Nine Years With Type One Diabetes -This Year’s Lessons On Balancing Mental & Physical Health

Today, August 4th, is my nine year diabetes diagnosis anniversary (or diaversary as said in the diabetic world). Every year when this day pops up, I reflect on the wild ride that is managing type one diabetes (T1D) and how the year’s events have affected my glucose management and vice versa.

This past year has opened my eyes to the connection between mental & physical health, as well as the importance of balancing them. I switched from multiple daily injections to an insulin pump less than a month before the unexpected passing of my brother last year. I’m grateful I’ve had the technology available this past year to take some of the burden and stress of diabetes management off my shoulders. This was especially true on the very low and bumpy parts of the year’s ride, when balancing my emotional, physical and spiritual health was a dangerous juggling act. The pump has taken a few steps off my plate and made it easier to administer insulin and make adjustments to doses, helping prevent lows and adjusting in realtime for highs. The pump does not replace the monitoring of my blood sugar levels or the multiple decisions throughout the day to keep myself healthy, but it’s definitely a welcome change to the multiple stabs and jabs of multiple daily injections. It’s a snazzy tool in my toolbox that I am certainly going to continue utilizing.

At the same time, I learned that technology cannot replace the responsibility and role you play in your own wellness. No doctor or therapist or expert can, either. When I was feeling very low, I handed off my wellness reigns to other people for some time -doctors and therapists being some of them. Eventually, I started to realize I am still the most important member of my wellness team. You have to learn how to utilize the tools and help available to you in a way that makes sense for you and keeps you in the driver seat or your own life. This in itself has been a balance for me to learn. I truly do believe nobody knows you as you know yourself, and the more in-tune you are with your body, mind and spirit, the better role you can play in advocating for yourself and determining what is enhancing your wellbeing and what isn’t. I have a tendency to go all-in on one area of my life - whether it be physical wellness, mental health or spiritual health - and essentially throw the equilibrium out of balance in the other important areas of my life. I’m still trying to figure out the rhythm here - some days, certain areas will naturally demand more from me than others, but I am keeping the overall need for balance in mind and giving myself grace when things are a bit out of whack. My insulin pump has a few different settings -one of which gives the technology more control over basal insulin doses throughout the day, and another that is a bit more structured. The pump is typically advertised for its “closed loop system” that determines those doses for you based on your glucose readings, but when I used that, my sugar was higher than I have ever seen it and very difficult to control. It did not make sense for me to continue using that feature as I achieve better time in range with a pre-determined amount of insulin flowing behind-the-scenes, in addition to correction and bolus doses throughout the day. (Note: diabetes really is it’s own language, and I will stop speaking it now and move on!)

This year has also taught me just how many things can throw your body’s homeostasis out of whack. If you’re stressed, tired, traveling, sick, inflamed, depressed/anxious, hormonal, out of routine, dehydrated, overheated, overwhelmed, taking certain medication, emotional, injured, burnt out… it all weighs on both your mind and body, affecting many things happening “under the hood” that most people don’t ever realize. The weight of some of the year’s grief/trauma & the emotions and situations that have come with it have thrown my own personal body into a loop this past year. I’m using 1/3 more insulin than I was prior to last September. It’s much harder for me to control my sugar spikes, despite using the pump & CGM, and I’m spending more time than ever out of my target glucose range. The internal weight of stress has required a new baseline of insulin, even almost a year later when I’m “doing better” I will likely never return to the doses I was using before this past year. My weight has fluctuated quite a bit this last year, which has added its own weight to the existing mental load. My A1C -or average glucose levels over 90 days -is the highest it’s been since being diagnosed with T1D. My doctors have tried to brush this off and tell me it’s “normal” that doses will go up over time, but it is still very confusing and frustrating for me to accept. I typically have better sugar readings than most patients who my doctors see- who are typically older, type two diabetics - so advocating for my health has been frustrating when I feel at times dismissed due to my age and numbers compared to other patients in different situations. Compared to the patient in the next room, my numbers may be fantastic - but looking at my labs increasing over the year is concerning to me, and I want to ensure nothing is missed. It makes me a bit nervous for the future and my overall insulin resistance, but I will keep on showing up and doing my best. Finding other medical opinions and getting into a new Endocrinologist are on the top of my list, but this process is typically lengthy as there is an imbalance of demand & practitioners.

Ultimately, life happens - some things will never be the same, and giving yourself grace with an autoimmune disease and letting go of the need to be perfect and accepting some things truly are out of your control, despite your efforts, will help you focus on the big picture. My big picture contains a happy, healthy life. Lots of time spent outdoors, a family of my own, a safe and relaxing place to call home, adventure, travel and surely lots of unknowns. The unknowns can be a little daunting, but I know that as long as I continue to show up for myself, give myself grace and take care of myself physically, emotionally & spiritually, the views will be worth the work, no matter what twists and turns lay ahead.