Help me understand diabetes....please!

If I have learned nothing else from having a loved one with diabetes, it is that it is incredibly isolating. I think juevenation is such a great way to try to minimize this, and I can imagine it is a very encouraging thing to have a group of people who truly understand what you're going through.

At the same time, as someone who is trying to understand diabetes, I think it's sometimes difficult to "dumb" it down for people have not had to deal with it day in and day out. (Especially if your loved one is studying science and you are a history major :P )

If we want more people to be aware of T1, I think it's important that those without diabetes understand it as well as those with it. I've done a bit of reading on diabetes but it's still a bit complicated; I don't fully understand what a "basal rate" is, and I don't really understand the mechanism behind "testing your basal rate". So if someone has the time, PLEASE help me out :)

Thank you!!

It doesn't matter if you are diabetic or not, human beings need a basal rate of insulin in their body at all times in order to survive.  The basal rate is basically a lubricant that helps your gears move, with out it the gears become stuck.  I'll give you a scenario: If I were to only give insulin when I ate, as opposed to taking a long acting insulin like lantus or in my case being on the pump which slowly gives short acting insulin all the time, my body would use the insulin I took with meals to try and stabilize itself, because of the lack of a basal insulin my body would try to take the small dose of insulin for the food and spread it throughout my body, kind of like spreading butter on toast.  But because I already take a basal, lantus or the pump, my body already has enough insulin to spread around so that this insulin I would take for a meal would cover the meal and not have to be spread around to cover the entire body.

When the doctor asks you to test your basal rate, he or she wants you to stop eating for a certain amount of time to see if your basal rate is enough or too much by checking your blood sugar and seeing the results that will come from it.  The reason you wouldn't eat is to minimize options for what your either high or low numbers could be coming from (basal, short acting, food selection, etc.).

I hope this helps, any other questions you know where to post em : )

Hi Reet,

There's no such thing as a dumb question except the question that doesn't get asked. I think that it's good you reached out for insight. Greg did a good job of answering your basal question with an accurate analogy, but I just wanted to second his statement that if you have any questions, you know where to go and there are tons of knowledgeable people here to give their thoughts and facilitate your understanding :)

Greg did a great job of explaining it.  A "basal" is the relatively tiny amount of insulin that is always in your system... for a non-diabetic, your pancreas does this naturally.  Since ours doesn't do this, we have to take this little bit all the time (delivered by a pump), or a shot of long-lasting insulin (Lantus, etc.). 

The idea behind doing a basal test is to eliminate as many outside factors as possible (food, insulin amounts taken for food) to determine if the little amount you're getting all the time (basal) is at the correct dose. 

Feel free to ask any more questions you might have!  And kudos to you for taking such an active role in wanting to understand it.  I wish there were more people like you in the world.

First diabetes is very complicated and there are many, even diabetics, out there that don't have a full understanding.  I think it is great that you are educating yourself to the point that your asking what is a basal rate.

A basal rate is the baseline amount insulin needed to maintain your blood sugar.  So an insulin pump pumps small amounts of insulin continuously throughout the day.  This is the basal rate.  Then when you eat you give yourself a bolus to cover the food.  So the basal rate is very important to establish.  If a basal rate is too high then your blood sugar will run to low and vice versa.  So to establish the correct basal rate you have to try to take all other factors out of the equation that can influence blood sugar.  So say you don't eat , exercise, etc from 10pm to 10 am - you can follow what your blood sugar is doing and adjust accordingly.  (I feel establishing basal rates during that time of day is easy compared to the afternoon hours.  It difficult to not have the influence of  food, a bolus, or exersice, stress, etc. as the day goes on. )

Once a basal rate is established then you can adjust for the other influencing factors easier.  I also want to point out that basal rates can be different throughout the day.  Everyone is different but I have 6 different rates.  So let's say your basal rates are perfect - now when you eat you figure out your carbs, etc then give yourself a bolus to cover the food.  If your blood sugar goes low then you know it's the bolus not the basal. 

So many things can influence blood sugar.  Food and exercise is the most obvious but stress, hormones, etc... etc... can also influence it.  These "other" influences are difficult to measure perhaps impossible. 

I hope this helps a little.

Hello. I think it is wonderful that you want to learn about Type 1 !! Juvenation is a great place to ask questions and get honest answers. Good luck in your search ; )

Here is a link to another thread from a female in your situation http://juvenation.org/groups/introductions/forum/t/1004.aspx  I hope it helps.

Once the basal rate(s) have been determined, that's not quite the end of it, because over a relatively long period of time (months, years) the basal needs may drift. That's why it's necessary to check the basal rate(s) from time to time, particularly when there is some reason to suspect that the basal rate(s) aren't quite right.

Hey Reet - I think it's awesome that you want to learn more for your boyfriend's sake. I know for my wife it is frustrating to her that she does not understand every little part of my diabetes. I once taught a class on diabetes, and found out that a very simple visual helped people who did not know what diabetes is, so maybe it will help someone in your situation: On a piece of paper draw a circle, to the right of that circle draw a square, and on the edge of the circle draw a triangle. The circle is a cell in the body, the square is sugar (glucose), and the triangle is insulin. Sugar is the fuel for the cell, and the only way for the sugar to get into the cell is through the insulin. Therefore, when we don't produce insulin the sugar in our bloodstream (blood sugar) cannot be absorbed into our cells, and this leads to high blood sugar; and conversely when we take too much insulin it is absorbed out of the blood too quickly leading to a low blood sugar.

The body's organs are constantly throughout the day secreting glucose, and the insulin needed to cover this is the basal rate. When we eat, we flood the body with the sugar ingested (as carbohydrates) and we need to bolus to cover this. Testing the basal rate is as simple as not eating for a defined period of time (usually 6-8 hrs), and constantly testing the blood sugar, which will tell you for this period of time what basal insulin is needed to cover the body's normal glucose secretions. This basal testing is generally done on three or four consecutive days, with a different 6-8 hr period covered on each day.

As for what you can do to help: just be supportive. Asking questions is always good, as it shows your bf that you care and want to understand. You need to realize that our moods will change as our blood sugar either spikes or drops (but don't let him get away with using this to his advantage ;) and be understanding that it sucks sometimes. Oh, and don't tell him he can't eat sugar! haha

Good luck, I hope this helps!!

Thanks for all the advice and info!! That clears a lot of things up! Being understanding about mood changes has been pretty easy for me (I grew up with 6 girls in the house, all very emotional people) but I do find it difficult sometimes because he is so preoccupied with it, understandably, but it often feels isolating. I'm wondering if any of you have experienced the same thing with your significant others? And any advice you might have for being more understanding about it? Thank you!

Oh Also!

How often do you test your basal rate? And is there a benefit to having lower or higher basal rate? 

 

Thanks for all the advice and info!! That clears a lot of things up! Being understanding about mood changes has been pretty easy for me (I grew up with 6 girls in the house, all very emotional people) but I do find it difficult sometimes because he is so preoccupied with it, understandably, but it often feels isolating. I'm wondering if any of you have experienced the same thing with your significant others? And any advice you might have for being more understanding about it? Thank you!

Oh Also!

How often do you test your basal rate? And is there a benefit to having lower or higher basal rate? 

 

Read Think Like a Pancreas: A Practical Guide to Managing Diabetes with Insulin. It is an easy read and is a practical down to earth book about diabetes written by a well qualified T1D.

Thanks for the recommendation, will let you guys know if I have anymore questions. If you think of any advice for me, I'd love to hear it!

 

Thank you!!!

Patience is always need, it is hard but always needed from the partner and from the T1D.  Keep asking questions and learning...after 40 as a T1D is never stops and know one knows it all.

Thank you...I'm reading "Thinking Like a Pancreas" and it's very insightful. Thank you for the recommendation!

This is great to hear. Thanks for dropping the note. I guess you read that you live in the first place where the Best first purified insulin and treated a dog then a kid for the first time, there in Toronto. I'll always remember visiting the plant many years ago and seeing the pile of pig pancreases getting ready for processing to make insulin. How far we have come.