I think that was bingeing, although I didn't even know what bingeing was at the time. Also, I don't know when it started, but my brother and sister started calling me "Fatso", which degenerated into "Fitzer" which my brother still calls me. But I look at my childhood pictures, and I was by no means fat, nor even overweight -- just built rounder than my skin-and-bones sister. If anything, I was normal weight, and she was too thin. When I got out of college, and went to work, I started rebelling against the food restrictions that had been put on me. I did NOT have diabetes at the time, but I imagine the food restrictions must have been similar, and to make it worse, I was (and am) a picky eater, too. My mother would insist on a certain size serving of vegetables, a serving of salad, an entree, a serving of a starch, a glass of milk and no dessert (because deserts have sugar). And I remember sitting at the table until my mother couldn't stand it any more because I wouldn't eat a vegetable she had served, and she was determined to force me. So, my rebellion took the form of eating all the sweets I wanted, and eating a LOT of them. Half a gallon of ice cream at one sitting, a whole package of cookies, half an angel food cake, etc. I DID gain weight, but did not become obese -- at my largest, I was BMI 27. But because of my childhood experiences, I have ALWAYS seen myself as fat, even though my BMI is currently between 24 and 25, (which is pretty normal for my age) and my friends tell me I'm small. But I confess to looking at the anorexic, skinny models and actresses in magazines and movies (who are nowhere near my age, anyway) and wishing I looked like them. Intellectually, I know I'm not fat, but emotionally, I don't. So, OK, I turn 43, and my BG starts going up on lab tests (138 and 131 3 months later, and A1c of 4.8 2 months after that. The A1c was LYING!) It wasn't diagnosable at the time -- my doc told me it was hyperglycemia, and sent me to get a meter (smart doc), but the CDEs told me I DID have diabetes, which sent me into a tailspin -- I bawled the whole time they were trying to teach me to use the meter and set up a meal plan. All I could hear were the voices in my head saying "I told you so, I told you so!!!!!!!" I did reasonably OK for 2 years, although I had a coronary artery spasm when I was 44, but by the time I turned 45, I was extremely symptomatic, couldn't teach a class without crossing my legs the last 15 minutes, couldn't get a sentence out without a sip of water, and ran to the bathroom every passing period, hoping I would make it back in time for the next class. I was also ravenously hungry, and ate until my stomach hurt, but DIDN'T gain weight. But also didn't lose it -- it WASN'T a classic T1 onset, but consistent with possible LADA, although I have never been formally tested. So I got diagnosed and put on a sulfonylurea, but it didn't help at all, so I begged for insulin after 5 months of misery. I will skip the story of finally convincing my doc that I needed T1 protocols because T2 insulin protocols weren't working, and how I eventually got a pump, and I will progress to what's happening now.
In the fall of 2010, for reasons not entirely clear to me, I started bingeing big-time. I did have the pump on, and I always had my basal, but I wouldn't always bolus sufficiently for what I was eating. One of the fears I have is taking too much insulin, because somehow in my head, I get the unreasonable thoughts that maybe the diabetes went away while I wasn't looking, and I really shouldn't be taking insulin at all. NOT because of wanting weight loss, although I wouldn't be honest if I didn't admit that I wish I weighed less, and had a model's body. But it's NOT an overwhelming urge -- the urge is NOT to have diabetes. So here I am, putting away large quantities of angel food cake, chocolate ice cream, regular cake, candy bars and not much else. If you take some insulin when you do this, your BGs may come down a good bit, but not down to baseline, so next time you do it, you start at a higher number, and go even higher, and don't come down to the new baseline. If you do this gradually, you can go for quite a long time before you start getting really sick. (I'm NOT meaning to encourage people to do what I did, but describing it so you know how I got into the mess I did. Not proud of it one bit!) So as my numbers got higher and higher, I gradually got sick -- had blackouts, diminishing mental capacity, losing my balance -- it's a miracle that I didn't black out while driving. But I couldn't remember appointments, could barely read, wasn't taking care of my house, and fell 6 times, twice down the stairs at my friend's house, and twice at home and couldn't get back up again. Once I had to call a friend to come pick me up, because even though I had crawled to the couch, I couldn't pull myself up. Another time, I pulled over a bookcase trying to get back up. I exploded my microwave because I put in a bag of popcorn and didn't enter the time right. My bed quilt ended up in the kitchen, and I have no idea how it got there, because I'm telling you stuff I totally don't remember, but my friends filled me in on. The brain does not function well on maple syrup. Ironically, I had gone to my endo 6 days before I went into the coma, with a FBG of 302, A1c of 10.7 and liver enzymes in the 100's (normal is below 40) and he didn't see anything wrong. I'm a low glycator, so my 10.7 is about equivalent to someone else's 20. By the time my friends got me to the hospital, my kidneys had shut down, my liver function was way off, and although they tell me they were able to walk me to the car, I remember nothing of it. They called my sister-in-law, who told the ER staff I was T2, and so they treated me as such, and it didn't work. I was unconscious for 2 days, and woke up thinking I was in Canada. The CDE on the case figured things out, and fought with the hospitalist to put me on T1 protocols (I'm not really thrilled with hospitalists), which is when my BGs started to come down. I was still having hallucinations and blackouts, but they were getting better. That would have been fine, except when they discharged me to a rehab hospital AKA Alzheimer's home, the T1 orders failed to follow me, and it was a Friday afternoon, and the hospitalist was gone for the weekend, so they would only give me insulin as a correction before a meal, but no basal and no bolus, so my BGs went right back up again, and I relapsed into blackouts and hallucinations. I won't go into the details, but I have never been so terrified, panicky or despondent in my life. Finally cornered the hospitalist on Monday, and got him to at least give me a basal and bolus in addition to corrections (which really weren't working very well at that point), but it was fixed dose. My pump had gotten lost in all the confusion, so it was Lantus and Novolog. It took THREE weeks in the delightful company of Alzheimer's patients (not THEIR fault, poor folks) before I got to go home. When I got home, I got honest enough with myself to know that I had to do something, so I went on a low-carb diet. It's like I know carbs are the enemy. But the problem for me is that I'm a picky eater, and it's really hard to force myself to eat vegetables, so at the moment, I'm mainly subsisting on dairy products and ground beef. My BGs ARE good if I stick to that, but I know it's not nutritionally adequate. And I lost all the weight I had gained by bingeing on carbs (you don't lose weight if you have insulin in your system, which I did). But I still get the urge to binge on carbs. This is a 2-part problem. One is, I will buy whatever sweet I'm craving, eat the whole thing, and not take insulin until my BG is in the 300's, and by then, glucose-induced insulin resistance has set in, and it's hard to get it back down again. The second part is that I go out to a restaurant or a party, and eat freely, and don't take insulin until I get home, and again, I'm pretty high by that time. And then I feel guilty and ashamed, and then I punish myself by not eating at all the next day. A sort of binge and bust cycle. And BGs are still high even when I'm not eating, because you just don't recover from a real high period all that easily. So while I'm open to and need practical tips, I'm also in need of ways to relieve the incredible guilt and rebellion I feel toward diabetes. Another way to put it would be sadness and anger. I've had diabetes for 20 years now, and I STILL can't accept it and make peace with it. And there you have my complete, unvarnished story.
Maybe I need to tell you the whole story (hope it's not too long), with no gaps and no omissions, because perhaps the first step is simply confronting the truth. Which I have been denying for as long as I could even think about it. This IS very painful to me, and the last thing I need is judgment. Which I fear, because I'm different. OK, start with history. My grandmother had diabetes, which she developed in the late 1920's. She was in her early 40's. I have one picture of her before she developed diabetes (don't know how long), and she was overweight, but I also have pictures of her from not too long after she developed diabetes, and she was definitely normal weight, verging on thin. But contrary to received knowledge, the diabetes never went away or improved in any way. Of her 5 children, 3 developed diabetes. My uncle was always thin; one aunt was overweight to start, but got thin, and the other aunt was normal weight, but gained weight. So I don't think weight has anything to do with diabetes in my family. My mother never ever showed any signs of diabetes or metabolic syndrome. She died at age 80 of COPD. However, my family was terrified of diabetes, and I was raised being told "Natalie, don't eat that, you'll get diabetes!" And to make things worse, my father was a dentist and my mother an RN, and they resolved that sugar should never pass our lips, due to their concern for our health, I'm sure, but those two pressures were a great setup for an eating disorder. I remember being in elementary school, longing for the white bread sandwiches and Twinkies that my classmates were eating. When we reached jr. high, my mother started giving us allowances, partly to buy lunch and partly for recreational spending money. I remember the 3 of us going to Sav-on and buying a dollar's worth of candy bars -- at 5c a bar, that was 20 bars each (and they were larger in those days), and sneaking them home, and eating them all in one sitting and then sneaking the wrappers out to the trash bin. In retrospect, I think that was bingeing, although I didn't even know what bingeing was at the time. Also, I don't know when it started, but my brother and sister started calling me "Fatso", which degenerated into "Fitzer" which my brother still calls me. But I look at my childhood pictures, and I was by no means fat, nor even overweight -- just built rounder than my skin-and-bones sister. If anything, I was normal weight, and she was too thin. When I got out of college, and went to work, I started rebelling against the food restrictions that had been put on me. I did NOT have diabetes at the time, but I imagine the food restrictions must have been similar, and to make it worse, I was (and am) a picky eater, too. My mother would insist on a certain size serving of vegetables, a serving of salad, an entree, a serving of a starch, a glass of milk and no dessert (because deserts have sugar). And I remember sitting at the table until my mother couldn't stand it any more because I wouldn't eat a vegetable she had served, and she was determined to force me. So, my rebellion took the form of eating all the sweets I wanted, and eating a LOT of them. Half a gallon of ice cream at one sitting, a whole package of cookies, half an angel food cake, etc. I DID gain weight, but did not become obese -- at my largest, I was BMI 27. But because of my childhood experiences, I have ALWAYS seen myself as fat, even though my BMI is currently between 24 and 25, (which is pretty normal for my age) and my friends tell me I'm small. But I confess to looking at the anorexic, skinny models and actresses in magazines and movies (who are nowhere near my age, anyway) and wishing I looked like them. Intellectually, I know I'm not fat, but emotionally, I don't. So, OK, I turn 43, and my BG starts going up on lab tests (138 and 131 3 months later, and A1c of 4.8 2 months after that. The A1c was LYING!) It wasn't diagnosable at the time -- my doc told me it was hyperglycemia, and sent me to get a meter (smart doc), but the CDEs told me I DID have diabetes, which sent me into a tailspin -- I bawled the whole time they were trying to teach me to use the meter and set up a meal plan. All I could hear were the voices in my head saying "I told you so, I told you so!!!!!!!" I did reasonably OK for 2 years, although I had a coronary artery spasm when I was 44, but by the time I turned 45, I was extremely symptomatic, couldn't teach a class without crossing my legs the last 15 minutes, couldn't get a sentence out without a sip of water, and ran to the bathroom every passing period, hoping I would make it back in time for the next class. I was also ravenously hungry, and ate until my stomach hurt, but DIDN'T gain weight. But also didn't lose it -- it WASN'T a classic T1 onset, but consistent with possible LADA, although I have never been formally tested. So I got diagnosed and put on a sulfonylurea, but it didn't help at all, so I begged for insulin after 5 months of misery. I will skip the story of finally convincing my doc that I needed T1 protocols because T2 insulin protocols weren't working, and how I eventually got a pump, and I will progress to what's happening now.
In the fall of 2010, for reasons not entirely clear to me, I started bingeing big-time. I did have the pump on, and I always had my basal, but I wouldn't always bolus sufficiently for what I was eating. One of the fears I have is taking too much insulin, because somehow in my head, I get the unreasonable thoughts that maybe the diabetes went away while I wasn't looking, and I really shouldn't be taking insulin at all. NOT because of wanting weight loss, although I wouldn't be honest if I didn't admit that I wish I weighed less, and had a model's body. But it's NOT an overwhelming urge -- the urge is NOT to have diabetes. So here I am, putting away large quantities of angel food cake, chocolate ice cream, regular cake, candy bars and not much else. If you take some insulin when you do this, your BGs may come down a good bit, but not down to baseline, so next time you do it, you start at a higher number, and go even higher, and don't come down to the new baseline. If you do this gradually, you can go for quite a long time before you start getting really sick. (I'm NOT meaning to encourage people to do what I did, but describing it so you know how I got into the mess I did. Not proud of it one bit!) So as my numbers got higher and higher, I gradually got sick -- had blackouts, diminishing mental capacity, losing my balance -- it's a miracle that I didn't black out while driving. But I couldn't remember appointments, could barely read, wasn't taking care of my house, and fell 6 times, twice down the stairs at my friend's house, and twice at home and couldn't get back up again. Once I had to call a friend to come pick me up, because even though I had crawled to the couch, I couldn't pull myself up. Another time, I pulled over a bookcase trying to get back up. I exploded my microwave because I put in a bag of popcorn and didn't enter the time right. My bed quilt ended up in the kitchen, and I have no idea how it got there, because I'm telling you stuff I totally don't remember, but my friends filled me in on. The brain does not function well on maple syrup. Ironically, I had gone to my endo 6 days before I went into the coma, with a FBG of 302, A1c of 10.7 and liver enzymes in the 100's (normal is below 40) and he didn't see anything wrong. I'm a low glycator, so my 10.7 is about equivalent to someone else's 20. By the time my friends got me to the hospital, my kidneys had shut down, my liver function was way off, and although they tell me they were able to walk me to the car, I remember nothing of it. They called my sister-in-law, who told the ER staff I was T2, and so they treated me as such, and it didn't work. I was unconscious for 2 days, and woke up thinking I was in Canada. The CDE on the case figured things out, and fought with the hospitalist to put me on T1 protocols (I'm not really thrilled with hospitalists), which is when my BGs started to come down. I was still having hallucinations and blackouts, but they were getting better. That would have been fine, except when they discharged me to a rehab hospital AKA Alzheimer's home, the T1 orders failed to follow me, and it was a Friday afternoon, and the hospitalist was gone for the weekend, so they would only give me insulin as a correction before a meal, but no basal and no bolus, so my BGs went right back up again, and I relapsed into blackouts and hallucinations. I won't go into the details, but I have never been so terrified, panicky or despondent in my life. Finally cornered the hospitalist on Monday, and got him to at least give me a basal and bolus in addition to corrections (which really weren't working very well at that point), but it was fixed dose. My pump had gotten lost in all the confusion, so it was Lantus and Novolog. It took THREE weeks in the delightful company of Alzheimer's patients (not THEIR fault, poor folks) before I got to go home. When I got home, I got honest enough with myself to know that I had to do something, so I went on a low-carb diet. It's like I know carbs are the enemy. But the problem for me is that I'm a picky eater, and it's really hard to force myself to eat vegetables, so at the moment, I'm mainly subsisting on dairy products and ground beef. My BGs ARE good if I stick to that, but I know it's not nutritionally adequate. And I lost all the weight I had gained by bingeing on carbs (you don't lose weight if you have insulin in your system, which I did). But I still get the urge to binge on carbs. This is a 2-part problem. One is, I will buy whatever sweet I'm craving, eat the whole thing, and not take insulin until my BG is in the 300's, and by then, glucose-induced insulin resistance has set in, and it's hard to get it back down again. The second part is that I go out to a restaurant or a party, and eat freely, and don't take insulin until I get home, and again, I'm pretty high by that time. And then I feel guilty and ashamed, and then I punish myself by not eating at all the next day. A sort of binge and bust cycle. And BGs are still high even when I'm not eating, because you just don't recover from a real high period all that easily. So while I'm open to and need practical tips, I'm also in need of ways to relieve the incredible guilt and rebellion I feel toward diabetes. Another way to put it would be sadness and anger. I've had diabetes for 20 years now, and I STILL can't accept it and make peace with it. And there you have my complete, unvarnished story.