dLife Bookshelf

Think Like a Pancreas:
A Practical Guide to Managing Diabetes with Insulin
by Gary Scheiner MS, CDE
(Copyright 2004, Marlow & Company)

Excerpted from Chapter 1 Introduction

What’s the Dang-Diddly Point? (with apologies to Ned Flanders of The Simpsons)

So, you have diabetes and take insulin. What could be simpler? How about predicting the stock market? The weather? The next five World Series winners?

By now you have discovered one common truism about managing diabetes with insulin: It ain’t that simple. But… what’s that? You already have a doctor who is taking care of your diabetes? That’s just swell. In this age of assembly-line health care dictated by third-party managed care organizations, most physicians are limited in the amount of time they can spend with their patients. After taking vitals, reviewing histories and lab results, performing physical exams, ordering new lab work, and writing prescriptions, precious little time is available for your physician to sit down with you to teach you the finer points of living with diabetes and controlling your blood sugar levels. It’s not from a lack of desire; most physicians I know are talented, motivated, caring people who wish they had time and resources to do more for their patients.

Don’t get me wrong. Your physician still plays a very important role in overseeing and directing your diabetes care. He or she should be viewed as an expert advisor who oversees your care rather than as a person who should micromanage every aspect of your disease. And it is your disease.

Diabetes forces us, as patients, to make countless important decisions every day. The time is now to learn how to do a better job of self-managing your diabetes, with your physician’s guidance and input. With new insulins, insulin delivery devices, dosing formulas, dietary plans and monitoring systems, just about anyone can – and should – learn how to manage blood sugar levels effectively.

Gone are the days when your doctor gives you a fixed insulin dose and asks you to adjust your life to match the insulin. You can manage your diabetes with insulin and live a perfectly normal, varied life, doing things you like to do when you like to do them – if you know what you’re doing. The purpose of this book is to do just that: to teach you how to match your insulin to your body’s ever-changing needs. In other words, to Think like pancreas.

My personal story of life with diabetes provides a good example.

My Story

It was two o’clock in the afternoon on a typically hot, muggy summer day in Sugarland, Texas (No, I’m not making this up. The irony is unbelievable.). After spending half the summer sucking down cold drinks and the other half peeing them out, I decided it was time to see the family doctor.

I hardly knew this doctor. My family moved to Sugarland just a year prior (I grew up in central New Jersey), but I had had about all I could take. My energy was almost gone, and there was no way the Houston summer could have caused me to lose all that weight (I had gone from 155 pounds to 117). The last straw came when my belt would not tighten enough to keep my pants from falling down. Then I saw an episode of M*A*S*H in which a chopper pilot with diabetes had the dame symptoms I had, so I figured I’d better get myself checked out.

It was only a 10-minute drive from out house to the doctor’s office, so I was able to make it with just one pit stop to use a gas station restroom. That summer, I learned where all the best public restrooms were along the I-95 corridor in southwest Houston. When I got to the doctor’s office, I put on my glasses (miraculously, I was able to see road signs without my glasses for the first time in 10 years), wiped off the steam created by the 10,000% humidity, and prepared myself for the worst.

After a quick physical exam, blood test, and urinalysis, the doctor came back in and said nonchalantly, “Gary, I’ve got good news and I’ve got bad news. The bad news is that you have diabetes, and you are going to have it for the rest of your life.”

I have no idea what the good news was, because I stoped listening at that point. The first syllable from “diabetes” stuck in my head like a knife. What the heck does diabetes mean? About all I knew was that it could make people really sick, and that it wasn’t going to go away. Ever.

I remember him telling me that my blood sugar level was 613, and that that was 6 times the normal level. I also remember him saying that I would have to take shots and be very careful of what I ate. The thought of giving myself shots was one thing. But limit what I eat? Was he crazy? I was an active 18-year-old with the metabolism of a small country. The very thought of not being able to eat whatever I wanted whenever I wanted made me hungrier than ever.

So, off I went to an endocrinologist at a fancy high-rise in downtown Houston. Keep in mind that the year was 1985 and there were no HMOs yet, so getting in to see a specialist was relatively simple.
“You are lucky to be diagnosed now,” explained the endocrinologist. “We have come a long way in the treatment of diabetes. I bet that in 5 or 10 years, your diabetes will be cured.”
That was 18 years ago.

The endocrinologist had me meet with a nurse, who taught me the “basics” about diabetes. I discovered what insulin is and why it is important. I learned about the importance of controlling blood sugar levels, and why the high blood sugars I had been experiencing all summer had turned me into a human sieve. She taught me how food and exercise affect blood sugars.

Finally, I was instructed on how to inject insulin. Forget the oranges, pillows and teddy bears. I gave myself my very first injection, right in my stomach. It hurt – probably because I had almost no fat left on my body, and the syringe needles were much thicker and longer than they are today. But mostly it hurt because I was tense and overwhelmed at the thought of sticking needles in myself for the rest of my life.