Today is the 26th anniversary of the day I was diagnosed with Type 1 Diabetes. Every year I mark this day on the calendar and anticipate it. It may seem odd to “celebrate” such a tragic day in my life. But, I see it as a time to reflect on the years I’ve spent managing this disease and give thanks for being healthy and (knock on wood) complication free after all these years.
I recently stopped using an insulin pump and returned to injections. There wasn’t one big catalyst for this change. My pump warranty expired several months ago and my insurance company has made a special deal with one particular pump company that I refuse to use. I researched other pumps, but didn’t feel drawn to any of them. I’ve been pumping for over five years, after taking a three year break when Teo was born. I was tired of being tethered to the pump.
One of the big virtues of pumping insulin is the ability to make small tweaks throughout the day by bolusing (delivering insulin) with the touch of a couple buttons. The thing is, this makes it really easy to snack all throughout the day or overeat. For example, tortilla chips at a party. If I ended up eating more than originally planned, I can just keep delivering insulin to cover them. I felt ready to be more intentional about my eating and injection insulin would make that a necessity.
Last time I used long acting insulin to cover my basal needs, the best option was Lantus. I assumed that’s what I’d be using again. But, my medical team advised that I use a newer insulin called Tresiba. They explained that it lasts longer than 24 hours so you don’t have to be as precise about dose timing. Also, it takes a few days to “build up” in your system to work at full capacity.
The first day of injections, my blood sugars ran high ALL day. I was injecting fast acting insulin constantly. It was very frustrating, but I remembered the advice about Tresiba and talked myself down. It was such an opportunity to practice letting go of my need for control and recognizing that change and transition are going to bring emotional upheaval! By the third day, my blood sugars ran low as the Tresbia was fully functional and I’d quickly become accustomed to bolusing extra insulin for meals. Eventually it all leveled out and I got the hang of it.
Diabetes has had such a huge impact on my life. When my blood sugars are high or low, it receives a lot of my mental and emotional energy. Each time I test my blood sugar or check my continuous glucose monitoring system, the result potentially impacts my emotional state. A “good” number (typically 80 – 160) is met with satisfaction and contentment. Whereas a “bad” number (anything outside 80 – 160) can trigger guilt, frustration, and anger.
I sometimes ponder what came first, my desire for order and control (aka perfectionism) or Type 1 Diabetes…? They have certainly developed simultaneously in my life. Diabetes provides circumstances that exacerbate my desire for control. That’s even what they extol as the great virtue of diabetes management: being under control! However, diabetes also provides many daily opportunities to let go of perfectionism and reject the judgments of personal worth based on the current data point of my blood sugar.
While diabetes can be very demanding, there are many times when it hums along in the background of my consciousness and doesn’t demand much attention. It can be like time in that regard, while always present, it can also slip by without notice for periods. Speaking of time, when I was diagnosed doctors said diabetes would be cured in five years. That was 21 years ago. While technology has made diabetes much easier to live with and manage, a true cure is not something I anticipate or hope for in my lifetime. I’m sure they’ll figure out the artificial pancreas or closed-loop system at some point.
I’ve come to realize that managing diabetes will look different throughout my lifetime. Diabetes management could involve pumping insulin, using injections, manual blood sugar testing or wearing a CGM. Lots of ways to accomplish the same thing: know what your blood sugar is and decide how much insulin you need. I’m not going to master one way of managing diabetes and use it forever. Life isn’t like that, we change, grow and adapt. This is one of the lessons that diabetes has helped me learn.