A Crash Course on Sponge Cake and The Pancreas

Hey internet people,

I’ve been absent from this corner of the web for a while now. I spent all summer working in and loving jobs that had nothing to do with teaching, while nurturing a nascent love of baking (see above and see also: I love you, Mary Berry). In September I came back to Spain and now it’s ALREADY NOVEMBER AND ALREADY DIABETES AWARENESS MONTH AND I AM LIVING IN ALL.CAPZ!

Fact: I’ve been living with this piece of shit for nineteen years! I am always grateful for my health and for the fact that the nature of my birth and my current residence make it so that I can live life with diabetes without worrying about going bankrupt. Nevertheless, it feels good to recognize certain truths from time to time. Like this one: as enlightening and formative as its been to live with chronic illness for most of my childhood and all of my adulthood, I am capital O, over it. I’d like my carry-on suitcase to be full of normal people things and I’d like for my days off to not include insulin or test strip pick-ups. I’d like to not know about any of this.

But I do know about it. So here I am. Do you have questions? Cool. I might have some answers.

Here’s one people tend to ask a lot: girl, can you eat that cake

Yeah girl, I can. I ate the hell out of that cake, buttercream and all baby.

It is, of course, more difficult to dose for food with high fat and sugar content (there are lots of complex molecules involved and one must also consider whether the moon is waxing or waning). A fully functioning pancreas does that work on its own*: dosing just the right amounts of insulin at just the right moments (he so romantic), so that your body remains in sweet homeostasis.

*and a lot of other things, alright? But I’m not a scientist.

What’s a pancreas, you ask?

Well, it’s this internal organ that kinda looks like a dick. Sorry. I’m trying to be more honest lately, to honor my own thoughts. I hate to say it, but it’s true: THE PANCREAS LOOKS LIKE A PENIS. Now that we’ve got that out of the way…

What does this phallic lil organ do?

Alright, let me backtrack. You know how you wake up in the morning and have the energy to get out of bed and do whatever it is you do? Well that’s thanks in large part to food. You ate some bread, some pasta, maybe some potatoes, and your perfect beautiful body took all those nutrients from your blood–namely, glucose–and delivered them to your cells so that you could continue living your life as an upright, functional being. The pancreas plays a huge role in that process, you see. We’ll get to that in a minute. Your cells are itty bitty little things and glucose’s fat ass can’t get in there. She needs help.

So how does she get into the cell?

I’m so glad you asked. Insulin!

What the hell is insulin?

Well, apart from being one of the most expensive liquids in the world (I’m coming for you later, pharma), insulin is a hormone produced by the peen, excuse me, the pancreas, that facilitates glucose transport. Without insulin, you consume carbohydrates and that glucose just floats around the blood, knockin’ on cells, not gettin’ in, freakin’ out. Your cells start to shrivel up and scream OMG I’M STARVING SOMEBODY PLEASE HELP ME! But there’s nobody there to help. Glucose can’t get her ass in the door so she hangs around the blood, your body gets sticky, that precious homeostasis ends, and you die.

What’s all this have to do with diabetes?

In type 1 diabetes, the pancreas no longer produces insulin.

One day, the immune system  says “hey, I’m feelin’ destructive, let’s go tear some stuff apart. How about those cute insulin-producing cells (islets) in the pancreas? Yeah, let’s go for those. That sounds cool.”

And bam! There you have it. Type 1 diabetes: an autoimmune disease in which the life-sustaining islets in the pancreas are mercilessly destroyed. A total bummer.

So if your body doesn’t produce insulin, what do you do?

You hope to the lord above and all that is holy that you live in a place where synthetic insulin and the education and tools to know how to use it are available to you. And then, if everything goes right on that front, you try your damn hardest to be as perfect as a human body is. For as flawed and disturbing and crazy as we are as humans, our physical bodies do a remarkable job of maintaining internal balance. Most people who aren’t doctors live blissfully unaware of this awesome power until something in their own body ceases to work.

But seriously, how do you eat that cake? I’ve, like, heard all these jokes about cupcakes and diabetes and stuff and people dying after eating chocolate. I just don’t get it!

I do the job that your body just naturally does for you, with my insulin pump and my sometimes questionable math skills. I calculate how many carbs are in the cake, I deliver insulin according to the ratio I’ve worked out with my doctor through trial and error, and I hope there’s nothing weird in the water that day and that my calculations are correct (my life, like yours, is a science experiment, only more so).  Some days I do a better job than others.

But anyway, girl, it’s not a good idea for anyone to eat a 4-layer spongecake on the regular, so just keep that in mind and calm down, OK? Calm.down.

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