Taking Charge of My Diabetes
(The Pittsburgh Post-Gazette, August 26, 2003)   

I was supposed to be blind, on kidney dialysis or dead by now. In 1973, when I was diagnosed with type 1 diabetes at age 9 at Children's Hospital of Pittsburgh, my parents were told to expect complications from the disease in a decade. Now, after 30 years, my eyes and kidneys are slightly damaged but still fully functional -- and I work hard to keep them that way. 
   
I am not a diabetes victim. I'm a survivor. 
   
Insulin shots and a blood sugar test kit are my survival tools. First thing every morning, I prick my finger and place the blood on a strip in a machine. Then I wait 20 seconds, breath held, for the result. If I did everything right the night before--and if my body is playing by the rules this day -- I should get a reading somewhere between 80 and 120 milligrams of sugar per deciliter of blood. 
   
Next, I calculate my insulin dose: roughly 1 unit for every 15 grams of carbohydrates I plan to eat. If my sugar is high, I add an extra unit for every 50 mg/dL it is above normal. But if I plan to exercise after eating, I cut the dose back so that my sugar level doesn't drop too low. (When that happens, I have to eat something sweet to keep from passing out.) I inject the insulin into my upper arm, thigh or abdomen. Then I eat. 
   
I repeat the same process before lunch, before dinner, and sometimes again in between. Bedtime brings another sugar check and another shot, this time with a dose of long-acting "background" insulin to keep my metabolism working through the night and the next day during times when I'm not eating. 
   
How do I feel about this daily regimen of pricks, sticks, and arithmetic? Extremely proud. Diabetes is my burden, but also my badge of honor. Some folks climb mountains. Others pilot hot-air balloons. I manage my diabetes. Granted, I didn't choose this challenge, but I have chosen to rise to it. 
   
That choice was relatively recent, though. For the first 22 years, I didn't really try to control my diabetes, even though I was well aware of its dangers. I remained in denial even after undergoing laser surgery in 1991 to seal up leaky sugar-weakened blood vessels in my right eye. 
   
My turning point came in 1995. A urine test showed high levels of protein, a sign that all those years of filtering excess sugar from my blood had begun to wear down my kidneys. That's it, I thought. Diabetes had finally overtaken me. I spent several weeks steeped in self-pity. 
   
Finally, something clicked. "Nobody else can do this for you," I told myself. "It's your choice." From that moment, I decided to take control. After all, I was only 31. I had a lot of living left to do. 
   
Have you ever finally attempted something you'd been avoiding because you feared it would be too hard, and discovered you could do it after all? It's a great feeling. Now, every good blood sugar reading is my own mini-victory, like making a basket in the trash can from across the room. Lucky me -- I get at least four free throw chances every day. 
   
Of course, my record still isn't perfect. A blood sugar that's off the mark requires a review of possible reasons: Did I overlook a carb at my last meal? Am I premenstrual? Stressed out? More often than not, the answer is simple: I got distracted or lazy, and wasn't paying close enough attention. But I don't let myself slide for long. To do so would be to fall victim again, and I'm too invested in survival. 
   
It saddens and frustrates me to hear others with diabetes say things like "I have a blood sugar machine, but I don't use it," or "I don't really control it. I'm just waiting for a cure." Not only are these folks risking their physical health, but I believe they are also depriving themselves of an equally important life-force: A sense of empowerment over their own destiny. What could be more essential to the human psyche than that? 
   
When it comes to the concept of cure, I'm oddly ambivalent. It's as if I fear that being cured of my diabetes would somehow make life too easy -- the way I felt when pocket calculators first came out or when bowling alleys switched to automatic scoring. 
   
But that's ridiculous, of course. Diabetes isn't a game. It's a life-threatening disease I share with 17 million other Americans, many of whom don't have the employer-provided health insurance that is my lifeline. I know I'm lucky, and I don't take it for granted. 
   
Moreover, there may come a time when my energy and enthusiasm wane, or when the disease outsmarts even my best efforts. So yes, if a safe, proven cure comes along, I will embrace it while simultaneously shifting my focus to other life challenges. I'm sure there will be plenty to choose from. 
   
After all, with 30-plus years under my belt, I'd still merit the title "survivor."

​​​Miriam E.Tucker