by Riva Greenberg
Published in the
Juvenile Diabetes Research Foundation, ChapterNews, Spring 2005 Issues and Answers
At 50, having been a Type 1 diabetic for 32 years, I thought it timely to visit an endocrinologist and for the first time, a diabetes educator. I wanted to see if I knew everything I could about best managing my disease. I decided to do this for a number of reasons. Although I read information online regularly and skim the Countdown magazine, maybe there were some new technological advancements or nutritional and management tips I should know about. Also, a knowledgeable friend recently asked why I wasn’t on Lantus. I learned that I’d only have to take this relatively new type of insulin once a day rather than my long-acting Lente that I take twice a day.
So I set off for my first appointment with my diabetic educator. “Yes,” she said, “we could try you on Lantus, but given your lifestyle,” – unregimented work as a consultant and frequent travel, due to my Dutch husband – “have you considered going on the pump?” My heart froze. The pump is something I know about but have always kept locked behind a door. I know about it as a layperson; it’s a small machine that’s hooked up to you and people who can’t control their blood sugar use it. I, on the other hand, am managing my diabetes well on four shots a day, which I don’t particularly mind. Why would I want to be attached to a machine 24/7?
But before I could register my displeasure, my diabetic educator was showing me the pump she recommends to her patients. It was, admittedly, smaller than I expected, and not entirely un-cool looking. Its technical operation was not very complex and she began to wax poetic about the freedom it would give me from having to make all my day’s decisions about food, meals and exercise when I took my pre-breakfast shot at 7:30 AM. I began to wonder, would it release me from the necessity to eat lunch by 1 PM? Or eat at all? Would it help me avoid hypoglycemic episodes, particularly after exercise, with insulin delivery that’s moment-to-moment? And, would it give me better control and thus prevent or delay complications?
Then other questions flew into my head. Do I want a constant visual reminder of my disease? Where on my body can I comfortably wear it? What about when I go to a wedding and want to look, and feel particularly attractive? And, what about sex? If anything could kill the mood, this would seem to be it. Ultimately, how do I weigh the emotions that I don’t want to be attached to a machine with the better health it may give me?
When I left my educator’s office she said, “Think about it.” And you know, that’s exactly what I’m doing.