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    Taming the diabetes dragon
Self-discipline key to managing low blood-sugar levels
      

By John Perry

Dan Gormley knew it was wrong. But he was in a hurry, and he thought he could get away with it.

“It’s a fine line to walk,” Gormley would say later.

At 6:10 a.m., Gormley was running late. To save time, he skipped breakfast. He remembers dragging the garbage out, but at the curb he became confused and couldn’t remember where he was going. He focused his thoughts, reminding himself it was Friday, and he needed to drive to work.

Shuffling toward his car, Gormley lost sensitivity in his feet and couldn’t feel the ground. Light-headedness became dizziness. His vision began swirling. He felt faint.

Acting on instinct, he got behind the wheel of his car and pushed the automatic door locks. Then came a sensation like slowly falling down a deep well. He gripped the steering column to stop his descent. The well was bottomless. Darkness closed in.

On Sunday, when the darkness receded, Gormley, an accountant with Aviation, was lying in a Southwest Memorial Hospital bed.

He learned that EMS had broken the car window to rescue him.
“This is what can happen if you don’t respect your blood-sugar level,” Gormley said.

An experience worth missing
Just as he had done every morning for the last 32 years, Gormley, who has type 1 diabetes, tested his blood-sugar level. It had fallen into the low deciliters of blood. Pre-breakfast blood-glucose monitoring should yield a reading between 75 and 100 mg/dl.

He should have eaten something right away.

Gormley never skipped his three-times-a-day insulin injections, but he wasn’t always so diligent about his diet.

“Problem is,” Gormley said, “once your blood-sugar falls too low, your decision-making process gets impaired. You make mental errors in judgment and might not realize what’s happening.”

Now, Gormley tests his glucose levels before meals and then again two hours afterwards to make sure the level is staying in the normal 100 to 140 mg/dl range.

If it slips too low, that’s the signal to have a snack.

“I keep a box of raisins handy,” Gormley said. “And I drink bottled water throughout the day. It’s important to stay hydrated.”

Type 1 diabetes, formerly known as juvenile diabetes, accounts for five to 10 percent of all diagnosed cases. It occurs when the pancreas no longer produces insulin. Sometimes, for reasons scientists don’t entirely understand, the body’s own immune system attacks and destroys the insulin-producing cells. Once dead, the cells never come back.

“My pancreas quit producing insulin when I was 28,” Gormley said. “I’ve had to take injections to compensate.”

With a regimen of insulin and careful eating, Gormley is successfully managing his diabetes.

“I live my life to the fullest,” Gormley said. “I never say ‘Oh, woe is me.’ I make following the rules of good health a way of life that includes monitoring, dieting and visiting my doctor every three months.

“Otherwise,” Gormley concludes, “I could find myself pushing up tulips.”

Plan costs for prescriptions and diabetic supplies
 
HMO
PPO
in-network
PPO
out-of-network
Out-of-area

Prescriptions/
supplies
30-day supply

$10/ 30/ 45
$10/ 30/ 45
$10/ 30/ 45
$10/ 30/ 45
Prescriptions/
supplies
mail order
90-day supply
$10/ 30/ 45
$10/ 30/ 45
$10/ 30/ 45
$10/ 30/ 45
Equipment
20 %
$30 copayment + 20 %
40% after deductible
20% after annual deductible

 

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Aviation employee Dan Gormley successfully manages his diabetes with diligent glucose monitoring, insulin injections and a healthy diet. Photo by John Perry

Assess your risk

You may be at a higher risk for diabetes if you have any of the following risk characteristics:

• Family history of diabetes
• Low activity level
• Poor diet
• Over 45
• Excessive body weight
• High blood pressure
• Impaired glucose tolerance


A diabetic’s diary

In a typical day, John Calhoun must be diligent with monitoring food intake and blood sugar, or risk a life-threatening attack.
• Wake up to morning blood-sugar monitoring
• Self-inject doctor-prescribed insulin
• Breakfast: usually a bowl of cereal with fruit
• Go to work
• Before lunch, monitor blood sugar
• Lunch: usually protein with a piece of fruit
• Finish work day
• Before dinner, monitor blood sugar
• Inject insulin
• Dinner: a sensible portion of almost any entrée with two vegetables
• Bedtime blood-sugar monitoring
• Inject insulin
• Snack: usually cheese & crackers or peanut butter & crackers
• Go to bed