One of the consistent methods of understanding how your BSL control is going over a long term period is a HbA1c test and what this does is look at the average glucose level over a 30 day period. This test helps understand the risk of complications which include blindness, nerve damage, circulation issues, kidney disease, heart disease, impotence, etc etc etc. as you can see if I choose to go down the road of ignorance and denial then the repercussions could be life changing again. To tell you the truth life has been challenging enough without adding in the possibility of more and that doesn't even mean that a complication isn't around the corner as control is only a measure of sanity in this war and at any stage the enemy can lob an unseen attack at any part of me.
Anyway back to HbA1c throughout my teenage hood my ranges would range anywhere from 7 to 13. Now this doesn't seem like a big number but when you look at a non diabetic their HbA1c would be between 4 -6 and your body automatically releases insulin or glucose depending on what is needed to stay in that range. Any figure higher than this makes the sugar crystals that attach themselves to the blood cells start to create damage to your organs and seeing as these tests are an average over an extended period someone could be doing damage on a constant basis. My routine through my teenage years and early into my adult life I was having 5 standard injections a day also referred to as multiple daily injections (MDI). 3 quick acting insulin injections before meals and a long acting insulin injection before bed and when I got up in the morning. The difficulty with this routine, above and beyond the eating for the insulin, was in fact the long acting insulin injections. I can only speak for myself as everyone will have their own mix that will work for them but the long acting insulin, which was supposed to keep me level between meals was the cause of a number of the severe hypo's. For some strange reason my body, in the middle of the night, would go higher which would mean the night time injection would need to be higher but in saying that after the increase then in the second half of the night and in the early hours of the morning my body would do the complete flip and drop low which meant the store of emergency glucose that is stored for emergency in the kidneys needs to be released. Unfortunately due to the nature of T1D the natural senses that monitor if and when the these stores are used is hit and miss and when it is released then the amount usually is just not enough. So while sleeping I would go on a roller coaster ride all while I was asleep and to put how serious it is to know what is happening, other than complications caused by T1D, the thing that can cause death is falling low while sleeping and not knowing. Like anything in life the more you do something the more you take it for granted or have less feeling for the situation. The same is said for hypo's. If someone has constant lows then the body gets used to it and starts to think that this is normal and you start developing hypo unawareness, which can be dangerous.
Everything about this routine, even though it was a long term routine and it was the norm, it was still frustrating and a lot of the time I would have times in the day where I just felt crap. Whether it was from being high or low it had an effect. But then all of a sudden (well after some investigation and research) everything changed. The insulin infusion pump was introduced to me and became my best friend. This took away the long acting insulin injections and in fact the MDI and move to having 1 injection every 3 days. After nearly 30,000 injection the time for change was now. I was tired and my body was tired of being a pin cushion. This would also be the answer to a lot of my problems that I was having overnight as well as being able to have a near normal HbA1c for an extended period of time. There are complexities and I could go onto more about the pump but that is going to be a post all to itself.
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