My pancreas will not win the award of “Best Organ of my Lifetime”. For a start, it is incapable of digesting my food which is clearly a massive fail. It now appears that it’s getting a tad lazy about producing insulin in normal amounts and normal time frames. I do not have CF related diabetes (CFRD). As far as I’m aware. Yet. Instead, I have insulin resistance and glucose intolerance.
In my own imagination I think of my pancreas like a grade B conscript in the Glucose Management Army fighting in the War on Glucose. My pancreas lazes around as much as possible, its boots are not quite shiny enough, its bed is only just neat enough, it’s a tad late for drills and war games and a little slower on the salutes and “Yes Sirs!”. When the call is given to launch into battle and “Metabolise that glucose STAT!” my pancreas is AWOL having an unauthorised drinks break and smoko in the aircraft hanger. When news of the latest battle finally trickles through to my pancreas it launches into the fray, too late, but with much gusto and weapon drawn, yelling “She’s eating! There’s glucose! Go go go go go GO!” The glucose is quickly neutralised but the pancreas keeps firing insulin into my blood steam trying to get every last bit of that damn glucose and make amends for its tardiness. I really wish it wouldn’t bother overcompensating because some glucose is actually necessary for me to stay conscious and remain a functional member of society. This fundamentalist attitude about glucose annihilation and a too-much-too-late execution of these ideals is just not sensible.
What does all of this insulin resistance and glucose intolerance mumbo jumbo mean in practice, I hear you ask? It means I have a focus on food that I would really rather not have. I would much rather continue my MO of eating whatever I want, whenever I want. “Not possible” says my endocrinologist. Apparently I must now convert to the low GI way of life to try and manage my pesky pancreas in the short-term and help prevent the onset of CFRD in the long-term. All this, even though my endocrinologist cheerfully and freely admits there is no scientific evidence whatsoever that a low GI diet will actually help fend of CFRD. All this, even though I’ve been told I will get CFRD eventually – if I live long enough. I am resigned to this concept as I have seen Dave deftly handle CFRD for a decade so the futility of my mission doesn’t worry me particularly. In essence, I’d prefer to live long enough to acquire CFRD than to die prematurely and spend eternity CFRD free.
As I would rather not inject myself multiple times a day until I absolutely have to, I have tried but failed to embrace my new eating plan with the utmost enthusiasm. My preferred breakfast has been sadly retired. Instead I have sourced a low GI cereal which is actually pretty tasty and fills me up sufficiently. Oh, how I would love to just eat that cereal. But no, I must eat more to tide me through until morning tea. I reluctantly have two slices of (low GI – of course!) toast with peanut butter or fruit cheese for some fat and protein. It’s a struggle getting through those two pieces of toast. I just don’t want to eat them: I’m not hungry enough and I don’t like it enough. My dogs always get a few crusts to help me out – they are very willing helpers. At 9.30am I must have morning tea. It doesn’t matter how many patients I have to see or how late I’m running I halt and drink a (low GI – of course!) Vitasoy popper to keep my blood sugars in the green zone. Once that beverage is consumed the critical period finally passes. My pancreas seems to be much better behaved after morning tea and I can let my guard down slightly and truly live on the wild side by having a piece of shortbread after lunch to keep my sweet tooth happy.
I have become intimately familiar with the low GI symbol – I can spot it from 20 paces. I’m now one of those people who reads the dietary information on the back of packaging looking for low sugar and high protein food (for me) and gluten and dairy free options (for Dave) with at least 20g of fat (for Kalydeco Plus optimisation for both of us). If I have to add another dietary requirement into our lives my brain just might dislocate. My new low GI persona also buys in bulk. I scour supermarkets for the aforementioned Vitasoy poppers as they are really hard to find. I can only conclude that there must be lots of people just like me with a dodgy pancreas who rely heavily upon them. What else could explain why they are always sold out? There are no words to describe my joy when I stumble across a stash. I purchase as much as I can possibly carry and end up struggling home with 4L of the precious liquid.
Last Friday I had an oral glucose tolerance test (OGTT). This involved fasting from midnight, rocking up to have a cannula inserted into my one “lucky vein”, drinking a glucose packed and unsavoury drink and then kicking back for two hours of reading, people watching or sugar-high-induced-napping while the War on Glucose raged in my blood stream. Blood was taken at certain intervals to check on the status of the War. Afterwards I ate a goodly amount of food, walked home, and ate a goodly amount more to boost my sugars up and get them back under control. I don’t have the results yet but I’m pretty sure it’s a carbon copy of last year’s OGTT. I predict my next consultation with my endocrinologist will go something like this:
So, we have the results back.
Let me guess… I’m not normal… but I’m not too abnormal. Yet.
My pancreas was slovenly and then over zealous?
So, I’m sticking with the whole low GI plan then?
The appointment will take five minutes. Tops.