It’s Christmas Day 2015, and I’m 17. Four months ago, I was diagnosed with type one diabetes, and I’m battling sky-high blood sugars.
While Christmas dinner is being served at my family home, I sneakily check my blood glucose under the table, to avoid their concern.
I’m hit with a wave of panic seeing the numbers: It’s sitting at 18 millimoles per litre. Diabetes UK dictates a healthy target of between 4 and 7.
High blood glucose, or hyperglycaemia, can cause life-threatening complications and, ultimately can lead to a diabetic coma. So, my panic is understandable.
Although I have been struggling to come to terms with my diagnosis over the last few months, this time of year has been especially difficult – as the desire to indulge is ubiquitous.
Before I found out I had diabetes, I wouldn’t turn anything down at Christmas. Now, all I hear is a voice in the back of my head saying: ‘But what about your blood sugar?’ It fills me with shame, and a feeling that I am a ‘bad’ diabetic.
Months of continuously checking my blood glucose and injecting insulin day and night, has had me mourning the loss of my freedom. I’m burnt out with the knowledge that this disease is going to stay with me forever – it’s an unwelcome reminder of the permanence of my condition. There are no days off with type one – not even on Christmas Day.
An autoimmune disease, type one diabetes is an incurable condition that renders the pancreas unable to produce insulin. As a result, those living with type one must inject insulin, either with a needle or an insulin pump. The disease is unrelated to diet and lifestyle and is instead the result of a genetic predisposition.
I can’t help but berate myself for enjoying the celebrations like everyone else
While type two diabetes can, in some cases, be reversible, type one is a permanent condition: there’s no cure.
My diagnosis was a huge learning curve for my family: my nan didn’t yet understand that insulin allowed me to eat the same foods as everyone else and bought me a box of sugar-free chocolates. Burying my frustration, I smiled and thanked her. Visiting my auntie in the days before Christmas, she offered me a mince pie before backtracking.
‘Can you still have these?’, she blurted out. ‘Yes!’ I replied. Inside I was frustrated, but I understood her reaction. Type one diabetes is a journey – it takes a while to understand.
My family’s responses came from a place of love. They saw that I was struggling with my new diagnosis: they wanted to learn everything they could about type one, and sometimes, that manifested in misguided questions and awkward gifts.
But insulin is a beautiful thing: it allows me to enjoy all types of food as any non-diabetic would. If I want to eat a biscuit, I can do that. If I want to enjoy a festive tipple, I can do that.
But sometimes, it isn’t that simple. For me, Christmas is as much a mental battle as it is a physical battle.
If I correctly administer my insulin and monitor my blood glucose closely, then I can eat the normal Christmas fayre – but I continue to berate myself with the belief that I should be better. I should be above Christmas indulgence, prioritising above all my diabetic health.
But sometimes, I just want to enjoy the festivities like everybody else.
To me, it has felt as though society respects ‘good’ diabetics that eat ‘well’ and manage their blood sugars – and I never want to feel like I’m a burden on the healthcare system. So, in many ways, societal perceptions of diabetes fuel this desire to appear ‘perfect’ – and this drives the shame I feel during the festive period at enjoying decadent foods.
I feel almost embarrassed that I can’t keep my cravings under control, but in actuality, no one in my life is telling me that I shouldn’t indulge. It’s all fuelled by an imaginary voice.
Over the years, I’ve been really ill with complications from type one. When I was first admitted to hospital upon diagnosis, my doctor told me that I was ‘lucky’ not to be in a coma. A few years into my diagnosis, I was in the hospital overnight – my insulin pump had stopped working, and my blood sugars were skyrocketing. I was on a drip overnight as my levels recovered, with nurses monitoring me each hour.
These were intensely traumatic experiences: now, each time my blood sugars skyrocket, I’m reminded of this difficult period.
These aren’t things I want to relive at Christmas. Yet, each year, the festive season often brings up unwelcome memories of these struggles.
I can’t help but berate myself for enjoying the celebrations like everyone else, plagued by a persistent feeling that I should be more in control.
I constantly feel like a ‘bad diabetic’ for losing control of my blood glucose readings by indulging during the festive season, despite trying to plan ahead with extra insulin doses. Sometimes, I make mistakes, interpreting carbohydrate content incorrectly and administering the incorrect dosage. I’m only human, and yet, I constantly fear judgment from others.
Once, at a Christmas party, a well-intentioned friend saw me drinking a gin and tonic. Concerned, she asked, ‘are you allowed to drink alcohol?’ Burning red, I assured her that it was OK, and that I could take insulin if my blood glucose spiked.
On another occasion, I was enjoying a festive meal out with friends at a restaurant and was met with stares from the neighbouring tables and waiting staff alike as I administered insulin. These were the days before my insulin pump, so every injection was a public declaration of my type one. Christmas only enhances its visibility.
It’s no surprise that I’ve struggled – I’m certainly not alone.
Type one diabetes charity JDRF reports that less than one-third of those living with type one consistently achieve target glucose levels, and Diabetes UK reports that three in five people with diabetes experience emotional or mental health problems linked to their illness.
So, how can type ones learn to undo the shame that comes with festive eating?
Personally, I’ve made an active decision to love myself, despite my scars.
Diabetes is a difficult condition to live with, but I try to focus on the strength it’s given me. Poked and prodded each day, I’ve realised how strong my body is: it’s carried me from the darkest moments of diagnosis to the brighter moments of the present-day.
On a more logistical level, I’ve started increasing my base rates of insulin if I know that I’m going to be consuming food throughout the day, and I make sure to check my glucose at least once an hour. This allows me to constantly monitor my levels, since I know my blood glucose is likely to fluctuate with the increased intake of high sugar, high carb foods.
I can be my own worst enemy: in the past, I’ve internalised the belief that I shouldn’t be indulging, and that my blood sugars should always be in range, even at Christmas.
But I’ve learnt a lot over the past six years, and I’m in a much better place now. I can now enjoy the festivities without berating myself. Insulin exists for a reason, so why shouldn’t I be allowed to eat as others do?
The truth is that there isn’t a perfect way to be type one: diabetes can have a mind of its own, and there’s no secret formula towards mastering it.
Going forward, I endeavour to live in harmony with my condition rather than battle against it. This Christmas, it’s the only gift I’m in search of.
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