I’ve been a Type I for 28 years now (since 12 y.o.). Despite this, there are no signs of complications. Control was abysmal for the first seven years (no glucometers) and pretty wonky for years after that – hypos were a common event. Sometimes I got picked up off the street. It’s only since reading a book on the epidemiology of diabetic complications a decade ago that I realised with horror the sorts of things that could happen to me if I didn’t maintain proper control. This was hammered home even more when the DCCT results were released. So only in the last decade have I been getting regular HbA1c tests.
At one stage I went ten years without any eye tests. I felt that if many of the problems with peripheral nerves and limb damage etc. originate with poor circulation then what better way to prevent the beginning of the viscious cycle than by indulging in very high levels of aerobic activity. Evidence I’ve seen suggests that such activity improves morbidity for diabetics independent of bg control. From age of diagnosis (12) until 16 I lifted weights. Then from age 18 onwards, distance running. Recently it has been mainly cycling, up to several hundred kilometers per week (before and after work, through hills). Keeping up this level of activity is very taxing. I have to be careful to get plenty of sleep. If my blood sugars are too high for too long, my muscles don’t recover in time for the next ride: If I stop riding for a while, my control is shot to hell because my sensitivity to insulin changes drastically over a period of time.
Then, when I start up again, sensitivity changes again, but in the opposite direction and so more control problems occur. Most of the time I have to test my blood sugar at 4.00am and have between two and five injections a day using three different insulins for maximum flexibility. I test my bg’s up to ten times a day. Only long experience has helped me be able to predict to some extent the effects of doing or not doing such exercise. Even so I still get into trouble: last weekend I lost consciousness from low blood sugar on a day that I *wasn’t* cycling – I had misjudged the required dose. Fortunately my body pumped in loads of adrenaline which sort of brought me round enough to help myself (orange juice). My wife was out at the time!
