A box within a box within a box within a box.

Sometimes, that's the best description of my, your, or anyone else's diabetes.

The big box is Diabetes itself.

The next box is the "Type" box. Usually only two of them fit into the large case, but some folk will cram in two or more smaller boxes ("Gestational", "LADA", "MODY", and others) as well.

Then comes the "treatment" box. For Type 1s, there is basically one treatment box -- "insulin" -- but it is divided into sections marked "pump" and "MDI". For Type 2s, there's a whole caseload of boxes -- the large boxes for general medication type, with compartments for each drug in that class. In each of those subcompartment of each treatment type, for each type of diabetes, are boxes for diet types and comorbid conditions. Never mind that the comorbids often affect the choice of diabetes treatment for Type 2s, or the diet for someone with any type of diabetes -- they're sorted out at the finest level, leaving the individual with diabetes nobody else to turn to for assistance.

Let's look at another set of boxes.

The biggest box is the world. The next is the country in which you live. Next, the province or state. Finally, the town in which you live, and then the building.

You could be isolated from everyone outside your town -- and until the Industrial Revolution, you most likely were. But as slow and as unreliably as it might have traveled, you could get news to another town or county through messengers -- "the post". Riders on the king's, or the count's, business might have access to several waystations or posts at which they could refresh themselves briefly and exchange their tired horses for fresh ones. Before mounted riders, it would be relay runners -- and before letters and scrolls, word-of-mouth and a good memory.

For many of us, telephones and the Internet have followed in the paths of relay runners and post riders. Just as the post provided a dimension outside of the boxes of one's town and one's own transportation capabilities, the Internet provides us a dimension outside our tiny self-boxes, to speak with other boxes stored in the same set, case, carton, or pallet -- or to speak with others five levels down in another virtual shipping container half-way around the world. From these conversations, we learn what others have gone through before, and will be going through again. We connect out to our family, our friends, our doctors...

Doctor. Practice. Specialty. Certification board. License board. Licensing nation/medical school. These are the levels at which -- in theory -- the most knowledgeable members of our care team lie within their own collections of Matryushka dolls. The post that brings us news feeds of the latest experimental drugs brings them the same information. It is the town crier of old -- headlines, no story. For the story, you would need to go to "the individual(s) who knew". Unlike those days, we don't need the secret handshake into the more secret society to be allowed to hear the story -- we can sign up to view The Lancet, Nature, or The New England Journal of Medicine without sporting the initials "MD" after our names. (Granted, we may need to know how to pronounce the secret language and know something of its meaning in order to pass the story back to our doctors, lest we sound like the last receiver in a child's game of "Telephone".) As long as we can knowledgeably discuss our own bodies and what we have gleaned from others, as long as we can relay details about the sources of our information, as long as we can duplicate the secret scrolls by hitting the "print" button, we can, ourselves, be part of today's diabetes post system, connecting ourselves, our doctors, our loved ones, and the global diabetes community.

We are isolated only as much as we allow ourselves to be.