Type 1.5

A personal account of seizing control

“You need to get to the emergency room immediately. If you can’t drive yourself, call 911.”

Those are the words said to me by my primary care physician on the afternoon of Wednesday, December 6, 2023. He went on to pointedly tell me that the results of the blood tests I had taken that morning alarmed him to the point this action was necessary. Needless to say, I closed up my computer and drove myself to Williamson County Medical Center, where I was quickly whisked through the emergency room and found myself in the ICU. I touched on this in the blog I published on Christmas Day, and you can read (or reread) it here if you’d like: Granting Myself Permission.

In that blog, I shared how my two-day ICU stay impacted me heading into the new year. I also purposely didn’t share the reason all this happened as I decided my health was 100% my business, and I would share it when (if) I wanted. Well, I suppose that today is both if and when.

I have diabetes.

Without getting into specific detail, my blood sugar was off the charts, as you can see by the test results here, and my body was shutting down: my kidney functions were less than 4%, my pancreatic functions were less than 2%, and I was in full DKA or Diabetic Ketoacidosis. When you realize what that would’ve meant had I not gone to the hospital when advised by the doctor, it hits you pretty hard. Even though I knew something was up with my health leading up to last autumn's PromoCruise - mood swings, quick to anger, zero patience with just about anything, no appetite, frequent urination - I never thought it would or could be so serious or life-altering.

As I recovered from the DKA, I had another curveball hurled at me: I have neither Type 1 nor Type 2 diabetes – I have Type 1.5 or LADA (Latent Autoimmune Diabetes in Adults). As one of my friends said after I shared my diagnosis, “Of course, YOU had to have your own special type of diabetes.” I won’t get into details about what LADA/Type 1.5 diabetes is, as you can click on the link a few sentences above for a real explanation. In short, it’s an autoimmune disease form of diabetes that is a bit of a hybrid between Type 1 and Type 2, where, over time, my pancreas will stop producing insulin - some heavy stuff.

I was immediately put on daily oral medication and insulin shots – both long-acting (once a day) and short-acting (before every meal), began pricking my fingers four times a day to check my blood sugar, and tried to come to grips with my new reality which was, candidly, overwhelming. When you add the sheer amount of information available – accurate, inaccurate, and everything in between – the entire situation paralyzed me. The icing on the cake was that I was trying to learn how to deal with both the diagnosis and the treatment during what should be a joyous time – the holiday season.

I was sad, confused, and angry. However, and this may or may not come as a surprise, I was also resolved. I knew the progress of diabetes – even Type 1.5/LADA – could be strongly influenced by things that were very much in my control. In that respect, diabetes is one of the few diseases where the patient can have a say in the progression and the outcome. From the moment I got home from the ICU, I was determined to:

• Learn as much as I could from reliable sources.

• Change my diet based on guidelines provided by my nutritionist.

• Exercise at least five times a week – and actually stick to it.

• Do as much as I could possibly do within my control to give myself the best opportunity to both reclaim my life and ensure it isn’t shortened due to my medical condition.

I created a spreadsheet to track my blood sugar before every meal and listed the food I ate to better understand how it impacted me, my energy, and my blood sugar. Every week, I shared it with my doctor, and we both watched my pre-meal glucose levels creep closer to normal. Slowly but surely, he allowed me to reduce the amount of pre-meal insulin. By the time the PPAI Expo in mid-January, I no longer had to administer pre-meal shots unless my blood sugar was high. While I was still on the daily shot of long-acting insulin, I celebrated this small victory and felt much more comfortable traveling.

At this point, I could’ve been satisfied as, for the most part, I had my life back. I figured out what foods didn’t help my blood sugar, exercised daily, substituted Jack & Coke for Jack & Coke Zero, and felt better than I had in a long time. However, it wasn’t enough. I was determined to get off insulin – period.

When I returned home after the PPAI Expo, I continued my very militant approach to “managing” this disease. Over the next 60 days, I went from 30 units of my long-acting insulin a day to ten. I was getting closer, but there was still a hurdle to clear: after three months, it was time to measure the most important indicator of my pancreatic functions and health as it relates to diabetes: my A1C

The day I was admitted into the ICU, my A1C was a ridiculously unhealthy 15.1, and my blood glucose level was an insane 813 as you saw above. Much like taking a final exam after studying all semester, I was nervous to the point where I didn’t sleep the night before. Numbers don’t lie, and I would soon find out if the work I had done would yield the results I hoped.

To make this long story short(er), I aced the test as you can see here. My A1C was (and still is) far below pre-diabetic and diabetic indicators. My fasting glucose, while a bit high at the time it was taken - likely due to my anxiety - was dramatically improved. As you might imagine, my doctor, my family, and my friends who knew what I was dealing with were thrilled. Even so, I was still on the long-acting, one-shot-a-day insulin, which tempered my excitement just a bit.

Much like when I was taken off the short-acting insulin, I could’ve stopped being so focused and moved on as I was clearly managing the disease. I could have, but I didn’t. I kept going and pushed because my goal of getting off all insulin remained the same. Plus, I wanted to see how far I could go. A few weeks after my appointment, the doctor lowered my nightly shot to six units. Closer, but not zero. So, I continued pushing until, in early May, my doctor asked, “Are you ready to try to go without the insulin to see how your body reacts?”

I’m sure you can guess my answer. And, as of this writing, it’s been a resounding success. In the future – perhaps years or even months – I will have to go back on insulin because my pancreas will stop producing it. However, even if I have to go back on insulin next week, I BLEEPING won.

Why? Because I took control of the things I could and didn’t concern myself with anything else. I had zero control over getting an autoimmune disease, the symptoms that came with it, or when I was diagnosed. But, what I could control was the food I put into my body, dedicating time to prepare healthy meals, and sticking to an exercise plan that worked for me instead of feeling like some sort of obligation. How often do we worry about, stress over, and waste time focusing on things outside of our control – both personally and professionally? If you stop and reflect on that for a bit, I sense that you would arrive at the same conclusion I did: more than anyone should.

Whether it’s business, your personal life, or simply a health goal, Andy Dufresne said it best in The Shawshank Redemption: “You can get busy living or get busy dying.” I, for one, chose the former. Because I have, I feel better than I have in over a decade, have lost (and kept off) 20% of my pre-diagnosis body weight, have more energy and patience, and have more confidence in my overall appearance. Sandy, my wife, doesn’t really like it when I suggest that this diagnosis may be one of the best things that’s happened to me in a long time, but it’s true. It was a wake-up call for me, and the choice was mine: let it ring or answer it.

I’m profoundly glad I picked up that call.