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People with diabetes, and those touched by diabetes, follow their journey with the disease through a myriad of winding emotional paths. Depression is very common for those newly diagnosed, sadness can rear its head at different stages in the game, and a little humor and humility can even find the door to expose itself from time to time. The keys for controlling those doors are littered all over the place and on  Wrld Diabetes Day today, you can follow this map of internet hotspots. Expose diabetes for all that it is, good and bad, and then share it with others. Find an emotion and embrace it!

 

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At 8am, I woke up to the alarm on my phone. I checked my blood sugar and was dumbfounded by the number on the screen. I was almost 100 points higher than I'd gone to bed at the night before. Pizza. Why are things never the same around here?

 

Around 9am, I left for work with an early start. Maybe I could leave early since I'd gotten some extra time the afternoon before as well. It was a thought at least. This week was my week to cut my hours back to my original 20. I'm attempting to stabilize my schedule before school throws another curve ball into the mix.

 

At 11am, I ate some crackers since my stomach was feeling a bit off. I didn't check my blood sugar and I didn't do insulin. I still haven't gotten totally comfortable with injections in my workplace. Especially since more people have been added in my office so I'm no longer alone.

 

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Several times a year, our social calendar involves an event in which each of us is expected to contribute food to be shared by all. In some parts of the US, this is known as a "covered dish dinner"; in ours, it's called "pot luck". Depending on the event and the organizer, there will be greater and lesser degrees of coordination regarding courses, types of dishes, and quantities to be contributed -- let's face it, unless it's a same-dish/recipe cook-off, even folk without diabetes would rather have more selection than five different pans of mac 'n' cheese, two different types of fried chicken, and twenty apple pies. When you add diabetes, food allergies, and other dietary restrictions into the mix, planning for success can get a bit rough.

 

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I'll admit I've never seen Buckaroo Banzai; however, the catch phrase "Wherever you go, there you are" has become as much a part of our popular culture as "Beam me up, Scotty" or "Time to make the donuts!" Yet, with about one in eleven US residents having -- or being at risk for developing -- diabetes, it's no wonder that almost every time we turn around, we meet (or learn about) somebody else "with the D".

 

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I'm no politician, but my day job does involve shaking the hands of many strangers. In the "normal" (i.e., non-diabetes-related) world, this is no big deal -- if the other person's hand is really icky, just use some hand sanitizer and be done with.

 

 

In the 1980's, AIDS-phobia taught us otherwise.

 

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Just as hyperglycemia is but the tip of the iceberg when discussing the physical ravages of diabetes, depression is but the most visible diagnosis of how diabetes affects our minds.

 

I'm not talking about the temporary states of anxiety or paranoia, lassitude or somnolescence, that accompany our glycemic highs and lows, but the long-term, "you should get psychological help for this" effects of living with chronic disease in general, and diabetes in particular.

 

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During the Diabetes Social Media Advocacy (#dsma) session on Twitter last Wednesday night, a lot of the discussion focused on Endocrinologists.  There were lots of great questions, and I enjoyed reading all the responses.

 

It soon dawned on me that there was a big difference between myself and many of the participants, and that being that I don't have an Endocrinologist.  I only have a Primary Care Physician/Provider (PCP) who helps manage the treatment of my type 2 diabetes.

 

So, just being curious, I asked the question: "Is it weird to not have an endo, and have everything managed through a PCP?"

 

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For several months, a bunch of us have taken part in Wednesday night Diabetes Social Media Advocacy (#dsma) chats on Twitter. Run by Cherise Shockley, these sessions are about an hour long and cover a number of predesignated topics ranging from support groups to diabetes-related conferences to relationships to insurance issues. A week ago this past Wednesday, talk centered around the glycosylated hemoglobin (HbA1c) test: how important it is (or should be) in determining our treatment, how accurate it is as a measure of our diabetes control, whether or not we consider current best-practice A1c goals to be realistic or not (and why), and what sort of self-treatment we use to achieve (or try to achieve) those goals.

 

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There's something that haunts every person who remembers Life Before Diagnosis. We describe it as spontaneity, carelessness, social acceptability, freedom.

 

What it boils down to are food and money.

 

For starters, diabetes robs from us the ability to "just" eat when we are hungry, not-eat when we're not, and not have to weigh, measure, and log every morsel that passes our lips. Then, it robs from us the (admittedly ill-advised) pleasures of the occasional ice-cream sundae or wolfing down half a pizza pie. And because we can't be certain of the foods that we don't prepare ourselves, it robs us of the ability to eat at friends' and relatives' homes, or even casual-dining restaurants.

 

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Since I missed this week's Diabetes Social Media Advocacy #dsma chat, I'm addressing this week's questions here. The topic was disclosure — who (and what institutions) do you let know you have diabetes, and who (or where) do you choose to keep in the dark.

 

1. To disclose or not disclose: do(es) your employer/school/friends know you have diabetes? Why or why not?

The company which employs me does not know that I have diabetes; several people at work (including my supervisors) do. There is neither place nor reason to mention diabetes (or any disability) on the job application — I believe it's actually illegal in the US to inquire before hiring — and since hiring/firing decisions are made at the store level, accommodations must be discussed and/or made at that level, rather than the corporate level.

 

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