Dealing with diabetes may mean facing fears head on.
June 2007 — Like everyone else in the world, I have fears. Fears about my diabetes and my future are at the top of the list. They're more visceral and "in your face" than my freak outs over spiders and snakes. Anyone with diabetes (as well as family and friends) can relate to this type of anxiety when thoughts of life with diabetes and complications burst through to the forefront of the mind. They're real, they don't go away, and if obsessed over, can overwhelm our lives. These fears can lead to "diabetes burnout", mental and physical illnesses, and interpersonal strife.
Each of us may have our own special fears, but we have many in common. If you share any of these, it might be helpful to understand what you can do to minimize, understand, and perhaps even face and conquer the fear. While the fear may still be there, it can be relegated to the back of your mind (where it can sit next to your fears of clowns and stepping in squishy things…), and you can live your life to the fullest.
I'm not a medical professional, but rather someone who has (dare I say it?) "been there, done that." You may have a better idea on how to deal with these fears, and I would hope you'd share these with the community.
Here are mine (and possibly yours) and how I handle these fears:
"I'm scared that if people find out that I am diabetic, they will treat me differently."
Sometimes, they do – and that can be OK in certain situations. I'm thrilled when someone finds out I have diabetes and wants to learn more about the disease. Two co-workers have approached me privately to ask about diabetes symptoms and subsequently been diagnosed with diabetes. I like being a source of information and dispelling the myths about the disease.
However, I understand that some people are, bluntly put, ignorant about the disease. They don't understand that it's not contagious or that we go about our daily lives much like everyone else. I counter this by a brief explanation, followed by an invitation to ask questions any time.
There are areas in which we may need to be treated differently. For some young diabetics, schools need to follow 504 plans that allow special circumstances based on need. Taking a test when your blood sugar is low or high can affect scoring tremendously, for instance, and an appropriate 504 plan can assist in these cases.
In the workplace, situations arise where low blood sugars occur – and the standard policy is "no eating at your desk". We do have rights under the ADA. Which would you rather have happen: not treat the hypoglycemic reaction and wake up in the ER or have a discussion with your supervisor regarding the need to treat the reaction immediately at your desk.
"I'm scared that I'll have a low blood sugar and act strangely or pass out in public."
Severe hypoglycemic reactions can be scary, not just for the diabetic, but for everyone else in the vicinity. A normal personality may suddenly be replaced by a raving lunatic, a spaced-out idiot, or someone who appears drunk. (I find everything absolutely hysterical and giggle inappropriately, right before I stare off into the distance, sweating and incoherent.)
This fear has a two-pronged solution: blood sugar checks when out in public and fast acting glucose on the body. As a failsafe, I also wear a medical bracelet and carry a glucagon kit in my purse. If I spend a significant amount of time with someone (co-worker, family, or friend), I will show them how to use the kit and where to find it. I did receive a glucagon injection in public and was grateful to be with someone who could administer it because he was trained.
"Complications? Blindness? Kidney Disease? Heart Attacks? WHAT?! WHEN?!"
Ahh…this is one of my huge fears, and I can guarantee that I am not the only one. When I was diagnosed and began to read about the long-term complications of diabetes, I was overwhelmed. Diabetes can affect almost every part of your body. After 24 years with the disease, I've begun to deal with complications. While I can get angry at the disease (and at times, myself, for not being in great control at times), it doesn't change what's happened.
When faced with a potential complication, I learn as much as I can about what I can do, the questions to ask my medical team, what the latest research has found about the complication, and apply that knowledge to daily life. We're in an exciting bio-technological age, when new treatments help treat many of the complications that were once prematurely fatal and devastating.
It's crucial to remember that while genetics play a part in complications from diabetes, what we do on a daily basis to control the disease has an impact. (The DCCT trial proved this without a doubt.) I may develop further complications, but if and when I do, I can honestly say that I am doing everything now to prevent them.
"How can I /my child /my spouse/ my friend live the rest of my/her/his life with this disease?"
The answer to this is simple and complicated: One day at a time.
The long view on life is scary and exciting and big and with many twists and turns. Twenty years ago, when I thought about my future with diabetes, my head would spin. Would I be cured? Living with many complications? Living at all?
My goal is to get through each day doing the best that I can with the tools I have to keep myself healthy. I talk with my family about how I feel about diabetes and they share their concerns and fears with me. Hiding the fear about the rest of my life isn't healthy, and I realized that talking about the future with my family and (and other diabetics) has helped to allay this fear.
If you feel that the fears you have are overwhelming you, talk with your medical team. They may recommend a support group or a mental health professional that specializes in chronic disease management. We are fortunate to live in a time when people openly talk about their fears – and rely on each other for that openness. We may always have fears about diabetes, but rather than keeping them locked away, we can bring them out into the light and expose them for what they are: a part of our life.
dLife's Viewpoints columnists are not all medical experts, but everyday people living with diabetes and sharing their personal experiences, most often at a set point in time. While their method of diabetes management may work for them, everyone is different. Please consult with your diabetes care team before acting on anything you read here to find out what will work best for you.
Cinnamon and Vanilla Yogurt Sour Cream Grilled Tuna with Herbs Potage Pierre Grilled Lamb Chops on Minted Tomatoes Salmon with Brown Sugar Glaze Ham and Hash Brown Casserole Thai Orange Beef Salad Spicy Crab Dip Snow Dusted Tea Cakes Crunchy Baked Mac and Cheese
Many people say that depression is a side effect or complication of diabetes. Without discounting the association of the psychological condition with the physical one, I'm not convinced that our high and/or unstable glucose levels are directly responsible for that change in our mental state. My belief is that the unrelenting need for self-care, for following the sort of care schedules that can drive licensed, professional caregivers crazy, is what overwhelms us...