His hands move over my waist to my hips.  He brushes by my insulin pump, which feels to me about fifty times its actual size.  I wonder, does he notice it there beneath my clothes, beneath his hand? 

My bloodsugar is 355 mg/dl.  I feel yucky.  I know I'm spilling ketones.  When he kisses me, do I taste like fruit, like wine, like the acetone that's eating away at me?  Does he see the awful dry feeling behind my eyes; is he thinking I look as horrible as I feel? 

He takes my hand, lacing his fingers through mine.  I trace his palm with my fingertips.  Why do these calluses feel so obvious, so hard and unfeminine? 

We are heated and intense.  I am lost in this embrace. My head is floating somewhere in a passionate, dizzy ether. Or am I low?  And if I am, how can I stop and ask for time at this particular moment? 

We're lying together, wrapped tight like well-sewn stitches.  And now I know I'm low.  And I hate leaving to test.  To treat.  To attend to this.  And I wonder if, somewhere in the back of his mind, he's as annoyed as I am at this inconvenience. 

Diabetes comes with physical complications that are listed and talked about.  Often, though, the trickier complications are those created in our own hearts and minds.  They are the complications we don't always talk about, because we're embarrassed or ashamed or because we don't want to appear weak.    

I feel like I say too often, "For the most part diabetes sits in the background of my life, but..."  Rarely does the thought that follows the but involve any sort of physical complication or issue.  It usually involves the way I FEEL inside about having diabetes.  It's usually something that a pill or a shot or an IV bag couldn't treat. 

One of the most prominent situations that create this kind of turmoil for me is intimacy. 

All of the questions above run through my mind again and again during intimate moments, no matter how many times I've been with someone - no matter how tender and sweet my partner is - no matter how encouraging and caring they are.   There are occasions, mostly when I've had a few to drink, when I can just let go and relax.  But just enjoying those private moments without any outside assistance from relaxants is challenging. 

Most women, I think, have anxieties around intimacy.  Am I thin enough?  Am I good enough?  Am I pretty enough?  Where are those lines between sexy and sleezy?  What is he thinking of me, of this? 

Diabetes adds a thousand questions.  A thousand insecurities.  The apparatuses, the insulin pump marks, the callused fingers, the physical symptoms of high bloodsugar, the challenges of low bloodsugar and the need for vigilance in the face of such (vigorous) activity.   These things are unfair considerations, but they're there, sometimes shouting in my heart, my head. 

The key, for me at least, in quieting the diabetes noise, is understanding that although vigilant treatment causes scars and bumps and distraction, vigilant treatment also results in a healthy, strong body.  Something that is measurably, incredibly sexy.  That insulin pump that intrudes on a caress, that gets twisted in my legs, that leaves me with holes and red marks helps me to maintain an excellent A1C and lets me manage the exercise that keeps me at an ideal weight.  Those calluses on my fingers are the marks that let me understand my body's patterns and make adjustments accordingly.  Those lost moments to give insulin or have juice to treat a low ensure that I'm able to come back to my love, happier and more at ease. 

Of course, I'm fortunate to have a partner that understands and appreciates that my diabetes comes with responsibility that is sometimes shared.   That I come with scars and bumps that are the keys to my good health.  For that I'm appreciative.  Perhaps someday, I'll be as accepting of myself as he is of me.  And I'll relax a little.