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Fear is a funny thing. In a controlled situation, say a movie theater or roller coaster, it can be exciting. It gets our blood pumping, gets our adrenaline racing. But in the real world, where anything can happen and safety isn't assured, fears can get out of hand.
For people with type 1 and type 2 diabetes, who have to grapple with their disease multiple times a day, there is no perfectly controlled situation. Something can always go wrong. So it's easy for our fears to multiply and drive our actions. But we don't have to let them.
In July, I wrote about five big fears that people with diabetes face and ways to deal with them. Here are five more, along with suggestions on minimizing them.
High Blood Sugar
If you've been a type 1 for a long time, you know that low blood sugars are the biggest concern in day-to-day control. You want to minimize highs, of course, for your long-term health, but it's the lows that pose immediate challenges.
But for people who are new to diabetes, or for family and friends who don't know much about the disease, it's the super-high blood sugars that seem scariest. They worry about comas and trips to the emergency room, about fatal doses of sugar and ketoacidosis.
This fear, thankfully, has an easy answer. As long as you take even modestly good care of your diabetes, it's not something to fret about. A decent dose of 24-hour insulin or a good basal program for your insulin pump will provide the coverage you need throughout the day. And as long as meals are covered with a logical dose of fast-acting insulin, you should be set.
That doesn't mean that a your blood sugars will always be ideal. It doesn't mean perfect A1c numbers are just around the corner. But it does mean that super-high blood sugars won't wallop you or someone you love. (And if they do come to pass, don't panic: Have an action plan worked out with your healthcare provider, and don't hesitate to call emergency medical personnel if the situation warrants it.)
In most cases, you aren't required to disclose your medical condition while looking for a job. It's simply nobody's business. But in the long run, you may be concerned that your disease will affect how others look at you in a professional context. Maybe they will be less likely to trust you with high-stress assignments or top-priority jobs.
Unfortunately, we can't control how everyone behaves toward us. But we can control how we behave toward them. Once on the job, if you need some sort of reasonable accommodation for your diabetes, don't be afraid to request it. Federal law requires employers to help you out. And I've personally found that talking to people about it in a low-key, low-drama way gets results.
After all, you can make the case that handling such a challenging disease day in and day out actually qualifies you to make bigger and more important decisions. You're weighing important decisions all the time.
In the wider world, there may occasionally be people who look at you oddly. After all, it's not every day you see people injecting themselves with a syringe or pricking their finger. Again, you have the power to deal with these situations. Make them as drama-free as possible and move on.
You can't control other people or what they think about you. But you can control your disease, and that's your most important job.
Taking care of diabetes can be expensive. If you're interested in some of the top-of-the-line technology available these days, it can be even more so. Grappling with the disease's complications can add even more costs, especially if they're severe.
So how do you pay for it all? There's no avoiding it: Folks with chronic diseases are some of those most poorly served by our current health care system. If you have a job with good insurance coverage, then you're lucky. But not everyone is lucky, unfortunately, and insurance plans change year by year-mostly for the worse.
All of that being said, though, there are reasons for hope. For one thing, the increase in health care costs has been slowing recently. Part of getting to a sustainable and sane health care system will be having health costs that keep pace with inflation, without taking ever-increasing bites out of our wallets.
Secondly, the Affordable Care Act, which will continue to be phased in this fall, offers subsidies for those who need to purchase health insurance but can't get it through their employers. It also dramatically expands Medicaid coverage (although not all states will implement that part of the law). While the law remains controversial, its benefits for those with chronic diseases could be quite real.
The best news of all? The most effective treatment for your diabetes isn't a pump or fancy meter. It's your own dedication. Educated people with diabetes can enjoy incredible results with some syringes, vials of insulin, and a cheap blood glucose meter.
Can They Handle It?
If you're a parent or spouse of someone newly diagnosed with diabetes, this will probably be one of your first questions. And one of your first fears. After all, you know your loved one well. You've seen him or her at the worst of times. Will this disease prove too much?
We can offer reassurance to this question, but it's limited. You can help your child or spouse learn. You can keep watch over them as best you know how. You can model good eating habits and healthy behaviors. (Your doctors and diabetes educators will be tremendous allies here, so don't hesitate to ask them help.)
You can do all of these things, and all of these things will helped your loved one. They really will.
But they only go so far. If you're a parent, you know that your child will ultimately have to face the world on his or her own. They will hopefully remember your lessons, but you'll have to trust them. If you're a spouse, you already know that there's only so much you can do to change someone. They have to go the rest of the way themselves.
... The Rest of My Life?
Over the course of writing this article, I had a challenging week. Some crucial supplies for my diabetes control were delayed. I was forced to take charge of my situation and try to fix it. I did, but the aftermath was quite difficult. My routine had been thrown off.
At times, I despaired. Not because I thought the situation wouldn't be resolved, but because it showed how difficult and labor-intensive this disease remains. Some days, it feels like I'm starting from scratch-after having been a diabetic for decades.
And that's our final fear. The one that every type 1 and type 2, has. The one that every caregiver has. That this chronic disease, this condition that changes our lives and habits and personalities-that we will just have to keep wrangling with it. That no matter what we do, it will progress.
Maybe we'll have complications. Maybe we'll suffer cardiovascular disease. Maybe all of our efforts, no matter how sincere, will fall short. In other words, we fear a future made perpetually uncertain.
There's no easy reassurance in store here. That's because the answer to this fear can only be found inside each one of us. We each have to decide how to view this future and how to square it in our minds. We can't know everything. We can't control all the variables. We must each make our own way, knowing that we will often fall short of perfection.
An ideal situation? Of course not. But we'll make the best of it. We have to.
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1 comment - Sep 5, 2013
Diabetes Health is the essential resource for people living with diabetes- both newly diagnosed and experienced as well as the professionals who care for them. We provide balanced expert news and information on living healthfully with diabetes. Each issue includes cutting-edge editorial coverage of new products, research, treatment options, and meaningful lifestyle issues.