The Untold Story of GSD1a: Navigating Life with a Rare Chronic Condition
GSD1a (Glycogen Storage Disease Type 1a) is a rare metabolic condition that affects how the body stores and releases glucose. In this post, I break down what GSD1a actually is â from genetics and symptoms to treatment and everyday living â in a clear, approachable way. I also share my personal experience growing up with GSD1a, how it impacts my mental health, and the routines I rely on to manage it. If youâre researching GSD1a, navigating a diagnosis, or simply curious about life with a rare chronic illness, this is a warm, honest introduction from someone who lives it every day.
GSD1a stands for Glycogen Storage Disease type 1a, a condition I live with every single day. Itâs something Iâve always had â and something I always will. The main thing about GSD1a? Itâs wildly misunderstood, and for many, itâs something theyâve never even heard of. So letâs dive into it.
Note: Everything in this post took me a while to fully grasp. In fact it still boggles my mind, sometimes. Iâm not a medical professional â just someone living with the condition. So Iâll be sharing both a clinical and patientâs view of what GSD1a is, what itâs like to live with it and how it impacts my life.
The Clinical Definition of GSD1a:
GSD1a is an autosomal-recessive inherited metabolic disorder caused by a mutation in the G6PC gene, leading to a deficiency of the enzyme Glucose-6-phosphatase.
This enzyme deficiency impairs the final steps of gluconeogenesis and glycogenolysis, which are the processes that release glucose from stored glycogen, especially during periods of fasting.
As a result, individuals with GSD1a experience severe fasting hypoglycaemia (dangerously low blood sugars) which can lead to other metabolic abnormalities. Source: National Center for Biotechnology Information â Glycogen Storage Disease Type I
I get it though: no one here wants to just read the clinical definition, but if youâre here, itâs because you want to understand what it really means. So what does all this technical stuff boil down to?
At its core, GSD1a is a rare inherited condition, where my body hasnât been built quite right. The result? My liver and kidneys store sugar (glucose) but canât release it when I need it the most. This means that, without proper care, I experience dangerously low blood sugar levels. But hereâs the thing: I canât always manage it on my own. I rely on others to help me stay safe and keep my blood sugar stable.
A rare inherited medical condition means itâs passed down from parent to child. For GSD1a, the mutated gene is recessive, meaning both of my parents must carry the gene to pass it on to me. However, neither of them âshowâ the condition, meaning theyâre carriers â each having one normal gene and one mutated gene. This is why it was such a shock and a very confusing time when I was diagnosed. At the time of writing this the prevalence of GSD1a is approximately 1 in 100,000 people. Source & Photo: Metabolic Support UK: Glycogen Storage Disease Type 1a.
Genetic Chances: Affected vs. Carrier vs. Normal
Letâs break it down a bit:
AÂ represents the normal gene (unaffected)
a represents the mutated gene (affected)
Hereâs the chances for me:
Option 1: AA â Normal: not a carrier, not affected. Likelihood: 25% (1 in 4)
Option 2: Aa â Carrier: Not affected, but carries one copy of the mutated gene (just like my parents). Likelihood: 50% (1 in 2)
Option 3: aa â Affected:Â has GSD1a (this is me!)Â Likelihood:Â 25% chance (1 in 4)
So yes â I ended up being the low-probability outcome, my parents always said I was extra special, but whatâs the probability if I have children? Photo Inspiration: Metabolic Support UK: Glycogen Storage Disease Type 1a
What does this mean for my children?
If I have children, the genetic inheritance pattern would be the same. If my partner is not a carrier of the mutated gene, our children would be carriers, not affected but carrying the gene. However, if my partner is also a carrier (or affected), thereâs a chance our child could inherit GSD1a.
Scenario 1: My Partner is Not a carrier:
My partnersâ genes (unaffected): AA
Scenario 2: My Partner is a Carrier
My partnersâ genes (carrier): Aa
Option 1: Aa â Carrier: Not affected, but carries one copy of the mutated gene. Likelihood: 50% (1 in 2)
Scenario 3: My Partner is Affected
My partnersâ genes (affected): aa
The chance of passing on GSD1a isnât just about the numbers and probabilities; itâs about being informed. Having the knowledge means that if we do decide to have children, we can make well-prepared decisions, understand the risks, and ensure we can support our future children â no matter what the outcome. Itâs about equipping ourselves with the right information to provide the best possible care, whether our child is affected, a carrier, or unaffected.
Following on from this, itâs also important to note that genetic counselling is an option before having children. This can help us understand the risks and probabilities in even more detail, and answer questions we may not have considered or fully understand yet. Itâs something I would likely consider, so we can make informed decisions for our family. And of course, we could explore other options, such as adoption, if thatâs what feels right for us.
When I first found all of this out, my outlook on life shifted. It wasnât easy at first, but now I see it as something that can either feel like the worst news in the world, or something that I can turn into a gift. Itâs all about perspective â and Iâve chosen to embrace it, using my experience to fuel my growth and perspective on life.
Most of the symptoms in people with GSD1a stem from the bodyâs inability to release glucose from stored glycogen in the liver, which leads to hypoglycaemia and other metabolic imbalances. Since I canât release glucose from my liver, it leads to low blood sugar episodes that affect my entire body. While every person with GSD1a is different, here are some of the most common symptoms (though not all apply to me).
Hypoglycaemia (low blood sugars): In medical terms, âhypoâ means low and âglycaemiaâ means the concentration of glucose in the blood. My medical team defines, low blood sugars as anything below 4.0mmol/l (72mg/dl).
Hepatomegaly (enlarged liver): occurs when the body canât release glycogen from the liver into the blood stream. Instead, it builds up, causing the liver to enlarge over time. This was prevalent for me more in childhood than now.
Growth Issues: People with GSD1a often experience slower-than-normal growth because the body prioritises survival (keeping glucose levels stable) over growth. This is why I often appeared smaller in size as a child.
Lactic Acidosis: This is a build up of lactic acid in the blood. Because the body canât efficiently convert glycogen into glucose, it can cause symptoms like fatigue, nausea, rapid breathing and confusion.
Hyperlipidaemia (high blood lipids [fats]): The body starts breaking down fat for energy instead of glucose, leading to higher cholesterol and triglyceride levels.
Kidney Nephromegaly (enlarged kidneys): Similar to enlarged liver, the kidneys can accumulate glycogen, causing them to enlarge over time, which could lead to complications.
Bone and Skeletal Issues: People with GSD1a can develop Osteopenia or Osteoporosis which means weakened bones that are more prone to fractures. There can also be joint pain or stiffness. Although I havenât been diagnosed with osteopenia or osteoporosis, when I was younger, my ankles would break or sprain a lot.
Fatty Liver Disease: Fat can build up in the liver, leading to non-alcoholic fatty liver disease (NAFLD), which can cause long-term complications.
Delayed Motor and Cognitive Development: In infants, hypoglycaemic episodes and metabolic stress can cause developmental delays, particularly in motor skills and cognition, due to deprived glucose to the brain.
Feeding Difficulties: People with GSD1a may experience issues like: frequent feeding (eating every few hours). Oral sensitivity (difficulty tolerating certain foods, textures, or the act of eating), poor appetite (yet still have to eat), or even require tube feeding.
Frequent Infections: Due to the metabolic stress, the immune system can be compromised. making it harder for the body to fight off infections
Sources: NHS: Low blood sugar (hypoglycaemia), Moderna Clinical Trials: Glycogen Storage Disease Type 1a (GSD1a), MedlinePlus: Glycogen Storage disease type 1
How this affects my life:
For me, many of the above symptoms were more pronounced in childhood, but with proper management, Iâve moved past some of these issues. However, that doesnât mean Iâm symptom-free. I still monitor my condition constantly, and managing GSD1a looks like this for me:
Thereâs more information in the below section about how I monitor GSD1a, but managing the physical symptoms of GSD1a requires constant surveillance, which inevitably takes a toll on mental health.
These symptoms are only half the story â GSD1a affects mental health just as deeply, and the emotional impact is just as real as the physical one, and itâs something Iâve had to learn to navigate as part of living with this condition.
What isnât often talked about, but should be just as much a priority as the physical symptoms, is mental health. People often think GSD1a is only physical â but the mental load is just as heavy. The psychological impact of GSD1a is profound, and here are the biggest emotional and psychological impacts I deal with:
PTSD (Post-traumatic Stress Disorder): GSD1a involves frequent medical interventions, physical strain, hypoglycaemic attacks and emotional stress, which can contribute to PTSD. Itâs not just about the physical symptoms, but also the fear, anxiety, and sometimes trauma that come with the condition.
Sleep deprivation: Sleep is a big issue. Many GSD patients (myself included) experience sleep deprivation because we have to wake up during the night to eat or deal with the effects of hypoglycaemia. Itâs exhausting and can lead to mood swings and cognitive fog.
Anxiety: Constant monitoring of health, food intake and blood sugar levels can create an underlying sense of anxiety. Iâm always hyper-aware of my bodyâs signals and sometimes, I can feel like something is going to go wrong at any moment, of which I have to be ready to deal with.
Isolation: GSD1a is so rare that is can feel like no one truly understands. I appreciate the people who try, but sometimes itâs hard to explain just how isolating it feels when others canât see the struggles I face. People often say, âYou donât look sickâ and while thatâs great, it also means they donât see the behind-the-scenes work that goes into managing my health.
Fear of the Unknown: When I was first diagnosed, my parents didnât know what the future would hold. Now that Iâm older, I understand the fear they had â and Iâve inherited some of that anxiety (through no ones fault). But as time goes on, Iâve learned to manage my condition and accept it as part of who I am.
Frustration and Exhaustion: The constant reminders â like checking my blood sugars, planning meals, restricting foods â can feel overwhelming at times. Itâs second nature now, but the physical and mental exhaustion still takes a toll. The hardest part is when others donât understand the urgency or seriousness of the situation.
Embarrassment: Explaining GSD1a in social situations can sometimes feel awkward, and I used to be self-conscious about it. But over time, Iâve learned to be more open about my condition â itâs become part of my story, not something to hide.
Overwhelmed: Staying on top of my health can be mentally taxing. Sometimes having to stay on constant alert to stay on track can feel overwhelming, and I struggle to balance that with maintaining a social life or a positive mood.
Living with GSD1a requires constant management, but itâs become second nature to me. Itâs a balancing act between keeping my blood sugar stable and managing the emotional ups and downs. Despite all of this, Iâve learned to adapt to my condition, and over time, itâs become part of who I am â not something that defines me, but something I live with.
Out of all the symptoms, whether physical or mental, they come in waves. Some days are harder than others, but most days, I look and feel like everyone else. And while people often donât see what I go through, Iâve learned to accept myself as I am, including the challenged that come with GSD1a.
If you or someone you know is dealing with a chronic condition like GSD1a, know that youâre not alone. Itâs a tough journey, but finding the strength in the struggle make us stronger every day, and one thing that I will always remember, is when a friend said to me.
âGod only makes those who are strong enough, deal with sh*t. Youâre a lot stronger than you think to be here todayâ.
For people with GSD1a, managing blood sugar is the cornerstone of daily life. A lot of people assume itâs just about eating, and while thatâs a big part of it, thereâs a lot more going on.
Living with a rare condition like GSD1a is a daily balancing act, and over the years Iâve learned just how much goes into keeping my blood sugars stable. The body really is amazing.
Itâs about timing meals, adjusting based on physical activity, and staying ahead of the curve so that I donât face the harsh consequences of low blood sugar. There have been days when it felt like a constant battle to keep everything in balance.
So how does treatment look?
First thing Iâll mention is the hospital visits â these have been a huge part of my life. At times, it felt like the hospital was more of my first home than a second one. Thankfully, things are much better now. I only need to go every six months to my General Medicine follow-up appointments and once a year to the Hepatology follow-up appointments. Each department serves a different purpose: one focuses on managing GSD1a while the other deals with the consequences of not managing GSD1a properly in my early years.
Treatment for GSD1a changes over time. Itâs different when youâre a baby, a child, a teenager, and finally, an adult. In my early years, it was all about frequent snacking, eating regularly with high carbohydrate intake, and tube feeding. Now, itâs about getting carbs primarily from cornflour and ensuring my other nutrients come from my meal times. Hereâs what a typical day looks like for me.
Breakdown of my daily routine (mealtimes):
9:00 am: Breakfast of choosing + 30 mins after completing the meal, 30g cornflour
12:30pm: Lunch of choosing + 30 mins after completing the meal, 50g Glycosade
Managing my blood sugar isnât just about food â itâs also about the tools and medication I use:
Continuous glucose monitor (CGM). I use the Freestyle Libre 2 plus (though there are other options). CGMs needs to be used with caution since they donât always provide perfectly accurate readings and can lag behind real-time changes in blood sugars. But the positive side is they alert me when I have asymptomatic hypoglycaemic attacks or situations when Iâm unaware Iâm having one. This has definitely saved me more times than I can count.
Blood Glucose Monitor Meter. My GP gave me the GlucoRx meter. Itâs a reliable, and getting the accessories (like lancets and testing strips) through the GP is much easier than sourcing them myself.
Cornflour. Yes the regular cornflour you use to thicken up sauces and bake desserts. There are several brands, and depending on the person, some work better than others. Iâve tried a few, and while people talk about the Aygo brand from the U.S., I stick with Brown & Polson Cornflour from the UK. I buy it on Amazon, which is super convenient. If I run low and canât get it delivered in time (rare, thanks to Prime), I use Tescoâs own brand. This releases glucose more gradually over time compared to food
Glycosade: This is a modified cornflour produced by Vitaflo (Nestle health science) with a slower release than regular cornflour. I use this because it releases glucose more gradually over time.
Other medication: I take multivitamins, vitamin D and calcium tablets because of GSD1aâs side effects.
Why Glycosade and cornflour?
Some people with GSD1a just use Glycosade; others just use cornflour. I use both, because they play specific roles in my routine. Regular cornflour is digested faster, which makes it useful during shorter fasts or when Iâm more active. Glycosade, on the other hand is digested at a slower rate and provides a steady supply of glucose, which is great for longer periods between meals.
Each meal, my carbohydrate intake is between 10â15g with some protein and vegetables. I also limit my sugar intake to around 2g (whether natural or added).
And hereâs the part no one really likes to talk about, but itâs important: Yes, Iâm a woman, and yes, I menstruate. One week before my period, and during my period, I need to increase my carbohydrate intake by 5g each mealtime (this includes glycosade and cornflour intake). I didnât know this for years â and since adjusting it, I havenât had as many hypos.
All aspects of GSD1a management is perfectly calculated; what people do and how itâs treated depends on the person; occupation, weight, height, gender, ethnic background etc.
How do I manage it all? Honestly, itâs a mix of luck, and a âfake it âtil you make itâ attitude. No Iâm joking â but seriously, hereâs how I keep everything running smoothly:
Alarms: I have 9 alarms set every single day for all the timings listed above. My alarm schedule is like clockwork: 1:00am, 6:00am, 9:00am, 9:30am (just in case I forget to put my 30 minute timer on after finishing my breakfast), 12:30pm, 1:00pm (same reason but for Lunch), 5:00pm, 7:00pm, and 8:00pm.
Timers: I also set two additional 30-minutes timers after breakfast and lunch to remind me when to take my next dose of cornflour or Glycosade.
Prep: For my cornflour and Glycosade, I weigh out everything at the end of the week for the next week ahead. I batch-cook; Ready meals, pre-made meals and takeaways are off the table because they usually have too much sugar or too many carbs. (Sidenote: there is one GSD1a-friendly restaurant Iâve found â Nandoâs! I order chicken wings and a side of chips, though I still have to weigh out the chips.)
Support system: I wouldnât be here without the support of my parents, partner, and the AGSD charity. Theyâve been my rock, especially during severe hypoglycaemic episodes, illness, and general day-to-day management. AGSD also provides information and social activities that keep me going.
Liver Transplant; In some cases, a liver transplant can replace a damaged or diseased liver with a healthy one.
Gene therapy; This is a developing area of research and could be a game-changer for GSD1a patients. Although itâs still in progress, the studies so far look promising and could improve quality of life for people with GSD1a in the future.
Living with GSD1a requires constant vigilance, but with the right treatment, tools, and support system, itâs manageable. It may not be easy, but itâs become my way of life, and Iâve learned to adapt. If you or someone you know is dealing with GSD, know that youâre not alone, and there is always support out there.
Living with GSD1a and what that means to me
Living with GSD1a shapes every part of my life â from the way I plan my day to the way I see myself; it has taught me the importance of patience, persistence, and adaptability.
Itâs not always easy, but Iâve come to realise how strong my body and mind have become because of the way Iâve learned to manage this condition. While itâs tough, I wouldnât change the life itâs given me.
Living with a rare condition means constantly learning how to advocate for myself and explain it to people who might not understand. I wonât lie â this can be draining and annoying but itâs necessary for my safety. When someone actually takes an interest, because they want to, not because they have to, it makes the world of difference.
I always liked proving people wrong and being the woman who âbeats all oddsâ because thatâs what my whole life has felt like. This really hit home when I moved away for university.
My mam and I were both worried and we had so many conversations about it. The original plan was for me to live at home and commute to a local university, but after a lot of talking, we realised that if I didnât move away thenâŚ. When would I?
So I did it â with a lot of planning â and it felt like a huge achievement. It gave me a massive confidence boost. I remember feeling so proud, and Iâve never looked back since. In fact, I keep asking myself, What can I do next?
That move taught me that independence doesnât mean doing everything alone â it means learning what support I need and how to manage things safely.
Of course, there are days when Iâm brought back to reality of ~I have GSD1a~ and things donât go as smoothly. On those days, Iâm reminded of how much attention this condition needs and how much I still rely on other people. As sad as it sounds, I need those days â they keep me balanced and remind me why I take my routine so seriously.
Every day begins at 6am, wake up cornflour then either a) get ready for work or b) go back to sleep for another two hours before making breakfast. Some mornings are easier than others. If I havenât had a good nightâs sleep, my blood sugar can be off right from the start. But Iâve learned to expect this, my house is full of snacks and emergency foods for exactly these moments.
I have to be very strategic about what I eat and when. I know that certain foods can cause my blood sugar to spike, while others might leave me feeling lightheaded or dizzy.
Iâve become an expert at balancing meals and snacks to keep myself on track and if you want more information â or recipe ideas I actually use â let me know. Iâm more than happy to write a post about it.
Travelling is a whole different challenge. I donât travel abroad unless I have to, mostly because itâs always interesting going through security, and the thought of being stuck in another country where no one speaks my language genuinely terrifies me. Doctors rarely know what this condition is, so if I need help, it would be very difficult to get that message across.
I do still travel â I still have to live a good life â this topic is not a fear, itâs just risk management, and I never do it alone all we need to do is preparing. I have to carry extra snacks and make sure I have access to food thatâll keep my blood sugar stable. I always check hotels beforehand and hope they have a fridge in the room (which often increases cost), and I check what nearby stores and restaurants are around so I know where I can eat or get what I need. It adds a layer of complexity that most people donât think about but itâs feasible.
Living with GSD1a will always be complicated, but I refuse to let is stop me from living my life to the fullest. Despite the challenges, Iâve learned to build a life I love â just one that takes more planning than most. And thatâs okay â my life just has a different rhythm, and Iâm learning to embrace that.
GSD1a is complicated, and itâs something I live with every day â but itâs only one part of who I am and itâs no longer something that limits my life. Itâs just one part of my story.
Living with it means navigating symptoms others may never see, and managing a condition that demands strategy, patience, and resilience. Itâs not easy â but itâs absolutely possible.
If youâre living with GSD1a or any rare condition, please know this: you are stronger than you realise, and you are not alone in this journey. Remember: âGod only makes those who are strong enough, deal with sh*t. Youâre a lot stronger than you think to be here today.â There is support out there, and you deserve every bit of it. Keep advocating for yourself, keep asking questions, and keep showing up one day at a time.
This space is for you. If you feel comfortable, share your experiences in the comments. Your voice matters here.
I welcome any feedback, notes and discussion. See you next week about ADHD. I hope you have a lovely day and week.
Link to blog on medium: https://medium.com/@scatterlight.gsd/gsd1a-105945b82e6c