As Crohn’s suffers; patients; the lucky few (or is it really that few); or however we choose to label ourselves, life has certainly drawn us a short straw. Although, I have to admit, the rapid weight loss can be a great way to get back into that fun outfit buried deep in your wardrobe, however even that is short lived after a few weeks of Prednisone munchies. The truth of the matter is that as Crohnies we cherish good quality toilet paper and always know where the closest washroom is. We have Crohn’s for life – isn’t that enough for one person to have to deal with? The trouble is, unfortunately not!
Diagnosed with Type 2 Diabetes
If you do a quick Google search on “Crohn’s and type-2 diabetes” about 1,150,000 results are found. Comparatively, a search for Chicken Gumbo soup stirs up about 257,000. With numbers like these, maybe an association between Type 2 or T2 Diabetes and Crohn’s Disease is not that uncommon after all. For many of you who have read my history please bare with me – I promise I will be brief. I was first diagnosed with Crohn’s disease in 2005 (age 33). I would not say that my disease ever went into remission but for awhile I did live drug free – although I am positive my gastroenterologist would have scolded me. Late last fall I started to experience persistent chest pains. Like most guys, stubborn as we are , I kept putting it off. I suppose I am still gun-shy from years of Doctors telling me that my digestive issues were “all in my head”, and to try to get another bizarre diagnosis or feel like I am wasting a doctors time is not my favourite past time. By late November, the pains had increased to a point that on my way home one evening I made a detour to the local emergency department. 12 hours later I was sent home with a “clean bill of health” (albeit with the pains persisting). A few hours later the emergency department called, noting that further review of my blood work showed that my blood sugar levels were elevated (11.9 mmol/L or 215 mg/dl for my U.S. friends) and to follow with my family doctor. The question that went through my head at the time was simply this, “Was being in the emergency department, enough to get everyone’s heard pumping, and adrenaline flowing. No wonder my sugars where high!” Denial, right?
Like a good patient, over the next few weeks I met with my family doctor going over the various test results – it was confirmed, “Delayed Fasting Glucose” or “Prediabetes”.
What is prediabetes?
Well the Public Health Agency of Canada describes prediabetes as:
Pre-diabetes means that your blood glucose levels are higher than normal, but lower than if you have type 2 diabetes. Pre-diabetes is also called impaired glucose tolerance or impaired fasting glucose.
If you have been diagnosed with pre-diabetes, then you have an increased risk for developing Type 2 diabetes.
Over the coming months my fasting glucose levels (collected after an 8 to 10 hour fast) were bouncing all around the board – 6.8, 9.1 – needless to say, enough was enough. It looked like, pre-diabetics education and a few lifestyle changes were in order. Education / knowledge is power after all, right?
I have to commend the South Lake Regional Health Centre on an excellent diabetes education, support program and staffing. Although I admit, the cohort in the pre-diabetes class was a little skewed towards the retired and me at 38 just didn’t fit in. Regardless, the day long course I attended in late January provided an overview of “Diabetes” and more importantly how to not to be one of the 4 out of 10 people in the class whose disease would progress to Type 2 Diabetes.
Exercise, diet, portion size, managed carbohydrate intake was to become my new norm, and fibre became my next best friend. Ok – lets put on the breaks a little – did he just say fibre? Sounds easy enough! However, when we had a little training session in the class on how to your a glucomoter, I know I was in trouble – at the end of the training the nurse did a little roll-call on what our blood-sugar levels were – 4.5, 5, 6.5 – I don’t recall anyone being above 7.0 – that was until they came to me – 9.9 (anything under 10.0 two hours after a meal is considered normal). Only thing the diabetes education nurse emphasized in the class was that if through good diet, and exercised, It could take years for someone to progress from prediabetes to diabetes – in my case, the years were more like months as you can see in the chart.
As of March 18th, 2010, I was officially diagnosed with Type-2 Diabetes. Chronic illness number two! WOOT! UGG!
What is Type-2 Diabetes
Diabetes Canada defines Type 2 diabetes as a disease in which your pancreas does not produce enough insulin, or your body does not properly use the insulin it makes. As a result, glucose (sugar) builds up in your blood instead of being used for energy. Your body gets glucose from foods like bread, potatoes, rice, pasta, milk and fruit. To use this glucose, your body needs insulin. Insulin is a hormone that helps your body to control the level of glucose in your blood. High blood glucose levels can cause complications such as blindness, heart disease, kidney problems, nerve damage and erectile dysfunction (did that one get your attention?).
For myself, I like to look at diabetes like an engine. A normal working pancreas is running on all cylinders – much like an engine on gasoline, it burns sugar as fuel. A Type-1 diabetic – well their pancreas is dead and does not burn any sugar, insulin is used as a substitute to manage glucose control. With Type-2 diabetes, look it as our pancreas is getting lazy. In my case, my pancreas is working at about 30% – or back to my engine analogy running on three of eight cylinders. The engine sounds like crap, however, it will still get us from point A to point B – just don’t count on it do it well or pretty. Overall, I blame my Crohn’s – yes, Type-2 diabetes does run in my family. My mom was diagnosed in her late fifties, her uncle around the same age – however for me, at 38, I was a bit ahead of the curve. At the same time, I have had the fun experience of having pancreatitis (inflection in the pancreas) on two occasions that probably beat the pulp out of my pancreas. I suppose it could be worse – I could have easily ended up as a Type-1 diabetic.
OCTOBER 2018: The last few months have been interesting and my diabetes has been kicking my butt. Lethargic, my A1C shooting up, rarely a blood sugar reading below 16 (300 mg/dl), and my C-peptide tanking. For the time being (I am being optimistic) a full fast acting regiment of insulin before every meal along with the remainder of my diabetes pills and injections. I will be sure to check in again soon with an update.
Life as a Diabetic with Crohn’s
It is always fun going back and reading some of my older blog posts. Its 2017, seven years after I originally wrote this post. It is incredible how quickly time flies. Today I am a diabetic and a Crohnie and the best part, most people would not know about either. I exercise (run and the gym), I still enjoy ice-cream and milkshakes, and still have terrible morning glucose readings however, my A1C or HBA1c is typically below 7.
The A1C test is a common blood test used to diagnose type 1 and type 2 diabetes and then to gauge how well you’re managing your diabetes. The A1C test goes by many other names, including glycated hemoglobin, glycosylated hemoglobin, hemoglobin A1C and HbA1c.
The A1C test result reflects your average blood sugar level for the past two to three months. Specifically, the A1C test measures what percentage of your hemoglobin — a protein in red blood cells that carries oxygen — is coated with sugar (glycated). The higher your A1C level, the poorer your blood sugar control and the higher your risk of diabetes complications. Typically an A1C of less then 7 is considered good glucose management.
Food and being a Crohn’s patient has always been a challenge – high finer, low glucose is always best for diabetics. However, high fiber may not necessarily work for Crohn’s patients all of the time. This is particularly important when we are fighting a flareup. Although I spend most of my life balancing my Crohn’s on pillars of Methotrexate and Humeria, when I have had to fall back to Prednisone my glucose levels have skyrocketed and life dependant on insulin and resembling a Type-1 diabetic has been my norm. However following these basic rules sets a great habits no matter how our other chronic disease is behaving and, knock on wood, life for me seems pretty “normal” – I know it is a relative word.
|Eat three meals per day at regular times and space meals no more than six hours apart. You may benefit from a healthy snack.||Eating at regular times helps your body control blood glucose (sugar) levels.|
|Limit sugars and sweets such as sugar, regular pop, desserts, candies, jam and honey.||The more sugar you eat, the higher your blood glucose will be. Artificial sweeteners can be useful.|
|Limit the amount of high-fat food you eat such as fried foods, chips and pastries.||High-fat foods may cause you to gain weight. A healthy weight helps with blood glucose (sugar) control and is healthier for your heart.|
|Eat more high-fibre foods such as whole grain breads and cereals, lentils, dried beans and peas, brown rice, vegetables and fruits.||Foods high in fibre may help you feel full and may lower blood glucose (sugar) and cholesterol levels.|
|If you are thirsty, drink water.||Drinking regular pop and fruit juice will raise your blood glucose (sugar).|
|Add physical activity to your life. – No excuses here, I live off of Methotrexate and Humeria. I have bad days / weeks like everyone else however, exercise does wonders.||Regular physical activity will improve your blood glucose (sugar) control.|
Eat Right Ontario
For those like myself that live in Ontario, Canada – EatRight Ontario (ERO) is a free service that connects residents of Ontario to the trusted advice of a Registered Dietitian to help you make healthier food choices and answer your nutrition questions.
Whether you are a parent, consumer, health professional or community leader, here are the three easy ways to reach a Registered Dietitian. Check out their website at www.eatrightontario.ca or:
- Call this toll-free number: 1-877-510-510-2
- Email the Email a Dietitian service
- Use this website to read healthy eating articles, watch videos, find recipes and explore interactive tools to help you with menu planning and portion sizes and setting goals
Notes: Edited September 25, 2017. Originally published April 1, 2010.