Shhh, Beta Cells Are Sleeping

I woke up thinking about first phase insulin response and oral glucose tolerance tests (OGTT).  Does that ever happen to you?

This is on my mind because I went in for a blood test last week and the result of my HbA1c was so good – better than it’s been in years – that I actually thought to myself… maybe you don’t have diabetes anymore.  It was the best thought I’ve had in a long time and I allowed myself to entertain it for a few hours.

But the scientist in me did not allow the lunatic in me to get too carried away.  And so I realized that if I were to be the first person (aside from Halle Berrie) whose diabetes magically disappeared, I would need proof.  I, therefore, decided to perform my very own OGTT.

Disclaimer: Unfortunately, I am not really a scientist, nor am I a doctor.  I am a diabetes patient who has taken (and failed) a lot of OGTTs.  Do not take this as medical advice.  Do not take this seriously.

Jessica Apple’s Homemade OGTT:

3 Tablespoons of  granola (oats, almond flour, white flour, butter, brown sugar, vanilla)

3 ounces of whole milk

Enthusiasm

Approximate carb count: 12 grams

I sat down to eat my very small portion of granola with the intention of having my beta cells secrete just the right amount of insulin to keep my blood sugar from going over 120.  To encourage them to do their thing I cheered them on: Go Betas, Go Betas, Go Betas!

It was such a hopeful (albeit delusional) time for me.  Of course, I know the facts: the GAD65 autoantibodies, and the low C-peptide mean only one thing.  But the thought I was entertaining- that diabetes might be gone- was a magnificent feeling.

Much less magnificent was the feeling that I needed to put my head down on the table about thirty minutes after my delicious OGTT.  I checked my blood sugar. 149.

What I have lost completely in the course of my thus far slow-progressing (knock on wood) case of autoimmune diabetes (LADA), is the first phase insulin response.  My beta cells will still make some insulin after I eat, but it will arrive too late to help.  In a situation like the small snack of granola, my blood sugar can easily go up to 200.  Three or four hours after I’ve eaten, however, when there’s no granola in my stomach, my beta cells will secrete.  Thanks, Betas.  I appreciate your effort, however, you’re doing nothing but making me hypoglycemic.

At this stage of my diabetes, I prefer to think of my beta cells as sleeping, rather than dead, since eventually they do come through (and it’s less depressing).  I’ve read a little bit about beta cell stress.  And recently I came across this post: Do Beta Cells Need Secretory Respite? In my unprofessional opinion they do, which is why I eat a very low-carb diet.  I don’t want to exhaust my beta cells.  Some of them may be lost for good.  I know this.  But to those who aren’t I say, Hang in there little friends.  Don’t die. Sleep your deep sleep now, like the poisoned Snow White.  While you’re resting keep in mind, someday our prince will come.

[youtube]http://www.youtube.com/watch?v=KUT06K5eGz4&feature=related[/youtube]

Jessica Apple

Jessica Apple grew up in Houston. She studied Bible and Ancient Near Eastern Studies at the University of Michigan, and completed an MA in the same field at the Hebrew University. She began to write and publish short stories while a student, and has continued to write essays and fiction while raising her three sons (and many pets).

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Jessica Apple

Jessica Apple grew up in Houston. She studied Bible and Ancient Near Eastern Studies at the University of Michigan, and completed an MA in the same field at the Hebrew University. She began to write and publish short stories while a student, and continues to write essays and fiction while raising her three sons (and many pets). Jessica’s work has appeared in The New York Times Magazine, The Financial Times Magazine, The Southern Review, The Bellevue Literary Review, Tablet Magazine, and elsewhere. She is the diabetes correspondent for The Faster Times. In 2009 she and her husband, both type 1 diabetics, founded A Sweet Life, where she serves as editor-in-chief. Jessica loves spending time with her sons, cooking with her husband, playing with her cats, reading, biking, drinking coffee, and whenever possible, taking a nap. Follow Jessica on Twitter (@jessapple)