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#i mostly wrote this just to consolidate stuff wjaifpweaf
amporella · 2 years
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Facts about Kyle & Diabetes
ANYWAY, THE POST I MEANT TO MAKE:
I don’t think the specific effects of diabetes in daily life are all that widely known, so here are some notes/facts you might find interesting if you’re planning on writing a Kyle POV and canon/realism is important to you:
- Kyle’s specific type of diabetes is never mentioned in Cherokee Hair Tampons, but it’s highly likely that he has type 1. Type 1 diabetes is a (theorized) genetic condition that usually presents early in life, while type 2 is more lifestyle related. 
- Sheila mentions that Kyle has been diabetic all his life, implying it appeared at a fairly young age. Type 1 diabetes appears at two noticeable peaks - 4 to 7 and 10 to 14 years old - so it’s likely that Kyle’s diabetes developed between the ages of 4 to 7. Maybe even on the younger end of that?
- In type 1 diabetes, the pancreas produces little to no insulin. Because of this, EVERY PERSON with type 1 diabetes must take insulin on a daily basis.
- The bolus secretion is the insulin your body releases at mealtimes, and the basal secretion is the small amount of insulin that’s always in a non-diabetic’s blood. Basal secretion is the only necessary type of insulin, and some diabetics choose to only take basal insulin. Basal insulin constantly brings down high resting blood glucose levels, while bolus insulin is much more powerful but much more short lived. It’s what you’d take at mealtimes/in moments of extremely high blood sugar.
- Speaking of types of insulin, there are multiple types a diabetic might take:
Rapid-acting: takes effect within 15 minutes and is typically taken at mealtime. Mimics the bolus secretion.
Regular/short-acting: takes effect between 30 minutes to an hour. Is also taken at mealtime, but lasts longer than rapid-acting insulin. Also mimics the bolus secretion.
Intermediate-acting: lasts for 10-16 hours and is typically taken twice a day. Imitates the basal secretion.
Long-acting: lasts for 20-24 hours and is typically taken once a day, but some might take it twice a day for better control of their blood sugar. Mimics the basal secretion.
Pre-mixed insulin: combines two other types of insulin.
Basal-bolus insulin therapy: A treatment in which the diabetic takes a combination of basal and bolus insulins throughout the day. Allows for diabetics to not have to eat meals at specific times of day.
- Dosages for insulin are specific from person to person, and are often finicky and require frequent adjustments.
- Insulin CANNOT be taken as a pill. Type 1 diabetics can only take insulin through daily injections or through an insulin pump.
- There are four main areas a diabetic will inject insulin: the abdomen, the back of the arm, the thighs, and the hips/butt. Injections into the abdomen will absorb the fastest, followed by the arms, thighs, and hips.
- Insulin is designed to be injected into the subcutaneous tissue layer; ie, the layer directly under the skin. Injecting it into muscle will cause it to absorb significantly slower.
- Constantly using the same injection site will cause the body to develop a resistance/scar tissue, and insulin will be absorbed slower. It’s important to rotate insulin injection sites every so often.
- Heat and exercise also both effect insulin absorption; heat opens up the blood vessels and allows for insulin to be absorbed faster, and leg exercise increases the rate of absorption in the legs (but slows it slightly in the abdomen!). However, physical activity only increases insulin absorption in rapid-acting and regular/short-acting insulins.
- 20-40% of type 1 diabetics choose to use an insulin pump instead of using injections. Insulin pumps and injections are equally effective, but insulin pumps come with the risk of the pump failing to perform. People with insulin pumps still need to check their blood sugar, and pumps vs injections really just come down to a matter of choice. It is entirely feasible for Kyle to go with either.
- Some diabetics check their blood sugar using finger sticks, and others check it using a continuous glucose monitoring (CGM) system. CGM systems check glucose levels every ~10 minutes, and the glucose sensor must be moved to a different area every 1-2 weeks. People using CGM systems still need occasional finger pricks for reliability.
- Young adults with type 1 diabetes are more prone to developing excess body weight than non-diabetic young adults.
- Poor muscle health is a complication of diabetes, even in very active people. Overactivity in people with diabetes may reduce metabolism and accelerate the rate of developing disability. Exercise is important to help reduce excess weight gain, but diabetics shouldn’t exercise beyond the recommended amount.
- A kidney transplant alone (like the one Kyle got in Cherokee Hair Tampons) is not a cure for diabetes; a pancreas transplant is the only way to fully cure it. However, pancreas transplants are typically reserved for people with very significant complications. 
And huge thanks to @girl-kendallroy for adding the following information!!
- 100-150 is typically the goal range for blood sugar, below 100 is low, 150-200 is moderate, and 200-250 is high. Correction insulin/water is given when blood sugar is considered high, which is also when high blood sugar symptoms start to show.
- Type 1 diabetics are prone to low blood sugar seizures, as well as other diseases and autoimmune disorders. As a result, they undergo routine testing for thyroid issues, celiac disease, and other organ functions (such as kidney, liver, and eye).
IN CONCLUSION: Not all of this is relevant on a day to day basis, but a lot of it is, and if you plan on writing a Kyle POV that encompasses multiple scenes/lasts for a long period of time, the above information may be worth considering if realism in fic is up your alley! 
SOURCES:
https://diabetes.org/healthy-living/medication-treatments/insulin-other-injectables/insulin-pumps-relief-and-choice
https://www.uptodate.com/contents/blood-glucose-monitoring-in-diabetes-beyond-the-basics
https://www.sciencedaily.com/releases/2018/04/180418092042.htm
https://bmcendocrdisord.biomedcentral.com/articles/10.1186/s12902-022-01062-y
https://www.endocrineweb.com/conditions/type-1-diabetes/type-1-diabetes-insulin
https://www.medicalnewstoday.com/articles/316616#what-is-basal-bolus-insulin-therapy
https://pubmed.ncbi.nlm.nih.gov/619237/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7609903/#:~:text=Physical%20exercise%20increases%20the%20rate,in%20older%20long%2Dacting%20insulins.
https://www.diabetesselfmanagement.com/blog/affects-insulin-absorption/
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