Living with Diabetes
People with diabetes have a part time job managing their Diabetes in addition to their full time job, family commitments and other obligations. In addition to having to watch everything they eat, exercise regularly, and monitor their sugars, people with type I diabetes and some people with type II diabetes need to take Insulin injections. All people with Diabetes need to learn to live with the fear of complications from this disease.
The burden of daily management is much greater for a person with type I than type II diabetes. Every single day, a person with Diabetes Type I needs to test his sugar at least several times per day. He may need a snack if his sugar is too low, and he may need to take insulin if his sugar is too high or he knows it is about to become too high: he must decide how much insulin to take by measuring his current blood sugar then factoring in his anticipated food intake. He must constantly keep track of his blood sugar and adjust his diet and activity level accordingly in order to stave off emergency hospital visits and more long-term health problems. He knows he may do everything he was advised to do and because of factors beyond his control still end up in the hospital with uncontrolled blood sugars, DKA, or a complication from Diabetes. Because this disease strikes at a young age, women have to decide if they should assume the risk of pregnancy. Many patients are attached to insulin pumps and they have to make sure they are working. They may be frustrated because they may take the same amount of insulin, eat the same things, and get the same amount of exercise with very different results when they check their sugars. The treatment of diabetes commands so much knowledge and discipline that it becomes overwhelming for both the patient and their families. Other family members and friends without diabetes may find it challenging, even impossible, to understand or appreciate the day-to-day struggle of individuals with Type I Diabetes. Many patients show remarkable courage and resilience when taking control of their condition and find ways to balance diabetes management along with everything else going on in all areas of their “normal” lives.
Diabetes does not only influence a person’s physicality, but it also enters many other aspects of life. For example, family dynamics often change when a child is diagnosed with Type 1 Diabetes. Parents often take strict control over the child’s diabetes management in an attempt to prevent long-term health consequences, and sibling relationships often deteriorate. Normal rebellious activities during adolescence are frequently exacerbated when the young adult has diabetes, and behavioral problems and poor school performance often develop.
Tension may also arise between diabetic patients and their physicians, especially when blood sugars are not well-controlled. The physician cannot always determine whether the inconsistent blood sugars are due to the diabetes itself or to the patient’s lack of effort in managing the condition. Physicians must understand the daunting task of constantly following a structured regimen of diabetes management while performing everyday tasks like going to school or work. In addition, the physician must understand the patients’ reasonable frustration when diabetes prevents them from doing enjoyable activities. For example, exercise or other physical activities like sports can cause blood sugar to fall, making the diabetic individual feel tired and unable to continue the activity he/she had been enjoying. Adolescents need to figure out how to socialize with their friends without appearing weird because of insulin pumps, dietary restrictions, the need to check sugars, as well as the need to avoid alcohol. Physicians must make the effort to understand all the forces that influence their patients’ behaviors in relation to diabetes management, and do all they can to coach their patients into performing the best they can. Physicians have a responsibility to their diabetic patients to help assess quality of life and the patients’ abilities to meet their life goals in addition to managing their diabetes. It is necessary for the doctor to get to know the patient as a unique human being in addition to understanding the disease afflicting the patient. Instead of treating only the disease, the physician must work as a team with the patient to teach him how to treat the diabetes himself.