I had a moment of sudden pride and gratitude last week, while sitting in the waiting room of the Penn Rodebaugh Diabetes Center (my wonderful diabetes center where I check in and receive support — you guys are fantastic, in case you ever stumble across this little blog post). I was there for my initial meeting with the nurse educator who is in charge of pump training, as I am about two weeks away from switching over to a t:slim insulin pump after 23 years of daily injections. This is, of course, a big change for me, and I’m both excited and nervous for it. Twenty-three years is a long time, and I’ve gotten quite used to my daily routines. So I was sitting there, thinking about this whole transition and wondering how it will go, when I looked across the room and saw a young woman, maybe 15 or 16, there with her mother in the waiting room. She was wearing a pump, and I felt a sudden onrush of admiration and appreciation for just how well we handle this serious illness of ours.
It’s easy for us to forget how exceptional we are, really. Of course, we have a manageable disease, and treatment advances have made it progressively easier for us to limit the harmful effects it has on us. But that doesn’t mean we don’t have to put in an extraordinary amount of time, work, and care into it. It doesn’t mean living with diabetes is somehow easy! And it doesn’t mean living with diabetes is just some afterthought for us. Diabetes is a big part of our lives, and something that requires a great deal of intellectual and emotional maturity. Seeing this adolescent with her insulin pump just brought this all back home for me.
It takes time
With all of the advances in treatment over the last 20 years, including fast-acting insulins, continuous glucose monitors, and of course pumps, it’s easy for outsiders to think that diabetes management is just automatic now. But we know this is very far from the truth! Pumps require MORE user input and MORE blood sugar testing, not less. Continuous glucose monitors are great, but all that information can be very overwhelming, and to use it effectively means devoting more time to analyzing the trends and really working to understand what’s causing them. Fast-acting insulins meant we could move away from set meal plans, but it also meant we had to be able to count the carbs in any food we were going to eat, and do it accurately!
It takes work
Diabetes ain’t easy. Good control is the result of constant smart decisions, accurate assessments (of carbs, of stress levels, and so much more), and disciplined follow-through. It is the result of collaborative data-review with our health-care teams. We have to learn how our foods work in our bodies — how to count carbs, how non-carb foods interact to change the absorption rate of said carbs into our blood sugar, and the physiology of how illness, stress, lack of sleep, or emotional ups and downs impact our blood glucose (because they all do). We have to respond to unexpected high blood sugars and low blood sugars intelligently, to bring our numbers back in line and avoid the dreaded Somogyi effect!
It takes care
It takes a great deal of emotional intelligence, emotional maturity, and self-care to live with diabetes. I don’t always succeed in this, but I do my best. It’s easy to beat ourselves up when our numbers are running high. It’s easy to get super angry about it. It’s easy to feel burnt out and resentful of having to keep that constant “diabetes calculator” running in the back of our head (you know what I’m talking about — that part of our brain that seems to be permanently devoted to tracking our diabetes — “Is my blood sugar OK? It is moving up? Is it moving down? I’m about to exercise, should I eat something now? How much? I didn’t get much sleep last night, should I increase the basal by 10%? How many carbs are in this sandwich? Should I wait 10 minutes or 15 min….”). We have to be emotionally grounded to live with this condition 24 hours a day, because it won’t always behave, no matter what we do. And we do need to live carefully. That doesn’t mean we have to live limited lives — we can accommodate most foods, most activities, and most choices. We have that flexibility thanks to the advances we’ve made in how we manage this disease. But we need to exercise care in our decisions.
And we keep going!
Back to my moment of pride and gratitude; I’m proud to be a member of a group that manages this every day. I’m grateful for the worldwide community of Diabetians, and grateful to the doctors, researchers, and pioneers who are out there striving to make this thing easier to live with and easier to manage. I’m proud of all of us for living each day fully in spite of this disease that can, at times, demand so much of our time and energy. We are an extraordinary group, and I’m so proud to be a part!
The FDA has approved the combination oral diabetes medicine Synjardy XR for use, along with a healthful diet and exercise, in adults with Type 2 diabetes. Bookmark DiabetesSelfManagement.com and tune in tomorrow to learn more.