There have been a few new diabetes diagnoses among my friends and family lately, and it got me thinking about the uniqueness of diabetes as a disease. It’s hard watching my friends go through the realization of how all-encompassing it is because there is little I can do to help. They have to come to terms with it on their own, and the longer it takes, the higher the risk of a negative impact.
Part of that realization is that diabetes is not a condition that can ever be set aside. It’s not like my other conditions that affect only one part of my body, like when I take a pill once a day and my asthma is stable or I use orthopedic inserts and my plantar fasciitis stays quiet. No, diabetes is 24/7 vigilance. If a diabetic isn’t careful, diabetes has the potential to affect every system in my body, including, but not limited to Cardiovascular System: cardiovascular disease. Integumentary System (Skin, Hair, Nails): skin cracking and yeast infections; Skeletal System: osteoporosis; Muscular System: muscle atrophy; Lymphatic System: lymphedema; Respiratory System: COPD; Digestive System: gastroparesis; Nervous System: multiple neuropathies; Endocrine System: the disease itself where the pancreas is dys- or non-functional; Urinary System: kidney disease; Reproductive System: sexual dysfunction.
That’s the bad news.
The good news is that diabetes is one of the conditions we know the most about. The first description of diabetes and use of the term diabetes occurred in the 2nd century. Yes, you read that right, The 2nd century, as in the year 101 C.E.
In the years since, we have come a long, long way. We know that there are several types – Types 1, 1.5, 2, and gestational – and have developed effective treatments for each: Insulin has been around for 100 years (2021 is the centennial of its discovery!); treatments for Type 2 are continually being developed and improved; and lifestyle treatment (nutrition and exercise) have long been known to have positive impacts on all of the types.
We have been this close to curing diabetes for decades.
We know what to do to live happy, healthy diabetic lives.
That’s also the bad news.
It’s my choice to do all the things I need to in order to stay healthy, and I mean all. Effective treatment isn’t just meds or exercise or nutrition. It’s all of them all the time. My type of diabetes requires a constant flow of a synthetic hormone regulated by a machine or two that is attached to my body. Walking away from it means either several daily injections or getting really sick and risking (more) long-term damage. And things can go wrong. In the last month, I have had both a catastrophic equipment failure, as well as a vial of insulin go bad. Not exercising is a risk, as is not getting enough sleep or eating my favorite foods more than once in a while. Oh, and stress. Getting too stressed out or even getting excited about something can negatively affect my condition.
(Controlling for the emotion-related factors is literally impossible. You can’t control how you feel. Think about someone getting engaged. That’s exciting! It also could require modification of medication so your blood sugar doesn’t spike. So romantic to give or get the ring then immediately pull out your pump to make sure you’re not treating high blood sugars for the rest of the night.)
This constant requirement to be “on” is really hard, both physically and psychologically, and it will drain you. It’s so easy to slip off the treatment wagon. You can get by for a long time in a marginal state of diabetic control, and the most damaging complications don’t manifest immediately upon straying from your healthy regimen. Much like smoking-induced cancers, you can follow the straight and narrow for a decade or more and the complications show up anyway.
There are definitely times when I wish for a disease that was less complicated to treat, even if it means less control, which isn’t very noble, but I think it’s very human. The grass is always greener, right? But I can’t switch. So, until we go from this close to an actual cure, I am stuck shouldering the burden of choice.