The Highest Highs and the Lowest Lows

Where to start?! I guess with some background about me. I’m Melissa, a 30-year-old type 1 diabetic, living in Nottingham. I got married to my husband Brendan in 2021, I love running, gymming, and swimming, and I LOVE eating.

I wanted to start this blog to help other diabetics – from those just diagnosed, to those who have been struggling with it for years, like me. I also hope this gives a bit of understanding to people who aren’t diabetic about the things that diabetics struggle with, that non-diabetics might take for granted. And I promise it’s not all ‘woe is me’! I’m hoping to tell you about plenty of highs, along with some of the lows… please excuse the pun. I was diagnosed in October 1998, a few months after I turned 6. I remember the doctor telling my parents, and not really understanding. The next thing I really remember is hiding from the doctor trying to do my first injection. How terrifying was the first injection?! “just let me stick this needle in your leg… oh and by the way, you’ll have to do this every day, for the rest of your life.” No thank you, I’ll hide in the toilets and hope you forget about me. For as long as I can remember, I’ve had a bit of a disordered (to put it mildly) relationship with my diabetes. When I was around 14, I intentionally and healthily lost a good bit of weight. I went to my next diabetic clinic, and the dietitian asked me if I had skipped injections in order to lose the weight, as my HBA1C had increased. I hadn’t, but that was it; an easier way to lose weight?! I was in. Over the next few years, I was in hospital twice with DKA, and I’d say I was on the verge a few more times. I fluctuated between something like 52kg to around 68kg, and my diabetes control, as loose as it already was as a teenager, went out the window completely. The next 4 or 5 years were a bit of a whirlwind of drinking, eating, partying, and just general unhealthiness. I did my injections, but paid little attention to my actual control. I just had a terrible lifestyle, and even worse control of my diabetes. I’m sure a lot of diabetics can relate to this in their late teens. Fast forward to 2013. I’d just been asked to be a bridesmaid at my uncle’s wedding in New York, and I knew I could not go to that wedding, wearing that dress, feeling like I did. I had just met Brendan, and we had started to go to the gym together. I knew part of getting healthy was gaining some sort of control of my diabetes, so that’s what I set out to do! I quickly lost around 3 stone, fell in love with running, and started to get some sort of control over my sugars. But I guess that’s where another set of problems began – despite what I think is probably popular belief, I do not feel like type 1 diabetes and exercise go hand in hand! I have spent the last 10 years trying (and failing, most of the time) to juggle diabetes control, exercise, and my weight. Honestly, it has been so draining. I have managed to run 3 marathons, 8 half marathons, countless 5 and 10ks, and have hit my goals in all of them. I got married wearing my dream dress and felt like a princess. I got my HBA1C down to 6.5 and felt like I’d won the lottery. BUT – and it’s a big but – none of these happened at the same time. I just could not pull them all together. It was one or the other; goal weight, or goal HBA1C. Run a marathon, or have tight BG control. At the end of 2022, I felt a bit helpless. It all came crashing down. I couldn’t juggle everything anymore, and I had a week off work because I just felt so drained with it all – I am so sure that any type 1s reading this (if anyone at all is reading this!) will be able to relate. I felt like I needed to open up to my specialist team at the clinic – I needed them to give me a solution, instead of just ideas. And they finally put me forward for the Omnipod. So, after almost 25 years of (at least!) thrice daily injections, Tuesday 21 February 2023 was the day I finally had an insulin pump fitted. I’ll be honest, I put this off for years. When it was first offered to me as a teenager, it sounded like so much work that I just was not prepared to do. I remember my diabetic consultant telling me that I would need to do something like 10 blood sugar readings a day, which, as a teenager with MUCH more important things (like boys and Lambrini) to think about, I just did not have time for. It was suggested a few more times after that, but I’ll be honest, the look and the hassle of it put me off. Why would I want basically a pager hanging off my stomach by a wire, ruining my carefully put together outfits? I’ll pass, thank you. But now I’m 30, more sensible (I hope!), married, and ready to get serious. It just seemed like the right time, and I knew something had to give. So when my diabetic nurse suggested she take me to the panel for pump funding, I said yes. That was back in October, and now the day has arrived. I’ve been looking forward to this since I got the letter through. I’ve definitely felt some feelings of anxiety around it – it’s such a huge change – but excitement has been the overriding emotion. I got to the hospital at 9.30am (on the dot, after sprinting up flights of stairs and down corridors to make it on time, I HATE being late), and arrived at the diabetic unit to 4 other people waiting for me. I had no idea it was a group appointment. My bad. We were taken round to the Diabetic Education Room. I remember doing DAPHNE in there years ago – I was 18, and couldn’t really think of anywhere I wanted to be less than I wanted to be in that room that week – but today I just felt excited. We sat down in front of an Omnipod booklet, and a box of pumps. I could see the little handsets plugged in to charge behind each of us. Eek. All I could think was, “can we skip all of this and just get them on?!”. Despite being diabetic for 24 years, the thought of a new injection or device still makes me a little bit nervous, and I just wanted to get the scary part over with. But we had a lot of things to go through before we could actually fit the pump. Ugh. I won’t bore you with the details, but essentially, we went through the functions of the pump, the information we need to input, how it prevents (or helps you to prevent) highs and lows; all of the things you’d expect. The nurse was so helpful and actually, so were the other people. Listening to their questions, experiences and requirements from the pump helped me so much – there were a lot of things I would never have thought to ask, but actually will help me massively going forward.

If you haven’t already gathered, my main requirement for the pump is to stop (or reduce, but you know, in an ideal world…) highs and lows around exercise. We spoke about this, and it seemed so simple! Reducing your basal rate for an hour before, the duration of, and an hour or so after your workout… so far, it just seems so simple! I guess if anyone is reading this, thinking about a pump, a big question is how does it actually feel to fit it. I remember getting the Libre for the first time – I saw that needle (you know the one!) and I was TERRIFIED. How was I meant to actually inflict that on myself?! But we all know now it’s basically painless. I tried to keep that in mind when it was time to put the pump on. Essentially, you take it out of the pack, fill it with your insulin, remove the backing on the sticky plaster, and apply it to wherever you want it. I chose my lower back on my left side. The cannula doesn’t go in yet – this is literally just sticking it on. You then use your little mobile like device to say you’ve applied a new pump, and click ‘confirm’. Once you do this, it starts ticking. Ticking. Like a tiny, terrifying bomb. It clicks down from 5 (why not 3?! Why prolong the nerves?! Omnipod – this needs looking at. It’s cruel.) and then, ‘CLICK!’. The cannula is inserted. No more needles for 3 days! I think the best way to describe the feeling is like a tiny electric shock, but some of the others in the group described it as being softly pinged by an elastic band, which I don’t think is far off the mark, either! It certainly isn’t painful, but it’s definitely noticeable! But honestly? If you’re diabetic, you’ve been through a lot bloody worse. So that was that. It was on, we were ‘educated’ (like you’re educated when you leave year 11 and think you know it all. You absolutely do not), and we were allowed into the big wide world to live our lives with our new digital pancreas. It’s such a surreal feeling, and I can’t quite describe it. It’s like relief and terror. Like a big exhale after you’ve been holding your breath for minutes, but the anxiety of knowing you might be dunked under water again at any second. Injections had been my way of life since I could remember, and it was over like that. I was suddenly relying on this little piece of plastic to keep me alive. In saying that, I felt like I understood it, and I felt confident with it. My first 24 hours went so smoothly. I turned my basal rate down when I felt like I was going

low, inputted my carbs correctly so I got the right doses of insulin when I ate, had to have the odd jelly baby here and there, and somehow, managed to stay in target 96% (NINETY-SIX PERCENT!? Who actually am I?!) of the time in the first 24 hours. Honestly, I felt on top of the world.

But I did spend basically the entire day in the house, sitting on my butt, getting used to it. That is not my normal life. I guess the real trial comes in the next few days, weeks, months. The nurse did say that the first 2-3 months will be quite up and down, and I fully expect her to be right. My initial feelings about the Omnipod are that it is, quite simply, a dream come true. It feels like a life changer, like I’ve been falling for years, and someone has finally stuck out a big net. I expect the bubble to burst; this is just the first step on this journey, and I know it’s going to be a journey full of highs and lows (literally); but it is a sense of relief that I have never, ever felt in all these years being diabetic.

It finally feels like maybe, just maybe, I might be able to balance the scales I’ve been trying desperately to balance for all these years.