Talking about diabetes

I have a super-human ability for spotting insulin pump tubing among headphone cords and blood glucose meter cases among wallets and I like talking to people about diabetes, so when I saw the infamous black case I knew I had to start a conversation.

spot the meter“You have diabetes.” I said as I pointed to the meter case (Yes, I realize this is not the best approach for privacy and personal disclosure, but he had left the case sitting out…).

“How did you know?”

“I have it too.”

He shared a little about his recent blood sugar results and the blurry vision he gets when his blood sugar is too high. We talked about the frustration he feels when he is wait for his numbers to come back down.

He told me he wished that he had known about his family history with diabetes sooner because he would have made different choices so he wouldn’t be facing the battle he is now.

It doesn’t really matter what type of diabetes a person has, a lot of the feelings and actions are the same. I don’t get blurry vision when my blood sugar is high, but my body definitely lets me know in other ways that it is unhappy. I also get really frustrated when I wait for a stubborn blood sugar to come back down. I do have the “benefit” of insulin to speed up the process, but I understand the feeling.

Towards the end of our brief conversation, my new friend with diabetes told me about his most recent A1c result and that his doctor had told him that as long as he stays in that range he doesn’t have to take insulin. He mentioned someone else he knows who has diabetes “really bad” and has to take shots. My friend shared that he is really trying to make the right decisions because he doesn’t want that to happen to him.

There is a lot that I don’t know or don’t understand about type 2 diabetes, but I have picked up a few important pieces of knowledge from being a part of the greater diabetes community. One of those things that I’ve learned is that type 2 diabetes is a progressive disease. There is a good chance that eventually his pancreas will get burned out and need a little assistance in its insulin supply from an outside source. I shared what little I knew about the progression, and shortly after that we both had to get back to our tasks.

There is a lot of talk about diabetes – online, in person, with health care professionals, and in the media. How do we move the conversation from the idea of insulin signifying some sort of failure toward the acknowledgement and acceptance that it is the regular progression of a disease?

P.S. I don’t think insulin = failure is an issue just for people with type 2 diabetes. I know I have been in situations where it is so tempting to compare basal rates or total daily doses with other people with type 1 when really our insulin amounts have very little to do with each other.


  • Most of the people I know offline who have diabetes have type 2 and the idea that needing to take insulin means they’ve failed is so prevalent. I think that many with type 2 view insulin as a final, permanent treatment that they’re going to be stuck with forever. I recall saying to a very disheartened family member, “Having to take insulin doesn’t mean that you failed, your body has been through a lot and it may need help.”
    I feel that they don’t get the benefit of complete education from their health care team and insulin becomes a threat rather than a medication.

  • Sara, I had a similar conversation with someone a week and a half ago. I didn’t think through what I was going to say (not always a good idea for me), but I reminded the person that our bodies can give up, even if we never do. People need to identify with diabetes as a disease, rather than a failure. Thanks for giving me something to think about.

  • Iinsulin doses aren’t judgement free. I realize this could just be in my head, but isn’t it actually better—if you can swing it, and I don’t mean morally but for health but I guess there’s some factor of (goodness vs evil) high ground in my mind—to use less insulin by eating fewer carbs and moving your large muscles around a lot? Like ooh ahhhh she only needs one unit of Lantus a day because she’s a professional dancer or ew, ugh, yuck, danger, this kid eats 200 grams for lunch and takes 20 units to cover it.


    • I’m projecting. And saying too much. I just know that in my current situation, I won’t need insulin as long as I don’t eat a ton of carbs, and I definitely would feel like a pig if I was not able to stick to th

      • There is something to be said for making life choices that reduce our insulin needs. Smaller doses = smaller mistakes. BUT I guarantee you that if you have LADA (especially), your disease will progress to the point that you need insulin. You haven’t failed. Your pancreas did.

  • There is definitely a lot of judgy-mc-judging around insulin doses :)…people freak right out when I say my insulin to carb ratio is 1:5, and that I take about 45 units in just basal insulin per day. It’s a LOT of insulin because I am highly insulin-resistant, as a Type 1, who has PCOS and a lot of other issues that make my body act as a Type 2 as well. Thing is, if you’re type 1, you’ll always need *some* amount of insulin. Insulin is the “bus” that carts the glucose out of your bloodstream and gets it to your cells (like, including brain cells) to give you energy. Even if you burn off that sugar by exercising or existing, it still needs a way to get out to your body. Unfortunately, I just need MORE of it to bus that sugar crap out of my bloodstream, and it’s a never-ending struggle.

  • Two of my (young) stepsons have T1. The older boy diagnosed at 4, his brother was 7. Their rates of insulin are different, the one who had it first was taking more insulin, then their rates met, and now the younger one gets more insulin. Fun times considering the younger one requiring more insulin watches his food intake much better than his will-nilly brother. And now they are entering puberty together. Ahhhh!

  • In my previous job, I used to tell patients who were bummed about starting insulin that it made our jobs, both of us, a lot easier becuase he/she could give me numbers for a week and I could quickly titrate insulin over the phone and they would feel better a lot faster than waiting 3 months for oral agent adjustments. I said it in a half joking/half serious way and it seemed to really help many. It’s also the truth. Insulin is just EASIER if you can get over that it’s an injection and also… insulin…
    I could go on and on about this for days and days.

  • I have Type 2 Diabetes and am aware that in the future (hopefully not in the near LOL!), my system will eventually have its time. I guess the best thing that I can do, as well as other Type 2 Diabetics, is to try to delay it by making wise and healthy choices…

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