I was talking with a colleague the other day who knows a young person with diabetes. According to my colleague, this young person (not an adult, but more than old enough to be making adult decisions in regards to health) wasn’t doing a good job with diabetes management, even using diabetes control (or lack of) to “hurt” the caregivers emotionally.
It was hard trying to explain to my co-worker how complicated having diabetes can be sometimes. Sure, all of my co-workers see me with my insulin pump. They see me bolus for food. They see me test. They hear my cgms beeps. They’ve seen me go low and have to suck down juice boxes. But short of the two co-workers that I know who have immediate family members with T1 diabetes, none of them grasp it completely.
When my colleague was talking with me all I could think to tell that person was to think about how hard it was to be a teenager. Add to that a less than ideal home life. And THEN add a chronic illness that requires thought for every little decision that you make. A teen who has a need for control (or even an adult, because I could be accused of this) in an out of control time will reach for the things that they CAN control. For some teens, this leads to things like eating disorders, problems with depression, cutting, and a host of other issues. For a young person with a chronic illness like diabetes, there is another thing you can control (or chose NOT to control, which in a sense is some sort of control).
I could tell I wasn’t quite getting through and I knew it. So I tried another approach. I’m going to share it with you here.
You get to work late. You skipped breakfast and instead grabbed a pack of vending machine crackers to munch on. For most people, that’s it. For a person with diabetes, there is so much more to that. I look at that pack of crackers and I think:
- “What’s my blood sugar now?”
- “How do I feel right now?”
- “Do I have any insulin in my system right now?”
- “How many carbs are in those crackers?”
- “Am I going to be eating lunch early today?”
- “Am I going to be eating lunch late today?”
- “Do I have anything with me to treat a low, in case I miscalculate my insulin?”
- “How much fat is in those crackers? (It affects digestion, which affects insulin and how/when you give it)”
- “Am I planning on being ‘off schedule’ for my day?”
- “Will I be more or less active than normal?”
- “How much insulin am I going to give?”
These are just some of the questions that float around in my head on a regular basis. And that was just for one pack of crackers. Even though each of those thoughts might not be individual conscious thoughts every time, they’re there, floating around in the back of my mind. For a pack of crackers cause I’m hungry. Never mind if I’m thinking of taking a car trip somewhere, or going to exercise, or eating a meal that’s not something I’ve eaten before.
That’s a lot to take on. For an adult, let alone a young person. When I finished telling my college about that series of questions, you could see the shock. People don’t realize how complex this disease can be. While my example may be a little over the top to some, it’s true. Diabetes doesn’t take a break. Ever.