Given the hectic pace of modern life, exhaustion seems to be an affliction that affects all of us at some point. When Majella Hollywood started feeling more tired than usual, going to the bathroom more often at night and feeling thirstier than usual, she blamed it on being overwork and her recent 40th birthday.
However, after a visit to her GP, she was shocked to discover that she had type 1 diabetes, a condition historically referred to as “juvenile diabetes” and one of the most prevalent chronic diseases of childhood and adolescence. It is now known that it can develop at any age, with half of newly diagnosed cases occurring in adults, like Majella.
“I had suffered from very low iron a few years previously due to another health condition so I assumed the fatigue was partly due to that, combined with a heavy workload and traveling every weekend to look after an elderly parent” , she says. “I went to the doctor in late September 2017 who said my iron was fine (still low but fine for me) – but she was concerned about celiac disease and started putting in a referral for me when I was brief about the insatiable thirst and run to the toilet more often. “She said she wasn’t worried but got me to do a urine test every now and then – and was horrified to find my blood sugar was really high.”
After that appointment, the 45-year-old was told to go home, pack a bag and go straight to the emergency room. After a medical examination, she was told that she probably did not have diabetes as her blood sugar had dropped, but that she should go back to the doctor for a re-examination.
“They sent me home late at night and told me to go see my GP again and they would go from there,” she says. “So I did, a little scared but also convinced that I probably had type 2 diabetes and would never be able to eat bread again.
“But a few weeks later I received two calls on the same day, one from the diabetes clinic at the hospital asking me to come that day if possible and the second was the GP’s office telling me my reading was very high and so I had to go to the hospital immediately. That was on October 19, 2017.
“I had to learn what hypoglycaemia is, what happens with high glucose levels over the long term and what to do to treat both at home myself.”
“It was a whirlwind when they were told that while they were fairly certain it was Type 1, further testing was needed to absolutely confirm it. But I was put on a simple, slow-acting insulin once a day and sent home with all sorts of supplies – needles, glucometer, test strips, insulin pens and a sharps bin. There was so much to process and I was completely overwhelmed. I had to learn what a hypo is, what happens with high glucose levels over the long term, and what I can do to treat both at home myself. With all the monitoring, diet and blood sugar testing, I was scared to sleep and scared to eat – I cried every day. And living alone with brilliant friends nearby and family up north added so much to the anxiety.”
Majella, Executive Director of Chamber Choir Ireland, Ireland’s leading professional choral company, says she’s learned a lot since her diagnosis and while it took some getting used to, she was determined to stay in control. “In the beginning we had to learn a lot, make decisions and make compromises, but I’m a pretty positive person,” she says. “I’ve joined a few support groups on Facebook and while I haven’t been very active in them, the online diabetes community has been an incredible source of support for all the silly questions I’ve had.
“I’ve learned more about foods in terms of how they affect glucose levels through trial and error. I’m an avid bread baker and foodie in general, but while it’s been a while, I now don’t compromise on what I want to eat – instead I look at the size of carb portion I want and pretty much know which ones This will have implications for me later.
“Every time I want or need to eat something, I have to make a series of decisions – when was the last time I ate and took insulin? What is my current glucose level. Did I just play sports or will I play sports soon? I `m ill? So the decision-making takes over more of daily life.
“But I was just starting out in hiking and long-distance hiking when I was diagnosed and later joined a hiking group, which was one of the best things I’ve ever done and is now a regular part of my life. And I’ve had to learn not to hide the condition – I have to inject insulin when I eat, and sometimes that has to be in public. It’s taken a while (and some wardrobe management) but I’m getting more and more comfortable.”
Majella, who lives in Dublin, says the biggest problem she had in the beginning was being afraid to sleep and setting alarms to make sure her glucose levels were where they needed to be. But she’s settled on things now and would tell other newly diagnosed people that “everything will be fine.”
“I secured a CGM (continuous glucose monitor) from my diabetes clinic in early 2022 and it has been life changing as I have not set an alarm since knowing my CGM will wake me up when needed,” she says . “It gave me more detailed information throughout the day and allowed me to make more informed daily decisions about my insulin regimen.
“I am very well and healthy today – probably so much healthier than before the diagnosis. I hike every two weeks and plan to climb Ben Nevis at night later this summer to raise funds for Diabetes Ireland. I eat whatever I want to eat and for the most part I get my insulin doses pretty accurate since my average glucose levels are good and in range.
“Diabetes is always on – you can’t turn it off. But for me, being on top of things means I’m in charge rather than controlling myself. I don’t let that stop me from taking on new challenges or doing all the things I want to do in life. So my advice to other diabetes newbies is that there will be tough days and because there is so much to process it can be overwhelming.
“There are some great courses that are essential for educating and incorporating diabetes management into everyday life.”
“But there are some great courses that are essential for educating and including diabetes management in everyday life. And don’t be too hard on yourself – there will be days when it doesn’t make sense – but there are better days too, so celebrate the wins and skip the other things. Above all, find someone with Type 1 who can support you. I had an amazing friend who made me laugh so often. Explained the trickier hypos to me and gave wise advice when needed.”
In 2020, 40 per cent of children newly diagnosed with diabetes in Ireland were seriously ill when admitted to hospital. And Clair Naughton, Regional Development Officer North West for Diabetes Ireland, says the charity is running a type 1 awareness campaign, the TEST campaign, to highlight the signs and symptoms of type 1 diabetes with the aim of helping early diagnosis ensure in order to avoid critical illnesses.
“A simple acronym can help people remember the most common signs and symptoms of type 1 diabetes,” she says.
“TEST stands for:
SSudden unexplained weight loss
Toilet – excessive urination
“If these symptoms (in a family member) occur or are observed, a doctor should be consulted immediately.”
A simple fingerprint blood test to check blood sugar levels can be performed by a GP, nurse or pharmacist and results are available in seconds. If this test shows a high glucose reading, the family doctor will send the person to the emergency room for evaluation and treatment.
Additional symptoms can include increased appetite, poor concentration, bedwetting, constipation, mood swings and frequent infections.
About type 1 diabetes
⬤Type 1 diabetes is a lifelong condition that occurs because the body stops producing the hormone insulin.
⬤It’s an autoimmune disease, meaning the immune system attacks the insulin-producing cells in the pancreas and stops producing insulin. It is currently unavoidable.
⬤It affects around 3,000 children and young people in Ireland.
⬤With untreated diabetes, the level of glucose in the blood becomes too high. Delaying diagnosis can lead to critical illness as a life-threatening condition known as diabetic ketoacidosis (DKA) can develop.
⬤DKA is a medical emergency, the symptoms are dehydration, vomiting, abdominal pain and breathing problems. Left untreated, DKA can progress to coma and be fatal.
⬤Early diagnosis of type 1 diabetes avoids critical illness and DKA and also improves long-term outcomes for the individual.
⬤Type 1 diabetes requires continuous daily self-management, but with the support of the diabetes team and education on how to manage it on a daily basis, people can lead normal lives.
For more information visit diabetes.ie or contact Diabetes Ireland by email: email@example.com or phone: 01 842 8118
https://www.independent.ie/life/health-wellbeing/i-thought-i-was-tired-due-to-low-iron-it-was-a-shock-to-be-diagnosed-with-type-1-diabetes-in-my-40s-41894185.html “I thought I was tired from iron deficiency – it was a shock to be diagnosed with type 1 diabetes in my 40s.”