We speak to Careerforce staff who have experience in managing diabetes from two different perspectives. Lorisa Perebooms is a Product Manager at Careerforce, and was diagnosed with Type 1 diabetes. Phil Reilly is a Careerforce Health and Wellbeing Assessor and a former nurse and clinical manager.
Type 1 Diabetes: Is like a tenant you need to learn to live with
At 24, Lorisa was diagnosed with type 1 diabetes. “I was told I was quite lucky I got it late in life. It’s the type that traditionally young children would get and it’s an auto-immune condition.” The body sets up an attack against the cells that make insulin. The result is that the body does not produce any insulin.
According to Diabetes New Zealand, it is estimated that about 10% of people with diabetes have type 1. This type cannot be prevented, only managed through a combination of medication, healthy food choices and exercise. If you have a blood relative with diabetes, you are more likely to develop type 1 diabetes. However, type 1 diabetes often occurs in people who have no one in their family with the condition.
“I refer to it like having a tenant that’s renting my body and I can’t get rid of it so I’ve just got to get along with it,” says Lorisa.
The onset of symptoms started rapidly for Lorisa. She remembers feeling a bit unwell. “I was extremely thirsty. I’ll never forget how thirsty I was. I would have a glass of water or a couple of glasses of water and within minutes I would feel like I hadn’t drunk anything for hours and had run a marathon.”
“I ended up in A & E, not in a coma, I was still conscious but my sugar level readings were 43.2. For someone with type 1 Diabetes, we’re told that we should try and keep our sugar levels between 4 and 8 millimoles per litre. So 43.2 is pretty high.”
“Leading up to the day I was diagnosed, my flat mates at the time noticed mood changes. I would later find out that’s what happens with hyperglycemia which is high sugar levels.”
Lorisa took her time to grieve about her now lifelong situation and while grieving, got herself educated and informed. She shares, “I went to classes and I used some of the support that was around me which was my diabetes nurse and because I’m a type 1, I also regularly see a diabetes specialist and my GP and practice nurse are pretty on to it.”
Like a tenant with a mind of its own, diabetes tries to take charge sometimes. Lorisa says she always needs to get the balance right between the food, the exercise and the insulin. Stress and what’s going on in her life also can impact on the management. One further thing she wanted to share was that having diabetes shouldn’t be a barrier to living life.
“I was a competitive cyclist for a number of years, and in all honesty, having the diabetes wasn’t a disadvantage. There were elements of having Type 1 diabetes that made it an advantage. I learnt and experimented a lot with food. As a result, before races I would always have the same food for breakfast. I would have the same snack a half hour before the race would start so that it was kicking in by the time I’d start. And then I’d know that every hour of racing thereafter I would need to fuel myself with some sort of food.”
People with type 1 diabetes are prone to hypoglycemia. Some people feel tingling in their lips or tongue, excessive sweating or headaches. Lorisa shares that her go-to in managing hypoglycemia are glucose tablets that are always in her drawers and bag, and sometimes jelly beans or jet planes.
She admits she doesn’t get it right all the time, but she seeks professional support when she needs it. “Part of the reason why they’re always talking about the importance of having good management is to reduce your chance of getting complications. And it will give you a better quality of life by having good management.”
Type 2 Diabetes: Seeing the end result and how to prevent them
Years of working in healthcare and aged care gave Phil Reilly insights into the effects and impacts of diabetes in people’s lives. He has seen leg ulcers, and blackened feet that led to amputations and mobility issues, eyesight impairments, and even skin problems.
Type 2 diabetes is the most common form of diabetes. For many people (but not all), it can be prevented following a healthy lifestyle. In type 2 diabetes, either the body doesn’t produce enough insulin, or the cells in the body don’t recognise the insulin that is present. The end result is the same – high levels of glucose in your blood.
“As healthcare practitioners, we often see the end result of a lifetime of poor choices, or perhaps lack of education, and the effects of diabetes on these people. So, we can work back from there and identify what is it we can do to try to prevent this happening in the first place?”
“We know, or should know, that for a healthy lifestyle we should eat more fruit and vegetables. We need to become more active, sit less, walk around, go to the gym, go swimming, walk the dog, jog or whatever exercise we choose to do.”
Phil shares, “My understanding when I was training was that type 2 diabetes happened to people over 40 and usually people who are overweight, who smoked, who ate too much sugar and too much fat in their diet. Now it’s happening earlier, and we’re now finding that teenagers have been diagnosed with type 2 diabetes due to obesity and poor lifestyle choices, and it’s really tragic.”
“There are genetic markers in people, for instance, some Asian ethnicities, Hispanic, Maori, and Polynesian are more predisposed to developing type 2 diabetes. Although, there are lifestyle choices that people can make to try and prevent it or lessen the effects when it does happen.”
He says educating young people about the effects and potential impacts could be a way of helping to prevent them developing diabetes. “I always think that if you look at what you do now in your life usually will impact you in 20 years-time health-wise. So, if you’re living on McDonalds and sugary drinks all the time, eating fatty foods and smoking, and not exercising, it may not impact you now, but it might in time.”
There are signs and symptoms that people should look out for and Phil suggests consulting with your GP if you notice any of them. “Symptoms might be things like fatigue, increased thirst or hunger, frequent infections, numbness in the hands or feet, areas of darkened skin usually under the armpits are sometimes an indication that something’s not quite right. People may also experience frequent urination, blurred vision, slow healing sores, lack of focus and, surprisingly, even unintended weight loss, which is quite interesting.”
“If you think about how insulin works, it’s a hormone that helps move the sugar in our bloodstream through the cell membrane into the cells where it’s needed. Insulin is like a key to a door. If you don’t have the insulin or not enough insulin, it’s not transferring that sugar through the cell membrane into the cell. So, if your cells aren’t using the glucose then it’s just getting secreted and you lose weight.”
Movement and becoming more aware of what we eat are important. Phil says, “It is important to read the labels. Often processed food, and I include bread in this, contains sugar. If you look at any label, even ones with the heart tick, they have levels of sugar or salt, because they need the flavour. Even items such as salad dressings, ketchup, mayonnaise and cereals contain sugar.”
“So, we go back to the healthy options of eating more fruit and vegetables, less processed foods or take-aways, more exercise and stay away from smoking. We will feel better for it.”