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Type 1 diabetes not just a kids disease
For six months, Alexandra Swann didn't know what was wrong.
She visited her doctor three times, and three times she was sent for tests, looking for everything from vitamin deficiencies, to thyroid and hormonal issues.
It all started with an increasingly unquenchable thirst, one that would wake her up in the middle of the night so she could drink water. That was matched by a frequent need to urinate and a pain in her leg at night.
And she was losing weight, about 30 pounds in the month before her diagnosis. She'd been exercising and dieting and got a lot of positive feedback for her new slimmer self.
She started experiencing cognitive issues, speaking slowly and not as fluently as she normally would. And she had an infection that just wouldn't go away.
Then it happened. She landed in hospital where tests showed her blood sugar levels, which are normally in the four to 10 mg per litre range, had hit 29 mg.
Within hours she finally had a diagnosis: Swann was a Type 1 diabetic at age 26.
Now 29, the Burnaby resident says she believes the diagnosis took so long partly because of the misperception that Type 1 diabetes is a children's disease. Her doctor never tested for it and if it came up in her own Internet research, she never clicked on it.
"I was in denial. I didn't want to think something was happening to me."
Swann shared her story to raise awareness of the disease during Diabetes Awareness Month.
Previous notions of Type 1 diabetes being a childhood disease and Type 2 happening mainly in adults are no longer accurate, said Dr. Janet Hux, the Toronto-based chief scientific advisor for the Canadian Diabetes Association.
Half of people diagnosed with Type 1 are over age 15, with some occasionally being diagnosed in their 40s while the obesity epidemic is leading to more cases of Type 2 in children, Hux said.
Type 1 diabetes is an autoimmune disease in which the body's immune system attacks the cells in the pancreas that produce insulin, which regulates the process in which the body turns what we eat into energy. When those cells are all destroyed, the body can't make its own insulin and patients are dependent on injections for the rest of their lives.
While some people are born with an increased risk, it's believed that a virus triggers the immune response, sending it into overdrive and eventually attacking the pancreas, Hux said.
"People at any age should be aware of what the symptoms are, which would include thirst and increased urination, and that's because the sugar is trapped in the bloodstream, your body is trying to fix that by peeing it out. And because you're making so much urine, you're thirsty."
Because the sugar can't exit the bloodstream, it can't be converted into energy, resulting in fatigue and weight loss.
The symptoms of Type 2 diabetes are similar but the disease progresses more slowly, with people often having it for five to 10 years before they're diagnosed.
"If you think of insulin as being the key that lets the sugar into the cell, in Type 1 diabetes you've lost the key," said Hux. "In Type 2 diabetes somebody has changed the lock. You've still got insulin, in fact they may have above average insulin levels, but it no longer works."
Medication helps those with Type 2 diabetes to use the insulin they have.
"When you think of nine million Canadians living with diabetes or pre-diabetes, those numbers are pretty staggering," she said. "All of us need to be thinking about a healthier lifestyle to reduce our risk of ever getting it. Maintaining a healthy weight and being active are important steps for everybody."
As for Swann, three years after her diagnosis she has learned to manage the disease, exercising regularly and eating well, matching her carbohydrate intake to the amount of insulin she receives.
There's nothing she did before that she can't do now, with the possible exception of international travel where she has to think about the availability of insulin and refrigeration. The software analyst had an opportunity to go to Oman for work, but it would have been in July in the desert nation. She wasn't able to confirm that as a foreigner and a woman in the Arab country that she would be able to easily purchase insulin when she needed it.
Otherwise, "it's changed my life for sure but I don't think it's limited me hugely."