Making the most of available supports and learning more about food by trial and error has helped Chamber Choir Ireland CEO Majella Hollywood thrive despite the blow of developing diabetes as an adult
With the busy pace of modern life, feeling exhausted seems to be an affliction which affects us all at some point or other. So, when Majella Hollywood began to feel more tired than usual, coupled with getting up to the bathroom more frequently at night and feeling thirstier than she would normally, she put it down to working too much and having just turned 40.
But after visiting her GP, she was shocked to discover that she had Type 1 diabetes, a condition which was historically named ‘juvenile onset diabetes’ and is one of the most prevalent chronic illnesses in childhood and adolescence. It is now known it can develop at any age, with half of the newly diagnosed cases occurring in adults, like Majella.
“I’d suffered a few years earlier from very low iron due to a different health condition so presumed the tiredness was partly that, combined with a heavy workload, and travelling each weekend to care for an elderly parent,” she says. “I went to the doctor in late September 2017 who said that my iron was OK (still low but OK for me) — but she was concerned about coeliac disease so began typing up a referral for me when I mentioned briefly about the unquenchable thirst and running to the bathroom more frequently. “She said she wasn’t worried but got me to do a urine test then and there — and was horrified to discover that my glucose levels were really high.”
Following this appointment, the 45-year-old was told to go home and pack a bag and go straight to A&E. After being examined by medics, she was told that it wasn’t likely that she had diabetes as her blood sugar reading had reduced, but she should go to the doctor again for another check-up.
“They sent me home late that night telling me to get checked again with my GP, and they would take it from there,” she says. “So, I did, feeling a little scared but also convinced I probably had Type 2 diabetes and that I’d never be able to eat bread again.
“But a few weeks later, I got two calls on the same day, one from the Diabetes Clinic at the hospital asking me to come in that day if possible, and the second was the GP practice telling me my reading was very high and that I needed to get to hospital straight away. That was October 19, 2017.
"I had to learn what a hypo was, what would happen long-term with high glucose levels and what to do to treat both of these things myself at home. ”
“It was a whirlwind of being told that while they were fairly certain it was Type 1, more tests were needed to absolutely confirm. But I was set up on some basic slow-acting insulin once a day and sent home with all sorts of paraphernalia – needles, glucose monitor, test strips, insulin pens and a sharps bin. It was so much to take in and I was completely and utterly overwhelmed. I had to learn what a hypo was, what would happen long-term with high glucose levels and what to do to treat both of these things myself at home. With all the monitoring, food diarising and glucose diarising, I was afraid to sleep and afraid to eat — I cried every day. And living alone, despite having brilliant friends nearby and family up north, contributed so much to the fear.”
Majella, who is the CEO of Chamber Choir Ireland, Ireland’s flagship professional choral ensemble, says she has learned a lot since her diagnosis and while it took some getting used to, she was determined to be in control. “There was a lot of learning, decision-making and compromising to begin with, but I’m a fairly positive kind of person,” she says. “I joined a few support groups on Facebook and while I wasn’t very active on them, the diabetes online community was an incredible support for all of the stupid questions I had.
“I learned more about food by trial and error regarding the impact it had on glucose levels. I’m an avid bread baker and foodie in general, but although it took a while, now I don’t compromise what I want to eat — but rather consider the carbohydrate portion size I want to have knowing pretty much what the impact will be for me later.
"Every time I want or need to eat requires a series of decisions — when did I last eat and inject insulin? What my current glucose level is. Have I just exercised or will I be exercising soon? Am I sick? Am I stressed? So the decision-making rather takes over daily life.
“But I was just getting into hiking and long-distance walking 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 that sometimes has to be in public. It took a while (and some wardrobe management) but it’s becoming more comfortable for me.”
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 what they needed to be. But she has got used to things now and would advise others newly diagnosed that “things will be OK”.
“I secured a CGM (continuous glucose monitor) from my diabetes clinic in early 2022 and it has been life-changing as I haven’t set an alarm since, knowing my CGM will wake me if I need to,” she says. “It has given me more detailed information throughout the day and enabled me to make more informed daily decisions about my insulin regime.
“I’m really well and healthy today — probably so much healthier than I was before diagnosis. I hike every fortnight and have plans to climb Ben Nevis at night later this summer raising funds for Diabetes Ireland. I eat everything I want to eat and for the most part, get the insulin dosages fairly right as my average glucose levels are good and in range.
“Diabetes is always on — you can’t switch it off. But for me, staying on top of it means I manage it rather than it controlling me. I don’t let it stop me taking on new challenges or doing all the things I want to do in life. So, my advice to others new to diabetes is that there will be tough days and because there is so much to take in, it can be overwhelming.
"There are some great courses which are essential for education and working diabetes management into everyday life.”
“But there are some great courses which are essential for education and working diabetes management into everyday life. And don’t be too hard on yourself — there will be days where it doesn’t make sense — but there are also better days, so celebrate the wins, and skip over the other stuff. More than anything, find yourself someone else with Type 1 who can support you. I had an amazing friend who made me laugh about it so many times. Talked me through the trickier hypos and gave sage advice when it was needed.”
In 2020, 40pc of children newly diagnosed with diabetes in Ireland were critically ill on admission 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 ensuring early diagnosis in order to avoid critical illness.
“A simple acronym can help people to remember the most common signs and symptoms of Type 1 diabetes,” she says.
“So, TEST stands for:
Sudden unexplained weight loss
Toilet — excessively passing urine
“If these symptoms are experienced or observed (in a family member), medical attention should be sought immediately.”
A simple finger prick blood test to check the blood glucose level can be done by a GP, nurse or pharmacist and the results are available in a few seconds. If this test shows a high glucose reading, the GP will send the individual to A&E to be admitted for assessment and treatment.
Additional symptoms may include an increase in appetite, lack of concentration, bed wetting, constipation, mood swings and frequent infections.
⬤Type 1 diabetes is a lifelong condition that occurs because the body stops producing the hormone insulin.
⬤It is an auto-immune condition, meaning the immune system attacks the insulin producing cells in the pancreas and it stops making insulin. It is not preventable at present.
⬤It affects approximately 3,000 children and adolescents in Ireland.
⬤In untreated diabetes, the level of glucose in the blood gets too high. If there is a delay in diagnosis, it 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. If untreated, DKA can progress to coma and can be fatal.
⬤Early diagnosis of Type 1 diabetes avoids critical illness and DKA and will also improve the long-term outcomes for the individual.
⬤Type 1 diabetes does require continuous daily self-management, but with the support of the diabetes team and education on how to manage it daily, people can lead a normal life.
For more information see diabetes.ie or contact Diabetes Ireland by e-mail: email@example.com or phone: 01 842 8118